2017 Politics open thread, June 25 — July 1

What’s the buzz on politics?

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191 thoughts on “2017 Politics open thread, June 25 — July 1

  1. I must be in the anger stage right now. Thinking about this health care bill and if it passes, I tell myself that this is what the people voted for in the election(or in many cases didn’t even bother to vote). We are getting what we deserve. I suppose my FB page will be filled more with GoFundMe requests to help with medical care.

  2. Rhett, there are a lot of people whose visions don’t match reality.

    “According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You’d think that eligible individuals would need no prodding to sign up for such a benefit.

    And yet, according to its analysis of the GOP [House] ObamaCare replacement, the CBO believes that there are five million Americans who wouldn’t sign up for Medicaid if it weren’t for ObamaCare’s individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance. That’s more than 1 in 5 of the 24 million people the CBO (dubiously) claims would end up uninsured if the AHCA supplanted ObamaCare.”
    https://www.wsj.com/articles/medicaid-is-free-so-why-does-it-require-a-mandate-1489529946?mg=prod/accounts-wsj

  3. Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance.

    Does that surprise you?

  4. Maybe they read the Oregon study.

    Then your solution is to not offer or mandate heath insurance for the healthy poor, but if someone poor gets hit by a bus they get signed up for Medicaid? That’s fair, if that’s your proposal.

  5. I want to get on the phone later today. I am not even sure which senator office to call. My own reps of course are completely opposed. I just want some poor schleb in a Republican senators office to hear my anger.

  6. Scarlett, that Oregon study was one, extremely limited study, with mixed results. We’ve heard you cite it about a hundred million times now.

  7. I decided that Murkowski is my senator. They’re reporting her vote is up for grabs. I work in her district. Even though I don’t vote in her district, I can make an argument that I have an informed view on the situation.

  8. MM,

    Scarlett’s presumable position that the government shouldn’t provide insurance to the poor unless they are sick is a perfectly valid proposal. The chief flaw of course is the high marginal rates for someone with a chronic disease who tries to go back to work. If they work part time and make 12k they lose the $6k worth of benefits they get from Medicaid.

  9. My actual senator is unfortunately one of the Evil 13. He’ll hear from me again today.

  10. had no issue that it was the third marriage of Messr. Mnuchin (or the bride’s second).

    I love the NYTimes wedding announcements when they say, “The groom’s two previous marriages ended in divorce.”

  11. Scarlett – were those 5 million people able to qualify for Medicaid before the ACA? Someone who has been uninsured (and uninsurable) for years may not know that they qualify for newly expanded Medicaid.

    Here is a more balanced article from Forbes, discussing how the CBO keeps getting ACA wrong.

    “A key part of the CBO’s March 2016 baseline is an assumption that most of the states that have yet to expand Medicaid under Obamacare will soon do so. Hence, the House GOP plan will reduce coverage by 5 million people in the future, from states that have yet to expand Medicaid. Leaving aside the inherent subjectivity of this projection, there’s plenty of reason to believe that the CBO is wrong.”
    https://www.forbes.com/sites/theapothecary/2017/03/14/believe-it-or-not-cbos-score-of-house-gop-obamacare-replacement-is-better-than-expected/#76e315695951

  12. Layer upon layer of laws, rules and regulations have made our health care-financing system a complex mess, separating patients from direct payment for health care.

    1. He presumes the existence of a great untapped font of cognitive ability and executive function.

    2. He doesn’t mention that fact that voters have essentially no interest in direct payment of healthcare.

    Look no further than how laser eye surgery went from exotic to affordable during the years it was not covered by most insurance.

    Eye glasses and contacts are cheap and laser eye surgery is never an urgent matter of life and death. Does he honestly believe his own nonsense?

  13. I am really tired of the laser surgery thing. It is an easy, non-urgent procedure that lends itself to automation and speed. A better example would be dental work, another area where people largely pay out of pocket. Have dental costs decreased? I think not.

  14. ” He doesn’t mention that fact that voters have essentially no interest in direct payment of healthcare.”

    Even if there were interest, how many doctor’s office can tell you how much a procedure or doctor visit should cost before you actually book the appointment? What are you supposed to do? Negotiate your way through each person that walks in your room at the ER or hospital? I don’t know why they just don’t go single payer. One of the flaws is that the process is still driven by the insurance companies.

  15. Ada, given your profession and experience in her district, I think it would make a lot of sense to write to Murkowski. Your perspective would be very relevant to her.

  16. I’m very disappointed with the (Republican) Senate plan. Maybe I should have better judgment. I’m hopeful as the leadership tries to sweeten the pot to win over the likes of Sen. Paul they make the bill even more unacceptable to Sens. Heller, Murkowski, Murray, and Snow.

    I honestly don’t know what the real objective is. Seems like it’s just to (screw) over the bottom x% on the income/wealth scales.

  17. MM,

    You’re right, I have mentioned the Oregon study a few times. Because it was the gold standard — a large-scale randomized controlled trial. It’s Science that happened not to support the position that expanding access to Medicaid will improve health outcomes, but Science nonetheless. A few months ago, thousands of people took to the streets to defend Science, didn’t they?

    “When you do an RCT with more than 12,000 people in it, and your defense of your hypothesis is that maybe the study just didn’t have enough power, what you’re actually saying is “the beneficial effects are probably pretty small”. Note that we’re talking about a study the size of a pretty good Phase III trial for Lipitor, Caduet, or Avandia–some of the leading new drugs for treating high cholesterol, hypertension, and diabetes. Of course, to be fair, those trials enroll only people with the disease they’re targeting, so you should get more statistical power–but then, to also be fair, many of those studies have many fewer than 12,000 participants and still achieve statistical significance.
    And as Katherine Baicker, a lead researcher on the Oregon study, noted back in 2011, “people who signed up are pretty sick”. Yet the study failed to find statistically significant improvement on the three targets associated with the most common chronic diseases. This, mind you, is the stuff that we’re very good at treating, and which we’re pretty sure has a direct and beneficial effect on health.” http://www.thedailybeast.com/study-giving-people-government-health-insurance-may-not-make-them-any-healthier

    The goal is to improve health outcomes, not simply to provide health insurance.

  18. I’m also for people not being financially ruined by routine and acute health care needs. The Oregon study showed it was very effective for that.

  19. Scarlett,

    So again, you agree that if someone poor gets hit by a bus they should get Medicaid but the poor should be otherwise uninsured? That’s a perfectly sensible plan so why not claim it as your own?

  20. Scarlett,

    You’ve brought up the Oregon study many times. Why? In support of what solution?

  21. I would like to see each of the Republicans in the Senate and House live by whatever their state ends up doing. They shouldn’t get to fallback on DC’s plan, which will likely be a lot better than what the red states are able to do.

  22. Rhett,
    In support of the proposition that removing people from Medicaid is not going to kill them, and that those funds might be far better spent on providing subsidies for low-income people to purchase private health insurance, especially catastrophic insurance that doesn’t cover the nickel and dime routine care but will kick in for the person who gets hit by the proverbial bus.

    I bring up the Oregon study to as a response to the knee-jerk arguments by the mainstream media and others on the left that criticize any attempts to cut back on Medicaid and, by labeling their opponents as uncaring, make it impossible for any constructive engagement. We have seen that dynamic on this site, repeatedly.

    Here are some interesting statistics on the effects on mortality of factors other than medical care:

    “A number of studies have attempted to assess the impact of social factors on health. A review by McGinnis et al. estimated that medical care was responsible for only 10%–15% of preventable mortality in the U.S.;45 while Mackenbach’s studies suggest that this percentage may be an underestimate, they affirm the overwhelming importance of social factors.25,26 McGinnis and Foege concluded that half of all deaths in the U.S. involve behavioral causes;18 other evidence has shown that health-related behaviors are strongly shaped by social factors, including income, education, and employment.46,47 Jemal et al., studying 2001 U.S. death data, concluded that “potentially avoidable factors associated with lower educational status account for almost half of all deaths among working-age adults in the U.S.”48 Galea and colleagues conducted a meta-analysis, concluding that the number of U.S. deaths in 2000 attributable to low education, racial segregation, and low social support was comparable with the number of deaths attributable to myocardial infarction, cerebrovascular disease, and lung cancer, respectively.49”

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863696/

    I’m not a health policy expert, and don’t pretend to have solutions that have eluded Congress and the rest of the government. Obamacare was rushed through without sufficient deliberation or transparency, and the current efforts to repeal and replace are being rushed through for political reasons that aren’t completely persuasive.

  23. Scarlett,

    Would it change your position any if I could demonstrate that very little savings would result by going to catastrophic only insurance?

  24. The idea that Obamacare was rushed through without debate or hearings is just not true. There were something like 80 House bipartisan hearings and markups. Over 100 amendments. The Senate had an equivalent number of hearings and accepted something like 150 republican Amendments.

  25. Very little savings for the population that would be moved from Medicaid to catastrophic only private sector insurance I mean.

  26. Better health outcomes is certainly one goal of health insurance, but protecting people from financial ruin is another big one. Otherwise why would any of us bother?

  27. “A review by McGinnis et al. estimated that medical care was responsible for only 10%–15% of preventable mortality in the U.S.”

    So is it even worth it to go to the doctor? I wonder if Ada is reading this and has an opinion

  28. “The goal is to improve health outcomes, not simply to provide health insurance.”

    I don’t think there is a clear consensus on this, as Mooshi suggests. This lack of consensus is one of the problems in the national healthcare/health insurance debate. Another is the conflating of health care and health insurance.

  29. Always worth reading Vox’s deep dives into healthcare insurance topics – they have people who just study this stuff all the time. From today’s article on the CBO scoring of the AHCA

    —————————————————————–
    “So here is what the CBO is saying: The BCRA’s subsidies are too small to make the silver plans affordable for low-income people, and the plans it is trying to make affordable — the ones that cover 58 percent of expected costs — carry such high deductibles that low-income Americans won’t buy them because they won’t be able to afford to use them.
    This, then, is what the BRCA actually does: It makes health insurance unaffordable for poor people in order to finance a massive tax cut for rich people.”
    —————————————————————-
    In other words, the AHCA makes worse the very things that people had started to complain about with the ACA.

    https://www.vox.com/health-care/2017/6/26/15876778/cbo-senate-health-bill-gop

  30. “The goal is to improve health outcomes, not simply to provide health insurance.”

    I don’t think there is a clear consensus on this

    This is exactly right. If there is a poor family with kids and they have Medicaid, then they have some measure of security and can sleep better at night. Imagine how well you would sleep if you had no insurance. Peace of mind is a legitimate good. Also, keeping the proles from rising up and killing us all is a legitimate good.

  31. The main reason we have health insurance is for financial reasons. We, along with many other Totebaggers, could probably pay for our health care without insurance, although a big health issue might take a lot of our assets.

  32. although a big health issue might take a lot of our assets.

    Or a chronic one. Like Type 1 diabetes.

    I seriously-really want to invest in medical tourism companies, but I can’t seem to find mainstream reliable ones.

  33. Kate, unless you are very wealthy, there are a lot of health issues that will bankrupt you

  34. MM – I know. I had a literal million dollar baby due to medical expenses. But based on past conversations here, it isn’t clear that people think we should have used so much $ to keep him alive. So, setting that aside, we have lots of medical expenses that don’t rise to that level and we could cover but for which I am very happy that we have insurance coverage. I suspect most Totebaggers are the same.

  35. Oh yes, I tend to get confused on the various major health issues. Yes, a baby with serious needs will do it. I think I was interpreting your statement to mean that you literally believed you could cover all health issues, though they might be a strain.

    And yes, there are many chronic illnesses that could bankrupt people too. I have a friend whose daughter is profoundly disabled due to encephalitis while an infant. Without insurance, they could not have kept up with her expenses.

  36. So…all this disagreement and delay in the Senate is just a ruse to give certain Senators cover (and maybe some pork for their states) when they eventually vote for this bill, right?

  37. I cannot figure out what McConnell is thinking. A lot of pundits thought he would just let the bill fail, so they could move on to tax reform. But he is going to double down and waste even more time on this dreadful piece of legislation. Honestly, is there anybody outside of the Republican side of the Senate who likes this bill? Everything I read, from the conservative press to the liberal press, is against it. Hardline conservatives hate it, progressives hate it, and polling indicates that the voters hate it.

  38. “I cannot figure out what McConnell is thinking.”

    I think he is thinking that he killed his opponent in his last election while running on a platform of Repeal and Replace. As did Rand Paul and Bevins. And Trump. Kentucky will be one of the states most affected by repealing Obamacare. They have sent a clear message as to what they want. I say that we need to give the voters what they were promised. It will probably not be great, but I think that Congress should be responsive to their constituents, even if I do think they are really misguided.

  39. To be fair, Trump pretty clearly stated that he would not cut Medicaid & would replace the ACA with something better and cheaper. Obviously that made no sense, but that’s what he campaigned on. Not sure what McConnell actually told the voters of Kentucky though beyond that he would repeal.

  40. McConnell campaigned on “pulling out Obamacare, root and branch.” He was pretty clear that he wanted to get rid of it. Bevins was seeking a waiver at the time of the presidential election. I feel like the people of Kentucky have spoken.

  41. I say that we need to give the voters what they were promised. It will probably not be great, but I think that Congress should be responsive to their constituents, even if I do think they are really misguided.

    I have learned that people are way more principled than I thought. They really will cut off their noses to spite their face(s) if it means that some group they hate will lose benefits.

  42. I am not being spiteful. Our side lost. Our vision is not the winning vision. It worries me that we can have elected officials who don’t try to carry out the wishes of their constituents.

  43. I didn’t mean you, Kate. I think you misinterpreted my comment.

  44. My homeless friend, who is sort of disabled and sort of a grifter, and is desperately trying to get on SSDI, voted for Trump. He’s going to get kicked off Medicaid when the Senate version of Trumpcare passes, as it will. But as long as whatever Obama wanted is destroyed, then he’s happy, even if he dies of some easily-curable disease.

  45. Ahh, got it RMS. I go back and forth at being really sad for people like your friend and then really angry at people like him. To keep from becoming hateful, I am going to frame this as a win either way. Able to buy insurance for all family members or a tax cut. Will it be door A or door b? Stay tuned!

  46. “Honestly, is there anybody outside of the Republican side of the Senate who likes this bill?”

    Yes.
    https://www.washingtonpost.com/opinions/the-senates-health-care-bill-could-be-one-of-the-gops-greatest-accomplishments/2017/06/24/75473678-585d-11e7-ba90-f5875b7d1876_story.html?utm_term=.5fd0a5d2b19b

    “For four years, thanks to Obamacare, Americans who buy their own coverage have been under tremendous economic pressure. The Democrats’ health law, on average, doubled the underlying cost of premiums for these individuals. Some premiums quadrupled. Deductibles and co-payments have skyrocketed as well. While the law’s premium and cost-sharing subsidies cushioned the blow for those near the poverty line, childless adults making more than $30,000 a year have gotten hammered.
    In many places where there were once a half-dozen insurers competing for Americans’ business, individual insurance markets have collapsed. In 2018, there will be more than 1,000 counties with one or zero insurers participating in the exchanges. In 2010, the Congressional Budget Office predicted that 23 million people would be enrolled in Obamacare’s exchanges by now. The actual number is closer to 10 million.”

    https://www.washingtonpost.com/opinions/the-senates-health-care-bill-could-be-one-of-the-gops-greatest-accomplishments/2017/06/24/75473678-585d-11e7-ba90-f5875b7d1876_story.html?utm_term=.5fd0a5d2b19b

  47. I agree with Kate.

    I just wish I could find a political party to affiliate with.

  48. Avik Roy just kind of makes stuff up in that WaPo article. I know 2 childless adults who make over $30k. Both are very concerned about what is going to happen. One because she has a brain tumor and no coverage at work. She is 25, so for now is covered for one more year under her parents policy. The other because before Obamacare she never had insurance. She is almost 60 years old.

  49. While the law’s premium and cost-sharing subsidies cushioned the blow for those near the poverty line, childless adults making more than $30,000 a year have gotten hammered.

    That’s not their concern though. They oppose the ACA because they don’t think the government should be in the business of bailing out those who have failed at life. To think they are doing this out of overwhelming concern for the 2% of the population who are paying out of pocket is just ludicrous.

    It makes me wish we had more engineers as politicians and fewer lawyers. Just tell us what you actually think for once and that goes for both sides.

  50. I have really mixed feelings about the health care bill. What I’d like to see from the Democrats is some acknowledgement that costs were rising out of control, contrary to their promises from seven years ago, along with some explanation as to why, and how they propose addressing it.

    But we’re not getting that, just hysteria that 20 million people are going to drop dead within a week after repeal, and Republicans don’t care, so we just have to fight them, and do nothing else.

    The federal and state spending increases on Medicaid are unsustainable. One side wants to tear it up, possibly going too far, and the other side wants to keep their heads in the sand.

  51. “What I’d like to see from the Democrats is some acknowledgement that costs were rising out of control, contrary to their promises from seven years ago, along with some explanation as to why, and how they propose addressing it.”

    Well, W Clinton did that.

    Healthcare costs have been rising since I have been an adult. Healthcare is expensive. Everyone pretends that there is some magic bullet to get costs under control that are just waiting to be unearthed. We would be better off having a discussion about death panels and when we should stop paying for care at end of life. But no one wants to talk about that.

  52. The federal and state spending increases on Medicaid are unsustainable.

    Medicaid pays for 60% of the nursing home beds and the boomers are getting to that age. What other options are on the table?

  53. and Republicans don’t care

    Many of them don’t. They just don’t think the government has a role to play in ensuring coverage for the least among us. It’s certainly a valid position to take so why the hysterics when someone suggests that’s the position taken by many republicans*.

    * I will note that polls indicate the rank and file republican voter is a populist defined as socially conservative and economically middle of the road. The powers that be in DC are far more libertarian than their base which explains the current difficulty getting the AHCA passed.

  54. No matter what policy is adopted, or not adopted, some people are going to lose coverage, or pay more for coverage, or have less generous benefits. In fact, that has been happening since Obamacare took effect. The Democratics are really becoming unhinged with their hysterical predictions of blood and death. So long as they insist that their political opponents are venal, they’re not going to be able to make the necessary compromises that will improve the defects of these bills.

  55. “The powers that be in DC are far more libertarian than their base which explains the current difficulty getting the AHCA passed.”

    So, take someone like McConnell. He used to be far more moderate. He has become more extreme because it gets him elected. So, people may claim to be more moderate, but the people they elect and voting records suggest otherwise. A lot of this has to do with campaign finance, but these elected people wouldn’t be taking the positions they take if it didn’t get them elected.

  56. “So long as they insist that their political opponents are venal, they’re not going to be able to make the necessary compromises that will improve the defects of these bills.”

    It doesn’t matter what Dems do. The Republicans are free to make whatever compromises they would like. Which is both a blessing and a curse. With control of the House, Senate and Presidency, healthcare is their baby. Some of the more forward looking Congress people realize this and are very worried. The people who have one foot in the grave just want a mark in the win column at sticking it to Obama. They will get a nice footnote in our history books.

  57. Rhett, there are only 1.4 million people in nursing homes. Most boomers will never end up there, and many of those who do, unlike the Greatest Generation currently of nursing home age, have resources to help pay for it.
    Medicaid is the second largest line item in most state budgets. Expanding access beyond children, pregnant women, the elderly, and the disabled is simply not sustainable without massive cuts in other sectors such as education and infrastructure.

  58. ALL politicians take positions that will help them get elected. That’s the problem with democracy. No one is willing to face up to the entitlement crisis and reform Social Security and Medicare along with Medicaid if they can keep appeasing seniors and minorities and other voting blocs with continued bennies.

  59. Most boomers will never end up there,

    That 10% is doing a lot of work in your argument:

    40%: The percentage of individuals who reach age 65 who will enter a nursing home during their lifetimes.

  60. Scarlett – agreed. My point was just that I think our elected officials’ viewpoints mirror the voters. Unlike Rhett, I don’t think there is a disconnect. I do think there is often a disconnect between what a person thinks he or she should get v the rest of society. But McConnell’s views reflect what his constituents want for society in general.

  61. Expanding access beyond children, pregnant women, the elderly, and the disabled is simply not sustainable without massive cuts in other sectors such as education and infrastructure.

    Or, you know, higher taxes.

  62. Scarlett,

    9 million: The number of Americans over age 65 who need long-term care in 2012.
    12 million: The number of Americans expected to need long-term care in 2020.

    Do you think higher taxes are required to fund the long term care needs of boomers?

  63. Rhett, per the Census there are currently 1.4 million nursing home residents. Not sure where the 9 million 2012 figure comes from, but perhaps you are using a different definition of long term care?

  64. “Or, you know, higher taxes.”

    It would have to hit the UMC. President Obama tried to scratch the surface on that by proposing eliminating 529s. Democrats, particularly the ones from Totebaggy districts, mutinied.

    Being realistic, now that the two parties have just about divided up the affluent — business owners to the right, graduate degreed coastal professionals to the left — neither can raise taxes in any meaningful way. Grover Norquist himself couldn’t have worked out a more foolproof solution.

    So death panels it is.

  65. neither can raise taxes in any meaningful way.

    The ACA raised taxes on totebaggers. It can be done. Not that it’s easy of course.

  66. So death panels it is.

    Republicans coined the term death panels and in so doing painted themselves into a corner.

  67. “The ACA raised taxes on totebaggers. ”

    Not really. I believe it was on taxable income above $250k. Totebaggers have gross income at 250, then they deduct 100k bw property taxes, 401k, HSA, 529…

    Anything meaningful has to hit the 100k+

  68. Health care rationing seems like the obvious solution to me, although obviously named something besides death panels. To cover more people, we will have to cover less of the most expensive treatment. That seems so reasonable to me.

  69. I don’t think we can raise taxes on the $100k-250k crowd. They feel squeezed. Not rich, likely have been working hard at their 9-5s, feel like they should have more security than they do. Add in more taxes, and they will freak out. Especially when that tax money is going to those less deserving folks. Better to raise money on the $250k crowd. At a min, we could have higher brackets at $400k, $600k, etc.

  70. Baby boomers are supposed to have $30 trillion in assets to pass on to their heirs. And yet half of boomers have less than $100k in retirement savings.
    Maybe Milo is right that we’re going to see lots of grandparents living in the basement when the slacker sons move out.

  71. There are a lot more taxpayers in the $100-250 K bracket and many of them are salaried with few tax avoidance options.

  72. I don’t think we can raise taxes on the $100k-250k crowd. They feel squeezed.

    The reality is they have never done better. What people don’t realize is that statistically there jobs used to pay 100k but because of skills based technological change and globalization they now pay 133k.

  73. We need rationing with pharmaceutical and tort reform as well as raising taxes. That is so much easier to write then it is to do with all the groups who would fight each one of those reforms.

  74. Rhett, I think you’re ignoring geography and two income families as effects on the $100-$250k crowd. Jobs that pay $100k+ are disproportionately concentrated in high COL areas. Some of those families will decide to reduce their incomes rather than pay more taxes so it isn’t clear what the net effect of a tax increase would be- likely mixed.

  75. Rhett – maybe. But things like college costs have far outpaced increases in salaries. Very few people have pensions. What my parents on a middle class (maybe a low UMC) income did seems much harder to replicate today. Some of it is lifestyle inflation, but not all of it.

  76. WCE,

    Do you really think we’re anywhere close to the right side of the laffer curve? The fiscal disaster in Kansas says we’re not.

  77. Rhett, it depends on the family. Kansas is completely different from MA/NJ/etc and raising taxes on the $100-$250k household income crowd will not dramatically increase tax revenues from Kansas. It will probably influence more $120k, dual income households to become $80k, single income households with no childcare expenses.

  78. raising taxes on the $100-$250k household income crowd will not dramatically increase tax revenues from Kansas.

    That’s not what happened in Kansas. They cut taxes and revenue plunged contrary to the promises of the governor.

  79. It will probably influence more $120k, dual income households to become $80k, single income households with no childcare expenses.

    If that were true cutting taxes would result in some $80k households becoming $120k households (as was promised by the governor of KS.) That didn’t happen. As such, your theory isn’t correct for our current level of taxation.

  80. I’m not arguing that we should cut taxes as much as Kansas did, and state taxes are only part of the metric. The key metric is net household income. ~80% of my income goes to taxes and childcare and that’s part of why we are not a 9xth percentile income family. If you raise taxes for the long-term to Scandinavian democracy rates, you won’t know for decades what the real effect is, because more people will decide not to invest in, say, medical school. I don’t understand the economics well, but I understand it’s a tough problem to solve and that “the next year’s tax data” doesn’t fully answer the question of sensitivity to tax rates.

  81. “Some of it is lifestyle inflation, but not all of it.”

    I’ll channel MMM and point out that the best-selling vehicle in America is the Ford F Series pickup for over 30 years now. #2 is the Chevy Silverado pickup; #3 is the Dodge Ram pickup (this is a list of VEHICLES, not just pickups). Combined, those account for almost 2 million brand new, full-size pickup trucks sold in America every single year. The average sale price, I would guess, is probably north of $40k.

    You have to go all the way down to #4 on the list before you get to a practical, cost-efficient car like the Toyota Camry at 350,000 units.

    Then we have the statistic I mentioned yesterday that Americans now spend more money in bars and restaurants that they do at the grocery store.

    I’m not saying that the government should raise taxes, as I firmly believe that there is a lot of fat that ought to be trimmed before we get to that point. But in terms of entitlement reform, if we don’t want to make any concessions over the next couple of decades, then there just aren’t enough rich people in the country to make up the difference. Those in the comfortable middle class who are feeling squeezed are going to have to give up their expensive cars and frequent restaurants. Additionally, to WCE’s point, their housing would simply get cheaper.

  82. I think the ACA was a good first step. I agree with Scarlett that there are issues with the plan, but I feel some of those issues were a result of the compromises needed to get the legislation passed. I wish the discussions could be about how to fix the issues with the ACA vs. repealing it. But the voters want repeal, so I say repeal. And if people start to suffer from repeal, then I say VOTE.

  83. Milo, I agree that lots of people buying trucks should be buying health insurance with those monthly dollars instead, but neither the Republican nor the Democratic plans force them to do that.

  84. “What my parents on a middle class (maybe a low UMC) income did seems much harder to replicate today.”

    I don’t know. Your parents paid a lot more for bread, butter, eggs, and pork. They paid more for gasoline, more for heating oil, more for electricity. They paid more for clothes and more for shores, more for TVs, far more for a family computer for word processing. They paid more to take a family vacation. They paid a lot more for 100,000 miles from a car. They paid more if they wanted to take everyone out to dinner, or to a movie.

    It’s much easier to replicate that lifestyle today if you actually live the same lifestyle. The difference is your baseline standards are out of whack.

  85. . If you raise taxes for the long-term to Scandinavian democracy rates,

    That’s not on the table. We’re talking about taxes as a percentage of GDP going from 19% to 21%.

  86. “I wish the discussions could be about how to fix the issues with the ACA vs. repealing it.”

    I would say the same. And it’s hard to say if the voters really wanted “repeal,” or if they just wanted some more vague notion of improvement. I think Republicans are wrestling with that same question.

    It might be nice if we could ever get some sort of bipartisan health care legislation. Instead, the first one was passed without a single GOP vote, and if this one passes, it will be without a single Democrat. It seems to me that you wouldn’t have to work so hard to appease the far ends of either side if the moderates were willing to work — and actually vote — across the aisle, without fear of primary reprisals.

  87. more for TVs

    That’s probably true, but once it was paid for, it was paid for, you know? No cable, no Netflix, etc. No ongoing costs.

  88. , but neither the Republican nor the Democratic plans force them to do that.

    Democrats tried with the mandate but the current Republican plan calls for the elimination of the mandate but maintains the requirement that insurers sell to everyone in a given age cohort at the same price. The incentive of course is to wait until your sick. Apparently there was a recent amendment to add a 6 month waiting period but who knows if that stays in the bill.

  89. “That’s probably true”

    Oh hell yeah it is. I remember in 1992, not even going back to the 70s or something, and my parents were feeling flush so we went out one Friday night to upgrade the old 19″ TV in the family room. A new 27″ was like $500. That’s equal to $900 today.

    Obviously you can no longer buy a standard-definition CRT tube, but here’s a bigger, 32″ HD LED for $148.

    https://www.walmart.com/ip/VIZIO-D-Series-32-Class-31.51-Diag.-720p-60Hz-Full-Array-LED-HDTV-D32hn-E0/48194203

  90. Milo – I don’t disagree. But the people in the $100k-$250k crowd aren’t giving up their iPhones and weekly dinners out to fund the healthcare expenses of those perceived not to work as hard. And there are a lot of those voters. So, death panels.

  91. Just for another walk down memory lane, around the same time, 1993, we bought this car (loaded, but not the SHO) for $19k ($32k today):

    I drove it for two years in high school, but at 10 years and 130,000 miles, it was scrapped after its second transmission failure.

    Now, although it’s a much better car in every way, a base Fusion would probably be the closest equivalent, and you can get that for $22k, and expect over 200,000 miles from it.

  92. I agree with Milo. Our parents were able to raise large families on one income, but they did it in small houses with one bathroom, bunk beds, no A/C, one car, and no discretionary consumption. And they mowed their own lawns and cleaned their own houses and never flew anywhere with the whole family. No one want to live this way now.

    It’s the UMC that will have to pick up the tab for “free” health care and college and nursing homes for everyone else.

  93. I agree with Milo.

    It’s certainly true that many things are a lot cheaper. But, not only are many things cheaper, totebag incomes are much higher than they would be if the income distribution remained where it was c. 1971.

  94. Well, now that we have settled it, I look forward to seeing a tax increase on those with incomes under $250k.

  95. “totebag incomes are much higher than they would be if the income distribution remained where it was c. 1971.”

    That’s only because Totebag wives have gone out to work. They don’t expect to be penalized too much for that.

    If you look at individual salaries, I don’t think white collar professionals are raking it in like you assume. This puts a mid-level engineer in 1982 at $40k annually, or $100k today. Seems pretty much about the same.

    https://www.bls.gov/opub/mlr/1982/10/rpt2full.pdf

  96. ” I look forward to seeing a tax increase on those with incomes under $250k.”

    That was my point; it ain’t happening. The Democrats can’t afford to piss off so many people Northern Va., the NC Research Triangle, the Atlanta suburbs, Philadelphia suburbs, Boulder and Denver, Las Vegas suburbs. If they did, they’re toast on a national level. And they know it.

  97. And some of today’s professionals would have been blue collar workers or housewives BITD because of limited educational options. So there is that too

  98. “computer programmer inflation adjusted was $63,781 in 1985. Today it’s $79,840 an increase of 25%”

    Wasn’t it more of a technician type job in 1985, and now it’s more of an engineering role?

  99. You mean

    I heard poorly rated @Morning_Joe speaks badly of me (don’t watch anymore). Then how come low I.Q. Crazy Mika, along with Psycho Joe, came…to Mar-a-Lago 3 nights in a row around New Year’s Eve, and insisted on joining me. She was bleeding badly from a face-lift. I said no!

    Ahh, yes. That’s our President.

  100. I can totally understand how Ivanka was surprised at the level of viciousness in politics.

  101. Wasn’t it more of a technician type job in 1985, and now it’s more of an engineering role?

    That’s the point. The number and pay of these sorts of high G jobs has increased significantly while at the same time the number and wages of middle rung jobs have declined.

  102. Kate, this guy David Ernst, writing for the Federalist, figured out the President’s motivation (and to a certain degree, his appeal) six months ago:

    Antiheroes have long found homes in Westerns, gangster movies, and crime dramas, such as Al Pacino’s portrayal of Miami drug kingpin Tony Montana in “Scarface.” Tony begins an epic decline and fall in the film with a nasty fight with his wife at an exclusive Miami country club. She publically humiliates him in front of a bunch of dumbstruck, WASPy, black-tie wearing, golf-playing white hairs by loudly accusing him of being a murderer, a drug dealer, and incapable of being a decent father.

    If Tony were a classic hero, this would have been the beginning of his moral reckoning and his search for repentance. But this is “Scarface,” and Tony is no hero, so he responds to his public exposure as a criminal in polite society by turning the mirror back on his audience and dressing them down:

    “What you lookin’ at? You all a bunch of f—in’ a–holes. You know why? You don’t have the guts to be what you wanna be. You need people like me. You need people like me so you can point your f—in’ fingers and say, “That’s the bad guy.” So… what that make you? Good? You’re not good. You just know how to hide, how to lie. Me, I don’t have that problem. Me, I always tell the truth. Even when I lie. So say good night to the bad guy! Come on. The last time you gonna see a bad guy like this again, let me tell you.”

    A criminal’s longing to be accepted by rich people who aren’t criminals themselves isn’t a new theme. Nevertheless, considering that Oliver Stone wrote the screenplay, Tony’s rant is likely commentary about the hypocrisy of supposedly “respectable” people in cutthroat, capitalistic, Reagan-era America who are substantively no different than Tony is. All these well-to-do Miami types wouldn’t be caught dead associating with someone like Tony, even though they know full well that the cocaine business is making them all rich, and many of them probably abuse his product.

    Thus, from Tony’s perspective, what’s the point of being decent when the people who supposedly model “decency” have none of it themselves? Wouldn’t a sign of moral contrition to these people be a perverted mockery of moral contrition? Wouldn’t it be degrading even for Tony?

    Tony isn’t a hero or a villain: he’s an antihero. You probably won’t admit to rooting for him, but if you enjoyed watching him stick it to those (presumably) stuck-up hypocrites, then it’s likely that you did. He’s everything his wife said he was, sure, but at least he has the balls to be honest about it.

    In other words: even if I have been a no-good, rotten, disgusting scoundrel, what does that make you? At least I don’t pretend to be decent; you people, on the other hand, have the gall to pretend that you’re any better than I am. Let’s dispense with the fiction that you would have treated me with any less contempt if I had bothered to live up to any of your standards of decency in the first place, and acknowledge that they have nothing to do with decency per se, and everything to do with power. Your presumption of any moral superiority is a willful, bald-faced lie, and I’m going to keep calling you on that crap until it puts me in the White House.”

    He nailed it. And I don’t know anything about Morning Joe or Mika, but this morning’s conjoined Tweets are classic Trump, exactly as described in this six-month-old writing. They (apparently) pretend to hate him on TV, but given the chance, are happy to suck up to him and his power.

  103. Late to this. I just want to comment on Scarlett’s assertion that premiums doubled under Obamacare. Yes, if you go from $0 spent on insurance (because you have none) to whatever it costs under the ACA, your premiums are going way up. And don’t laugh and say that is ridiculous – the way the Republicans are doing the numbers on their healthcare plan, they are counting people who drop their plans as paying less in premiums. That is how the Republicans were able to claim that the House plan would lower premiums – by counting the people who drop coverage. There were some great wonky analyses of the numbers back when the House plan was being proposed, mainly on Vox where they really focus on healthcare a lot and devote some reporters to that area. One of the problems with reading articles in the general press is that most reporters, conservative or liberal, don’t actually understand healthcare economics very well.

  104. In Kentucky, people voted for repeal and replace because they honestly thought it meant they would get something better. Seriously.

  105. Ehhh. Trump is just a thin skinned mean girl. Mika wasn’t even with him. And she and Joe are Republicans. He just lies and makes crap up. I understand why he appeals to people and it isn’t pretty. He is totally emblematic of all that is wrong with our country. Sad!

  106. Nevermind the antihero stuff, I’m more interested in (get ready for your AP English Lit question!):

    The Motif of Blood in Trump’s Anti-female Invective: Compare and Contrast with Either the Motif of Blood in Macbeth, or the Use of Invective in Richard III.

    You have 90 minutes.

  107. Milo, there were plenty of high falutin’ software engineers in 1985. That was the era of Lisp machines, and Prolog, and the birth of graphical user interfaces, and the Internet.we all thought AI would save the world. People who worked with that stuff were pretty sophisticated. I actually spent the summer of 1985 writing code for an automated proof checking system.

  108. hmmm. I spent that summer getting ready for K.

    The blood theme is curious, but I no longer remember much about Macbeth, other than my English teacher comparing Lady Macbeth to…Hillary.

  109. The blood theme is curious, but I no longer remember much about Macbeth, other than my English teacher comparing Lady Macbeth to…Hillary.

    You are absurdly young.

  110. RMS – those were the types of questions I loved to BS my way through… except I don’t remember much about MacBeth (I did read it over 20 years ago… sad) and I never read Richard III (I think honors English read Richard III and the regular classes had R&J. I was in the regular class that year). What I do remember is Lady MacBeth’s guilt (Out damned spot…)… and that MacBeth believed he was invincible because the Witches told him he would be undone by a man not born of a woman… he never realized that c-sections were a thing…

  111. Did Trump introduce “Sad” into our lexicon as a snarky retort? Or was it twitter in general? I am sick of it. It is used way too much by everyone.

  112. WCE, our local paper recently had an article about how the largest medical insurer in our state is moving to the payment model mentioned in the article you posted.

    The mom of one of DS’ best friends is a solo practice pediatrician. If I have a chance to talk to her (those will probably be much fewer with the kids flying their nests), I’ll ask her about it.

  113. WCE, that article reminds me of Mountains Beyond Mountains, about Paul Farmer’s work in Haiti.

  114. WCE, that article reminds me of Mountains Beyond Mountains, about Paul Farmer’s work in Haiti.

    Great book!

  115. “It might be nice if we could ever get some sort of bipartisan health care legislation. Instead, the first one was passed without a single GOP vote, and if this one passes, it will be without a single Democrat. It seems to me that you wouldn’t have to work so hard to appease the far ends of either side if the moderates were willing to work — and actually vote — across the aisle, without fear of primary reprisals.”

    I totally agree with this. This is what I, personally, would like to happen. A moderate health care bill that makes everyone a little unhappy and a little happy. Keep the mandate, cut the Medicaid expansion a little bit, tweak the details. And yes – some sanity around limits without death panel rhetoric.

    And for the love of God – can we cover birth control? Copay doesn’t have to be zero like the ACA.

    @WCE – I really don’t think people are anywhere near as rational about income/taxes as you think that are. And not everyone attributes all the incremental taxes and childcare to the wife either.

  116. Ivy, I didn’t mean to imply that the lower earning spouse was necessarily the wife.

  117. Not sure why contraceptive coverage should be a priority. We have discussed this issue before, but in human history birth control has never been cheaper or more widely available. The reason that half of all pregnancies are still “unintentional” is not because people can’t pay for contraception. Why not focus on the core issues of making health care affordable to low-income groups?

  118. WCE, thanks for posting that piece. I wonder if he is right that we would get a bigger bang for the buck by changing poor lifestyle choices rather than treating their consequences, given how difficult it is even for motivated Totebaggers to keep a few unwanted pounds off.
    We did it with seat belts and smoking, but both of those were amenable to legal restrictions in a way that obesity and lack of exercise are not.

  119. I wonder if he is right that we would get a bigger bang for the buck by changing poor lifestyle choices rather than treating their consequences, given how difficult it is even for motivated Totebaggers to keep a few unwanted pounds off.

    I think we could but it would require a level of intervention that would make people uncomfortable. If you are in the 99th percentile of executive function and cognitive ability you read these stories and many of them involve people who are in the 1st percentile. That’s 3.3 million people.

  120. The American middle class does not believe in saving up for health care expenses. The idea that you should have $10,000 – $15,000 set aside for the occasional acute medical episode is abhorrent. The idea that you should save up for the inevitable medical expenses of old age is abhorrent. We are not Singapore.

    Would could have been if free market zealots were a little more pragmatic and in tune with human nature. No, saving for retirement or healthcare can’t be a choice it needs to be forced like in Singapore. But, if you allow for that level of government intervention then you end up with far less dependence of government overall. But, they made the perfect the enemy of the good as they are want to do.

  121. Rhett, Lee Kuan Yew was the model of a benevolent quasi-dictator. I often think of him and compare him to most other dictators. Most people would have been corrupted by the level of power he possessed, I think.

  122. “because more people will decide not to invest in, say, medical school”

    As far as I know, there has never been a time in the past 1/2 century where people didn’t want to go to medical school. Despite relatively flat salaries and skyrocketing tuition (I don’t have numbers handy, but in 1980 average medical school debt was less than 1 year average resident pay), people want to be doctors. It’s a bunch of smart people not making the most financially lucrative decision.

    Plastics. That’s a lucrative decision.

  123. Covering birth control has the quick-fix appeal of seatbelts and smoking laws. When birth control is “free” (I know, I know, it’s not free), more people use it. More people using birth control reduces health care costs. If people did what was rationale, no one would smoke, you wouldn’t need seat belt laws and every sexually active 15 year old would defer iPhone for an IUD. However, even a $50 co-pay for IUD discourages some people from getting one. Which proves that many people are irrational. Let’s subsidize the irrational to prevent them from breeding.

  124. Many forms of birth control are already cheap. Almost free. But they require daily diligence or a surgical procedure or inconvenient medical appointments or have unpleasant side effects or make cooperation. That is why women don’t use them. Making them “free” is a subsidy for “rational” middle and UMC women who are already using birth control because they have done the cost-benefit analysis. It’s not going to keep the “irrational” from having babies.

  125. It’s not going to keep the “irrational” from having babies.

    Sure it will. At the margins. And the marginal cases are fairly numerous.

  126. “Not sure why contraceptive coverage should be a priority. ”

    Because it is a key component of providing health care to a large portion of the population – women or child bearing age. And it is much cheaper to cover it at least at the same level as other health care needs rather than pay for maternity/pediatric coverage for more people. I am fine with compromising that it doesn’t need to be “free” and should have the same 20% copay as allergy drugs or whatever. But it should be part of essential services, IMO.

  127. Medicaid pays for birth control for low-income women, who still have higher unintended pregnancy rates than their affluent peers. Requiring free birth control as part of employer-provided health insurance benefits has little to do with public health and much to do with politics. If employers believed that these programs saved money, they wouldn’t need a mandate.

  128. Yes, but Medicaid is not available to many poor women – in states that didn’t expand, for example. If you are a homeless addict living in Boise, you don’t get Medicaid. You might not prioritize the $800 it’s going to take to get an IUD.

  129. In Virginia, no Medicaid unless you have a kid. Which has always struck me as odd and not a good incentive program.

  130. “Texas Supreme Court Rules Against Benefits For Same-Sex Couples”

    In a nutshell Houston (the city, not the regular here) extended benefits to same sex couples and the plaintiffs — two taxpayers represented by same-sex marriage opponents — contend that Houston’s benefits policy goes further than the 2015 U.S. Supreme Court’s Obergefell decision requires.

    My simple solution: if the city takes federal funding for anything, then Obergefell applies and would require equal benefits for all eligible employees.

  131. You do, but many homeless addicts have them. So, it’s possible. Let’s remove all the barriers to giving every single woman an IUD who wants one – from promiscuous 15 year olds, to disorganized 20-somethings, to people with poor executive function, to frugal totebaggers who want to save the $500 copay.

  132. Let’s also follow Oregon’s lead and allow pharmacists to prescribe birth control pills and naloxone. The benefits of both clearly outweigh the risks.

    Let’s also do more research on the effectiveness of IUD’s, including types and those inserted soon after the birth of a child. In China, one study said 13% of women with an IUD got pregnant within 5 years. For women who know they are done with their families, let’s develop good numbers on IUD effectiveness vs. surgical methods. I think current IUD effectiveness numbers are too high and arguably IUD’s shouldn’t be inserted until after the “4th trimester” in most cases, i.e. the period when the uterus shrinks back to normal after birth.

  133. i had dinner tonight with two Germans, two Dutch, a Brazilian guy, a Swede, and another American. We discussed politics (Brazil is even crazier than the US), healthcare, and college stuff. The things that they could not wrap their heads around and kept asking about were 1( how can we not have universal healthcare coverage, and 2) if college tuition is so high, where does the money go?

  134. Birth control is just like high blood pressure pills – so friggin cheap for so much cost reduction. And both require daily diligence. Yet we squabble about covering birth control pills.

  135. I would love to see more states follow Oregon’s lead on birth control. I don’t have an issue with it not being free, but making it easily accessible would be great. I guess in a few years we’ll have enough evidence to see the effects.

  136. MM, the money goes to send academics to conferences in Italy.

    If birth control is so friggin cheap and saves employers so much money, why do they have to be forced to pick up the tab?

  137. Scarlett, are there any employers who don’t cover birth control pills for non-religious regions? If employers don’t cover any pharmaceuticals, that’s a separate analysis.

  138. I don’t think MM’s point was that it is a cost savings for the employer but instead a cost savings for society in general. That is the problem and why we need a mandate. Same with lots of other areas. I don’t quite understand why we focus on BC at all. It is such a small % of the costs. Let’s get to end of life care and the death panels.

  139. Scarlett, I am paying my way to this one, since our miniscule travel budget (which like at most universities is one of the smaller departmental items) ran out months ago and the younger tenure trackers need the money more. Maybe you should spend some time on your husband’s university budget committee.

  140. Very typIcally, universities either fund travel at 50%, or only allow a couple of trips each year (not enough for tenure trackers), or cut people off entirely after tenure. The thinking is that you are supposed to travel on grants.Except that the NSF increasingly cuts out travel budgets on grants. People from state schools usually only get state per diems, so you see a lot of people from state schools doubling up or staying in low cost hotels.

    Contrast this to industry, where people travel on 100% reimbursement, staying in nice hotels, and go places constantly, often as far as I could tell, for no real reason at all. There are piles of really expensive conventions in fancy places like Las Vegas which are geared towards industry – no academic goes to these things. But companies love sending their people.

  141. Something else… I am sitting in a room in the math building at the University of Bologna, one of the most storied universities in the world. Students from everywhere in the world flock here. Yet, by American standards, the building facility is completely unacceptable. You would never see anything this decrepit at a US university of similar stature. No AC (and it is HOT), cracks everywhere, junky old furntiture, one bathroom in the basement with most of the lights out and nonfunctional locks. The buildings of course are old and beautiful, but they have been that way since the middle ages. I have been at conferences at other European universities, and seen the same. They just are spending huge amounts of money on fancy buildings and amenities. At my university, at least, new buildings and refurbishments of older ones are a huge part of the budget. And back to the original healthcare topic, another big budget item at my university is “employee benefits” , which of course is largely healthcare. In Europe, since healthcare is paid for via taxes, it isn’t an employer expense

  142. MM, I suspect that your university and his are in different financial situations. His department research acccounts are generous. Faculty never have to pay their own way for a reasonable number of legit conferences, and those invited to speak at other universities or gatherings usually have their expenses covered completely by the host institution so that travel doesn’t deplete their own account. DH has enough to use his research account to send his students on travel. Actually, there are more sweet travel gigs than he has time to take advantage of. He would have made a profit on his Australia trip if I hadn’t joined him.

  143. MM, ask the Europeans about the starting salaries for junior faculty. In DH’s field, they are very low. Most of his European PhD students go back home only for personal reasons. The best ones try to stay in the US. His former student in Copenhagen earns the same salary as her secretary.
    Maybe they can’t construct improvements at Bologna because the facility is historically protected. They also don’t need lazy rivers and rock climbing walls and luxury dorms at a university where students live off-campus. And of course gourmet food courts that are essential at middle of nowhere schools here are not needed where you are!

  144. MM – that’s nuts. My wife would have a fit if I were spending our money for work travel. Not that she has ever given me a hard time about spending money, but she’s particularly attuned to what’s fair and just in terms of workplace policies (it makes us good salaried employees, not so much executives/owners.) There used to be so many things about the Navy’s time-off practices that drove her up the wall.

  145. “And of course gourmet food courts that are essential at middle of nowhere schools ”

    They’re never essential. Most students are too heavy, anyway. Food ought to be kind of boring.

  146. Milo, you are too young to remember the Freshman 15, but it happened in the era of extremely boring but plentiful dining hall food. FWIW there are very few heavy students here. They are in incredibly good shape despite the food courts.

  147. back when my husband taught at a very selective liberal arts college, he was on the budget committee. At that school, faculty got 2 trips funded per year which was not enough for tenure. So they all had to fund trips. On the budget committee, they jokingly referred to this as “faculty negative salary”

    When I worked at directional state u, we did not have a cap on trips, but we were funded at the state per diem level, which de facto was about 50% of costs. People tell me that is standard at state schools.

    Oh, and I just heard that CA will no longer fund trips to a number of states for some political reason – maybe the transgender bathroom thing? That is a topic that has people talking at this conference

  148. At my moderately selective school, they were happy to fund (airfare, registration, per diem, hotel, car) travel for the conference I presented a poster at (it wasn’t even that good of a poster). DH helped a bit, so his name was there, and it was a project with my BFF. So, the 3 of us had an all expense paid trip to the midwest to share our meager insights. I’m pretty sure the adjunct faculty member (definitely not tenure tracted) that also went was not paying her own way.

  149. “And of course gourmet food courts that are essential at middle of nowhere schools ”
    It has been interesting the watch the foodie escalation in the 10 years we have been taking college tours. On DS1’s tours, circa 2008, the pitch tended toward “you can get cereal any time of the day! We college kids love cereal while studying!” On DS3’s tours at the same schools, circa 2017, the pitch is “this chalkboard lists the local farms where many of our food offerings are sourced. Everything in this area is gluten free. Vegan is over here.”

  150. They are in incredibly good shape despite the food courts.

    That’s because they work it off in the state of the art gyms and rec centers.

  151. “And of course gourmet food courts that are essential at middle of nowhere schools ”

    Not so much everywhere. I have heard all school year about the dearth of fresh fruits and veggies

  152. Ada, how many fully funded trips per year did your school cover? I think most schools will fully fund 1 or 2 trips, or alternatively, partially fund lots of trips

  153. One of the reasons, btw, that schools limit trips is to encourage faculty to get grants. A lot of times, when you see someone travelling a lot, you will find they are using grant money. I’ve been using outside travel grants more in the past couple of years myself.

  154. Another bid difference with European universities is that US students are far more likely to live on campus and eat on a meal plan.

  155. And on the low salaries: I just had a conversation in the coffee break with someone from a US state flagship, about recruiting CS faculty, which is a huge issue right now. He mentioned that low salary was a big problem for them. What are they offering to fresh PhDs in CS? 65K. No wonder they are having trouble. But as a state school, they can’t offer any more. Low salaries are a problem everywhere.

  156. jumping back to the healthcare topic – my DS had reason to go to the doctor himself* for the first time yesterday, as he is never sick and only got his license a year or so ago. He texted me while he was filling out paperwork to ask if our insurance was medicaid, so I was explaining the concept and value of health insurance, even while he is young and healthy, to him last night. I was showing him some EOB forms that showed the original price of the service, the negotiated rate, then the part we were expected to be responsible for. Even though we have not hit a deductible for him, the huge benefit that I was trying to get him to see was the difference between the original amount submitted by the healthcare provider and the “negotiated rate” that we pay because we have insurance. I don’t understand why this part is never touched on in the health care debate. If my DH had no insurance when he needed the knee surgery, the providers collectively would have been dunning us for $48K. Even if we had been responsible for 100% of our costs, with the negotiated rates we would have been on the hook for only $11K instead of the $48K. That huge difference is a primary reason that being uninsured can quickly lead to a bankruptcy filing. The big win on having access to insurance has nothing to do with free birth control, and everything to do with making costs manageable when healthcare is needed.

    My DS was appalled that when he had to submit his proof of meningitis vaccine to enroll in college classes, I filled out the part claiming a conscientious objection to vaccines and faxed it in so he could enroll.(He had already had the first of the two shots, just not the second) He’s having none of my nonsense, and demanded to get the vaccine, so I told him to go to the clinic at the drug store up the street, and gave him the insurance card. He is such a different animal from my DD.

  157. Conversations with friends on the faculty of local flagship U left me under the impression that their professional travel, e.g., to conferences, is paid for by grant funding.

  158. “recruiting CS faculty, which is a huge issue right now.”

    I’ve read that Yale has been having a hard time meeting their CS faculty hiring goals.

    On the flip side, I’ve read a lot over the past several months on CC about how difficult it was for kids to get accepted into CS programs.

    These two items would seem to perpetuate a cycle. My guess is the most likely way the cycle will be broken is industry contributions to help colleges hire more CS faculty, with the goal of increasing the pool of CS grads for hire.

  159. Finn, at many schools, electrical engineering and computer science are the same department. When I was an undergrad,com s (my minor) was in the liberal arts college and computer engineering/electrical engineering (my second major for awhile; dropped it because required labs were at the same time as required chem e/chemistry labs) was in the engineering college. If the majors were in the same department, I would have had a second major. I was interested in understanding computers from the circuit level to the software design/algorithm level. My favorite class was software design.

  160. Becky, that’s great that you shared that with your DS. I hadn’t thought of it, but I will try to do the same with my kids, especially DS while he’s still home.

  161. Another way industry can help the CS logjam is to loan out some of their CS PhDs to colleges. I’ve heard of companies doing that with some of their engineering PhDs, e.g., paying full salary and benefits to facilitate teaching full-time, or reducing workload to facilitate teaching of a single class.

  162. “It has been interesting the watch the foodie escalation in the 10 years we have been taking college tours.”

    OTOH, all accounts I’ve heard about food at the school DS will be attending are that the dining hall food is not very good.

  163. OTOH, all accounts I’ve heard about food at the school DS will be attending are that the dining hall food is not very good.

    I think it’s a treasured, centuries-long tradition to complain about dining hall food.

  164. All the schools we visited had pretty nice food. Sushi! Who would have imagined sushi in the dining hall back in my day?

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