Letter: This is why Republicans can't find a replacement for Obamacare →

A key reason the Republican Party is having such a hard time with the replacement part of “repeal and replace” is that Obamacare is virtually the same privatized mandate plan it pushed for since President Richard Nixon first proposed the National Health Strategy in 1971 then again in 1974. Then the GOP revived its privatized mandate plan again in 1993 with then-Senate Minority Leader Bob Dole helping to propose the Health Equity and Access Reform Today act or HEART as the alternative to the proposed single-payer plan Health Security Act of 1993 — commonly known as “Hillarycare“ — and then again when then-Gov. Mitt Romney proposed — and succeeded in implementing — the Patient Protection and Affordable Care Act of 2006 in Massachusetts.
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As a result, the GOP’s repeal and replace position backs it into a challenging corner. It has no real replacement plan because the ACA is essentially the privatized mandate it has pursued for so many years. The only possible alternative to a 40-year-old GOP plan would be reverting to the old system, leaving millions of people without full coverage or proper health care. Even those with coverage — perhaps through their employers — could then once again have a cap on lifesaving treatments, such as those for cancer, and thereby reinstating the privatized insurance “panels” deciding the profitability of patient treatment versus patient outcomes.
Or, the GOP could go with the Democratic option — a single-payer system — the same plan that virtually every major western democracy has successfully implemented with significantly lower cost and higher life expectancy than America has, according to a recent Commonwealth Fund study, and with much better patient-centric results. (America ranks 37th in the world in patient health outcomes as reported by the World Health Organization.)

Donald Trump and the Future of Intelligence →

The relationship between the Trump administration and the intelligence agencies will be worth keeping an eye on. The loss of trust will lead to otherwise-avoidable intelligence failures.

But while there is a long history of intelligence-policy friction, the hostility between the incoming administration and the intelligence community is unprecedented. This is not just due to Trump’s tweets, though they have certainly played a role. Gen. Flynn’s statements about the CIA must sound ominous to insiders, given his checkered past. As director of the Defense Intelligence Agency, he reportedly alienated subordinates by telling them “that the first thing everyone needed to know was that he was always right. His staff would know they were right, he said, when their views melded to his.” Because the White House is the CIA’s most important consumer, rejection by the president’s national security advisor would be particularly troubling.
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The intelligence community faces two looming dangers in the next four years. The first is neglect. If the president elect means what he says, he is likely to downplay intelligence or ignore it completely. Trump has already announced that he won’t receive the President’s Daily Brief on a daily basis. Instead, he’ll get intelligence briefings three times a week and rely on his advisors to alert him when international events require his attention. The issue of neglect, however, goes beyond the number of formal interactions between the president elect and his intelligence officials. The real question is whether such actions will have any value to the policy process, or whether they will descend into brief pro forma exercises. Policymakers can easily ignore intelligence while going through the motions.
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Whatever the cause, neglect has serious consequences for the conduct of foreign policy. Intelligence agencies have access to unique sources of information, along with personnel who are specially trained to make sense of it. As a result, ignoring intelligence removes a potentially important source of information from policy deliberations. It also removes an important check on policymakers’ assumptions. Like anyone else, leaders are susceptible to cognitive biases that reinforce prior expectations. Healthy intelligence-policy relations are a natural barrier to this kind of tunnel vision. Ignoring intelligence, on the other hand, opens a pathway to policy myopia.  

The second problem is politicization, or the manipulation of intelligence to reflect policy preferences. Politicization comes in many flavors. Direct politicization refers to crude arm-twisting, as leaders try to coerce intelligence officials to deliver politically convenient estimates. Indirect politicization is more subtle: rather than threatening or cajoling intelligence officials, policymakers send repeated tacit signals about what they expect to hear. And like the problem of neglect, intelligence agencies can also be responsible for politicization if they let their own policy preferences affect their estimates.

Ethics Rules Are National Security Rules →

...Ethical transparency is critical to national security because it ensures that personal financial interests are not placed before the interests of the country.
Identifying conflicts is the first step in preventing harms. Once a conflict is disclosed and identified, it might be eliminated by either ending the financial relationship or requiring individual recusals. Where that doesn’t occur, the disclosure process allows for the public and other stakeholders to assess a government official’s judgment for indications of bias. The White House and the cabinet are charged with immensely consequential decisions; not infrequently, they determine matters of life and death. The legitimacy of the office of the presidency rests on public faith that the government is placing the interests of the country first.
The demand for adequate ethics disclosure and vetting reflects the national security strategy of—as Reagan put it—“Trust, but verify.” We ask for verification that our government officials are free from undue influence because it goes to the core of basic democratic legitimacy. There should be no questions regarding the purity of the motives of individuals we authorize to place our soldiers, foreign service officers, or intelligence agents in harm’s way. Because of the necessary secrecy that surrounds a great many of these decisions, full vetting and transparency at the outset are critical to ensuring the Executive branch is, in fact, placing country first and also to maintaining basic integrity and legitimacy in the eyes of the people.
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Recently, the Director of the Office of Government Ethics (OGE) has sent a letter to Congress warning that not all of Trump’s nominees have submitted the paperwork required for the legally-mandated ethics review. A large number of consequential—and controversial—confirmation hearings have been scheduled for Wednesday. OGE cautions this schedule does not allow sufficient time to complete reviews, especially considering the complex financial backgrounds of Trump’s “Billionaire cabinet” and the necessity for highly-detailed reviews of individuals like Exxon Mobil CEO Rex Tillerson. Confirmation hearings are traditionally not scheduled before ethics review is complete, not only because Senators must be fully informed in their votes, but also because the confirmation process serves as important leverage in ensuring full compliance. Once a nominee is Senate-confirmed, there is little incentive for the individual to fully and timely comply with ethics disclosure, especially of potentially controversial matters.
The relationship between ethics and national security is perhaps most important when it comes to the President himself. President-elect Trump’s refusal to divest himself of his business interests invites conflicts, though Trump asserts that the President cannot have legally cognizable conflicts. That is a controversial legal argument, at best, but it also fails to recognize the distinction between a legal conflict and a conflict in fact. Because of his multinational business interests, President Trump will eventually face a decision where the interests of the nation run contrary to his personal financial interests, whatever his interpretation of legislation on conflicts might be. And a Politico poll this morning found that 65% of those polled believed Trump’s business interests will “affect his decision making.”

This old bill could be the secret to affordable universal health care →

You can think of the AmeriCare approach as a public option on steroids. It would create a new single-payer program called AmeriCare that would take on everyone ensured by Medicaid and SCHIP, and would automatically enroll all children at birth. It would pay the same rates to providers as Medicare, meaning it'd be considerably less generous to doctors and hospitals than private insurers.
Unlike Sanders's plan, AmeriCare involves cost sharing very similar to what you'd find in a private plan. There are deductibles ($350 for individuals, $500 for families), co-insurance (20 percent of spending above the deductible), an out-of-pocket spending cap ($2,500 for individuals, $4,000 for families), and premiums.
However, cost sharing would be sharply limited for low-income families. Individuals and families living on less than twice the poverty line ($48,500 for a family of four in 2015) wouldn't have to pay premiums, deductibles, or co-insurance, and there would be premium subsidies and lower deductibles for people between two and three times the poverty line.
Here's the kicker: Employers could buy into the plan. They'd have to pay 80 percent of the premium, leaving 20 percent to employees, but it'd be an alternative every company got to their existing private plan.

Economists, Doctors' Cartels, and Uber →

...What is striking is that the enthusiasm for the virtues of competition seems to disappear when we switch the topic from the taxi cartel to the doctors' cartel. Doctors actually have been far more effective than taxi companies in limiting competition. Doctors largely get to set standards of care, which not surprisingly requires twice as high a percentage of highly paid specialists as in other wealthy countries. They also restrict the number of doctors with a wonderfully protectionist rule that prohibits doctors from practicing in the United States unless they have completed a U.S. residency program. This means that even well-established doctors in places like Germany, France, and Canada would face arrest if they attempted to practice medicine in the United States.
As a result of this cartel, doctors in the U.S. earn on average more than $250,000 a year, putting the average doctor not far below the one percent threshold, even assuming no other family income. This is roughly twice the pay as the average doctor earns in other wealthy countries.
It is striking that the doctors' cartel gets so much less attention from economists than the taxi cartel. After all, we spend close to $250 billion a year on doctors compared to $6 billion a year on taxis. I could suggest that the lack of interest is due to the fact that many economists have parents, siblings and/or children who are doctors, but I wouldn't be that rude...

If Donald Trump Targets Journalists, Thank Obama →

An important note, and not just sour grapes. We all need to do better at keeping the president's feet the fire on free speech, no matter their party:

Mr. Trump made his animus toward the news media clear during the presidential campaign, often expressing his disgust with coverage through Twitter or in diatribes at rallies. So if his campaign is any guide, Mr. Trump seems likely to enthusiastically embrace the aggressive crackdown on journalists and whistle-blowers that is an important yet little understood component of Mr. Obama’s presidential legacy.
Criticism of Mr. Obama’s stance on press freedom, government transparency and secrecy is hotly disputed by the White House, but many journalism groups say the record is clear. Over the past eight years, the administration has prosecuted nine cases involving whistle-blowers and leakers, compared with only three by all previous administrations combined. It has repeatedly used the Espionage Act, a relic of World War I-era red-baiting, not to prosecute spies but to go after government officials who talked to journalists.
Under Mr. Obama, the Justice Department and the F.B.I. have spied on reporters by monitoring their phone records, labeled one journalist an unindicted co-conspirator in a criminal case for simply doing reporting and issued subpoenas to other reporters to try to force them to reveal their sources and testify in criminal cases.

Postal Service business is up, deficit is all politics →

For starters, the Postal Service actually is operating in the black. USPS revenue exceeded operating expenses by $610 million in Fiscal Year 2016, bringing its total operating profit the past three years to $3.2 billion. Bear in mind that this is all earned revenue; by law USPS gets no tax dollars.
This impressive performance stems from two ongoing structural factors: As the economy gradually improves from the worst recession in 80 years, letter revenue is stabilizing. And as the Internet drives online shopping among Bay area residents and beyond, package revenue is rising sharply (up 16 percent in 2016), auguring well for the future.
There is red ink but it has nothing to do with the mail and everything to do with congressional politics. In 2006, a lame-duck Congress mandated that the Postal Service pre-fund future retiree health benefits.
No other public agency or private company has to do this even one year in advance; USPS must pre-fund these benefits decades into the future. That $5.8 billion annual charge not only accounts for the ‘red ink’, it disguises the actual profits postal operations have been generating for years.

Are We Becoming More Moral Faster Than We're Becoming More Dangerous? →

In The Better Angels of Our Nature, Steven Pinker convincingly makes the point that by pretty much every measure you can think of, violence has declined on our planet over the long term. More generally, "the world continues to improve in just about every way." He's right, but there are two important caveats.
One, he is talking about the long term. The trend lines are uniformly positive across the centuries and mostly positive across the decades, but go up and down year to year...
The second caveat is both more subtle and more important. In 2013, I wrote about how technology empowers attackers. By this measure, the world is getting more dangerous:...
Pinker's trends are based both on increased societal morality and better technology, and both are based on averages: the average person with the average technology. My increased attack capability trend is based on those two trends as well, but on the outliers: the most extreme person with the most extreme technology. Pinker's trends are noisy, but over the long term they're strongly linear. Mine seem to be exponential.
When Pinker expresses optimism that the overall trends he identifies will continue into the future, he's making a bet. He's betting that his trend lines and my trend lines won't cross. That is, that our society's gradual improvement in overall morality will continue to outpace the potentially exponentially increasing ability of the extreme few to destroy everything...