Gay rights update

On same-sex marriage, Obama still has cold feet

Hillary Clinton, addressing a gay-pride celebration at the State Department this week, was in spirits as festive as her robin’s­-­egg-blue pantsuit.
The “historic vote in New York” legalizing same-sex marriage, the secretary of state told the gathering of gay and lesbian foreign service workers, “gives such visibility and credibility to everything that so many of you have done over so many years.”
Describing the conversion of one New York Republican senator who “became convinced that it was just not any longer fair for him to see one group of his constituents as different from another,” Clinton exulted: “I’ve always believed that we would make progress because we were on the right side of equality and justice.”
Clinton left out one salient detail, though: She and her boss, President Obama, oppose legalizing gay marriage.
It was but the latest display of the internal contradiction in the Obama administration’s policy on gay marriage — a position made even less tenable by New York’s vote.
At the core of Obama’s stance is a logical inconsistency: He believes gay Americans should be fully equal under the law, but by opposing gay marriage he supports a system that denies same-sex couples some 1,300 federal rights and benefits that married couples receive. The civil unions Obama favors as an alternative have little meaning in federal law.
Few questioned Obama’s (or Clinton’s) civil-union dodge during the 2008 presidential campaign, because gay marriage was politically impossible in most parts of the country. But the vote by the New York legislature — including the Republican-controlled Senate — and national polling have shown that marriage equality, though still politically difficult, is within reach.
For Obama, this is less about the issue than about leadership. Even if he backed gay marriage, it wouldn’t become legal without Congress rewriting the federal definition of marriage, which currently demands “a legal union between one man and one woman.” But if Obama really believes, as he says, that a class of Americans is suffering unconstitutional discrimination, you’d think he would take a stand as a matter of principle. Instead, to borrow a phrase one of his advisers applied to the administration’s Libya policy, the president is once again “leading from behind.”
On the eve of the vote in New York, Obama was heckled by an audience of gay New Yorkers when he again declined to endorse gay marriage. He further infuriated listeners with his observation that “traditionally marriage has been decided by the states” — a position that would leave unchallenged the 41 states that ban same-sex marriage.
Days before that, White House communications director Dan Pfeiffer was booed at a blogger conference when he asserted: “The president has never favored same-sex marriage. He is against it. The country is evolving on this, and he is evolving on it.” More like devolving: Pfeiffer claimed that a 1996 questionnaire, which has Obama’s signature and states his support for same-sex marriage, was “filled out by someone else.”

Random Links

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Economics and finance links

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The Real Endgame In Greece That European Leaders Are Privately Praying For

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The Good Banker

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Paul Krugman: The Eurozone Is Now In "Meltdown Territory"

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Healthcare update

HIV Google Map Gives New Perspective on Epidemic

CMS to review 'burdensome' hospital requirements

Booming for-profit hospice care leads to 'cherry-picking' concerns

For-profit hospice care has grown at a stupendous rate, possibly complicating the financial aspects of transferring a patient out of hospital care, concludes a study recently published in the Journal of Law, Medicine and Ethics.
For-profit hospices grew 128 percent between 2001 and 2008, according to "In the Business of Dying: Questioning the Commercialization of Hospice." By contrast, government-run hospices grew by just 25 percent, while non-profit hospices grew by just one percent.
The study's authors suggest that for-profit hospices have focused on both aggressive marketing efforts and "cherry-picking" of particular patients to boost profits.
"It turns out that in part they're doing it because they are very selective about the types of patients that they treat. So there's clearly a strategy whereby they're going to target the patients that are least costly to care for," Joshua Perry, one of the study's authors, told Healthcare Finance News.
Medicare pays the same per diem rate for hospice care no matter their illness, creating a perverse incentive to select patients who would remain in hospice care longer. That means patients with dementia would likely be preferable over those with cancer, notes Perry. Conversely, hospitals may find it more difficult to move cancer patients--who are very expensive to treat--into hospice care.
However, a spokesman for the National Hospice and Palliative Care Organization said such practices would be illegal.

The Quagmire: How American medicine is destroying itself.

Why are high-risk pools having so much trouble?

Perhaps as a result, many Americans remain clueless about what’s in the Affordable Care Act — and even whether it still exists. As recently as late February, a poll conducted by Kaiser Family Foundation found that nearly half of Americans thought that health reform had been repealed or said they didn’t know whether that was the case. Within that context, it’s not surprising that so few Americans are rushing to sign up for a special insurance program that, up until recently, had relatively stringent requirements for participation.
The obstacles that these early deliverables have encountered have prompted even some reform supporters to wonder whether the Dems were overly ambitious about what they could accomplish immediately. In addition to the high-risk pools, for example, a new insurance regulation banning some bargain-basement insurance plans has prompted HHS to issue 1,370 waivers to businesses and other policyholders to exempt them from the program, as I recently reported. “It was a huge lift — it was always going to come out of the gate more slowly than they thought,” Peter Harbage, a health-care consultant and former Clinton administration official, told me, referencing the high-risk pools. “It’s like turning around an aircraft carrier.” Nevertheless, having made big promises about the immediate benefits of health reform, Democrats might be under growing pressure to deliver.

China update

A Quick Guide To China's Latest Big Bailout

Why China's 2-3 Trillion Yuan Local Government Bailout May Only Be The Beginning

TV Censorship in China; Reflections on the Yuan as a Global Reserve Currency; Hype Sells

40 Ways The Chinese Economy Is Beating The Living Daylights Out Of The US

Chinese Hacker Cracks Hundreds of Gmail Accounts, Including Those of U.S. Officials

China’s workforce is expected to start shrinking in next few years

China’s large labor force has been central to its rise as an economic power, allowing companies to tap a seemingly endless pool of workers willing to move from their home towns, often live at the factory site and accept comparatively low wages.
That era is ending.
In a shift that is intensifying the economic competition between China and the United States, China’s working-age population has plateaued in size and will begin getting smaller sometime in the next five years, according to demographers and recently released census data. The number of 20-to-24-year-olds, a main source of entry-level and factory labor, is already shrinking, the leading edge of an eventual decline in the overall population.
The demographic change is ushering in higher wages and inflation and remaking the country’s social fabric — particularly in rural villages such as this one south of Beijing, where working adults have all but disappeared to major cities. If there are children, they are living with or visiting grandparents.
The shift has also prompted a national push to develop technology- and innovation-driven industries that need fewer workers — industries in which the United States has traditionally held an advantage. Instead of the “cheap” China of the past 30 years, U.S. business and government officials face a country that is demographically stagnant, increasingly expensive and pressing hard to compete.
“China is a country in a race against time,” the U.S. Chamber of Commerce wrote in a study of China’s emerging economic policies. As it rushes to develop an economy in which a smaller force of more productive workers can support an explosion of retirees, “the country can’t get rich before it gets old,” the report said.
China’s use of state power and support to boost industries such as biotechnology, telecommunications and alternative energy has become a main concern among U.S. business and government officials — and is arguably a more direct threat to American economic interests than, say, China’s low exchange rate. In hearings and diplomatic meetings, U.S. officials and lawmakers have focused on Chinese policiesthat have barred top U.S. technology companies from some types of business, undercut others with state subsidies and aimed to develop Chinese competitors in industries such as commercial aircraft manufacturing that currently support tens of thousands of U.S. jobs.
It is a natural step for an economy that has rapidly industrialized over the past quarter-century, largely by producing what others ordered it to produce at a world-beating cost — the “China price.” Demographics, however, are making the change more urgent as the country confronts the long-term consequences of its strict population-control rules. China’s 30-year-old family-planning policy limits most couples to one child, a restriction the government imposed to curb a large and then-rapidly growing population that officials feared the country could not support.
The first generation born under the one-child policy is now approaching middle age, providing a clearer sense of the rule’s impact. The results are “alarming,” said Wang Feng, a demographer and director of the the Brookings-Tsinghua Center for Public Policy in Beijing, after the release of the country’s latest census.
The new data showed that overall population growth slowed more than expected during the past decade, to 0.57 percent annually. Wang said the fertility rate is now fewer than 1.5 births per woman, among the lowest in the world and well below the replacement rate of 2.1 births per woman. This will push forward the point when China’s population peaks at around 1.45 billion, he said, currently forecast for 2029. After that, the population will decline.
China currently has around 1.3 billion people. The number under age 14 fell by more than a third in the past decade, while the number over 60 grew by more than 20 percent.
That sort of demographic momentum — with far more people preparing to leave the workforce than are entering it — is extremely difficult for a nation to reverse.
The number of people of working age is still expected to grow, slowly, for perhaps five more years before reaching its peak, and a recent study by the U.S. Chamber of Commerce in China noted that there are still around 25 million “surplus” workers in rural areas available to move into factory jobs.
But that rural labor pool is expected to disappear in perhaps four years as manufacturers continue to expand and hire. Over the past two years in particular, wages have been rising rapidly, while businesses small and large complain about increasing worker demands and employees who are quick to quit because they can easily find other jobs at better pay.
Industrial development has been shifting toward more rural parts of the country, with major exporters such as Taiwanese manufacturing conglomerate Foxconn moving to Guanxi and Hunan provinces to avoid labor shortages and higher wages in China’s more heavily developed coastal areas.
In the industrial city of Langfang, south of Beijing, local authorities say they need to recruit another 100,000 rural workers into factory jobs to meet the demands of companies at its sprawling industrial park.
The family dynamics in small villages such as Shizhao show the constraints the country is facing.
Within a generation, families such as that of Shi Qingzan, 75, went from producing a sizable “demographic dividend” — creating the workers who manned China’s rapid growth — to setting the stage for an era of decline. Removed to the countryside in 1962 to become a farmer when China was coping with the aftermath of famine, Shi had four children in the years before the one-child policy. Now ages 38 to 48, those children and their spouses — eight adults — have produced just five children.
The village school here closed two years ago.
When he was young, “the government moved everyone back home to help out with agricultural production,” Shi said, but the impetus now is to move to major cities. “In 20 years, there won’t be anyone here.”

Politics and government links

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11 Things You Should Know About The U.S. Postal Service Before It Goes Bankrupt

Does your laptop have rights? Congress should pass legislation requiring probable cause to view the contents of electronic devices.

A U.S. military worth saluting. The U.S. military is the most respected institution in American life, according to several polls.

Cyber Combat: Act of War. Pentagon Sets Stage for U.S. to Respond to Computer Sabotage With Military Force

Pentagon seeks mini-weapons for new age of warfare. In an effort to cut costs and avoid civilian casualties, manufacturers are developing small 'smart bombs,' drones that resemble model planes and microscopic crystals to tag enemy targets.

The Pentagon Has a Classified List of Cyber Weapons Approved for Cyber Warfare

How The Criminal Justice System Takes Down Terrorists (INFOGRAPHIC)

S.E.C. Case Stands Out Because It Stands Alone

One Person, One Vote? Not Exactly

Link

Two economists, Brian Knight and Nathan Schiff, set out a few years ago to determine how much Iowa, New Hampshire and other early-voting states affected presidential nominations.

Mr. Knight and Mr. Schiff analyzed daily polls in other states before and after an early state had held a contest. The polls tended to change immediately after the contest, and the changes tended to last, which suggested that the early states were even more important than many people realized. The economists estimated that an Iowa or New Hampshire voter had the same impact as five Super Tuesday voters put together.
This system, the two men drily noted in a Journal of Political Economy paper, “represents a deviation from the democratic ideal of ‘one person, one vote.’ ”
A presidential campaign is once again upon us, and Iowa and New Hampshire are again at the center of it all. On Thursday, Mitt Romney will announce his candidacy in Stratham, N.H. Last week, Tim Pawlenty opened his campaign in Des Moines. The two states have dominated the nominating process for so long that it’s easy to think of their role as natural.
But it is not natural. It’s undemocratic, in fact. It is unfair to voters in the other 48 states. And it distorts economic policy in several damaging ways.
Most obviously, the federal government has lavished subsidies on ethanol, even though those subsidies drive up food prices and do little to solve the climate problem, partly because candidates pander to the Iowa corn industry. (Mr. Pawlenty, who now says the subsidies must end, is an admirable exception.) Beyond ethanol, a recent peer-reviewed study found that early-voting states received more federal dollars after a competitive election — so long as they supported the winning candidate.
Pork is hardly the only problem with the voting calendar. In the long run-up to the first votes, Iowa and New Hampshire also distort the national conversation because they are so unrepresentative. They are not better or worse than other states, to be clear. But they are different.
Their populations are growing more slowly than the rest of the country’s. Residents of Iowa and New Hampshire are more likely to have health insurance. They are older than average. They are more likely to work in manufacturing.
Above all, Iowa and New Hampshire lack a single big city, at a time when large metropolitan areas are crucial to lifting economic growth. Big metro areas are where big ideas most often take shape and great new companies are most often born. The country’s 25 largest areas are responsible for 52 percent of the country’s economic output, according to the Brookings Institution, and are home to 42 percent of the population.
Yet metro areas are also struggling with major problems. The quality of schools is spotty. Commutes last longer than ever. Roads, bridges, tunnels and transit systems are aging.
You don’t hear much about these issues in the first year of a presidential campaign, though. No wonder. Iowa, New Hampshire and the next two states to vote, Nevada and South Carolina, do not have a single city among the country’s 25 largest. Las Vegas, the 30th-largest metro area, and the Boston suburbs that stretch into New Hampshire are the closest these states come.
So the presidential calendar becomes another cause of what Edward Glaeser, a conservative-leaning Harvard economist, calls our “anti-urban policy bias.” Suburbs and rural areas receive vastly more per-person federal largess than cities. One big reason, of course, is the structure of the Senate: the 12 million residents of Iowa, New Hampshire, Nevada and South Carolina have eight United States senators among them, while the 81 million residents of California, New York and Texas have only six.
Bruce Katz, a Brookings vice president and veteran of Democratic administrations, points out that the world’s other economic powers take their cities more seriously. China, in particular, has made urban planning a central part of its economic strategy.
“The United States stands apart as an anti-urban nation in an urbanizing world,” Mr. Katz told me. “Our political tilt toward small states and small towns, in presidential campaigns and the governing that follows, is not only a quaint relic of an earlier era but a dangerous distraction at a time when national prosperity depends on urban prosperity.”
The typical defense from Iowa and New Hampshire is that they care more about politics than the rest of us and therefore do a better job vetting candidates. But the intense 2008 race between Barack Obama and Hillary Clinton showed that if Iowa and New Hampshire care more, it’s only because of their privileged status. In 2008, turnout soared in states that finally had a primary that mattered, be it Indiana or Texas, North Carolina or Rhode Island.
A more democratic system would allow more voters to see the candidates up close for months at a time. The early states could rotate each year, so that all kinds — big states and small, younger and older, rural and urban — had a turn. In 2016, the first wave could include states that have voted near the end recently, like Indiana, North Carolina, Oregon and South Dakota.
A rotation along these lines would enliven the political debate. Investments in science and education, which are the lifeblood of future economic growth, might play a bigger role in the campaign. You could even imagine — optimistically, I know — that the deficit might prove easier to address if Medicare and Social Security recipients did not make up such a disproportionate share of early voters.
The issues particular to small-town America would still receive extra attention because so many of the 50 states are rural and sparsely populated. It’s just that Iowa and New Hampshire would no longer receive the extreme special treatment they now do.
And that special treatment is a nice thing, indeed. It focuses the entire country, and its next leader, on the concerns of only 1 percent of the population, as if democracy were supposed to work that way.
At a recent candidates’ forum in Des Moines, The Wall Street Journal reported, the moderator did something that seemed perfectly normal: She chided Mr. Romney for not having spent enough time in Iowa lately. “Where have you been?” she asked.
How do you think the rest of us feel?