Sat, 31 Jan 2009

The Medicaid Waiver: Selling the Assembly

Imagine I've come to you with an idea for lowering heating bills in your house. "This amazing device will cut your heating bills by a quarter," I say. Naturally, you say, "What is this marvelous invention and how much does it cost?" And I reply, "I'm not sure about either, really, but we'll figure out something. No one will get hurt, and you know you can trust me because I'm wearing a nice suit. Did I mention it will cut your heating bills by a quarter? Sign here." Would you sign or send me packing?

If you were the leadership in the General Assembly -- House Speaker William Murphy and his team -- you'd sign. Yup, knowing almost none of the important details, those hard-boiled realists happily bought the assurances from Governor Carcieri and Gary Alexander, his director of Human Services, that the Medicaid "global waiver" under consideration is a good idea. What's more, they bought it in a highly undemocratic fashion: the Speaker simply declined to schedule a vote on the subject, and under the terms set last year, it goes into effect automatically. Legislators who object to this fiasco have had no opportunity to do so since the idea was sprung on them in a surprise budget amendment last June.

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12:22 - 31 Jan 2009 [/y9/cols] link

No, not everyone has an ID

In fact, around 11% of people don't, according to a study by the NYU law school and the Brennan Center. Find it here.

09:50 - 31 Jan 2009 [/y9/ja] link

Mon, 26 Jan 2009

Cheaper isn't always better

Last week, the US Immigration and Customs Enforcement Service terminated its contract with the Donald W. Wyatt Detention Facility in Central Falls, part of the continuing fallout over the death last summer of Hiu Lui Ng, a Chinese computer engineer who had overstayed his visa and was in detention there. This is as good a time as any to review history of the Wyatt jail. But first, a word about the real-world meaning of sophisticated economics abstractions.

A few months ago, I had to buy a new stove. The event gave me an opportunity to reflect on the phenomenon of productivity. This is the amount of goods or services a company provides divided by the cost of making it. Increasing productivity is a grand-sounding economics abstraction that conjures up images of marvelous robots and complicated machines that automatically weld each metal panel onto my stove, along with the logistics advances and Just-in-Time inventory controls that cut warehouse expenses. Not only does it sound grand, but doesn't it do your heart good to know that American productivity growth over the past 10 years was double the two decades before? Picture with me the armies of efficiency experts, manufacturing engineers and computer programmers who made possible this revolution in manufacturing. Marvelous, no?

But technically speaking, increases in productivity don't just mean assembly-line robots. They also explain why my stove's bottom drawer is a flimsy and nearly useless piece of junk that already jumps its rails as a matter of course. Whoever it was who figured out how to make a stove drawer out of plastic and what seems like tinfoil increased productivity just as much as the engineers who figured out how to assemble it efficiently. That is, there are good and bad ways to increase productivity. The market is supposed to be the arbiter of which ways remain in use, but in a market driven by price, quality will always be driven to the ragged edge of adequate. (Or beyond -- since when is a sled a disposable item?)

So now consider prisons. Ideas for increasing productivity have been lurking about since Jeremy Bentham developed his "panopticon" design in 1785. His idea was that by laying out the cells properly, one guard could see all of them, and adequately guard many more prisoners than in a prison of a more traditional design. That's a useful insight, and lots of prisons are built to incorporate some of these ideas now.

But another way to increase productivity is just to skimp on training your guards, pay them poorly, be stingy with inmate medical care, and buy cheap food, too. Unlike my stove drawer, though, people's lives are put at risk by these kinds of productivity increases, and last summer, Mr. Ng died, reportedly due to a lack of necessary medical care. Here's the best part: this is a completely predictable outcome. Once private companies start competing for business, in an environment where price rules, you can count on the service eventually to settle to the level of barely adequate, if that. What's more, to advocates of privatizing services, that's the whole point.

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00:29 - 26 Jan 2009 [/y9/cols] link

Fri, 16 Jan 2009

Hard choices, well maybe not.

Last week we saw Governor Carcieri unveil his plan for solving the state's budget nightware. There are some good ideas in it: reforming long-term care for the disabled and elderly, increasing the size of the state's health insurance purchasing pool and relieving some of the unnecessary legal burdens on cities and towns. These are important changes, and I wish they'd been undertaken years ago, but these weren't the meat of the matter. Unfortunately.

In his speech, Carcieri said our state "faced difficult choices." Unfortunately, he chose the easy way on every single one of those choices. What's so difficult about that? He would have us balance our budget by throwing poor people, state employees and cities and towns under the bus. Better now than in a few weeks. After RIPTA makes its schedule cuts at the end of January, it will be hard to find a bus.

He closed this way: "The decisions I have outlined here tonight balance our budget without raising broad-based taxes, without removing the safety net from anyone in need, and without putting anyone out of a job." It sounds good, even stirring, but not a word of it is true.

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22:35 - 16 Jan 2009 [/y9/cols] link

Sat, 10 Jan 2009

Ideology of the center

This is good:

Some folks, of course, will oppose the Stark plan because they’re right-wingers who don’t want to expand health care coverage. And some folks, will want to focus their energies on other, worse, plans because those plans have a better chance of passing. But what’s incredibly frustrating is that a lot of people who claim to want to change public policy to expand health care coverage and better control health care costs will nonetheless fail to embrace Stark’s plan or anything similar for no real reason other than ideological posturing. It just can’t be the case, as a matter of centrist dogma, that the best solution is actually the most left-wing solution. It’s a far more ideological stance than anything you’ll ever hear from Pete Stark or from me. But the people hewing to it will insist on being called pragmatists.

23:14 - 10 Jan 2009 [/y9/ja] link

The Problem with Immigration

An article in the New York Times a couple of weeks ago drew heavily on the irony that the private Donald Wyatt jail in Central Falls relies heavily for its income on the Department of Homeland Security. DHS places arrested illegal immigrants there, many of whom have recently been arrested -- in Central Falls. The irony is rich and the human cost of the arrests combined with the insanely opaque immigration bureaucracy is tragic, but what of the big story? Illegal immigration is constantly in the news, but why is it so hard to find a solution?

Solution? Maybe it's best to ask first, what is the problem?

Some say it's obvious: illegal and mostly Hispanic immigrants are taking jobs that could be held by native-born Americans. But it used to be obvious that housing prices could rise faster than wages indefinitely, so calling it obvious isn't good enough.

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21:02 - 10 Jan 2009 [/y9/cols] link

Sun, 04 Jan 2009

Census Numbers: What Do They Mean?

Right before Christmas, the Census Bureau published its estimates for state population changes as of July 2008. The news wasn't great for Rhode Island, which is along with Michigan, one of only two states to lose population between 2007 and 2008. You can bet that this will provoke the usual round of teeth-gnashing, I am sure, and since most of the usual teeth-gnashers find everything to be a reason to cut taxes on rich people, you can bet that's coming, too.

But what is the story behind these numbers? Is it worth inquiring further about what they really mean? Your answer to this question will depends on whether you really want to solve problems, or whether you just enjoy complaining about stuff. I am interested in solutions, so I peeked, and this is some of what I found.

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13:27 - 04 Jan 2009 [/y9/cols] link

A pretty picture

The X axis is the ratio of median rents to median incomes, and the Y axis is the change in public school enrollment between 2004 and 2008. The line is fitted to the points using a simple least-squares method. For them who are interested, the slope of the line is good to about the 99% significance, while the intercept is only good to the 95% level. (See below.)

Update: The graph was mislabeled, leading to the impression that these numbers were much smaller than they are. I fixed the offending axis label, my apologies to all.

13:27 - 04 Jan 2009 [/y9/ja] link

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