. . . and asks "what happened in 1980?" If I had to guess, I'd say "some sort of data discontinuity", but other than that, I don't know.
I do, however, have a plausible candidate for what happened in 1986, when the thing starts rising briskly over a period of years: the Reagan tax simplification. It got rid of a lot of the ability to expense lifestyle enhancements for workers, but left an important one intact: the deduction for health care.
You can argue that the employee health care deduction basically explains the entire cost differential between American systems and the others. Take a look at this graph (you'll have seen some variant of it many times during the health care debate, but I got this particular one from a presentation by Scott Atlas at Hoover last month):
The blue lines show per capita spending; the purple, spending as a percentage of GDP. Now look at that same image, hamfistedly altered by yours truly to show what the graph would look like if the approximately 35% tax subsidy we give to employer health care benefits were withdrawn:
Suddenly, the US isn't really an outlier. We'd still be spending more--but we're richer, and in general, rich countries spend more of their GDP on health care.
Is this dispositive? Hardly. But it's suggestive. And there's some literature to back up effects that are huge, if not quite 35%, like Jonathan Gruber's recent paper.
Naturally, this puts me in mind of Ezra Klein's recent post:
The problem is that Medicare can't control costs too much better than private insurers or, as you see from the article above, doctors will simply abandon Medicare. In a world where there's only Medicare and Medicare decides to control costs, doctors can either take the pay cut or stop being doctors. And as we see from other countries, lots of people want to be doctors, even if being a doctor doesn't make you particularly wealthy. But in a world where Medicare is just one of many payers and Medicare decides to control costs, doctors can simply stop taking Medicare patients and a lot of legislators will lose their jobs.
Given how hard it's proven to tackle the tax subsidy for employer-sponsored insurance, I'm not seeing much of a change any time soon. In fact, a recent post by Austin Frakt suggests that we're expanding it:
Are you getting this? Let me make it clear. The PPACA may make it possible for workers to get the same tax break for purchasing health insurance on the individual market (via an exchange or otherwise) as they would if they bought their employer-sponsored plan (if they're offered one). If this is the case, it removes one huge incentive for maintaining employer-sponsored coverage. With respect to taxation, it levels the playing field between the group and non-group (individual) markets.
There are some economic efficiency arguments for doing this, but it's not going to help us control costs. Perhaps quite the opposite.
Freddie Gray's death on April 19 leaves many unanswered questions. But it is clear that when Gray was arrested in West Baltimore on the morning of April 12, he was struggling to walk. By the time he arrived at the police station a half hour later, he was unable to breathe or talk, suffering from wounds that would kill him.*
Gray died Sunday from spinal injuries. Baltimore authorities say they're investigating how the 25-year-old was hurt—a somewhat perverse notion, given that it was while he was in police custody, and hidden from public view, that he apparently suffered injury. How it happened remains unknown. It's even difficult to understand why officers arrested Gray in the first place. But with protestors taking to the streets of Baltimore since Gray's death on Sunday, the incident falls into a line of highly publicized, fatal encounters between black men and the police. Meanwhile, on Tuesday, a reserve sheriff's deputy in Tulsa, Oklahoma, pleaded not guilty to a second-degree manslaughter charge in the death of a man he shot. The deputy says the shooting happened while he was trying to tase the man. Black men dying at the hands of the police is of course nothing new, but the nation is now paying attention and getting outraged.
Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.
After a five-month delay, Loretta Lynch made history last week. On Thursday, the Senate confirmed Lynch as the next U.S. attorney general, the first African American woman ever to hold this Cabinet position. Her long-stalled nomination sometimes seemed in doubt, held hostage to partisan jockeying between Democrats and Republicans. But one political bloc never gave up, relentlessly rallying its support behind Lynch: the black sorority.
During her initial hearing, the seats behind Lynch were filled with more than two dozen of her Delta Sigma Theta Sorority sisters arrayed in crimson-and-cream blazers and blouses, ensuring their visibility on the national stage. These Delta women—U.S. Representatives Marcia Fudge and Joyce Beatty among them—were there to lend moral support and show the committee that they meant business. The Deltas were not alone. The Lynch nomination also drew support from congressional representatives from other black sororities: Alpha Kappa Alpha members Terri Sewell and Sheila Jackson Lee took to the House floor to advocate for a vote while Sigma Gamma Rho members Corinne Brown and Robin Kelly and Zeta Phi Beta member Donna Edwards used social media and press conferences to campaign on Lynch’s behalf.
Four hours after learning about Saturday's devastating earthquake in Nepal, I received a Facebook notification I had never seen before: Sonia, a journalist friend based in northern India, was "marked safe." An hour later, the same notification about a different friend popped up. Then another. Soon, several of my friends wrote that they, too, had learned via this strange new notification that their friends in Nepal were okay.
A few hours later, the mystery was solved. On Saturday afternoon, Facebook CEO Mark Zuckerberg announced on his timeline that the notifications came from Safety Check, a service the company launched last fall. "When disasters happen, people need to know their loved ones are safe," he wrote, "It's moments like this that being able to connect really matters."
In her new book No One Understands You and What To Do About It, Heidi Grant Halvorson tells readers a story about her friend, Tim. When Tim started a new job as a manager, one of his top priorities was communicating to his team that he valued each member’s input. So at team meetings, as each member spoke up about whatever project they were working on, Tim made sure he put on his “active-listening face” to signal that he cared about what each person was saying.
But after meeting with him a few times, Tim’s team got a very different message from the one he intended to send. “After a few weeks of meetings,” Halvorson explains, “one team member finally summoned up the courage to ask him the question that had been on everyone’s mind.” That question was: “Tim, are you angry with us right now?” When Tim explained that he wasn’t at all angry—that he was just putting on his “active-listening face”—his colleague gently explained that his active-listening face looked a lot like his angry face.
A magnitude 7.8 earthquake struck Nepal early on Saturday, centered 10 miles below the surface, less than 50 miles from the capital of Kathmandu. At least 2,200 are already reported to have been killed by the quake and subsequent avalanches triggered in the Himalayas. Historic buildings and temples were destroyed, leaving massive piles of debris in streets as rescue workers and neighbors work to find and help those still trapped beneath rubble. Below are images from the region of the immediate aftermath of one of the most powerful earthquakes to strike Nepal in decades. (Editor's note, some of the images are graphic in nature.)
“People skills” are almost always assumed to be a good thing. Search employment ads and you will find them listed as a qualification for a startling array of jobs, including Applebee’s host, weight-loss specialist, CEO, shoe salesperson, and (no joke) animal-care coordinator. The notion that people smarts might help you succeed got a boost a quarter century ago, when the phrase emotional intelligence, or EI, entered the mainstream. Coined in a 1990 study, the term was popularized by Daniel Goleman’s 1995 book . Since then, scores of researchers have shown how being in touch with feelings—both your own and other people’s—gives you an edge: compared with people who have average EI, those with high EI do better at work, have fewer health problems,and report greater life satisfaction.
There is a tendency, when examining police shootings, to focus on tactics at the expense of strategy. One interrogates the actions of the officer in the moment trying to discern their mind-state. We ask ourselves, "Were they justified in shooting?" But, in this time of heightened concern around the policing, a more essential question might be, "Were we justified in sending them?" At some point, Americans decided that the best answer to every social ill lay in the power of the criminal-justice system. Vexing social problems—homelessness, drug use, the inability to support one's children, mental illness—are presently solved by sending in men and women who specialize in inspiring fear and ensuring compliance. Fear and compliance have their place, but it can't be every place.
Soon, thousand of police officers across the country will don body-worn cameras when they go out among the public. Those cameras will generate millions of hours of footage—intimate views of commuters receiving speeding tickets, teens getting arrested for marijuana possession, and assault victims at some of the worst moments of their lives.
As the Washington Post and the Associated Press have reported, lawmakers in at least 15 states have proposed exempting body-cam footage from local open records laws. But the flurry of lawmaking speaks to a larger crisis: Once those millions of hours of footage have been captured, no one is sure what to do with them.
I talked to several representatives from privacy, civil rights, and progressive advocacy groups working on body cameras. Even among these often allied groups, there’s little consensus about the kind of policies that should exist around releasing footage.
In Baltimore, where 25-year-old Freddie Gray died shortly after being taken into police custody, an investigation may uncover homicidal misconduct by law enforcement, as happened in the North Charleston, South Carolina, killing of Walter Scott. Or the facts may confound the darkest suspicions of protestors, as when the Department of Justice released its report on the killing of Michael Brown.
What's crucial to understand, as Baltimore residents take to the streets in long-simmering frustration, is that their general grievances are valid regardless of how this case plays out. For as in Ferguson, where residents suffered through years of misconduct so egregious that most Americans could scarcely conceive of what was going on, the people of Baltimore are policed by an entity that perpetrates stunning abuses. The difference is that this time we needn't wait for a DOJ report to tell us so. Harrowing evidence has been presented. Yet America hasn't looked.