. . . 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show what the graph would look like if the approximately 35% tax subsidy we give to employer health care benefits were withdrawn: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.
Trump is replacing his national-security adviser with John Bolton, a persistent advocate of military intervention.
On Thursday, Donald Trump replaced a man who built the case for war with North Korea as a last resort with a man who just made the case for war with North Korea as more of a first resort. Trump announced that National-Security Adviser H.R. McMaster will be succeeded by John Bolton, the George W. Bush-era United Nations ambassador who has advocated for U.S. military action to prevent Saddam Hussein, Ayatollah Khamenei, and most recently Kim Jong Un from amassing weapons of mass destruction.
North Korea is an “imminent threat” to America because it is only months away from achieving the capacity to deliver nuclear warheads to the U.S. mainland, Bolton wrote in late February in The Wall Street Journal. Therefore “it is perfectly legitimate” for the U.S. to defend itself “by striking [North Korea] first.”
Gigantic piles of impounded, abandoned, and broken bicycles have become a familiar sight in many Chinese cities, after a rush to build up its new bike-sharing industry vastly overreached.
Last year, bike sharing took off in China, with dozens of bike-share companies quickly flooding city streets with millions of brightly colored rental bicycles. However, the rapid growth vastly outpaced immediate demand and overwhelmed Chinese cities, where infrastructure and regulations were not prepared to handle a sudden flood of millions of shared bicycles. Riders would park bikes anywhere, or just abandon them, resulting in bicycles piling up and blocking already-crowded streets and pathways. As cities impounded derelict bikes by the thousands, they moved quickly to cap growth and regulate the industry. Vast piles of impounded, abandoned, and broken bicycles have become a familiar sight in many big cities. As some of the companies who jumped in too big and too early have begun to fold, their huge surplus of bicycles can be found collecting dust in vast vacant lots. Bike sharing remains very popular in China, and will likely continue to grow, just probably at a more sustainable rate. Meanwhile, we are left with these images of speculation gone wild—the piles of debris left behind after the bubble bursts.
Before he was the national-security adviser, he wrote a lacerating account of generals who failed in advising Lyndon Johnson. What will he say now that he is free to talk about Trump?
“They have their exits and their entrances,” wrote Shakespeare, and so it is, as actors deliver frantic speeches while others leap, slide, or crawl on and off the stage.
Rex Tillerson said farewell to the Department of State much as he entered it: clueless about government service, clueless about his department, and clueless about his boss. He invoked the cliché of Washington as a “mean-spirited town”—as though executive suites in Houston were foreign to nastiness, and as though the capital were demonstrably short of the amiability that characterizes Chicago, Miami, Los Angeles, or Las Vegas. He could not accept the true diagnosis of his failure: that he had chosen to work for an immoral egomaniac who predictably treats his subordinates—and treated him—as shabbily as he has betrayed his wives and allegedly attempted to buy his sex partners.
Data misuse is a feature, not a bug—and it’s plaguing our entire culture.
After five days of silence, Mark Zuckerberg finally acknowledged the massive data compromise that allowed Cambridge Analytica to obtain extensive psychographic information about 50 million Facebook users. His statement, which acknowledged that Facebook had made mistakes in responding to the situation, wasn’t much of an apology—Zuckerberg and Facebook have repeatedly demonstrated they seem to have a hard time saying they’re sorry.
For me, Zuckerberg’s statement fell short in a very specific way: He’s treating the Cambridge Analytica breach as a bad-actor problem when it’s actually a known bug.
In the 17-months-long conversation Americans have been having about social media’s effects on democracy, two distinct sets of problems have emerged. The ones getting the most attention are bad-actor problems—where someone breaks the rules and manipulates a social-media system for their own nefarious ends. Macedonian teenagers create sensational and false content to profit from online ad sales. Disinformation experts plan rallies and counter-rallies, calling Americans into the streets to scream at each other. Botnets amplify posts and hashtags, building the appearance of momentum behind online campaigns like #releasethememo. Such problems are the charismatic megafauna of social-media dysfunction. They’re fascinating to watch and fun to study—who wouldn’t be intrigued by the team of Russians in St. Petersburg who pretended to be Black Lives Matter activists and anti-Clinton fanatics in order to add chaos to the presidential election in the United States? Charismatic megafauna may be the thing that attracts all the attention—when really there are smaller organisms, some invisible to the naked eye, that can dramatically shift the health of an entire ecosystem.
Lawmakers couldn’t reach an agreement to stabilize Obamacare or extend DACA in their omnibus spending bill, possibly dooming the issues until after the November elections.
Congress crammed something for just about everyone into the $1.3 trillion spending package unveiled on Wednesday—more money for the military, border security, the opioid epidemic, infrastructure, student loans, election security, and even a few modest measures to prevent gun violence.
But lawmakers whiffed on striking agreements on two of their biggest priorities of the last six months: stabilizing the individual health insurance markets under the Affordable Care Act and resolving the status of young undocumented immigrants protected under the Deferred Action for Childhood Arrivals program. Negotiations over both issues broke down in the final days leading up to a March 23 deadline for funding the government. And given the likelihood that the omnibus spending bill will be the last major piece of legislation enacted before the midterm campaign heats up, Congress may have missed its best chance to act either on DACA or Obamacare before the November election.
The Cambridge Analytica scandal is drawing attention to malicious data thieves and brokers. But every Facebook app—even the dumb, innocent ones—collected users’ personal data without even trying.
For a spell during 2010 and 2011, I was a virtual rancher of clickable cattle on Facebook.
It feels like a long time ago. Obama was serving his first term as president. Google+ hadn’t arrived, let alone vanished again. Steve Jobs was still alive, as was Kim Jong Il. Facebook’s IPO hadn’t yet taken place, and its service was still fun to use—although it was littered with requests and demands from social games, like FarmVille and Pet Society.
I’d had enough of it—the click-farming games, for one, but also Facebook itself. Already in 2010, it felt like a malicious attention market where people treated friends as latent resources to be optimized. Compulsion rather than choice devoured people’s time. Apps like FarmVille sold relief for the artificial inconveniences they themselves had imposed.
The president is surrounding himself with familiar faces from his favorite cable-news network—but may not find in them what he seeks.
Remember “bring in the grown-ups”? They have have all now been carried off, with the sole exception of Secretary of Defense James Mattis.
Instead, Trump is staffing his administration and his legal team with familiar personalities from his preferred cable-news channel—much like a frightened child pleading that his crib be stuffed with his TV-cartoon favorites.
Now perhaps the most important West Wing job of them all is to be filled by John Bolton, a figure with an authentic background in government, yes—he held a recess appointment as ambassador to the United Nations from August 2005 until December 2006—but whose achievements over the past dozen years have been posted principally in the field of television punditry.
How sugar daddies and vaginal microbes created the world’s largest HIV epidemic
VULINDLELA, South Africa—Mbali N. was just 17 when a well-dressed man in his 30s spotted her. She was at a mall in a nearby town, alone, when he called out. He might have been captivated by her almond eyes and soaring cheekbones. Or he might have just seen her for what she was: young and poor.
She tried to ignore him, she told me, but he followed her. They exchanged numbers. By the time she got home, he had called her. He said he wasn’t married, and she doesn’t know if that was true. They met at a house in a different township; she doesn’t know if it belonged to him. Mbali, who is now 24, also doesn’t know if he had HIV.
She enjoyed spending time with the man during the day, when they would talk and go to the movies. But she didn’t like it when he called at night and demanded to have sex, which happened about six times a month. When she refused him, he beat her. For her trouble, he gave her a cellphone, sweets, and chocolates.
Schools are moving toward a model of continuous, lifelong learning in order to meet the needs of today’s economy.
When the giant Indian technology-services firm Infosys announced last November that it would open a design and innovation hub in Providence, the company’s president said one of the key reasons he chose Rhode Island was its strong network of higher-education institutions: Brown University, the Rhode Island School of Design, and the Community College of Rhode Island.
In a higher-education system that is often divided between two- and four-year colleges and further segregated between elite and nonelite institutions, it’s not often that a community college is mentioned in the same breath as an Ivy League campus. Nor is a two-year college seen as a training ground for jobs in the so-called creative economy, which include industries such as design, fashion, and computer gaming that typically require bachelor’s degrees.
How evangelicals, once culturally confident, became an anxious minority seeking political protection from the least traditionally religious president in living memory
One of the most extraordinary things about our current politics—really, one of the most extraordinary developments of recent political history—is the loyal adherence of religious conservatives to Donald Trump. The president won four-fifths of the votes of white evangelical Christians. This was a higher level of support than either Ronald Reagan or George W. Bush, an outspoken evangelical himself, ever received.
Trump’s background and beliefs could hardly be more incompatible with traditional Christian models of life and leadership. Trump’s past political stances (he once supported the right to partial-birth abortion), his character (he has bragged about sexually assaulting women), and even his language (he introduced the words pussy and shithole into presidential discourse) would more naturally lead religious conservatives toward exorcism than alliance. This is a man who has cruelly publicized his infidelities, made disturbing sexual comments about his elder daughter, and boasted about the size of his penis on the debate stage. His lawyer reportedly arranged a $130,000 payment to a porn star to dissuade her from disclosing an alleged affair. Yet religious conservatives who once blanched at PG-13 public standards now yawn at such NC-17 maneuvers. We are a long way from The Book of Virtues.