The New York Times notes today that Medicare spending has flattened out over the past decade. They say that no one knows why its spending growth is now so low, but I'd put it differently. Here is medical inflation over the past 50 years:
The growth of medical spending has not always been sky high. In fact, for most of our history it grew only modestly more than overall inflation. It was only for a 15-year period between about 1983 and 1997 that medical inflation was high, and since then it's reverted to its historical average of 1-2% above overall inflation. In the past few years it's actually been lower than overall inflation.
So the way I'd put it is: Why did it take so long for Medicare spending to slow down? It should have started to flatten around 2000, but instead it kept rising all the way until 2010.
In any case, this is the basic reason for the flattening. There are other factors too, including policy changes under Obamacare, but the big underlying cause of the recent good news for Medicare is that there's been recent good news for all of health care.
Why peculiar? According to the Conference Board, job satisfaction declined steadily and by a large amount for more than 20 years from 1987-2010. Then it abruptly turned around and has risen steadily and by a large amount for the past 12 years from 2010-2022.
Why would this be the case? Job satisfaction seems to have nothing to do with recessions and nothing much to do with economic conditions in general. It wasn't improved by the dotcom boom and it wasn't hurt by the COVID pandemic. It just motored along.
Right now, job satisfaction is allegedly at its highest point in 35 years. This isn't because of Bidenomics or Trumpenomics or the Great Resignation or remote work or any of that. We've just been getting happier with our jobs every single year since 2010.
Why?
POSTSCRIPT: I should mention that Gallup's poll of job satisfaction is basically dead flat for this entire period. So maybe there's something wrong with the Conference Board's methodology? Or with Gallup's?
Here in California, state senator Aisha Wahab has introduced a bill to add caste to the list of groups protected from discrimination. It was subsequently watered down thanks to efforts from two members of the Assembly, Evan Low and Alex Lee. All three represent Silicon Valley, where nearly every immigrant Indian hails from one of the upper castes—mostly Brahmin or Kshatriya:
The affair has had repercussions for Wahab in her heavily South Asian district. It’s become a bitter lesson in the pitfalls of wading into nuanced cultural issues in an ever-more diverse nation.
....Lee’s office, which typically logs about 10 constituents providing a stance on a bill, received over 600 messages on SB 403. Just 26 were in support, according to a spokesperson. Low said that the ratio of opposition to support was “99 to 1.”
Indians will not ask outright what caste you are, as it’s seen as overly discriminatory, but they use more subtle methods to identify your place in the caste structure. “Sometimes they ask, ‘Are you vegetarian?’ If you say yes, they ask are you vegetarian by birth or by choice, before getting into which village you come from, because sometimes the village gives up your caste,” Sam said.
In more than 100 job interviews for contract work over the past 20 years, Kaila said he got only one job offer when another Indian interviewed him in person. When members of the interview panel have been Indian, Kaila says, he has faced personal questions that seem to be used to suss out whether he’s a member of an upper caste, like most of the Indians working in the tech industry.
As for the 99 to 1 opposition to Wahab's bill, I imagine you could have gotten something similar for a civil rights bill in Alabama in 1960. It doesn't mean the bill is bad. It means that caste bigotry is almost universal in Silicon Valley.
Jeff Stein in the Washington Post has an alarming story about the federal deficit that comes with this chart:
I was all ready to lay into this because the numbers seemed wrong. The CBO's most recent estimates for the federal deficit were $1.4 trillion in 2022 and $1.5 trillion in 2023. That's an increase of $100 billion, only a little bit more than inflation.
But Stein is right and I was wrong. There are two things that caused this:
In September 2022 the Treasury took a $430 billion charge for President Biden's student loan forgiveness program. In reality, that never happened, so spending was $430 billion less than the official figure.
There was a big decline in tax revenue late in 2023. The CBO estimated revenue of $4.8 trillion, but in reality it looks like revenues will come in at only $4.4 trillion.
Bottom line: The deficit in 2022 was $430 billion lower than the original CBO estimate while the deficit in 2023 is now projected to be $400 billion higher. This nets out to an annual increase of nearly $1 trillion rather than $100 billion—and this in turn produces an approximate doubling from 2022 to 2023. That said, if you extend the chart with projections for future years it looks a little less alarming:
2022 and 2023 are both outliers, and if the CBO's projections are correct the deficit has been steadily increasing since 2017 and will stabilize around 6% of GDP. That's very high, but perhaps not quite as alarming as a doubling from 2022 to 2023 would imply.
POSTSCRIPT: The lower spending figure for 2022 means that spending increased about 5.4% in 2023 after adjusting for inflation. That's considerably more than the -2.0% decline you get just by looking at the official numbers (which include the fictional student loan costs).
The Wall Street Journal asked Republican voters what they thought of the economy over the past year:
Here's the actual data for the past 12 months:
Real GDP: Up 2.5%
Inflation: CPI down from 8.4% to 3.3%
Jobs: Up 3 million
Stock Market: S&P 500 up 10%
Housing: Median home price down 7%
In fairness, I'd probably agree that things were getting worse if I spent all day marinating in Fox News, Donald Trump, right-wing Twitter, talk radio, and the Wall Street Journal editorial page.
Young Americans are the country’s most pro-union generation. Labor has poll ratings most politicians only dream about, and the Biden administration is making workers’ pay, benefits and rights its calling card.
....Heralds of change include well-publicized organizing efforts in new sectors of the economy, broad public sympathy for the Hollywood writers’ struggle, and big wage gains by workers increasingly willing to strike for them. There is also President Biden, the most outspokenly pro-labor president since Franklin D. Roosevelt and Harry S. Truman.
Hmmm. I would like to be equally optimistic, and it's certainly true that President Biden has made labor central to his presidency in a way other Democratic presidents haven't. Unfortunately, the last few years haven't been great ones for unions.
Private sector unionization continues to fall, declining to 6% in 2022. And although union members generally earn more than nonunion workers (about $1,150 per week compared to $1,000 per week), their wage gains have fallen behind:
Since 2012, union members have seen real wage gains of only 1.4% compared to 5% for nonunion workers. As much as I wish it were otherwise, this is not a sign of strong union health.
You've probably heard that wages have lately been going up faster for the poor than for the affluent. It's true:
Don't make too much of this, however. As you can see, nearly everyone is within about 1% of their pre-pandemic wages. The only exception is the very poorest, who are up 6%. But it's worth keeping in mind that this amounts to an increase of $32 per week over four years. It's better than nothing, but hardly enough to get excited about.
Rich Lowry: So let’s go to you, Phil Klein. Give us percentage odds Republicans will impeach Joe Biden one way or the other.
Phil Klein: I’d say about 70 percent that they’ll impeach him.
Charlie Cooke: I think it is slightly lower, maybe 60–40.
Michael Brendan Dougherty: 65 percent.
Lowry: Yeah, I think we’re all circling the same area. I might say 60 or 65.
Shazam! But why will he be impeached? The NR folks seem less interested in that, but a little earlier Cooke took a stab at it and the answer is.......surprise! It's all about Hunter Biden and his miasma of sleaziness:
I would just ask the question that I've asked before: Why? Why do we have a network of shell companies moving millions of dollars between them, with the president or his family as the ultimate destination? Why do we have pseudonymous email accounts exchanging emails with Joe Biden's son and his foreign business partners? What is the possible innocent explanation for that? I'm genuinely open to it. But I can't see one.
Cooke says he is genuinely open to innocent explanations, so here goes:
I don't know why Hunter Biden used offshore companies to handle his finances, but lots of people do. Who cares unless Joe Biden was involved with them?
"The president or his family" is doing a lot of heavy lifting here. There is zero evidence to suggest that Joe Biden was the recipient of any money from these accounts. The recipients were "his family," not "the president or his family."
White House folks have routinely used pseudonymous email accounts for years. They explained in 2013 that this was a way of having email channels that weren't instantly clogged with hackers and spam. Barack Obama had one too.
These private accounts have no impact on FOIA. The National Archives has repeatedly explained that they scan all email accounts belonging to a person when they get a FOIA request.
One of the emails allegedly informs Hunter of a phone call that Joe Biden has scheduled with Ukraine's president. But this is no smoking gun. In reality, it's an email from a White House aide that has Joe Biden's daily schedule attached. This schedule includes an entry for Biden's return to Wilmington for the one-year anniversary of Beau Biden's death. It's only a coincidence that it also happens to include a phone call with Ukraine's president.¹
Some emails from Hunter's firm have been released that include requests for White House tours. That's as scurrilous as it gets. There are no emails between Joe Biden and Hunter's "foreign business partners."
So that's it. Innocent explanations all around.
¹The call was about a Ukrainian pilot being held in Russia. It had nothing to do with Burisma or anything else related to Hunter.
Bridgette Exman, an assistant superintendent in Mason City, Iowa, describes how she tried to comply with her state's new law banning books in schoolrooms that contain “descriptions or visual depictions of a sex act”:
We created a list from several lists of commonly challenged books, then deleted from our list any book challenged for reasons other than sexual content. We then further winnowed our list to books in our school library collections.
That’s when we turned to ChatGPT for help. For each of these titles, we asked: Does the book contain a description of a sex act? ChatGPT identified 19 books, though for each, its response contained a caveat: “Yes, but,” noting a scene’s literary value or contextual appropriateness.
That sounds very clever to me! Oddly, not everyone thought so, even though Exman and her fellow humans read through all the books flagged by ChatGPT to make sure they really did contain sex acts.
In other words, it's not as if AI was busily censoring books here. It was the Iowa legislature that did it, and Exman was legally required to comply. Given that, what's wrong with a bit of labor-saving help for an onerous job she never wanted to do in the first place?
Needless to say, people were also upset about the particular books that were removed. One of them was Toni Morrison's Beloved, undoubtedly for this passage:
All forty-six men woke to rifle shot....When all forty-six were standing in a line in the trench, another rifle shot signaled the climb out and up to the ground above, where one thousand feet of the best hand-forged chain in Georgia stretched. Each man bent and waited.
....Kneeling in the mist they waited for the whim of a guard, or two, or three. Or maybe all of them wanted it. Wanted it from one prisoner in particular or none—or all.
"Breakfast? Want some breakfast, nigger?"
"Yes, sir."
"Hungry, nigger?"
"Yes, sir."
"Here you go."
Occasionally a kneeling man chose gunshot in his head as the price, maybe, of taking a bit of foreskin with him to Jesus.
Is this appropriate for school kids? That's a matter of opinion. Personally I think it's fine. But then, we could buy subscriptions to Hustler for every five-year-old in America and I'd be OK with it. Obviously my opinion is not a widely held one. But regardless of how you feel about it, how bad is it that in a gray area like this Iowa has one opinion while, say, California has a different one?
I suppose this makes me a bad liberal, but I can't get too worked up about all this. It's not as if Beloved is banned from the entire state of Iowa, after all. It's just considered inappropriate for Iowa school libraries. Maybe that's out of touch with modern mores, but it's hardly the end of civilization.
The growth of medical spending has not always been sky high. In fact, for most of our history it grew only modestly more than overall inflation. It was only for a 15-year period between about 1983 and 1997 that medical inflation was high, and since then it's reverted to its historical average of 1-2% above overall inflation. In the past few years it's actually been lower than overall inflation.
