As I watched this presentation at Bloomberg on how Americans die, something occurred to me that I hadn’t thought about before. I wonder what the long-term economic implications of the significant number of men aged 25-44 who died of AIDS between about 1980 and 1994 will be?

Something sobering but not particularly surprising from the presentation: over the last half dozen years or so there’s been a notable uptick of deaths due to suicide or drug use.

Something else that’s not particularly surprising: the stuff that gets the most attention in the media isn’t necessarily the stuff that’s most important.

If you’re convinced that searching for metrics for the performance of the PPACA is a sure sign of a concern-trolling Republican hack, you might want to take a look at this post from Lambert Strether at naked capitalism:

When you force people to purchase a crapified product under penalty of IRS enforcement, it’s entirely natural they’ll resent it, and think ill of the people and the institutions that forced compliance on them. If Krugman were the sort of New Deal Democrat who put all that good will on the Party balance sheet for Obama to piss away, that’s what he’d be focusing on: Not the sign-up metric, but metrics that show whether concrete material benefits are being delivered to citizens by public policy. Instead, he’s epater-ing le Republicans and beating the tribal pom poms.

Sean Trende of RealClearPolitics considers what it would take for Democrats to win seats in the Senate in the fall, rather than losing seats and, possibly, the house as analysts including himself and Nate Silver expect:

For Democrats to gain seats this cycle would be the equivalent of drawing a straight flush. With that said, straight flushes do occur, so it’s worth examining how it might occur here.

Here are the conditions he suggests under which Democrats could eke out a victory:

1. The president’s approval rating goes up sharply, enough to lift “the collective Democratic boat”.
2. All four “red state” incumbent Democrats (Mary Landrieu, Kay Hagan, Mark Pryor, and Mark Begich) win.
3. Democrats win at least one of the three open seats.
4. The Republican candidate loses in one or more of the notionally solid Republican states (Kentucky, Georgia, Kansas, Mississippi, and South Carolina).

I agree with Mr. Trende that those are a lot of “ifs”. However, as I’ve long contented, while all of those pieces falling into place isn’t particularly likely for some of them to happen is a lot more likely which is why I think we’ll have a 50-50 Senate in 2015 which means that Democrats retain control of that house.

Update

Hammering home a point I’ve made for some time, Harry Enten of FiveThirtyEight points out the states in which President Obama’s approval rating hurts the Democratic Senate candidates’ chances: North Carolina, Louisiana, Kentucky, Alaska. Which seats are most important to Democrats’ holding on to the Senate? North Carolina, Louisiana, and Alaska.

One interesting race is Georgia. In Georgia the president doesn’t hurt the Democrat’s chances of winning. In that race whichever Democrat wins the Georgia primary will still be an underdog but with a weak Republican candidate Georgia could still move into the Democratic column.

Examination of the chemical composition of the teeth of people interred in ancient Cahokia has determined that a considerable portion of the population grew up elsewhere:

Teeth that form in infancy, for example, like the first permanent molars, will reveal a person’s location as a newborn, while those that form in the early teens, like the third molars, will bear the chemical traces of their home in adolescence.

Armed with this technique, Slater’s team studied 133 teeth from 87 people, found in 13 different burial contexts throughout American Bottom.

The results showed that 38 of the teeth, about 29 percent, had strontium ratios that were outside the local range, indicating that those people had been born and raised elsewhere and migrated to Cahokia as adults.

Interestingly, the remains of those believed to have been sacrificial offerings are more likely to be those of locals than other remains.

The Cahokia mounds, which flourished between about 600 BCE to 1400 CE, constitute the largest and most complex pre-Columbian North American city north of Mexico. Artifacts found there suggest that it traded over an enormous area, from the Gulf of Mexico to the Great Lakes. And, as we are learning, it may have attracted people from an equally great range.

If you ever find yourself in downstate Illinois, it’s well worth a visit.

This year marks the centennial year of my dad’s birth. He was born above a saloon located at 14th and Clark in St. Louis, Missouri on October 10, 1914. Nowadays that’s a parking lot across the street from the ScottTrade Center but a century ago it was a gritty urban neighborhood right around the block from City Hall.

Over the course of the next year I plan on posting regularly about my dad and the times he grew up in. I write for multiple audiences here and one of them is my siblings and their kids. I think it’s important that I pass on what my dad told me. It might even prove interesting for a more general audience.

If not, bear with me.

I don’t use recreational drugs. Never have. There are several reasons for that. For one thing, the only thing I really have going for me is my brain and I’ve never felt that putting that at risk was worth it. Additionally, my family tends to have what are referred to as idiosyncratic or paradoxical reactions to drugs. You know those warnings in fine print that you receive on the handouts that accompany prescription medicines these days? The ones that begin “In some rare cases…” That’s me. Example: one of my siblings was recently prescribed post-operative pain medication. It induced extreme pain.

All of that notwithstanding I’ve long felt that marijuana should be legalized or, at the very least, it should be legalized for medical purposes. However, findings like this make me wonder about the prudence of that course of action:

Young adults who used marijuana only recreationally showed significant abnormalities in two key brain regions that are important in emotion and motivation, scientists report. The study was a collaboration between Northwestern Medicine and Massachusetts General Hospital/Harvard Medical School.

This is the first study to show casual use of marijuana is related to major brain changes. It showed the degree of brain abnormalities in these regions is directly related to the number of joints a person smoked per week. The more joints a person smoked, the more abnormal the shape, volume and density of the brain regions.

“This study raises a strong challenge to the idea that casual marijuana use isn’t associated with bad consequences,” said corresponding and co-senior study author Hans Breiter, M.D. He is a professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and a psychiatrist at Northwestern Memorial Hospital.

“Some of these people only used marijuana to get high once or twice a week,” Breiter said. “People think a little recreational use shouldn’t cause a problem, if someone is doing OK with work or school. Our data directly says this is not the case.”

The study was small and local and, honestly, there could be other explanations for the results they found but it’s interesting.

Abnormal development in the areas of the brain they studied is associated with abnormal responses to learning, fear, aggression, and impulsivity, just to name a few. If there’s anything we need more of, it’s indifferent or unmotivated kids with learning difficulties.

As I see things, the present spirit of the times is moving in the direction of some sort of legalization of marijuana. We might want to think about some of the more longitudinal implications of that before getting too far down that road.

The graph above accompanies the very interesting post by Tom Liu at The Incidental Economist on how we can be confident that the PPACA hasn’t caused healthcare costs to fall which I recommend you read in full:

While reducing unnecessary utilization is one goal of ACA delivery system reforms, those reforms didn’t predate the signing of the law. For example, the Medicare Shared Savings Program and Pioneer ACO programs weren’t launched until 2012. And they are still finding their footing—of the 32 Pioneer ACOs (arguably best poised to achieve utilization reduction), only eight of them significantly slowed cost growth relative to their local markets in their first year. More dramatic value-based models such as Iora Health or Qliance, which can claim inpatient reductions of up to 41%, are only just beginning to achieve scale.

Something else must be causing the slowdown in utilization growth over the last decade.

What caught my eye in the graph above was how neatly it illustrates the point I’ve been making, the importance of not merely reducing the rate of increase of healthcare spending but actually reducing the spending. Note the labeling of the graph at left. Spending is divided into two components, a price component and a utilization component. The topline green line is the total increase in the rate of spending. That line has been above zero every single year for the last twenty years, i.e. real healthcare spending is rising monotonically. Actually, that’s been the case for the last forty years.

I would be remiss in not mentioning that to at least some degree the distinction between prices as a driver of spending an utilization as a driver of spending is specious. Physicians create utilization. An alternative interpretation to the last few years of that graph are that as the rate of increase in prices decline the rate of increase in utilization rose to maintain a more-or-less constant rate of increase.

Let’s do a thought experiment. Imagine a country in which healthcare spending, education, and defense spending account for a third of the economy and all of that spending is government spending. If spending in those three categories alone rise just 3% and general rate at which prices are increasing is 1%, those three categories account for 100% of the growth in the economy.

Now imagine that every dollar in those three sectors results in fewer people being employed than in any other sector of the economy. That’s a country in which fewer people will be able to find jobs every single year.

Now, there are two distinct strategies for addressing the obvious problem that presents. One is for those three sectors to start employing more people at lower wages than they’re accustomed to. The other is for the growth in those three sectors to be less than the average growth in the economy outside of those three sectors. In some years it might be a little more, in some a considerably less, but on average the growth would be less than the growth outside of those three sectors. That would be an economy in which more people would be employed each year, allowing for what’s quaintly known as “the natural increase”.

My thought experiment is over-simplified but IMO it’s a reasonable simulacrum of the actual economy. My assessment has been that it will be easier to contain spending in those three sectors than to change how they operate in more drastic ways, e.g. having much, much more of the actual work now being performed by physicians being performed by twice as many technicians and other practitioners who are being paid a third what today’s physicians are (for example). That’s why I think that healthcare spending must fall.

I am somewhat surprised to see Megan McArdle entering the lists of the conspiracy-minded. Here’s her reaction to the announcement that the Census Bureau is changing the questions it will ask in its regular survey so that we will never know confidently how many more people have received healthcare insurance as a consequence of the PPACA:

I’m speechless. Shocked. Stunned. Horrified. Befuddled. Aghast, appalled, thunderstruck, perplexed, baffled, bewildered and dumbfounded. It’s not that I am opposed to the changes: Everyone understands that the census reports probably overstate the true number of the uninsured, because the number they report is supposed to be “people who lacked insurance for the entire previous year,” but people tend to answer with their insurance status right now.

But why, dear God, oh, why, would you change it in the one year in the entire history of the republic that it is most important for policy makers, researchers and voters to be able to compare the number of uninsured to those in prior years? The answers would seem to range from “total incompetence on the part of every level of this administration” to something worse.

I think as good an explanation as any is that the good folks at the Census Bureau are merely justifying their jobs. If you never change anything in the surveys, why would you retain people who write surveys or figure out how to improve them? That the timing of the change is good for the administration is just a lagniappe.

Besides, as supporters of the PPACA have demonstrated time and again, they don’t really care about the practical impact of the legislation. It’s the idea of it they like.

The Watcher’s Council has announced its winners for last week.

Council Winners

• *First place with 5 votes!Joshuapundit –Yes, The Peace Talks Are Dead – And An Opportunity For Real Peace Comes Alive
• Second place with 3 1/3 votes –Bookworm Room – We don’t have a “gay mafia,” we have a “gay Soviet”
• Third place with 1 2/3 votes –Liberty’s Spirit – An Open Letter to the Jewish-American Community: What is wrong with you?
• Fourth place with 1 1/3 votes –The Noisy Room – The Cuban Spring That Never Was – A Social Networking Petri Dish
• Fifth place *t* with 2/3 vote –Ask Marion – The Elephants in the Room
• Fifth place *t* with 2/3 vote –The Colossus of Rhodey – Mozilla CEO forced out due to radical P.C.
• Fifth place *t* with 2/3 vote –The Right Planet – Video: Common Clod Jeb Bush Launches Ad Campaign Promoting Common Core
• Fifth place *t* with 2/3 vote –Nice Deb – The Curious Case of Obama’s Cancelled State Dinner In Saudi Arabia

li>Sixth place *t* with 1/3 vote – The Glittering Eye –The Distraction

li>Sixth place *t* with 1/3 vote –The Razor – Obamacare Tax Is Here for Individuals Too

Non-Council Winners

• First place with 3 1/3 votes! – Matt Walsh – Hey gay rights militants: your fascism is showing submitted by Joshuapundit
• Second place with 2 votes – Qanta Ahmad/National Review – Honor Diaries: Silencing Speaks Volumes submitted by Liberty’s Spirit

li>Third place with 1 2/3 votes –Victor Davis Hanson–America’s New Anti-Strategy submitted by Bookworm Room

• Fourth place with 1 1/3 vote–Bryan Preston/PJ Tattler –Massive Vote Fraud Discovered in NC’s 2012 Election submitted by Nice Deb
• Fifth place *t* with 1 vote –Sultan Knish –A World War of Community Organizers submitted by The Noisy Room
• Fifth place *t* with 1 vote – Carnegie Europe – Dangers of German Strategy submitted by GrEaT sAtAn”S gIrLfRiEnD
• Fifth place *t* with 1 vote –Michael Quinn Sullivan – Constitution Doesn’t Matter submitted by Rhymes with Right
• Fifth place *t* with 1 vote–The Other McCain – ‘Highly Intoxicated Vaginal Penetration’:RapeCulture and Campus Reality submitted by Watcher
• Sixth place *t* with 2/3 vote –The Daily Dish – The Hounding of a Heretic submitted by The Glittering Eye
• Sixth place *t* with 2/3 vote –The Blaze – What if an ex-KGB officer predicted that the USSR would fake its own collapse to ultimately defeat the West … and no one listened? submitted by The Right Planet
• Sixth place *t* with 2/3 vote –The Centre Left – The Guardian reaches a new low (iii) submitted by Simply Jews
• Seventh place *t* with 1/3 vote – Andrew Stiles/Washington Free Beacon – Harry Reid Took Money from Koch Lobbyist submitted by Ask Marion
• Seventh place *t* with 1/3 vote –Yevgen Sautin/The American Interest –Russia’s Next Move in Ukraine submitted by The Razor

The announcement post at the Watcher’s site is here.