I didn’t want to let this get away without commenting on it and a hat tip to Megan McArdle at Bloomberg for the graph above, the data for which are from the Bureau of Economic Analysis. The graph depicts the quarter on quarter changes in real healthcare spending from 1999 to 2013.

You may have heard that the rate at which healthcare costs have been increasing has been going down. That’s illustrated in this graph by the general downward trend from 2001 to 2012 (when you average the changes over the year for 2011 the overall trend is still slightly downwards despite the slight spike). However, that trend may have ended as illustrated by the spike in the third quarter of 2013, the highest rate of increase since the second quarter of 2004.

I think there are several things to keep in mind.

• As depicted these data are very noisy—there’s lots of up and down motion.
• Since June of 2012 the rate of change in spending has increased fairly sharply.
• This charge does not depict expenditures. It depicts the rate of change in real expenditures.
• Real expenditures are going up and they have been going up for decades.
• No one knows why expenditures have started going up again just as no one knows why they went down. No one knows if the recent increase in spending is a fluke or part of a trend.
• The CBO, etc. found that the slowing in the rate of change in spending could not be attributed to the PPACA.
• Real spending on healthcare is increasing, it’s increasing faster than incomes or non-healthcare spending, and that’s been going on for decades. That’s illustrated by the two quarters over the period of the last 14 years in which spending did not increase. That’s only two quarters out of more than 50.
• I really wish the graph went back another thirty years. If it did, what you’d see is very sharp increases from 1965 to 1980 with the rate of increase moderating considerably after that, roughly to what it is now. You would also see that the pattern is cyclical, i.e. they go up for a while, then they slow, they they go up for a while, and the pattern repeats.

This graph reflects intentional behavior. By that I mean that it’s not like weather patterns, the tides, or the motions of the planets. It’s more like a fencing match. Incentives matter. Different people engage in different behaviors and the net effect is what you see in a graph like the one above. Healthcare providers respond to changes in government policy. Individuals respond to changes in costs. Policymakers respond to political pressure.

Update

Fron the President’s Council of Economic Advisors, also using data from the Bureau of Economic Analysis, here’s a graph illustrating the growth in healthcare spending with a longer time horizon:

The portion at the far right of the graph, roughly from the 2002 spike to the present, illustrates the same data as are in the graph at the top of the page. As you can see typical growth rates in healthcare spending over the period have been at around 6%, with slower growth since about 2006. Remember, both of these graphs depict the rate of increase rather than just plain old expenditures.

Note that this chart completely bears out the thumbnail analysis I made in the body of the post:

very sharp increases from 1965 to 1980 with the rate of increase moderating considerably after that, roughly to what it is now. You would also see that the pattern is cyclical

If this Gallup poll is correct, Illinois residents are much more discerning than I gave them credit for. Illinois residents are less trusting of their state government than those of any other state in the union:

PRINCETON, NJ — Illinois residents trust their state government to handle their state’s problems far less than residents in any other state. Twenty-eight percent of Illinois residents trust their state government “a great deal” or “a fair amount.” In contrast, at least 75% of North Dakota, Wyoming, and Utah residents trust their state governments.

What’s a ten letter word that begins with ‘P’ and means you think that everybody is against you? That’s right. Perceptive.

Too soon you get old. Too late you get smart.

For some reason that doesn’t seem to prevent Illinois voters from returning the same misfeasant, malfeasant, nonfeasant shnooks to office year after year after year. Among other things I’d attribute that to the difficulty in getting on to the ballot here. Everything is stacked in favor of incumbents.

I’ve just published a foreign policy-related post at Outside the Beltway:

Who Needs Europe or the US?

Here I take note of an op-ed from Gazeta (in translation). Russia may just not be that into us.

If this is a fair characterization, I find it pretty disturbing:

After citing Jean-Jacques Rousseau’s (!) views on the shortcomings of representative democracy, Breyer quotes James Wilson, one of the Founding Fathers, who argued in a 1792 commentary that the First Amendment’s purpose was to establish a “chain of communication between the people, and those, to whom they have committed the exercise of the powers of government.” Again quoting Wilson, Breyer elaborates: “This ‘chain’ would establish the necessary ‘communion of interests and sympathy of sentiments’ between the people and their representatives, so that public opinion could be channeled into effective governmental action.”

And here’s how Breyer sums it all up: “Accordingly, the First Amendment advances not only the individual’s right to engage in political speech, but also the public’s interest in preserving a democratic order in which collective speech matters.”

The emphasis on “matters” is again Breyer’s. We’d have italicized “collective” as the key concept. As with the Second Amendment, he and the other dissenters assert a “collective” right, the establishment of which is purportedly the Constitution’s ultimate purpose, as a justification for curtailing an individual right.

from which I would infer that rather than the near-absolute protection on political speech that Justice Breyer believes the federal government has the legal power to groom political speech, nearly the inverse of what I would take as the First Amendment’s purpose.

Forget Justice Ginsburg. It may be time for Justice Breyer to retire.

I have repeatedly suggested fairly severe restrictions to various political activities like campaigning, fund-raising, lobbying, and so on. I recognize those would require constitutional amendment. Other liberal democratic countries, e.g. Germany, have such restrictions without having become a totalitarian hellhole. Germany is arguably more democratic than we are. Some of the measures I’ve suggested could also be implemented by reforms in Congressional standards of ethics, which I think is about as likely as cats foreswearing mice.

I find that deciding that the federal government already has those powers to be pretty remarkable.

The reason that GM didn’t live up to its legal responsibilities and recall millions of vehicles years ago isn’t because of the CAFE standards, as suggested by its new CEO, Mary Barra:

Federal regulations essentially prevented Detroit from building the small cars more cheaply offshore. That’s because the auto makers still had to meet stringent fuel-efficiency averages for all the cars they produced domestically. So in order to keep building the big vehicles they could make profitably, they had to churn out lots of fuel-efficient vehicles and somehow make them cheap enough to compete with cars produced by non-union workers.

Is this why GM didn’t make much earlier what seems like a relatively inexpensive fix? Ms. Barra suggested as much this week. “In the past,” she said, “we had more of a cost culture, and now we have a customer culture that focuses on safety and quality.”

I find that excuse, as the WSJ concurs, to be pretty threadbare. There are all sorts of ways that GM could cut costs. For example, they could cut executive pay. CEO pay now stands at roughly $14 million. It is obvious, except possibly to GM executives, that there’s room for cost-cutting there. The pay of top management pulls up the pay of the next layer of managers which pulls up the next layer and so on. And there are so many layers. You’d think that GM’s near-death experience would have impelled cultural change but, sadly, not enough:

Keep in mind that GM’s culture would have been turned upside down and might no longer exist if the government hadn’t preserved it. In the throes of the financial panic and recession, Chrysler and GM could no longer be sustained without help from Washington. In December 2008 they began receiving money from the Troubled Asset Relief Program. More aid came in 2009 when the feds engineered bankruptcies.

There’s plenty of room for flattening GM’s organizational structure. Why haven’t they done it?

GM’s cover-up of its defective switches persisted during the federal government’s oversight of GM. Either that oversight was quite superficial with the single-minded objective of preserving the labor unions or the federal government was complicit in the cover-up.

The 12-step programs say that the first step on the road to recovery is acknowledging that you have a problem. GM doesn’t seem to have taken that first step yet and the federal government has abetted the company’s failure to adapt.

Last month GM sold about 1,500 Volts. I guess that makes it worth it.

He was born Marcel LePlat in Pasadena. When he joined the Ballet Russe de Monte Carlo, its director, Leonid Massine, Russified his name to Marc Platoff. On Broadway and in Hollywood he was called Marc Platt.

He danced the “Dream Curly” in the original Broadway production of Oklahoma, was a lead in Hollywood musicals in the 1940s, and was the oldest dancing brother in the movie 7 Brides for 7 Brothers. He has died at the age of 100:

Platt, who celebrated his 100th birthday in December, died Saturday in a hospice facility in San Rafael, Calif. The cause was complications from pneumonia, said his daughter, Donna Platt.

He was born Marcel Emile Gaston LePlat in Pasadena on Dec. 2, 1913, the only child of a concert violinist and soprano singer. The family traveled a lot for performances and finally settled in Seattle. When his father died around the time of the move, his mother “got a job in Mary Ann Wells’ dancing school,” Platt said in a 1946 Hedda Hopper column that ran in the Los Angeles Times. “I wanted to help buy the bacon, so I got a job as an errand boy at the same school.”

But Wells saw his potential as a dancer, and after eight years of lessons, she arranged for him to audition for Ballet Russe when the company visited Seattle.

That was followed by Broadway and then by Hollywood. In later years he directed the ballet company at Radio City Music Hall, then ran a dancing school in Fort Myers, Florida. His last screen appearance was in a documentary in 2005. He just couldn’t get show business out of his blood.

He was an extraordinarily gifted performer.

In re the announcement that the FBI is opening a criminal investigation of Citigroup, Jonathan Weil of Bloomberg remarks:

The big story of the morning comes from New York Times reporters Ben Protess and Michael Corkery, although it’s important to remember that, in the U.S. these days, criminal investigations of large banks don’t result in criminal prosecutions of large banks, because the Justice Department for all practical purposes has deemed them immune: “Federal authorities have opened a criminal investigation into a recent $400 million fraud involving Citigroup’s Mexican unit, according to people briefed on the matter, one of a handful of government inquiries looming over the giant bank. The investigation, overseen by the FBI and prosecutors from the United States attorney’s office in Manhattan, is focusing in part on whether holes in the bank’s internal controls contributed to the fraud in Mexico.” Here’s what I’d like to know: What was Corbat’s basis for certifying that Citigroup’s internal controls were effective when the company filed its 2013 annual report? Because, at least from the perspective of an outsider looking in, they sure don’t seem like they were effective in all material respects.

I think we’ll find that this is theatrics or, more precisely, battlespace preparation. How are you going to extract large political contributions (not to mention justifying that million dollar job after getting out of government) if you don’t have a nice club to wield?

Today is Tally’s 16th birthday. Happy Birthday, Tally!

Every day with her these days is a blessing and a new adventure. She has difficulty negotiating the three stairs from the house into the backyard so I carry her down the stairs. I just stabilize her a bit when she’s on her way back in. We need to coax her to eat. Recently, I’ve taken to tempting her by adding bacon grease or melted pork lard to her food which she likes very much. I’m sure her teeth hurt her but she’s frail enough there’s not much we can do about them.

Somewhat to our surprise we got the pressure sore, the equivalent of a bed sore, on her right hip under control. She’s a bit unkempt in this picture but she really doesn’t think very highly of grooming these days.

Tally is the oldest Samoyed we’ve ever had and, I think, the oldest Samoyed I’ve ever met. When people ask “how old do Samoyeds get?” the usual answer is 12 to 14 years. She’s outlived the actuarial tables.

She’s still eating, pooping, walking around, doing her stuff. She’s still happy. As long as that’s the case I’m willing to do what I can to keep her that way.

When I saw the caption “Tillis, Berger Issue Joint Statement on Newly Discovered, Alarming Evidence of Voter Error and Fraud”, I presume I should be forgiven for expecting evidence of voter error and fraud. I was disappointed. What was actually presented were warning flags. Here’s an example:

765 voters with an exact match of first and last name, DOB and last four digits of SSN were registered in N.C. and another state and voted in N.C. and the other state in the 2012 general election.

That’s not evidence of actual fraud. I do think it suggests that more investigation is warranted.

Some of the numbers presented were actually pretty alarming:

155,692 voters with the same first and last name, DOB and last four digits of SSN were registered in N.C. and another state – and the latest date of registration or voter activity did not take place within N.C.

765 votes would not be enough to swing North Carolina’s statewide elections in 2012. They might have been enough to influence the House elections.

However, 765 votes would have been enough to change the outcome of the Minnesota election for the U. S. Senate, for example, which could have made the difference between the PPACA’s being passed or not.

I honestly don’t understand why progressives pooh-pooh claims of widespread vote fraud. It’s not like Bigfoot. There have been enough convictions in the courts that its existence can’t reasonably be disputed and in very close elections a few votes one way or another can make a difference.