I can’t manage to work up much ardor about the recent Supreme Court decision governing individual political contributions one way or another. If you’re looking for commentary on it I found these remarks by Robert VerBruggen at RealClearPolicy as good as any.

I’m not particularly libertarian when it comes to political contributions, lobbying, and political influence, generally. If I were king, I’d restrict paid political advertising on television severely, limit individual political contributions, prohibit contributions by non-individuals, prohibit lobbying any representatives other than your own, and other measures with an eye towards de-professionalizing politics. I have no illusions that anybody but I support such an idea.

I’ve just published a couple of foreign policy-related posts at Outside the Beltway:

That’s a Good Question

Jeffrey Tayler asks President Obama ten questions about the Ukrainian situation. Foreign policy does tend to happen to presidents, willy-nilly. It’s how the job is defined.

No Meltdown But the End of 10% Economic Growth for China

In this post I excerpt and remark on a good column by Martin Wolf in The Financial Times.

The editors of Bloomberg enter the lists on reforming the PPACA:

Now that the rush of enrollment has passed, the challenge is to identify and respond to at least three kinds of concerns. The first involves relatively narrow problems with the law itself. For example, many state-run exchanges are poorly run; states such as Maryland and Massachusetts need help to fix them in time for the next open enrollment period, which starts in November. The law’s programs to cushion insurers from excess risk may also need reinforcement — if not enough young people sign up for insurance — to lessen any shocks to premiums next year.

That leads to the second kind of problem — with the health-care system generally. This includes persuading still more young people to sign up next time; getting more doctors and hospitals to coordinate care, making good on the promise to make medicine more affordable; and smoothing the transition from employer-based coverage for people who lose it.

I’ve mentioned before the stated objectives of the PPACA:

The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs.

It’s just about four years since the PPACA was enacted into law and neither of those objectives has been effected. Some say that other worthwhile objectives have been acconmplished and those were, in fact, the real objectives. To believe that you must believe that the president and Democratic Congressmen have been lying. I prefer to believe that they genuinely believed that insurance reform would effect the changes that were the stated objectives.

But that can only be true if care and insurance are identical. Not just congruent. Identical. And they most definitely aren’t. Care is limited by the resources available for care and those resources are limited by design. Roughly a third of doctors won’t accept new Medicaid patients. About 10% of doctors (and 57% of psychiatrists) don’t accept insurance at all and that trend is increasing rather than decreasing. Among primary care providers more than 30% plan to stop practicing within five years (more than 50% among physicians over 50). There is already a critical shortage and that’s before you factor in an increased number of people seeking care.

We’d better all hope that excessive care-seeking by the insured is a figment of our imaginations.

I think the prospects for reforming the PPACA in any substantial way are very slim for the foreseeable future. They’ll fight it out on this line if it takes all summer.

the editors of the Chicago Tribune respond to Chicago Mayor Rahm Emanuel’s plan for addressing Chicago’s public pension problem:

Three years into his mayoral term — after campaigning on a promise to fix pensions — Rahm Emanuel finally is ready to file legislation that would reduce the city’s dangerously unfunded pension liabilities for municipal workers and laborers. Emanuel says he has a deal with those employees’ unions that would bring two of the city’s four funds for retirees closer to full funding. The agreement includes a mix of politically risky property tax increases and benefit cuts.

Note the operative word: two of the city’s pension funds. City Hall hasn’t come to terms with police and firefighters over the unfunded liabilities in their pension funds, or with teachers who work for Chicago Public Schools, a separate taxing body. Yet to stabilize just two of the funds, he already is proposing an increase in property taxes, to be phased in over five years.

Why has it taken the mayor so long? I can think of any number of reasons. He may have had the vain hope that the Illinois legislature would save the city. It’s far from a done deal that they will even approve his plan or whether once approved it would survive court challenge.

He may have hoped that an improving economy would render the question moot. That hasn’t happened.

He might have been too busy planning his next career move to formulate a plan.

Something that non-Illinoisans should keep in mind: the city is just one of dozens of independently taxing entities, all of whom will undoubtedly be increasing the property tax. Add to that the “temporary” increase in the personal state income tax which the governor has proposed be made permanent and the state’s persistent economic woes and we’re right on track to be the state with the highest taxes, the highest rate of unemployment, and the lowest state contribution to education.

For most people Illinois is only an attractive place to live when business in the state is good. Attracting blue chip businesses (which will only cut jobs going forward) with inducements in the favor of special tax treatment just puts the burden on companies and individuals who can’t get similar treatment is a lousy strategy. It appears to be the only strategy our state’s leaders have.

The editors of the Wall Street Journal take the opportunity provided by the original end of the open enrollment period of the PPACA to critique the week-old proposal for amending the PPACA proposed by the “ObamaCare 12”, the twelve Democratic senators who are up for re-election this year, all of whom voted in favor of the PPACA. I posted on the subject at the time. As you might expect, the WSJ editors aren’t impressed:

In an op-ed for Politico, Ms. Landrieu and Senate co-authors wrote, “let’s stop trying to score political points by turning up the rhetoric and instead roll up our sleeves and get to work.” But the fix-it ploy is all about political points, a way for these Democrats to distance themselves from ObamaCare while still embracing it. The only way their constituents can truly mend the problems their Senators voted to create is by defeating them in November.

Why are the twelve Democratic senators up for re-election nervous and what impact is the law likely to have on the November elections? I think it’s good to keep in mind that the PPACA polls differently in the states in which those senators are running for re-election than it does in the country at large. According to the RealClearPolitics index of polls nationally the law has an unfavorable approval rating of 40/52. In Louisiana 50% favor outright repeal; only 14% support expansion. In West Virginia 51% support repeal while 13% favor expansion. In Colorado 51% favor repeal while 30% favor expansion.

My own view is best summed up by Macbeth:

If it were done when ’tis done, then ’twere well
It were done quickly…

and Uwe Reinhardt’s characterization of the PPACA as an ugly patch on an ugly system that is largely a re-affirmation of that system.

The truly pressing need in healthcare reform is not insurance reform but cost control and I see the continuing bickering over the PPACA as a distraction from the more pressing need to the advantage of insurance companies and healthcare profiteers.

In response to a comment, I think that one of the biggest foreign policy mistakes we’ve made over the years is in not fostering the transition from autocracy to democracy properly in some of the countries we’ve supported over the years. That transition is like farming rather than flipping a switch or winning the lottery, something that happens in a single, wonderful stroke.

In Russia, Iraq, Egypt, the Palestinian territories, and even Libya we should have been offering incentives, both in the forms of carrots and sticks, for the autocratic governments to allow the formation of institutions that will, ultimately, lead to liberal democracies. Things like a free press, the rule of law, a robust system of civil law that products the rights of minorities and individuals, and an independent judiciary.

That’s the work of decades, even generations, and I think it’s likely we don’t have the patience for that kind of stewardship. If that’s the case we should prefer stability. Civil wars or chaos in which an order of magnitude more people are killed than the autocrats would have done do not work in our favor.

In the specific case of Egypt, our two best alternatives were either starting decades ago and fostering the development of the sorts of institutions mentioned above or else supporting Mubarak to the hilt. At least we would have had one friend in Egypt.

After echoing my remark of yesterday (“the end of the beginning”), Megan McArdle considers some of the things we still don’t know about the PPACA:

· How many people have bought and paid for policies

· How many people have signed up for Medicaid who weren’t eligible before 2010

· How many people who are buying insurance didn’t have insurance before

· How the new policies compare to the old policies

· How much subsidies are costing

Will we know the answers in due course? Insurance expert Bob Laszewski isn’t so sure:

We only need ask the carriers for two numbers:
The number of people they insured (and were paid for) in both the individual and small group markets as of December 31, 2013––the day before Obamacare started covering people.
The number of people that were insured (and paid for) in both the individual and small group markets on a specific date––March 31, 2014, for example.
I will suggest that asking for both the small group and individual market numbers is important as people have a tendency to move between the markets, particularly as employers drop coverage and their people go, or don’t go, into the exchanges.

Then subtract one total from the other. We would have an excellent idea of just how many more people, net of any gains and losses, secured private insurance since Obamacare’s launch.

It would probably be best if the administration answered some of the open questions as quickly as possible and certainly within the next several weeks. I can assure you from personal experience that, as Mr. Laszewski asserts, the carriers know the answers and can provide them very rapidly. Congressional Republicans have telephones,too.

Update

See also Charles Ornstein’s consideration of some of the same questions.

Some of the law’s supporters don’t care how effective the PPACA is or isn’t. It’s the idea of it they support and they’re convinced that they’ve secured their victory regardless of the law’s performance or actual results. We’ll know in due course.

Me auld mither had an expression, “It’s not the man but the cloth”, generally used to explain why she wouldn’t express open disrespect for someone in a position of responsibility. I think that ties directly to Bret Stephens’s catalog of explicit or implicit expressions of disrespect of President Obama on the part of leaders in Russia, Iran, Israel, Turkey, and Saudi Arabia.

Frankly, I think that at least in part they’re taking their cues from the open expressions of disrespect for the president being shown by his political opponents. Such expressions should be kept in the family and in a world in which even the most off-the-cuff utterance can make its way around the world in milliseconds, that’s darned hard to do.

So disagree, even vehemently, but don’t disrespect. If not for the man, for the cloth.

Robert Samuelson wonders if the slowdown in growth in the U. S. economy is permanent:

Economists’ pessimism emerges from their projections of “potential GDP.” GDP (gross domestic product) is the economy’s total output. Potential GDP is an estimate of what could be produced when everyone who wants a job has one and when businesses are operating at maximum capacity. Two factors govern the growth of potential GDP: changes in the number of workers (and time spent on the job) and changes in labor productivity. Productivity means “efficiency” and reflects many influences (technology, worker skills, management quality).

Potential GDP’s growth represents the economy’s speed limit when it’s near peak capacity. Trying to grow faster, it’s argued, will create shortages of workers, goods and services — and raise inflation. Even before the Great Recession, economists had lowered estimates of potential GDP, reflecting the anticipated exit of baby boomers from the labor force. But the recent revisions go beyond this widely predicted shift.

There are various explanations for why this may have occurred including demographic change, lack of “animal spirits”, reduced investment. Interestingly, he mentions a point I’ve made here frequently:

Another possibility is that the economy’s slowdown started before the crisis but was obscured by the artificial stimulus caused by the credit bubble.

I think the stage has been set for our economic problems for some time—twenty years or more—and a major factor is currency manipulation on the part of our trading partners. However, Mr. Samuelson also mentions a possible explanation that seems pretty likely to me:

Economist Robert Gordon of Northwestern University has argued that, since the early 1970s, technological advances have lagged and that the Internet boom of the 1990s was only a brief interruption. Naturally, productivity growth has suffered. Nobel Prize-winning economist Edmund Phelps of Columbia University, in his book “Mass Flourishing,” identifies a clash of values between what’s required for faster economic growth and what’s desired for personal security.

“Increasingly, the processes of a nation’s innovation — the topsy-turvy of creation, the frenzy of development, and painful closings,” he writes, are seen as something “that we are unwilling to endure any longer.”

This raises the question who is this “we”? As suggested earlier today some people are doing very, very well. My view is that they wouldn’t do nearly as well if we were following policies are than those we have and they’re fighting, successfully, to prevent us from adopting policies that would produce more robust growth. They’re just happy with the status quo.