I have just a few more observations on opioid abuse. In the New York Times article that sparked this line of inquiry by me, the editors cited Vermont and Massachusetts as examples for other states to follow. The most recent state report on opioid abuse in those states are here and here. Both have seen very small year on year decreases in prevalence and/or death due to overdose from 2017 to present—not statistically significant. I’m not pooh-poohing the steps taken by those states. It is simply too early to tell whether they have actually accomplished anything or the decrease is just random variation. Under the circumstances it’s hard to tell whether the NYT editors are reasoning from facts to conclusions or the other way around.

One last word. The entirety of the increase in opioid-related deaths in the U. S. could be attributed to fentanyl which our friends, the Chinese, are dumping in enormous quantities on the U. S. Sort of the reverse of the opium trade of the 19th century except it was Britain that was dumping opium on China. Wars were fought over it.

Yesterday I mentioned that the states with the highest prevalance of diagnoses of opioid use disorder didn’t comport with my preconceived notions. This article at U. S. News on the Congressional districts with the highest rates of opioid prescription does. All of the ten Congressional districts with the highest rates of opioid prescriptions are in Alabama, Arkansas, Kentucky, Oklahoma, or Virginia. The Congressional districts with the lowest rates of opioid prescriptions are in California, New York, or Virginia.

If you relate the graph in yesterday’s post with the tables in the article I’ve linked to today, a story emerges. Districts with very high median incomes and, presumably, very high rates of private insurance coverage have lower reported rates of opioid prescription. Districts with very low median incomes and, presumably, high rates of enrollment in Medicare have high reported rates of opioid prescription.

What lesson does Arlington, Virginia have for the rest of the country? That we spend too much money in Washington? Do the reported rates for private insurers comport with the actual rates?

I think we need to know more before we have enough information to start talking about policies.

I have to admit I was a bit baffled by this post at Brookings about making “wiser infrastructure investments” not the least reason for which is that they only include three bullet points:

1. Pooled procurement
2. Open source material competition
3. Eliminate or sharply reduce street parking in congested areas

which to my eye falls short by at least one bullet point. Even so the last point in particular rings false to my ear. Although 80% of Americans live in “urban areas” since the Census Bureau’s definition of “urbanized area” as having 50,000 or more people and “urban cluster” as having 2,500 to 50,000 people, that’s misleading. Both are included under the heading “urban area”.

Do you think of a town of 2,500 people as urban? Me, neither. But the Census Bureau does. The 48 urban areas with the largest populations account for just under two-thirds of the total U. S. population. But even that doesn’t tell the whole story. The central cities account for just a fraction of the total populations of those urban areas. In Chicago, for example, the population of the urban area is about 8.6 million and the percentage of the people in the urban area is about 31% of that. I live in Chicago, in what is considered the “central core”, and where I live is a residential area where reducing street parking would do exactly zero towards improving the allocation of infrastructure resources. Heck, where I live the most important thing that the city could do to improve the allocation of infrastructure resources would be to manage their projects competently or at least less incompetently. The street that runs in front of my house has been torn up for the last ten months and at least eight of those ten have been pure incompetence. But that’s a story for another time.

My point is that congestion parking is only an issue for a small fraction of a small fraction of the places where people live.

What can we actually do to spend our infrastructure dollars more wisely? Here would be my suggestions:

• Distinguish between investment and consumption
• Manage money better
• Convert public pensions from defined benefit to define contribution
• Focus on local government
• Establish priorities

“Investment” means that there is a quantifiable return over the life of the investment. Nowadays education and health care are being promoted as investment but in many cases they are actually consumption. A college degree is not an investment for many people. That’s something the statistics on lifetime earnings don’t tell you. Those statistics don’t talk about standard deviations for a good reason. Taking out a loan for $100,000 to get a Fine Arts degree is not an investment. Governments should concentrate on investment rather than consumption.

Borrowing to pay for infrastructure only makes sense under very specific circumstances. Here in Chicago where the population has been declining for the last 70 years it makes very little sense to borrow money to build a new road or bridge to serve today’s population when the debt you incur will be serviced by many fewer people.

Money spent on building a road here cannot be used to build a road somewhere else. Here in Illinois two-thirds of the state’s spending is spent on education, health care, or public pensions and all three of those will only increase over time. If we want to spend more on infrastructure, we need to get some sort of control over those other spending priorities. They crowd out all other priorities. In Illinois there is a desperate, urgent need to start converting defined benefit pensions to defined contributions. Doing that will require amending the state’s constitution and our politicians can’t bring themselves to do it.

Almost all infrastructure projects are decided on, financed, and managed by state and local governments. Forget about the federal government. It only contributes to building new roads not for maintaining the old ones. In the United States building a foot of road or bridge costs more than in an other developed country. To change that we need much better management at the state and local level.

We have lots of priorities. The environment, jobs that pay well, and better road, bridges, sewers, and other infrastructure are all priorities. We cannot maximize all of them simultaneously. We must choose. Over the last several decades infrastructure improvements have taken too great a backseat to other priorities. If you want better infrastructure, that has to change.

My four times great-grandfather, François Didier, arrived in St. Louis from France right around the time that Missouri became a state. I have no idea why he or his wife, Marie, emigrated or from where in France. They settled in Carondelet, a neighborhood in the extreme southeast of St. Louis on the banks of the Mississippi. At the time of his death in 1876 he left a considerable estate, valued at over $20,000, a substantial sum in those days.

François Didier and his wife had two sons, both born in France. The elder was my three times great-grandfather Hyacinth (spelled Eassaint in the federal census, an interesting study in linguistics). The younger was August Didier who married Philomene Constant, a member of one of St. Louis’s most prominent families. She is the reason that I wisecrack that members of my family were standing on the banks of the Mississippi selling real estate when the founders of St. Louis, Pierre Laclede and Auguste Chouteau, arrived.

Hyacinth predeceased his father and August became the guardian of my three times great-grandmother, Celestine Didier.

I have no idea how Celestine Didier, daughter of a prominent, wealthy family, met my great-great-grandfather, William Schneider, or much about his background. The 1880 federal census says he was a cigar-maker born in Wisconsin and his parents were born in Baden and Bavaria. He died quite young. The 1880s were hard on my family. Both my father’s great-grandfather Charles and my mother’s great-grandfather William died in the 1880s of tuberculosis. My mother met her great-grandmother once when Celestine was a very old woman. My mom told me that Celestine spoke only French.

Both August and Celestine became family names on that side of the family, borne by members of three generations. And that’s what I know of the Didiers.

And did those feet in ancient time,
Walk upon Englands mountains green:
And was the holy Lamb of God,
On Englands pleasant pastures seen!

And did the Countenance Divine,
Shine forth upon our clouded hills?
And was Jerusalem builded here,
Among these dark Satanic Mills?

I’ve been familiar with Blake’s poem, quoted above, for years. I always thought that “dark Satanic Mills” referred to factories. I didn’t think they meant newspapers. The editors of the Washington Post are concerned about Syria. They’re concerned that the civil war may end:

THE CIVIL war in Syria may be on the verge of another turn for the worse. Syrian government and allied forces are reportedly massing for a potential assault on the northern province of Idlib, one of the last areas of the country not under government control. Tens of thousands of rebel fighters are based there, including forces linked to al-Qaeda, along with some 3 million civilians, many of whom are refugees from other parts of the country. An offensive by the regime could mean thousands more deaths and drive a new wave of refugees toward neighboring countries, as well as Europe. Meanwhile, efforts by Iran to entrench itself in the country risk triggering a war with Israel.

National security professionals in the Trump administration appear to recognize these dangers. Last week, Secretary of State Mike Pompeo named a seasoned diplomat as special envoy for Syria, charged with reviving a U.N.-sponsored peace process. In a briefing, senior officials told reporters that U.S. forces based in eastern Syria would not be leaving anytime soon and insisted that reconstruction aid for government-controlled areas would be blocked until an acceptable political process was underway. On Wednesday, national security adviser John Bolton publicly warned the regime of Bashar al-Assad not to employ chemical weapons in any new attack and said the United States was determined to “deal with the presence of the Iranians.”

Any U.S. strategy in Syria would face steep obstacles, including the machinations of Russia, which claims to want to restrain the regime and remove the Iranians but, in practice, abets both. Yet the unique problem with this U.S. policy is that it is at odds with the stated positions of President Trump. Mr. Trump has repeatedly and bluntly declared that he wishes to withdraw U.S. forces from Syria as soon as possible; he has insisted on canceling U.S. stabilization aid to the area where those troops are deployed; and after meeting privately with Russian President Vladi­mir Putin in Helsinki last month, he appeared to endorse Russia’s plan for reconstruction, unlinked to any peace process.

These views come amidst the reports that not only did the lethal aid we gave to the “rebels” support Al Qaeda in Syria but so did the food aid that we delivered there. U. S. support for the rebels has been nothing less than Satanic, injuring not just the Syrians but us as well.

If we had really been concerned about reducing the death toll in Syria, we would have exerted all of our efforts to ending the civil war as quickly as possible. Instead we have done everything we could to maximize the death toll. If there is a better example of Conquest’s Third Law of politics than our policy in Syria, I don’t know what it might be.

After reading this New York Times editorial on the states where the rate of drug overdose has declined, I was filled with questions. First, why single out the responses in Massachusetts and Vermont? I got part of my answer from this article by Stoddard Davenport and Katie Matthews, from which the graphic above was sampled. The prevalence of opioid use disorder per 1,000 does not comport with my assumptions. I had thought it was a problem of poor Red States but, mirabile dictu, it is a much graver problem in rich Blue States. Both Massachusetts and Vermont have above-average state median incomes. Maryland has the highest median income (although I’d like to know the standard deviation).

Second, in what direction does the causality between insurance coverage and opioid use disorder go? Do states in which more people have health care insurance have higher incidence of opioid use disorder or do states in which people are more likely to use opioids have greater health insurance coverage?

Third, does the widespread use of naloxone result in fewer deaths due to overdosing or just fewer deaths relative to the number of overdoses?

Finally, which is the gravest problem? The rate of deaths due to overdose, the prevalence of opioid use disorder, or the role of physicians in both of the other problems? I don’t know the answers. I just have questions. It seems clear to me that these problems may have different solutions, indeed, the solutions may actually impede one another.

When my wife and I moved into the Sauganash neighborhood of Chicago from Evanston, Tony Laurino was 39th Ward alderman. A few years thereafter he resigned in the midst of a “ghost payrolling” scandal, dying while awaiting trial. His wife, one of his daughters, and her husband were convicted and served time in jail. Another daughter, Margaret Laurino, was appointed 39th Ward Alderman and has served as our alderman ever since. Her husband has been the ward’s Democratic committeeman; her nephew our state representative. The Chicago Tribune reports that Marge Laurino will not seek re-election in February:

Facing a likely tough re-election fight, longtime Northwest Side Ald. Margaret Laurino announced Friday she won’t seek another term.

Laurino was appointed by Mayor Richard M. Daley in 1994 to replace her father Anthony, who retired amid a ghost-payrolling investigation. Now, someone from outside her family is set to represent the 39th Ward for the first time since 1965.

One of Mayor Rahm Emanuel’s staunchest City Council allies, Laurino said in a statement Friday that she considered her professional and personal life in deciding against running for another term as alderman of the ward that touches the city’s northern border and includes tony Saugansh, Mayfair, North Park and parts of Albany Park and Old Irving Park.

“I have reviewed my professional commitments,” Laurino’s statement reads in part. “I have reflected on my personal life changes, such as my husband Randy retiring and my grandchildren Oliver and Emma. And I have decided that it is time to scale back my schedule. I will therefore not be seeking re-election as alderman of the 39th Ward.”

I like Marge personally. She’s a neighbor. But the sort of nepotism we have had in the 39th ward bothers me, she has been too much a rubberstamp for City Hall, and I don’t believe that Rahm Emanuel has been a good mayor for Chicago. I disagree with his policy of gentrification. He has mismanaged the city’s finances—a city that is shrinking cannot borrow its way to solvency. The city’s credit rating is the worst it has ever been and the worst of any other major American city. He has presided over the highest homicide rate per 100,000 population in the city’s history. It is not credible that he did not know about the Laquan McDonald video long before he acknowledged that he did. He bungled the teacher’s strike. If you’re going to capitulate to the union, why antagonize the union president? Why allow a strike at all? If you start to take Vienna—take Vienna.

At least in this part of the ward property taxes are a big issue. Over the last 30 years the value of my house has increased four-fold, my taxes have increased five-fold, and my income has increased three-fold, practically a microcosm of the U. S. Taxes are now at a confiscatory level and likely to move higher even as city services have deteriorated. We are starting to have violent crime in this neighborhood for the first time in my recollection.

Still, Marge’s retirement marks the end of an era. The first time in more than a half century that a member of her family has not been 39th Ward Alderman. I don’t what will follow.

I wish people would stop using the term “nation-state” incorrectly. A nation means a people, a group relatively homogeneous in language, culture, ethnicity, etc. “State” is generally synonymous with country. Finland is a nation-state; Hungary is a nation-state; Japan is a nation-state. When I employ a phrase I sometimes do, “the ethnic states of Europe”, I’m talking about nation-states.

“Nation-state” is not synonymous with “country”.

Pan-Arabism presupposes an Arab nation residing in the countries of Morocco, Libya, Tunisia, Egypt, Saudi Arabia, Jordan, and Iraq, most of which have non-Arab minorities.

The United States is not a nation-state. It never has been. Neither are India, Syria, Iraq, Mexico or Brazil. China is trying to decide whether it is a nation-state or or a multi-ethnic, multi-confessional empire. That’s not good news for the Uighurs, Tibetans, or any other Chinese people who aren’t Han Chinese.

I’m curious about something. How do we know about how much illegal activity takes place? How do we know the prevalence of illegal drug use? How do we know how much contraband of all kinds is brought into the country illegally? Or the number of people who’ve entered the country illegally? Or the crime rate among illegal immigrants?

In Chicago the “resolution rate”, the rate at which an arrest is made and a case goes to court, for homicides is around 15%. In other words we have no real idea of who the murderer was in 5 out of 6 cases. It is assumed they were gang-related because of the nature of the victims but we don’t really know.

Would there be policy implications if the numbers we’re assuming were twice what we’ve assumed they are? Or half? I would like to think so. That’s why I was so interested, for example, in “sewage epidemiology”. That’s an attempt at arriving at an empirical measurement of something that’s very hard to measure directly. I think we should be devising more such strategies. Models, interpolation, and extrapolation aren’t nearly enough.

We’re not the only ones who have this problem. I think that every large country has it. In China the people’s behavior frequently does not comport with what the official statistics say. People behave as though prices were rising out of control when the official statistics say they’re rising very slowly. Who do you believe?