We’re presently being inundated with showings of the television ad above. It doesn’t say anything I haven’t said a dozen times but it does say it pretty dramatically.

I think it will be very difficult for Rauner to be re-elected. Even more unfortunately it will be a victory for the do-nothing legislature in Springfield. I see little hope for Illinois if another governor who will just rubber stamp everything Madigan wants to do is elected but that’s likely what will happen.

If Democrats have a plan for resuscitating Illinois, I’d certainly like to see what it is. As it is it looks like their policy is that the beatings will continue until morale improves.

What more is there to be said about the terrorist attack in New York City yesterday that hasn’t already been said? Terrorist attacks are clearly retail as well as wholesale, something law enforcement has no means of stopping that aren’t draconian.

That’s exactly what the French, at even graver risk of such retail terrorist attacks than we are, have done. They have imposed what appears to be a permanent state of emergency and certainly appear to be moving inexorably towards becoming a police state. Égalité, oui. Liberté, non.

The most obvious response for the United States is also the longest overdue: we should abolish the diversity visa program. It has served its purpose and outlived its rationale. Now it poses risks that weren’t imagined when it was enacted into law. How much benefit do the citizens of the United States derive from randomly selected Uzbeki immigrants? Is it greater than the risk posed by randomly selected Uzbeki immigrants?

I also wonder if the murderer’s wife has been taken into custody. It is not credible to me that she didn’t know what her husband was preparing to do. If she isn’t in custody and hasn’t flown already, expect her to flee. That’s been the pattern.

This article at Atlantic opens a discussion of something that I think is a critical issue for the use of artificial intelligence in health care:

At a large technology conference in Toronto this fall, Anna Goldenberg, a star in the field of computer science and genetics, described how artificial intelligence is revolutionizing medicine. Algorithms based on the AI principle of machine learning now can outperform dermatologists at recognizing skin cancers in blemish photos. They can beat cardiologists in detecting arrhythmias in EKGs. In Goldenberg’s own lab, algorithms can be used to identify hitherto obscure subcategories of adult-onset brain cancer, estimate the survival rates of breast-cancer patients, and reduce unnecessary thyroid surgeries.

It was a stunning taste of what’s to come. According to McKinsey Global Institute, large tech companies poured as much as $30 billion into AI in 2016, with another $9 billion going into AI start-ups. Many people already are familiar with how machine learning—the process by which computers automatically refine an analytical model as new data comes in, teasing out new trends and linkages to optimize predictive power—allows Facebook to recognize the faces of friends and relatives, and Google to know where you want to eat lunch. These are useful features—but pale in comparison to the new ways in which machine learning will change health care in coming years.

which is how can our present regulatory framework deal with machine learning? The topic is particularly thorny in that even the designers of the algorithms can’t tell you why the program reaches the conclusions it does.

It’s also why I think that a likely scenario is that not just the United States but all countries with large health care systems and sophisticated regulatory frameworks are likely to become technological backwaters in health care. When the choice is between a computer program and nothing, the computer program is going to look much more attractive.

You might want to read this article at The Nation on a report that presents a post-mortem of the 2016 presidential election that is discordant with the prevailing narrative:

The Democratic Party lost just about everything in 2016, but so far it has offered only evasive regrets and mild apologies. Instead of acknowledging gross failure and astounding errors, the party’s leaders and campaign professionals wallowed in self-pity and righteous indignation. The true villains, they insisted, were the wily Russians and the odious Donald Trump, who together intruded on the sanctity of American democracy and tampered with the election results. Official investigations are now under way.
While the country awaits the verdict, a new and quite provocative critique has emerged from a group of left-leaning activists: They blame the Democratic Party itself for its epic defeat. Their 34-page “Autopsy: The Democratic Party in Crisis” reads more like a cold-eyed indictment than a postmortem report. It’s an unemotional dissection of why the Democrats failed so miserably, and it warns that the party must change profoundly or else remain a loser.

Reading the particulars of this critique, I had the impression that maybe the party got what it deserved in 2016. I do not mean that Trump deserved to win. Indeed, “Autopsy” mentions Trump’s campaign largely in passing, and the Russians only once. But this analysis does suggest that Trump became president mainly because the Democratic campaign was inept, misguided, smug, and out of touch with the country.

While the report does address the cul de sac into which identity politics is leading the Democrats, it doesn’t seem to come to terms with an even more basic problem, as great for Republicans as it is for Democrats. Professionalization is the doom of political parties. When you professionalize every aspect of politics, it is inevitable that you will not believe you need the voters and you will show it.

All of the major news outlets are full of news about yesterday’s indictments of individuals who figured highly in Donald Trump’s presidential campaign, to the exclusion of all else. I continue to be content with letting the process work.

To summarize where things stand now:

• Going to foreigners and/or foreign governments for opposition research: ugly but not illegal.
• Lobbying for foreign governments without registering, money laundering, and lying to the FBI: illegal.
• Russia’s objectives in its activities in the 2016 election appear to have been to discredit the American system.
• It worked, probably beyond their wildest dreams.
• In that light it makes sense that they would focus their efforts on Hillary Clinton. Like most of us they thought she was going to win.

Have I missed anything?

I don’t think that foreigners or foreign governments should interfere in other countries’ elections. I don’t think that Russia should do it. I don’t think that we should do it. Other than by being honest and open I’m not sure how it can be prevented.

I disagree pretty fundamentally with Christian Caryl’s piece in the New Republic, “Why Democracy Didn’t Work in Russia”. I think that there are any number of reasons that liberal democracy hasn’t flourished in Russia following the collapse of the Soviet Union. Here are three.

First, institutions matter. After the collapse of the Soviet Union the only functioning institutions in Russia were the military, the KGB, organized crime, and to some extent the Orthodox Church. Those are the institutions that form the foundations for today’s Russia.

Second, Russia has no tradition of liberal democracy. Certainly none of the institutions listed above has any tradition of liberal democracy or any interest in it for that matter.

Third, the transition was bungled, abetted by the West. What needed to happen was a much more gradual transition during which liberal democratic institutions like a free press or an independent court system could be nurtured. We should have been willing to foster that. Instead the transition was abrupt and you can see the results.

Was the outcome we see inevitable? I don’t think so. Was the outcome inevitable given the sudden collapse of the Communist Party and the whole Soviet system followed by an overly rapid transition away? I believe it was. It was at least a foreseeable consequence and we’re partially to blame.

At RealClearPolicy Gary Wolfram proposes what looks to me to be a dystopian plan for health care reform:

A solution much more likely to aid the poor is for the government to move Medicaid and Medicare to a form of health savings account. It would provide complete coverage for catastrophic care, and fund an account for recipients that they could use on health care spending. This would cause people to ask “How much does that test cost here versus another clinic?” This in turn would incentivize places like Wal-Mart having to employ nurse practitioners at their pharmacy who can provide health care at reasonable prices. Additionally, it would also spur innovation in medical techniques and pharmaceuticals that make people healthier at lower costs.

Such programs would only be available to the bottom 20 percent of the income distribution, with a phase out of the benefit as income rose. And eliminating the tax deductibility of employer-based insurance or allowing a deduction for private insurance premiums would prompt a move to individual health insurance policies rather than employer-provided insurance. The result would end the fear of losing insurance due to unemployment.

Note that this plan only renders the consumer side of the health care equation “market-based”. The vast array of regulations and subsidies given to providers including patents, occupational licensing, certificates of need, etc. would remain in place.

If Medicare is eliminated, how would the present residency system be funded? Presently the Medicare system pays about $80,000 for every medical resident, an enormous subsidy to medical education. Would the subsidy be paid from the general fund or would it be eliminated?

His proposed system would only result in reduced spending if two things happen: there is presently considerable over-utilization and reduced consumption would not be made up for with increased prices, i.e. producers will accept pay cuts. Dr. Wolfram appears unaware that nearly all health care consumption is directed by producers rather than patients.

It seems more likely to me that medical billing would rise, whether through higher prices or more procedures, to make up for the elimination of Medicare and Medicaid spending. The elderly who don’t fall within the bottom 20% of the income distribution would be penurized and more and more of the middle income would become de facto working poor.

And we haven’t even touched on the issues for the insurance industry, e.g. at this point for practical purposes the individual insurance market his system relies on no longer exists.

Okay, okay, I get it. E. J. Dionne thinks that tax cuts are a distraction from the graver problems facing the country:

It is a victory for Republicans that the political conversation — when it’s not being hijacked by President Trump’s assorted outbursts and outrages — is focused on tax cuts. No matter how critical the coverage gets, the sheer amount of attention risks sending a message that taxes are the most important issue confronting the country.

This is entirely wrong, and it’s essential to challenge the whole premise of the debate. The United States does not need tax cuts now. Reducing government revenue at this moment will do far more harm than good. Conservatives are proving definitively that they don’t care in the least about deficits. And their claims that tax cuts will unleash some sort of economic miracle have been proved false again and again and again.

However, the only thing in his column that he advocates is…a tax cut:

Meanwhile, as Dylan Matthews reported on Vox, Sens. Michael Bennet (D-Colo.) and Sherrod Brown (D-Ohio) have introduced a bill that would dramatically expand the child tax credit to $3,600 a year per child for those age 0 to 5, and $3,000 a year for those 6 to 18. To direct the most assistance to the poor and the less affluent parts of the middle class, the credit begins gradually to phase out for incomes of single parents at $75,000 a year and married couples at $110,000.

The plan, Matthews writes, would cut child poverty in the country almost in half, from 16.1 to 8.9 percent. The cost: roughly $1 trillion over a decade, as against the $1.5 trillion Republicans claim would be the net price of their tax cuts after they are done shuffling the tax code around.

I would have been delighted if Mr. Dionne had told us what he thinks the graver problems facing the country are but he doesn’t even drop any hints. Russian disinformation? North Korean nuclear weapons? What?

Heaven knows I recognize that every post can’t be about everything. At least it should be about something.

In an op-ed in the New York Times Michael Tomasky wonders why the leading Democrats aren’t articulating a vision of the future of the United States:

The Democrats are undergoing a historic transformation, from being the party that embraced neoliberalism in the early 1990s to one that is rejecting that centrist posture and moving left. There’s plenty about this to cheer — the neoliberal Democratic Party didn’t do nearly enough to try to arrest growing income inequality, among other shortcomings.

There will be necessary internecine fights, and they boil down to loyalty tests on particular positions demanded by the vanguard. Consider the debate within the party on Senator Bernie Sanders’s “Medicare for All” bill, which most (though not all) 2020 contenders rushed to attach themselves to. To fail to sign on to that legislation is to open oneself to criticism, even abuse, although it’s less a piece of legislation than a goal.

Forget about who’s right and wrong in these debates. Time will sort that out. My point is that they tend to consume a party experiencing a shift. The Democratic Party, because it is an amalgam of interest groups in a way the Republican Party is not, has always had a tendency to elevate the candidate who can check the most boxes. The current internal dynamics exacerbate that. It’s also worth remembering that no one besides party activists cares.

So when the party’s leaders tussle over this or that policy, they also need to take a step back, to see the direction the country — the West itself — is heading, and take a stand on it. This isn’t just a matter of high-minded idealism; it’s what separates great politicians from merely good ones.

The answer to the question is that they don’t have one. They don’t want to “make America great again”; they think it’s fine as it is. The Obama Administration made it eminently clear that Democrats believe what we’re experiencing is the new normal—slow to nonexistent growth. They don’t want to make things better. They want to manage the decline and divide the spoils.

I really wish that Democrats were paying a lot more attention to good governance and a lot less to political pandering. If they think we can have open borders and maintain a workable society, they should articulate that vision. If they think that higher corporate and personal income taxes will make this a better society, that’s a vision they should articulate as well. I’d like to explain the high homicide rates in Chicago, Baltimore, and St. Louis and the low homicide rates in New York and Los Angeles without referencing race.

I recently read something, articulated by a progressive, that we should figure out how to return to the conditions of income equality of a half century ago. I don’t think he realized what he was saying.