Topic: Health Care & Welfare

Mr. President, Don’t Scapegoat Private Schools

It is not often I get a chance to latch on to someone as high profile as the President of the United States saying that public schools “draw us together.” But in his appearance at Georgetown University a couple of days ago, President Obama blamed, among other things, people sending their children to private schools for breaking down social cohesion and reducing opportunities for other children.

First, let’s get our facts straight: Private schools are not the main way better-off people, or people with high social capital, isolate themselves from poor families. Only 9 percent of school children attend private schools, and as Matt Ladner points out in a great response to the President, that percentage has been dropping over the years. No, the main way the better-off congregate amongst themselves is buying houses in nice places, which translates into access to good school districts. Even the large majority of the mega-rich appear to send their children to public schools, but rather than paying school tuition, their tuition is the far-steeper, far more exclusive price of a house. And let’s not pretend – as the President hinted – that we’ve seen anything close to long-term decreased funding for public schools. Even with a slight dip during the Great Recession, inflation-adjusted, per-pupil spending in public schools has well more than doubled since 1970.

On the deeper point, do we really know that public schools “draw us together,” and more importantly, do so better than private schooling? No, we don’t. That’s the accepted wisdom, but basic history doesn’t necessarily bear it out. Roman Catholics ended up starting their own school system – which at its peak in 1965 enrolled about 12 percent of all students – because the de facto Protestant public schools could not accommodate them. African-Americans, of course, were long legally excluded from public schools, especially white public schools. Similar situations existed for Asians and Mexican-Americans in some parts of the country. And, of course, public schools reflected the communities they served, which were often small and homogeneous. Finally, public schooling forces diverse people into a single system, which has led to seemingly incessant, cohesion-tearing clashes over values, personal identities, and much more.

Retaliation and Intimidation within the VA

Mismanagement within the Department of Veterans Affairs (VA) is chronic. The agency mismanages its projects and its patients. Last year’s scandal at the Phoenix VA centered on allegations that veterans waited months for treatment while never being added to the official waiting lists. The VA Secretary resigned and the agency focused on changing course. New reports suggest that agency reforms still have a long way to go.

A congresswoman at a recent congressional hearing described the VA as having a “culture of retaliation and intimidation.” Employees who raise concerns about agency missteps are punished. The U.S. Office of Special Counsel (OSC), which manages federal employee whistleblower complaints, reported that it receives twice as complaints from VA employees than from Pentagon employees, even though the Pentagon has double the staff. Forty percent of OSC claims in 2015 have come from VA employees, compared to 20 percent in 2009, 2010, and 2011.

During the hearing, a VA surgeon testified about the retaliation he faced following his attempts to highlight a coworker’s timecard fraud. From July 2014 until March 2015, his supervisors revoked his operating privileges, criticized him in front of other employees, and relocated his office to a dirty closet before demoting him from Chief of Staff.

Another physician was suspended from his job shortly after alerting supervisors to mishandled lab specimens. A week’s worth of samples were lost. Several months later, he reported another instance of specimen mishandling and his office was searched. He became a target of immense criticism.

Sec. Clinton’s Criminal Justice Reform Proposals

Today, presidential candidate Hillary Rodham Clinton addressed criminal justice reform in a speech at Columbia University. Earlier in the week, the Brennan Center released a book with chapters from politicians across the political spectrum discussing the need for criminal justice reform, and Secretary Clinton contributed one of them. Now that the Democratic front-runner has joined Republican presidential aspirants in addressing reform, criminal justice appears to be a significant 2016 campaign issue.

Three of Clinton’s policy suggestions are problematic.

First, and perhaps the one that will get the most headlines, she called for making police body cameras “the norm everywhere,” by using federal grants and matching funds. Putting aside the considerable price tag to subsidize the roughly 18,000 American law enforcement agencies to buy body cameras, how officers use those cameras and how law enforcement uses their data must be of utmost concern. As my colleague Matthew Feeney noted in a blogpost yesterday, the proposed body camera policy in Los Angeles would allow officers to review body camera footage before giving statements on use of force incidents. That policy would not serve transparency interests, but instead police officer self-interest.

Throwing money for cameras to local police departments as a solution to police transparency may sound good in theory, but making it work will be much more difficult in practice. 

Second, she argued that low-level offenders, “must be some way registered in the criminal justice system.” The criminalization of drug consumption has been one of the primary drivers of incarceration. Diverting low-level offenses to drug courts, as Clinton suggests, could be an improvement over jailing offenders, but for many of these cases, it’s not clear that the criminal justice system should be involved at all.

End the Personal Bribes Members of Congress Are Getting Not to Reopen ObamaCare

The U.S. Constitution vests the legislative, executive, and judicial powers in separate branches of the government that are supposed to police each other. But what if one of those branches violates the law in a manner that personally benefits the members of another branch? That’s what has been happening since the day ObamaCare became law in 2010. For more than five years, the executive branch has been issuing illegal subsidies that personally benefit the most powerful interest group in the nation’s capital: members of Congress and their staffs. A decision today by the Senate Small Business & Entrepreneurship Committee not to investigate those illegal subsidies shows just how difficult it can be to prevent one branch of the government from corrupting members of another branch.  

It is no secret that executive-branch agencies have broken the law, over and over, to protect ObamaCare. King v. Burwell challenges the IRS’s decision to offer illegal premium subsidies in states with federally established health-insurance Exchanges. University of Iowa law professor Andy Grewal recently revealed the IRS is illegally offering Exchange subsidies to at least two other ineligible groups: certain undocumented immigrants and people who incorrectly project their income to be above the poverty line. Treasury, Health and Human Services, and other executive-branch agencies have unilaterally modified or suspended so many parts of the ACA, it’s hard to keep count – and even harder to know what the law will look like tomorrow. Even some of the administration’s supporters acknowledge its actions have gone too far

The longest-running and perhaps most significant way the administration has broken the law to protect ObamaCare is by issuing illegal subsidies to members of Congress.

“Charity Is in Its Nature Essentially Civilizing”: In Defense of Herbert Spencer

Ian Millhiser has responded to both my defense of Herbert Spencer and one from Reason’s Damon Root. Unwavering in his belief that Spencer was a monster, Millhiser has doubled down on his claim that Spencer advanced a kind of “genocidal libertarianism.” Millhiser has rightly retreated, however, from boldly claiming, without evidence, that Rand Paul is a fan of Herbert Spencer. I thank him for his response, and I offer a few more thoughts on Spencer here.

First, it’s clear that Millhiser is an active and vehement opponent of libertarianism. He seems to believe–although I don’t want to put words in his mouth–that libertarianism is inherently “genocidal,” regardless of whether it’s advocated by Spencer, Ayn Rand, Friedrich Hayek, or Milton Friedman. So, on one level, Millhiser’s reaction to Spencer is simply a reiteration of his distaste for libertarianism and, insofar as that is the source of Millhiser’s discontent, I’m not going to try to argue with him that libertarianism isn’t inherently a cold, heartless philosophy. The possibility of that debate being productive is long passed.

But is there something particularly odious about Spencer’s brand of libertarianism, as Millhiser seems to think? Spencer writes with the peculiar verve of a 19th-century British intellectual, coming from the same milieu as anthropologists who would blithely discuss the “savage and uncivilized mongoloid and negroid races.” Similarly, Spencer would insouciantly attack the lazy, shiftless, and incompetent.

Post-modern relativism makes us balk at these absolute terms. In modern politics we tend to think more about the conditions into which people are born rather than their personal responsibility. Discussions of the “deserving poor” and “undeserving poor” are now largely uncouth.

But to Spencer, as to most 19th-century political and social theorists, the distinction mattered. Like many modern libertarians and conservatives, Spencer was very concerned that profligate and indiscriminate assistance for the poor would incentivize bad behavior. Although many on the left loathe the idea that welfare can create bad behavior, most people understand that concern. To anyone who’s ever had to cut off ne’er-do-well friends or family from further charity in order to help them out, those concerns make sense.

Do Housing Vouchers Help Poor Children?

Why do poor parents have children who also grow up to be poor? One possible reason is that poor families do not have access to credit that would allow parents to invest more in the improvement of the human capital of their children. The conventional policy recommendation for this diagnosis is to increase transfers to poor families in order to remove their credit constraints.

The expansion of the Earned Income Tax Credit (EITC)—which uses the tax system to transfer money to low-income households—has been shown to increase standardized test scores. But critics of this research argue that factors unobservable to researchers but correlated with EITC receipt are responsible for children’s success, not the EITC transfers themselves.

Increasingly, economists use clever research designs that involve an element of random assignment, much like clinical trials of new pharmaceuticals, to provide more conclusive evidence of a program’s effectiveness or ineffectiveness. Recently, three researchers used a policy change in Chicago to test the effects of a change in housing subsidies.

Unlike many other welfare programs, housing subsidies are not given to everyone who qualifies for them, but are handed out on the basis of availability. In 1997, for the first time in 12 years, Chicago accepted applications for housing vouchers. About 82,000 people applied out of 300,000 poverty households in Chicago at the time. The applicants were randomly assigned a position in the waiting list. The first 35,000 on the list were told their number and that they would be offered a voucher within three years. The rest were told that they would not receive vouchers.

By 2003, 18,000 of the first 35,000 applicants had received vouchers. The Chicago Housing Authority had issued as many vouchers as it could fund, and stopped offering any new vouchers.

In a study I review in my “Working Papers” column in the current Regulation, Brian Jacob, Max Kapustin, and Jens Ludwig examine the outcomes 14 years later for children whose families “won” the Chicago housing vouchers versus the children of families that were told they would not receive a voucher. Families that won the lottery received a very large positive income shock—the equivalent of $12,000 a year—relative to the average income in the sample ($19,000 a year). If income alone allows families to improve the human capital in their children, we should see results from this experiment. 

The authors find very few effects on schooling, crime, or health outcomes—and none were significant. “Our estimates imply that extra cash transfers beyond the current level provided in the United States are likely to have a smaller impact per dollar than the best-practice educational interventions explicitly designed to improve children’s human capital,” they write. Their results are consistent with the findings of sociologist Susan Mayer, who concluded in her 1997 book What Money Can’t Buy (Harvard University Press) that there is “little reason to expect that policies to increase the income of poor families alone will substantially improve their children’s life chances.”

Curing Cancer with Innovation

While a “cure for cancer,” is not yet in hand, it is probably not as far away as you think. As an article in yesterday’s Wall Street Journal shows, we are making tremendous strides in the fight against cancer.

Let us take a moment to look at the data and rejoice in the many lives saved by medical innovation. We focus on gains made against the top four deadliest cancers: lung cancer, bowel cancer, breast cancer, and prostate cancer.

Consider how the lung cancer death rate per 100,000 men has decreased since the 1980s:

While the decline is global, the greatest gains can be seen in wealthy, developed countries like the United States. This is in part because, as HumanProgress.org advisory board member Matt Ridley notes, “In the western world we’ve conquered most of the causes of premature death that used to kill our ancestors,” and with old age comes an increased incidence of cancer, making gains against cancer more notable.