Employment-Based Green Cards Are Mostly Used by Family Members

The United States’ immigration system favors family reunification – even in the so-called employment-based categories.  The family members of immigrant workers must use employment-based green cards to enter the United States.  Instead of a separate green card category for spouses and children, they get a green card that would otherwise go to a worker. 

In 2014, 56 percent of all supposed employment-based green cards went to the family members of workers (Chart 1).  The other 44 percent went to the workers themselves.  Some of those family members are workers, but they should have a separate green card category or be exempted from the employment green card quota altogether. 

Chart 1

Employment Based Green Cards by Recipient Types

 

Source: 2014 Yearbook of Immigration Statistics, Author’s Calculations

ObamaCare: Not Promoting Quality Care As Planned

At The Health Care Blog, Jeff Goldsmith and Bruce Henderson of Navigant Healthcare offer a grim assessment of ObamaCare’s performance that is worth quoting at length:

The historic health reform law passed by Congress and signed by President Obama in March, 2010 was widely expected to catalyze a shift in healthcare payment from “volume to value” through multiple policy changes. The Affordable Care Act’s new health exchanges were going to double or triple the individual health insurance market, channeling tens of millions of new lives into new “narrow network” insurance products expected to evolve rapidly into full risk contracts.

In addition, the Medicare Accountable Care Organization (ACO) program created by ACA would succeed in reducing costs and quickly scale up to cover the entire non-Medicare Advantage population of beneficiaries (currently about 70% of current enrollees) and transition provider payment from one-sided to global/population based risk. Finally, seeking to avoid the looming “Cadillac tax” created by ACA, larger employers would convert their group health plans to defined contribution models to cap their health cost liability, and channel tens of millions of their employees into private exchanges which would, in turn, push them into at-risk narrow networks organized around specific provider systems. 

Three Surprising Developments
Well, guess what? It is entirely possible that none of these things may actually come to pass or at least not to the degree and pace predicted. At the end of 2015, a grand total of 8.8 million people had actually paid the premiums for public exchange products, far short of the expected 21 million lives for 2016. As few as half this number may have been previously uninsured. It remains to be seen how many of the 12.7 million who enrolled in 2016’s enrollment cycle will actually pay their premiums, but the likely answer is around ten million. Public exchange enrollment has been a disappointment thus far, largely because the plans have been unattractive to those not eligible for federal subsidy. 

Moreover, even though insurers obtained deep discounts from frightened providers for the new narrow network exchange products (70% of exchange products were narrow networks), the discounts weren’t deep enough to cover the higher costs of the expensive new enrollees who signed up. Both newly launched CO-OP plans created by ACA and experienced large carriers like United and Anthem were swamped in poor insurance risks, and lost hundreds of millions on their exchange lives. As for the shifting of risk, it looks like 90% plus of these new contracts were one-sided risk only, shadowing and paying providers on the basis of fee-for-service, with bonuses for those who cut costs below spending targets. Only 10% actually penalized providers for overspending their targets.

The Medicare Accountable Care Organization/Medicare Shared Savings Program, advertised as a bold departure from conventional Medicare payment policy, has been the biggest disappointment among the raft of CMS Innovation Center initiatives. ACO/MSSP enrollment appears to have topped out at 8.3 million of Medicare’s 55 million beneficiaries. The first wave, the Pioneer ACOs, lost three-fourths of their 32 original participating organizations, including successful managed care players like HealthCare Partners, Sharp Healthcare, and Presbyterian Healthcare of New Mexico and others. The second, much larger wave of regular MSSP ACO participants lost one third of their renewal cohort. Only about one-quarter of ACO/MSSP participants generated bonuses, and those bonuses were highly concentrated in a relative handful of successful participants. 

Of the 477 Medicare ACO’s, a grand total of 52, or 11%, have downside risk, crudely analogous to capitation. As of last fall, CMS acknowledged that factoring in the 40% of ACO/MSSP members who exceeded their spending targets and the costs of the bonuses paid to the ACOs who met them, the ACO/MSSP programs have yet to generate black ink for the federal budget. And this does not count the billions care systems have spent in setting up and running their ACOs. It is extremely unlikely that the Medicare ACO program will be made mandatory, or voluntarily grow to replace DRGs and the Medicare Part B fee schedule. 

And the Cadillac Tax, that 40% tax imposed by ACA on high cost employee benefit plans, a potentially transformative event in the large group health insurance market, which was scheduled to be levied in 2018, was “postponed” for two years (to 2020) by an overwhelming Congressional vote. In the Senate, a 90-10 bipartisan majority actually voted to kill the tax outright, strongly suggesting that strong opposition from unions and large employers will prevent the tax from ever being levied. Presumptive Democratic nominee Hillary Clinton has announced her support for killing the tax. So the expected transformative event in the large group market has proven too heavy a lift for the political system. 

As a result, the enrollment of large group workers in private health exchanges, the intended off-ramp for employers with Cadillac tax problems, has arrested at about 8 million, one-fifth of a recent forecast of 40 million lives by 2018. Thus, the conversion of the enormous large group market members to narrow network products seems unlikely to happen. As a recent New York Times investigation revealed, the reports of the demise of traditional group health insurance coverage (based on broad network PPO models) have been greatly exaggerated.

NATO’s Warsaw Summit

At the end of this week, leaders from the United States and Europe will convene in Warsaw, Poland, for a NATO summit. The meeting – only the second summit since Russia’s 2014 invasion of Ukraine – will include high level strategic discussions, and will likely see the announcement of an increased NATO troop presence in the Baltic States to counter potential Russian aggression there.

The biggest question leaders intend to address in Warsaw is how to deter Russian aggression towards NATO members in Eastern Europe following its seizure of Crimea and involvement in the conflict in Eastern Ukraine. In effect, leaders will try to find a compromise solution which reassures NATO’s eastern members, provides additional deterrence, but does not provoke further military buildup and distrust from Russia. They will almost certainly fail in this endeavor.

In fact, the expected announcement of the deployment of 4 battalions of additional troops to the Baltics has already produced heated rhetoric from Russia. These deployments will likely lead to a Russian response, ratcheting up tensions and increasing the risk for inadvertent conflict in the region. In other words, they will contribute to a classic security spiral of mistrust and overreaction. The irony is that such deployments are largely symbolic, not strategic. Even four battalions will not change the fact that Russia could likely conquer the Baltics quickly if it so chose. And even though some would argue that their deterrent value is largely as a ‘tripwire,’ it isn’t clear why the existing Article V guarantee is insufficient for that purpose.

To be frank, in the focus on how to defend the Baltics, leaders have largely overlooked the low likelihood of a conflict in that region. For one thing, there is a qualitative difference between attacking Ukraine and attacking a NATO treaty member; Vladimir Putin certainly knows this. For another, Russia’s force posture simply doesn’t indicate that it has any intentions on the Baltics.

Alton Sterling Shooting Raises Questions

In the early morning hours of Tuesday, July 5th police officers in Baton Rouge, Louisiana shot and killed Alton Sterling, a 37-year-old black man who was reportedly selling CDs outside a convenience store. The shooting was filmed by at least two citizens. The two officers involved in the shooting, who were wearing body cameras, are on administrative leave, and the Department of Justice has launched an investigation. The shooting raises a range of questions concerning police use-of-force, body cameras, and police procedure.

According to an unnamed senior law enforcement official, Sterling presented a gun to a homeless man, who then called 911. During the scuffle between Sterling and the officers, which ended with Sterling on his back and both officers on top of him, one of the officers yelled “He’s got a gun!” Shortly afterwards Sterling was shot numerous times at point blank range. Footage shows that Sterling did not have a gun in his hand when he was shot. 

Cato research associate Jonathan Blanks wrote about the shooting at Policemisconduct.net, highlighting (among other things) the “cooling off” period granted to many officers after they are involved in a shooting and before they answer questions.  

Today, I discussed the shooting with Caleb O. Brown, the Cato Institute’s multimedia director. 

What Do We Know about Education?

It’s the 50th anniversary of the legendary Coleman Report, as George Will discusses today in the Washington Post. Will summarizes what experts in 1966 believed about education, and what additional experience revealed:

The consensus then was that the best predictor of a school’s performance was the amount of money spent on it: Increase financial inputs, and cognitive outputs would increase proportionately. As the postwar baby boom moved through public schools like a pig through a python, almost everything improved — school buildings, teachers’ salaries, class sizes, per-pupil expenditures — except outcomes measured by standardized tests.

Andrew Coulson put that key fact in a handy chart:

Education spending and results

Politicians, experts, and the education establishment still aren’t willing to accept the lesson demonstrated by this chart.

But if money doesn’t work, what does? Coleman emphasized cultural factors, notably strong families. Coulson believed that schools could improve, and that competition could help us discover best educational practices. This fall, public television stations will broadcast his documentary asking why educational innovations are so rarely tested and replicated.

Elevated CO2 Stimulates the Growth of Papaya

Papayas are spherical or pear-shaped fruits known for their delicious taste and sunlit color of the tropics. Upon his arrival to the New World, Christopher Columbus apparently could not get enough of this exotic fruit, reportedly referring to it as the “the fruit of angels.” And the fruit of angels it may indeed be, as modern science has confirmed its value as a rich source of important vitamins, antioxidants and other health-promoting substances to the consumer.

Papaya production has increased significantly over the past few years to the point that it is now ranked fourth in total tropical fruit production after bananas, oranges and mango. It is an important export in many developing countries and provides a livelihood for thousands of people. It should come as no surprise, therefore, that scientists have become interested in how this important food crop might respond to increasing levels of atmospheric CO2 that are predicted for the future.

Such interest was the focus of a recent paper published in the scientific journal Scientia Horticulturae by Cruz et al. (2016). Therein, the team of five researchers examined “the effect of the elevated CO2 levels and its interaction with Nitrogen (N) on the growth, gas exchange, and N use efficiency (NUE) of papaya seedlings,” as they note there are no publications examining such for this species to date. To accomplish their objective, Cruz et al. grew Tainung #1 F1 Hybrid papaya seeds in 3.5 L plastic pots in a climate-controlled greenhouse at the USDA-ARS Crops Research Laboratory in Fort Collins, Colorado under two different CO2 concentrations (390 or 750 parts per million) and two separate N levels (8 mM NO3- or 3 mM NO3-). CO2 fumigation was performed for only 12 hours per day (during the day, 06:00 h to 18:00 h) and N treatments were applied to the pots weekly as a nutrient solution to reach the desired N levels. The experiment concluded 62 days after treatment initiation.

In discussing their findings, Cruz et al. report that compared to ambient levels of CO2, elevated CO2 increased photosynthesis by 24 and 31 percent in the low and high N treatments, respectively. Plant height, stem diameter and leaf area in the high N treatment were also enhanced by 15.4, 14.0 and 26.8 percent, respectively, and by similar amounts for the height and stem diameter in the low N treatment. Elevated CO2 also increased the biomass of leaf, stem plus petiole, and root dry mass of papaya plants regardless of N treatment, leading to total dry mass enhancements of 56.6 percent in the high N treatments and 64.1 percent in the low N treatments (see figure below).

Figure 1. Total dry mass of papaya plants grown in controlled chambers at two different CO2 concentrations (High and Low; 750 and 390 ppm) and two different N treatments (High and Low; 8 mM NO3- or 3 mM NO3-). Adapted from Cruz et al. (2016).

Figure 1. Total dry mass of papaya plants grown in controlled chambers at two different CO2 concentrations (High and Low; 750 and 390 ppm) and two different N treatments (High and Low; 8 mM NO3- or 3 mM NO3-). Adapted from Cruz et al. (2016).

 

Cruz et al. also report that “significant, but minor, differences were observed in total N content (leaf plus stem + petiole plus roots) between plants grown at different CO2 concentrations, but the same N levels.” Consequently, plant Nitrogen Use Efficiency (NUE) – the amount of carbon fixed per N unit – was around 40 percent greater in the CO2-enriched environments, regardless of the N level in the soil.

Commenting on their findings, Cruz et al. write that contrary to some other studies, which have suggested that low N reduces plant responses to increased CO2 levels, they found no such decline. In fact, their data indicate that elevated CO2 “alleviated the effect of low N on dry matter accumulation in papaya,” which they surmised is at least partially explained by a larger leaf area and higher rate of photosynthesis per leaf area unit observed under elevated CO2.

In light of all of the above, Cruz et al. conclude that “an increase in the atmospheric CO2 concentration [is] beneficial for dry mass production of papaya and alleviate[s] the negative effects of N reduction in the substrate on papaya growth.” Thus, in the future, those who cultivate this fruit of angels should find an angel in the ongoing rise in atmospheric CO2.

 

Reference

Cruz, J.L., Alves, A.A.C., LeCain, D.R., Ellis, D.D. and Morgan, J.A. 2016. Interactive effects between nitrogen fertilization and elevated CO2 on growth and gas exchange of papaya seedlings. Scientia Horticulturae 202: 32-40.

What We Know About Fatal Tesla Accident

Numerous media stories have reported the first fatality in a self-driving car. The most important thing to know is that the Tesla that was involved in the crash was not a self-driving car, that is, a car that “performs all safety-critical functions for the entire trip” or even a car in which “the driver can fully cede control of all safety-critical functions in certain conditions” (otherwise known as “level 4” and “level 3” cars in the National Highway Traffic Safety Administration’s classification of automated cars). 

Instead, the Tesla was equipped with an Advanced Driver Assistance System (ADAS) that performs some steering and speed functions but still requires continuous driver monitoring. In the NHTSA’s classification, it was a “level 2” car, meaning it automated “at least two primary control functions,” in this case, adaptive cruise control (controlling speeds to avoid hitting vehicles in front) and lane centering (steering within the stripes). BMW, Mercedes, and other manufacturers also offer cars with these functions, the difference being that the other cars do not allow drivers to take their hands off the wheel for more than a few seconds while the Tesla does. This may have given some Tesla drivers the impression that their car was a level 3 vehicle that could fully take over “all safety-critical functions in certain conditions.”

The next most important thing to know about the crash is that the Florida Highway Patrol’s initial accident report blamed the accident on the truck driver’s failure to yield the right-of-way to the Tesla. When making a left turn from the eastbound lanes of the highway, the truck should have yielded to the westbound Tesla. Still, it is possible if not likely that the accident would not have happened if the vehicle’s driver had been paying full attention to the road.

Mobileye, the company that made the radar system used in the Tesla, says that its system is designed only to prevent a car from rear-ending slower-moving vehicles, not to keep them from hitting vehicles laterally crossing the car’s path. Even if the sensors had detected the truck, automatic braking systems typically can come to a full stop only if the vehicle is traveling no more than 30 miles per hour faster than the object. Since the road in question is marked for 65 miles per hour, the system could not have stopped the Tesla.

Thus, the Tesla driver who was killed in the accident, Joshua Brown, probably should have been paying more attention. There are conflicting reports about whether Brown was speeding or was watching a movie at the the time of the accident. Neither were mentioned in the preliminary accident report, but even if true it doesn’t change the fact that the Tesla had the right of way over the truck.

Just two months before the accident, Duke University roboticist Missy Cummings presciently testified before Congress that auto companies were “rushing to market” before self-driving cars are ready, and “someone is going to die.” She didn’t mention Tesla by name, but since that is so far the only car company that allows American drivers to take their hands off the wheel for more than a few seconds, she may have had it in mind.

Tesla’s autopilot system relies on two forward-facing sensors: a non-stereo camera and radar. Tests by a Tesla owner have shown that the system using these sensors will not always stop a vehicle from hitting obstacles in the road. By comparison, the Mercedes and BMW systems use a stereo camera (which can more quickly detect approaching obstacles) and five radar sensors (which can detect different kinds of obstacles over a wider range). Thus, in allowing drivers to take hands off the steering wheel, Tesla may have oversold its cars’ capabilities.

The day before information about the Tesla accident became publicly known, the National Association of City Transportation Officials issued a policy statement about self-driving cars urging, among other things, that drivers not be allowed to use “partially automated vehicles” except on limited access freeways because “such vehicles have been shown to encourage unsafe driving behavior.” While this would have prevented the Tesla crash, it ignores the possibility that partial automation might have net safety benefits overall.

A few days after the accident became publicly known, NHTSA announced that traffic fatalities had increased by 7.7 percent in 2015, the largest increase in many years. As Tesla CEO Elon Musk somewhat defensively pointed out, partial automation can probably cut fatalities in half, and full automation is likely to cut them in half again. State and federal regulators should not allow one accident in an ADAS-equipped car to color their judgments about true self-driving cars that are still under development.