CIS’s Inaccurate Response to Cato Brief on ICE Detainers for Americans

Dan Cadman of the Center for Immigration Studies (CIS) has written a blog post purporting to identify issues in a short brief that I wrote about U.S. citizens in Texas for whom ICE filed detainers. In it, he makes numerous inaccurate and unsupported assertions. Cadman presents zero evidence to rebut the conclusion of the brief and instead accuses an ICE supervisory officer of perjury because his statements fail to support Cadman’s position.

My brief uses data from Travis County, Texas to identify people who claimed U.S. citizenship and presented Social Security Numbers to local authorities, but ICE submitted a detainer request for them anyway, only to later cancel or not execute it. Cadman responds:

While it’s true that people who later prove to be U.S. citizens sometimes find themselves in removal proceedings (something I’ve previously commented on and explained), most often this occurs because an individual doesn’t even know he is a U.S. citizen…

In his link in support of his “most often” claim, he cites a single case where the person didn’t know he was a U.S. citizen, while we know of many individual cases in which detainers were filed for U.S. citizens who asserted their citizenship at the start of the process (here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, etc.). In any case, every person in my brief asserted U.S. citizenship at the outset from the time of their booking by Travis County Sheriff’s Office until ICE finally cancelled their detainer. Cadman continues:

[Bier] would have us believe that ICE agents actively “target” American citizens even though it is clear that they have no hand at all into what individuals are arrested by police and booked into Travis County (or any Texas) jail, and merely respond to the information passed to them as a consequence.

I never claimed that ICE agents “actively” seek out people who they know are American citizens. As I wrote in the executive summary of my brief, I state that these are “mistakes” that ICE only belated attempts to correct. In any case, if a law enforcement agency arrests hundreds of innocent people, it is perfectly legitimate to say that hundreds of “innocent people” were targeted by that agency, even if the individual agents didn’t know or intend to target innocent people. Moreover, it is incorrect to claim that ICE agents “merely respond to information passed to them”—Travis County Sheriff’s Office doesn’t make assessments of removability or citizenship, nor do they issue detainers. ICE makes those determinations.

Cadman attempts to argue that even though ICE canceled the detainers for these people, we cannot suppose that it was because they were U.S. citizens. He attempts to sketch out what he believes is happening:

ICE agents don’t, nor should they, always accept such assertions [of U.S. citizenship] at face value because they know the frequency with which false claims are made. One strategy they exercise is to immediately file the detainer while concurrently obtaining the release date of the individual being held by the police. They then work against the clock to either verify the claim or disprove it… . Keep in mind that when ICE agents withdraw a detainer, it doesn’t mean the claim isn’t false — it just means they couldn’t break it in the time frame they had to investigate.

If this is what ICE agents are doing, it would violate current ICE policies, which require agents to issue detainers based on what they believe to be is “probable cause” of removability. A simple assertion of U.S. citizenship would never overcome a determination based on actual probable cause (such as a biometric record of a prior deportation). In the bad days before even agent-determined probable cause was required, an assertion of U.S. citizenship would not have triggered cancelation either. Again, ICE would require the U.S. citizen to substantiate the claim first.

Cadman’s scenario implies that ICE agents are issuing detainers for people claiming U.S. citizenship based on their gut instincts and then hoping to prove that the person is lying before they are released. If this is what is occurring, it would indeed explain why U.S. citizens are regularly targeted by ICE as well as showing that the agency is breaking its own policy. That is a poor defense of ICE’s actions.

In any case, my brief quoted court testimony under oath from ICE Supervisory Detention and Deportation Officer John Drane from Rhode Island stating that, in fact, a detainer canceled for a person claiming U.S. citizenship is almost certainly because they were a U.S. citizen. Cadman responds:

while even ICE agents in the northeast would not be completely immune to the phenomenon of false claims, the claims would be of a significantly smaller scale and different character from those in Texas. This would certainly have had an impact on how Drane framed his response to the question of withdrawing a detainer, because his experiences would be nothing like those of ICE agents working in south or central Texas.

This is simply incorrect. The rate of U.S. citizenship claims overall was actually higher in Rhode Island around this time (7.2 percent) than in Travis County (5.7 percent), so Drane dealt with the same issue: some people do make false claims, while others, including the litigant in the case, make valid claims of U.S. citizenship when targeted with detainers. Cadman continues:

The time frame of Drane’s deposition (April 2015) is also significant. In November 2014, President Obama and then-Homeland Security Secretary Jeh Johnson announced a host of new “executive actions” that would govern how immigration agencies administered their responsibilities… . . many detainers were withdrawn as not meeting the new criteria of criminality drawn up by Secretary Johnson and his cohorts… .

Cadman presents no data or even anecdotes to support the claim that many detainers were withdrawn due to the Jeh Johnson enforcement criteria. In fact, the Johnson policies changed the criteria for issuing a detainer, so detainers for people who were not subject to enforcement priorities were not issued to begin with, leading to a significant decline in detainers issued. In any case, 90 percent of the U.S. citizens identified in my brief were targeted before Johnson’s new enforcement priorities were in effect or after the Trump administration rescinded them. In addition, the rate of cancelations for people claiming U.S. citizenship actually decreased during those years. Cadman continues:

It’s not a surprise that Drane avoided speaking to these very real, very major reasons that many detainers were withdrawn by ICE. One can surmise that he sidestepped the issue of agents being obliged to cancel detainers under the imposed-from-above priority system for fear of his job.

Here, Cadman actually accuses an ICE supervisory agent of lying under oath to avoid disclosing the reasons for the detainer cancelations. I don’t understand how Cadman can have complete faith in ICE under some circumstances while assuming the worst about them in others without any evidence. More importantly, Cadman’s claims about Drane are simply false. He has zero incentive to lie. The Obama administration was not hiding its looser enforcement policies in 2015—it was bragging about them. More importantly, in the context of this case, Drane is admitting something that would place blame on his office for wrongfully targeting U.S. citizens—something that the Obama administration would certainly not want to disclose. Lastly, why would he risk potential jail time by perjuring himself on this point? It simply makes no sense. Cadman concludes:

Bier has taken what are clearly dubious conclusions about the number of U.S. citizens against whom detainers were filed in the Travis County jail after arrest for criminal offenses, and then through extrapolation and aggregation, applied them to assert that, if this many were caught up in ICE “targeting” of citizens in the county, then as a matter of simple multiplication one can derive how many U.S. citizens must have been “targeted” statewide… . . Each county and each state is sufficiently unique in population and demographics that using any one of them to extrapolate to a whole is different entirely than using legitimate random sampling techniques.

Cadman is correct that a state-wide random sample would provide far more useful data. Every county in Texas should release this information if they have it. But the data that we do have allow us to learn something about Travis County, at a minimum. Maybe Travis County is an outlier in either direction, we simply don’t know, but I never claimed that my extrapolation from Travis County to the whole state of Texas is anything but an estimate.

Travis County, Texas is the third largest recipient of detainers in the state of Texas, providing a significant sample of the detainers in the state. Moreover, the dynamics in Travis County are substantially similar to other counties in Texas—all are fairly close to the border and all are subject to Texas law with regard to immigration enforcement. Cadman takes issue with my hedging this extrapolation, but that is simply what prudent analysts do when the evidence is incomplete.

My brief shows that ICE often issues detainer requests for people who claim U.S. citizenship and present Social Security Numbers to local authorities, only to then cancel those requests. The best explanation—based on ICE policies and ICE testimony—is that ICE issued detainers for hundreds of U.S. citizens. It is noteworthy that ICE itself in a statement to the Washington Post did not use any of Cadman’s poor defenses, but only asserted that it works to improve its processes over time. That may be true, but severe deficiencies still remain.

Thank Goodness for Thomas Jefferson and 1800

Not long after the limited-government U.S. Constitution was ratified and the new government resumed operation, numerous political leaders began pushing to expand federal power. Leading politicians of the 1790s did not agree with each other about the proper scope of federal authority, either legally or practically.

Treasury Secretary Alexander Hamilton proposed ideas for top-down manipulation of the economy. And fellow Federalist President John Adams signed into law the infamous Alien and Sedition Acts in 1798, which among other things outlawed any “false, scandalous and malicious writing” against the government, the Congress, and the president.

An article in the Washington Post the other day discussed some interesting details regarding the enforcement of the sedition statute:

Adams and his Federalist Party supporters in Congress passed the Alien and Sedition Acts under the guise of national security, supposedly to safeguard the nation at a time of preparing for possible war with France. The “Alien” part of the law allowed the government to deport immigrants and made it harder for naturalized citizens to vote. But the law mainly was designed to mute backers of the opposition Democratic-Republican Party led by Thomas Jefferson, who also happened to be the vice president. Jefferson had finished second to Adams in the 1796 presidential election and again ran against him in 1800.

An early target of the new law was Rep. Matthew Lyon, who had accused Adams of “ridiculous pomp.” In the fall of 1798 the government accused the Vermont congressman of being “a malicious and seditious person, and of a depraved mind and a wicked and diabolical disposition.” He was convicted of sedition, fined $1,000 and sentenced to four months in prison. Lyon campaigned for reelection from jail and won in a landslide. On his release in February 1799, supporters greeted him with a parade and hailed him as “a martyr to the cause of liberty and the rights of man.”

… Another target was James Callender, a pro-Jefferson journalist for the Richmond Examiner and the man who had exposed Federalist Alexander Hamilton’s extramarital affair. In 1800, Callender wrote an election campaign pamphlet that said of Adams: “As President he has never opened his lips, or lifted his pen, without threatening and scolding; the grand object of his administration has been to exasperate the rage of contending parties … and destroy every man who differs from his opinions.” Callander was convicted of sedition, fined $200 and sent to federal prison for nine months. He continued to write from his prison cell, calling Adams “a gross hypocrite and an unprincipled oppressor.”

… The government also came after critics of some members of the Adams administration, such as Treasury Secretary Hamilton. In 1799, Charles Holt, editor of the New London Bee in Connecticut, published an article accusing Hamilton of seeking to expand the U.S. military into a standing army. He also took personal jabs at Hamilton, asking, “Are our young officers and soldiers to learn virtue from General Hamilton? Or like their generals are they to be found in the bed of adultery?” The government promptly charged Holt with being a “wicked, malicious seditious and ill-disposed person — greatly disaffected” to the U.S. government. He was fined $200 and sent to jail for three months.

The speech crackdown extended even to private remarks, as Luther Baldwin, the skipper of a garbage boat in Newark, discovered. In July 1798, while passing through Newark on his way to his summer home in Massachusetts, Adams rode in his coach in a downtown parade complete with a 16-cannon salute. When Baldwin and his buddy Brown Clark heard the cannon shots while drinking heavily at a local tavern, Clark remarked, “There goes the president, and they are firing at his arse.” Baldwin responded that he didn’t care “if they fired thro’ his arse.” The tavern owner reported the conversation, and both drinkers were fined and jailed for sedition.

Thomas Jefferson and James Madison led the opposition to the big government Federalist policies of the 1790s, and “in the end, widespread anger over the Alien and Sedition Acts fueled Jefferson’s victory over Adams in the bitterly contested 1800 presidential election.” Free speech was restored and the incoming president would focus on cutting the excess spending, taxes, and debt built up by the prior Federalist administrations.

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Addiction Abuse

Hardly a day goes by without a report in the press about some new addiction. There are warnings about addiction to coffee. Popular psychology publications talk of “extreme sports addiction.” Some news reports even alert us to the perils of chocolate addiction. One gets the impression that life is awash in threats of addiction. People tend to equate the word “addiction” with “abuse.” Ironically, “addiction” is a subject of abuse.

The American Society of Addiction Medicine defines addiction as a “chronic disease of brain reward, motivation, memory and related circuitry…characterized by the inability to consistently abstain, impairment in behavioral control, craving” that continues despite resulting destruction of relationships, economic conditions, and health. A major feature is compulsiveness. Addiction has a biopsychosocial basis with a genetic predisposition and involves neurotransmitters and interactions within reward centers of the brain. This compusliveness is why alcoholics or other drug addicts will return to their substance of abuse even after they have been “detoxed” and despite the fact that they know it will further damage their lives. 

Addiction is not the same as dependence. Yet politicians and many in the media use the two words interchangeably. Physical dependence represents an adaptation to the drug such that abrupt cessation or tapering off too rapidly can precipitate a withdrawal syndrome, which in some cases can be life-threatening. Physical dependence is seen with many categories of drugs besides drugs commonly abused. It is seen for example with many antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft), and with beta blockers like atenolol and propranolol, used to treat a variety of conditions including hypertension and migraines. Once a patient is properly tapered off of the drug on which they have become physically dependent, they do not feel a craving or compulsion to return to the drug.

Some also confuse tolerance with addiction. Similar to dependency, tolerance is another example of physical adaptation. Tolerance refers to the decrease in one or more effects a drug has on a person after repeated exposure, requiring increases in the dose.

Science journalist Maia Szalavitz, writing in the Columbia Journalism Review, ably details how journalists perpetuate this lack of understanding and fuel misguided opioid policies.

Many in the media share responsibility for the mistaken belief that prescription opioids rapidly and readily addict patients—despite the fact that Drs. Nora Volkow and Thomas McLellan of the National Institute on Drug Abuse point out addiction is very uncommon, “even among those with preexisting vulnerabilities.” Cochrane systematic studies in 2010 and 2012 of chronic pain patients found addiction rates in the 1 percent range, and a report on over 568,000 patients in the Aetna database who were prescribed opioids for acute postoperative pain between 2008 and 2016 found a total “misuse” rate of 0.6 percent. 

Equating dependency with addiction caused lawmakers to impose opioid prescription limits that are not evidence-based, and is making patients suffer needlessly after being tapered too abruptly or cut off entirely from their pain medicine. Many, in desperation, seek relief in the black market where they get exposed to heroin and fentanyl. Some resort to suicide. There have been enough reports of suicides that the US Senate is poised to vote on opioid legislation that “would require HHS and the Department of Justice to conduct a study on the effect that federal and state opioid prescribing limits have had on patients — and specifically whether such limits are associated with higher suicide rate.” And complaints about the lack of evidence behind present prescribing policy led Food and Drug Administration Commissioner Scott Gottlieb to announce plans last month for the FDA to develop its own set of evidence-based guidelines.

Now there is talk in media and political circles about the threats of “social media addiction.” But there is not enough evidence to conclude that spending extreme amounts of time on the internet and with social media is an addictive disorder. One of the leading researchers on the subject stresses that most reports on the phenomenon are anecdotal and peer-reviewed scientific research is scarce. A recent Pew study found the majority of social media users would not find it difficult to give it up. The American Psychiatric Association does not consider social media addiction or “internet addiction” a disorder and does not include it in its Diagnostic and Statistical Manual of Mental Disorders (DSM), considering it an area that requires further research.

This doesn’t stop pundits from warning us about the dangers of social media addiction. Some warnings might be politically motivated. Recent reports suggest Congress might soon get into the act. If that happens, it can threaten freedom of speech and freedom of the press. It can also generate biliions of dollars in government spending on social media addiction treatment.

Before people see more of their rights infringed or are otherwise harmed by unintended consequences, it would do us all a great deal of good to be more accurate and precise in our terminology. It would also help if lawmakers learned more about the matters on which they create policy.

Are the Carolinas Ready for Hurricane Florence?

As Hurricane Florence spins toward the Carolina coast, the nation’s attention will be on the disaster readiness and response of governments and the affected communities. Have lessons been learned since the deeply flawed government response to Hurricane Katrina back in 2005?

I examined FEMA and the Katrina response in this study, discussing both the government failures and the impressive private-sector relief efforts.

Last year, Hurricane Maria devastated Puerto Rico, again exposing all sorts of government failures. Well-known chef José Andrés has a new book on the Maria response. He had an eye-opening experience on the island volunteering on relief efforts with his World Central Kitchen.

The Washington Post’s review of the book says that Andrés saw the flaws of top-down bureaucratic relief efforts and embraces more of a spontaneous order view of effective disaster relief:

With We Fed an Island, chef-and-restaurateur-turned-relief worker José Andrés doesn’t just tell the story about how he and a fleet of volunteers cooked millions of meals for the Americans left adrift on Puerto Rico after Hurricane Maria. He exposes what he views as an outdated top-down, para-military-type model of disaster relief that proved woefully ineffective on an island knocked flat by the Category 4 hurricane.

… ‘My original plan was to cook maybe ten thousand meals a day for five days, and then return home,’ Andrés writes. Instead, Andrés and the thousands of volunteers who composed Chefs for Puerto Rico remained for months, preparing and delivering more than 3 million meals to every part of the island. They didn’t wait for permission from FEMA.

… These grass-roots culinary efforts didn’t always sit well with administration officials or with executives at hidebound charities, in part because Andrés was no diplomat. He trolled Trump on Twitter over the situation on Puerto Rico. He badgered FEMA for large contracts to ramp up production to feed even more hungry citizens. He infamously told Time magazine that the “American government has failed” in Puerto Rico. A chef used to fast-moving kitchens, Andrés had zero patience for slow-footed bureaucracy, especially in a time of crisis.

… After dealing with so much red tape and mismanagement (remember the disastrous $156 million contract that FEMA awarded to a small, inexperienced company to prepare 30 million hot meals?), Andrés wants the government and nonprofit groups to rethink the way they handle food after a large-scale natural disaster. He wants them to drop the authoritarian, top-down style and embrace the chaos inherent in crisis. Work with available local resources, whether residents or idle restaurants and schools. Give people the authority and the means to help themselves. Stimulate the local economy.

‘What we did was embrace complexity every single second,’ Andrés writes. ‘Not planning, not meeting, just improvising. The old school wants you to plan, but we needed to feed the people.’

Andrés and World Central Kitchen have embraced complexity. 

Hail to the chef!

 

 

The Hurricane Last Time

As of this writing, Tuesday, September 11, Hurricane Florence is threatening millions of folks from South Carolina to Delaware. It’s currently forecast to be near the threshold of the dreaded Category 5 by tomorrow afternoon. Current thinking is that its environment will become a bit less conducive as it nears the North Carolina coast on Thursday afternoon, but still hitting as a Major Hurricane (Category 3+). It’s also forecast to slow down or stall shortly thereafter, which means it will dump disastrous amounts of water in southeastern North Carolina. Isolated totals of over two feet may be common. 

At the same time that it makes landfall, there is going to be the celebrity-studded “Global Climate Action Summit” in San Francisco, and no doubt Florence will be the poster girl.

There’s likely to be the usual hype about tropical cyclones (the generic term for hurricanes) getting worse because of global warming, even though their integrated energy and frequency, as published by Cato Adjunct Scholar Ryan Maue, show no warming-related trend whatsoever.

Maue’s Accumulated Cyclone Energy index shows no increase in global power or strength.

Maue’s Accumulated Cyclone Energy index shows no increase in global power or strength.

Here is the prevailing consensus opinion of the National Oceanic and Atmospheric Administration’s Geophysical Fluid Dynamics Laboratory (NOAA GFDL): “In the Atlantic, it is premature to conclude that human activities–and particularly greenhouse gas emissions that cause global warming–have already had a detectable impact on hurricane activity.”

We’ll also hear that associated rainfall is increasing along with oceanic heat content. Everything else being equal (dangerous words in science), that’s true. And if Florence does stall out, hey, we’ve got a climate change explanation for that, too! The jet stream is “weirding” because of atmospheric blocking induced by Arctic sea-ice depletion. This is a triple bank shot on the climate science billiards table. If that seems a stretch, it is, but climate models can be and are “parameterized” to give what the French Climatologist, Pierre Hourdin, recently called “an anticipated acceptable range” of results.

The fact is that hurricanes are temperamental beasts. On September 11, 1984, Hurricane Diana, also a Category 4, took aim at pretty much the same spot that Florence is forecast to landfall—Wilmington, North Carolina. And then—34 years ago—it stalled and turned a tight loop for a day, upwelling the cold water that lies beneath the surface, and it rapidly withered into a Category 1 before finally moving inland. (Some recent model runs for Florence have it looping over the exact same place.) The point is that what is forecast to happen on Thursday night—a major category 3+ landfall—darned near happened over three decades earlier… and exactly 30-years before that, in 1954, Hurricane Hazel made a destructive Category 4 landfall just south of the NC/SC border. The shape of the Carolina coastlines and barrier islands make the two states very susceptible to destructive hits. Fortunately, this proclivity toward taking direct hits from hurricanes has also taught the locals to adapt—many homes are on stilts, and there is a resilience built into their infrastructure that is lacking further north.

There’s long been a running research thread on how hurricanes may change in a warmer world. One thing that seems plausible is that the maximum potential power may shift a bit further north. What would that look like? Dozens of computers have cranked away thousands years of simulations and we have a mixture of results: but the consensus is that there will be slightly fewer but more intense hurricanes by the end of the 21st Century. 

We actually have an example of how far north a Category 4 can land, on August 27, 1667 in the tidewater region of southeast Virginia. It prompted the publication of a pamphlet in London called “Strange News from Virginia, being a true relation of the great tempest in Virginia.” The late, great weather historian David Ludlum published an excerpt:

Having this opportunity, I cannot but acquaint you with the Relation of a very strange Tempest which hath been in these parts (with us called a Hurricane) which began on Aug. 27 and continued with such Violence that it overturned many houses, burying in the Ruines much Goods and many people, beating to the ground such as were in any ways employed in the fields, blowing many Cattle that were near the Sea or Rivers, into them, (!!-eds), whereby unknown numbers have perished, to the great affliction of all people, few escaped who have not suffered in their persons or estates, much Corn was blown away, and great quantities of Tobacco have been lost, to the great damage of many, and the utter undoing of others. Neither did it end here, but the Trees were torn up by their roots, and in many places the whole Woods blown down, so that they cannot go from plantation to plantation. The Sea (by the violence of the winds) swelled twelve Foot above its usual height, drowning the whole country before it, with many of the inhabitants, their Cattle and Goods, the rest being forced to save themselves in the Mountains nearest adjoining, where they were forced to remain many days in great want.

Ludlum also quotes from a letter from Thomas Ludwell to Virginia Governor Lord Berkeley about the great tempest:

This poore Country…is now reduced to a very miserable condition by a continual course of misfortune…on the 27th of August followed the most dreadful Harry Cane that ever the colony groaned under. It lasted 24 hours, began at North East and went around to Northerly till it came to South East when it ceased. It was accompanied by a most violent raine, but no thunder. The night of it was the most dismal time I ever knew or heard of, for the wind and rain raised so confused a noise, mixed with the continual cracks of falling houses…the waves were impetuously beaten against the shores and by that violence forced and as it were crowded the creeks, rivers and bays to that prodigious height that it hazarded the drownding of many people who lived not in sight of the rivers, yet were then forced to climb to the top of their houses to keep themselves above water…But then the morning came and the sun risen it would have comforted us after such a night, hat it not lighted to us the ruins of our plantations, of which I think not one escaped. The nearest computation is at least 10,000 house blown down.

It is too bad that there were no anemometers at the time, but the damage and storm surge are certainly consistent with a Category 4 storm. And this was in 1667, at the nadir of the Little Ice Age.

Regulatory Power Leads to Corruption

A Maryland story in the Washington Post last week presents a classic case of local political corruption. The broader message of the story is that when we give government the power to regulate an activity—in this case liquor sales—we open the door to corruption.

Even if you believe that regulatory regimes are created with good intentions, the politicians and officials in charge inevitably get swarmed by lobbyists and some of them will focus on lining their own pockets. With respect to the public interest, the resulting policy outcomes are a crapshoot.

Former Maryland state delegate Michael L. Vaughn (D) was sentenced to 48 months in federal prison Tuesday after he was convicted of accepting cash in exchange for votes that would expand liquor sales in Prince George’s County.

A jury found Vaughn guilty of conspiracy and bribery in March. During his six-day trial in U.S. District Court in Maryland, Vaughn and his attorneys argued that the bundles of cash he received from liquor store owners and a lobbyist in 2015 and 2016 were campaign contributions that he failed to report because he had personal financial problems.

But prosecutors for the government argued that the more than $15,000 that changed hands in a coffee shop bathroom, a dark restaurant and other locations throughout the county were bribes.

… Sentencing Judge Paula Xinis called Vaughn’s misconduct ‘exceptionally serious’ and ‘grievous bribery.’

Vaughn was one of seven arrested last year in a federal corruption case that investigators called “Operation Dry Saloon.” Liquor store owners, lobbyists, former liquor board commissioners and former Prince George’s County Council member William A. Campos (D) conspired to pass laws that would allow for Sunday liquor sales in the county in exchange for cash.

… Prosecutors, however, argued that Vaughn and former chief liquor inspector David Son hashed out a scheme in which local liquor store owners Young Paig and Shin Ja Lee would pay Vaughn $20,000 over two years to clear the way for Sunday sales.

… ‘He fully embraced the pay-to-play culture that has been a repeat phrase in this court for a decade,’ Windom said, alluding to the 87-month sentence former Prince George’s County executive Jack Johnson received for bribery and corruption.

Shrinking Medicare Expenditure

With public healthcare programs accounting for over a trillion dollars of federal spending, efforts to identify and remedy sources of waste are increasing. A new working paper finds: 

There is substantial waste in U.S. healthcare, but little consensus on how to identify or combat it. We identify one specific source of waste: long-term care hospitals (LTCHs). These post-acute care facilities began as a regulatory carve-out for a few dozen specialty hospitals, but have expanded into an industry with over 400 hospitals and $5.4 billion in annual Medicare spending in 2014. We use the entry of LTCHs into local hospital markets and an event study design to estimate LTCHs’ impact. We find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities (SNFs) – post-acute care facilities that provide medically similar care to LTCHs but are paid significantly less – and that substitution to LTCHs leaves patients unaffected or worse off on all measurable dimensions. Our results imply that Medicare could save about $4.6 billion per year – with no harm to patients – by not allowing for discharge to LTCHs.

The cost of healthcare in the United States remains a significant problem, but eliminating regulatory carve-outs such as LTCHs is one way to address this growing issue.

Research assistant Erin Partin contributed to this blog post.