Jonathan Rauch, who heads the Brookings side of the project, found that line of argument troubling. He asked me whether the interests of the responsible 80% should really have to yield to the interests of the irresponsible 20%. (Since the two groups aren’t distinguishable at a glance, there’s no way of restricting the consumption of problem users without somewhat inconveniencing non-problem users.)

That question, asked by someone whose intellect and ethical sensibility I have come to respect, led me to reflect on the difference between a moralistic or rights-based approach to a problem such as this one and a policy-analytic or outcomes-based approach. If you think of problem users and non-problem users as different people, it’s natural to ask which group’s interests ought to make way for the other’s. That seems to be a moral or constitutional question. But if you think of yourself as a potential user of a drug (or, as Jonathan suggested to me, the parent of a potential user), unable to know in advance whether your (or your child’s) use will remain controlled or will instead progress to dependency, and ask how much inconvenience in controlled use you want to sacrifice for protection against a bad habit, then you confront a practical problem rather than a moral one.

(Some readers will recognize in this Schelling’s solution to the puzzle of why it’s justified to save a larger rather than a smaller number of lives, when that’s the choice; if you imagine yourself as a member of one of the two groups, without knowing which one, it’s obvious you’d prefer a higher probability of survival to a lower one. Jonathan instead recognized this as a Rawlsian veil-of-ignorance argument, which also seems right to me.)

Of course, this same approach can be applied well beyond drug policy. Asking “How much do the non-poor owe to the poor?” is a moral question. Asking “How much protection would a reasonable person want against the risk of poverty?” sounds more like a computation. Of course, if you think of yourself as naturally immune to the risks of drug abuse or of poverty, you’ll be more inclined to let the drug abusers, and the poor, go hang. But that seems to me compatible neither with the Categorical Imperative nor with the Golden Rule. If we accept arguments from symmetry in physics, why not in ethics?

Glennerster describes the stunningly rapid adaptation of the British:

People began to rid their elderly relatives of their assets and claim [the housing benefit]. Local authorities, under pressure to cut spending, began to see that if they closed homes or privatized them the old people could still be looked after in residential care and the central government would have to pay for them through the social security scheme. Private [old age] home owners began to realize that if they increased fees locally in line with other homes the social security scheme would have to pay up.

The result, under the putatively tight-fisted Thatcher government, was that Social Security spending on old age homes increased from £10 million to £2,072 million, a more than 200-fold increase over 12 years!

Glennerster, a Labour Party man down to his bones, concedes the reality that is usually trumpeted by conservatives:

There could be no better example of the way individuals will change their behaviour in fairly ruthless ways to avail themselves of public money.

The last of these is scheduled not to happen until 2016; easing transitions is often a good idea, but does it take three years for golfers to put their long putter in the attic and buy another?  The basketball idea, which makes sense, raises the interesting question, should we pick a number, say one foot, and raise all the hoops that much at once, or raise them an inch every season until we’re happy with the result?  Sometimes we change laws a lot all at once, like allowing same-sex marriage; sometimes we make small adjustments, like the inflation adjustment in Social Security payments.

Some things have to be highly quantized: for the Brits to convert to right-side driving in stages, as the joke goes (“for the first week, the new rules will only apply to buses and trucks”) would be a bad idea.  But others allow for gradual change.  A one-foot change all at once would greatly devalue the muscle memory of all players, but gradual change would keep those skills mostly in service as the transition occurred.  I don’t think the mechanical costs of converting goals to be adjustable in this way are as daunting as, say, making soccer goals adjustable.

People who think science is more than a political flag one can choose to wave or not, depending on whether there’s profit in it, are pretty sure that one of the effects of global warming is increased frequency and intensity of extreme weather.

I wish I believed that a just Providence sent things like today’s tornado upon people who vote for oil-whore Oklahoma Republicans.  I don’t, but could the devastation in Moore possibly give the survivors something to think about along these lines?

UPDATE (21 May):

I obviously wrote the foregoing too quickly and too elliptically.  Let me unpack it here:

The reference to a just Providence was a pointer to the repeated meme, trotted out (for example) after Katrina, that natural disasters happen to people who deserve to be punished. The reason I “wish I believed that” is that if I did, I would feel OK about the consequences, I guess even the children whose school was shredded around them.    But I don’t: I believe natural systems are ordered by an amoral, implacable, scientific reality that we understand much better by taking it seriously and being smart than by theodicy.  I believe actions like putting carbon back in the air from underground as fast as possible have consequences, consequences that fall most heavily on the least deserving: the poor people who will not have enough to eat as floods and droughts deepen and come more often, and all the children still unborn around the world who didn’t get to dance at the fossil fuel party but will still have to figure out how to live in a toasted planet – yes, and children in tornado alley who never voted for anyone.

I also believe that the time to talk about politics and how we engage with that amoral reality is while the manifestations of foolishness, especially their injustice, are salient, and that doing so shows respect and sympathy for those who suffered and died for no good reason other than the cupidity of their leadership and its wilful ignorance (or worse, putative ignorance)

If Christine Quinn and Wendy Greuel win in their respective cities, we will have female mayors of both cities for the first time.  And the press will have a lot of fun with it, because the two women seem to epitomize their cities’ personalities.  Quinn is famously nasty and vicious, character traits she is now trying to ameliorate at least publicly.  Much less famously, but just as truly, Greuel is quite nice: I’ve known her for nearly 20 years, and you can’t deny that she is personally a very nice person.

And if you think about it, that is true more broadly.  If Anthony Weiner runs for NYC mayor, we’ll get another jerk trying to get to Gracie Mansion.  Greuel’s rival, Eric Garcetti, whom I’ve also known for a long time, is likewise very friendly and nice.  Even the campaign by realistic standards has been pretty tame.

If you think about New York mayors, they are hardly aiming for Mr. Congeniality: Ed Koch, Rudy Giuliani, and even Michael Bloomberg aren’t necessarily the sort of person you’d want to hang out with.  But on the left coast, Tom Bradley almost epitomized mellow moderation; Antonio Villaraigosa is probably too personally charming for his own good; Jim Hahn might not have been the sharpest pencil in the cup but is a genuiunely nice guy; even Richard Riordan is pretty friendly and cordial.  David Dinkins, of course, was notably polite and courtly — and seemed out of his element because of it.

Why is this?  Is it just New York Nasty and Los Angeles Nice?  Maybe, but perhaps this is something bigger going on here.

New York mayors wield vast power.  They control huge departments, manage an enormous budget, and dominate the city politically.  New York City comprises five different county governments and thus contains the counties’ power.  The New York mayor’s problem is keeping control over the whole thing, not to mention corralling a notoriously-fractious urban political party (and sometimes more than that if they have the Liberal or Conservative endorsement).  The Mayor also plays a major role in appointing the Board of Education.  Hizzoner has to knock heads to get anything done.

In Los Angeles, on the other hand, the Mayor is relatively weak.  Los Angeles city government is dominated by civil service personnel, whom the Mayor can’t just order around.  Before 1992, this was even the case with the Police Department: I distinctly remember my east coast friends saying to me, “If Tom Bradley hates Daryl Gates so much, why doesn’t he just fire him?”  Answer: he couldn’t.  And he still can’t: the police chief has a five-year term.  Even with other departments, the Mayor can’t appoint dozens and dozens of officials: instead, he appoints usually five-member volunteer commissioners, who, because they are volunteers, are usually dominated by professional civil service staff.  That is not a recipe for strong executive leadership.

The Los Angeles mayor has no control over the school district or the Board of Education.  The Los Angeles City Council only has 15 members, making each councilmember the monarch of his or her district; in New York, there are so many councilmembers that they comparatively little power, although not negligible.  The City of Los Angeles has no control over the vastly bigger County of Los Angeles.  The Mayor of New York can call up the Brooklyn borough President to berate and threaten him: in Los Angeles, the only way the City get the County to what it wants is through a lawsuit.

Or persuasion.  The Mayor of Los Angeles has to persuade all these other constituencies to do what he or she wants: they can’t bully or force them.  Los Angeles elections are nonpartisan, and so the Mayor doesn’t even have a political organization to use.  The only way a Los Angeles Mayor will be effective will be through the patient and often-maddening business of assembling political coalitions, community groups, public sector unions, developers, etc.  A screamer in Los Angeles City Hall is someone who literally has no chance of success.

No wonder, then, that voters seem so uninterested: it’s not abundantly clear what precisely the Mayor is supposed to do, a condition that the early 20th century Progressives who framed the Los Angeles charter wanted.

The political scientist Kenneth Waltz, who died last week at the age of 88, made a similar point about the personalities of Presidents and Prime Ministers.  A President has to try to use the power of the bully pulpit and his dominance over the executive branch to get things done.  A Prime Minister, on the other hand, has to use persuasion to maintain his party coalition — if he doesn’t, he’ll get kicked out by his own caucus.  I think that that works here.

Whether Garcetti or Greuel wins tomorrow, the next Los Angeles mayor will be a pretty nice person.  Whether Quinn or Weiner or someone else wins in New York, the next New York mayor will probably be something of a jerk.  But the political structure will have as much to do with this as any tired cultural stereotypes.

Oddly, no one seems to have asked the obvious question: Just what was I doing addressing the ISSDP wearing that particular headgear? Thereby hangs a tale.

The cap was a present from Jay Bergman, the DEA head honcho for Latin America, who – being considerably smarter and more open-minded than some of the people who call themselves “drug policy reformers” – decided that if a bunch of drug policy experts were coming his way he ought to find out what we might have to tell him.

My talk – the opening address of the conference – was about the difference between the enforcement perspective, which thinks of actions such as crop eradication as means to the end of reducing drug flows, and the policy-analytic perspective, which asks whether, to what extent, and how each proposed action could reduce personal and social damage. I argued that interdiction couldn’t pass the damage-reduction test because the illicit industry can and does adapt to it.

In the talk, I prefaced the section that took the enforcement perspective with “In my DEA hat, I’d say …”, at which point I put on the cap. When I finished the section and prepared to launch into the alternative analysis, I said, “Now, taking off my DEA hat, I’d say instead …”, again suiting the action to the words. Hardly up to Richard Pryor standards of comedy, but it was good enough to get a laugh from the ISSDP audience and to help me make my point.

The broader joke, of course, is that I have been a vigorous and persistent critic of the drug enforcement effort in general and of various DEA policies in particular, and am currently working with the Washington State Liquor Control Board to develop a regulatory system for the commercial production and sale of cannabis, a project directly contrary not only to the Federal law the DEA enforces but also to the drug-war ideology the DEA espouses.

But in my view being on the other side of a controversy – even a bitter controversy – doesn’t require being personally hostile. I have warm friendships and relations of intellectual respect with some people who support treating all drugs more or less the way we currently treat alcohol, which I think would be a mistake, and also with some people who support more or less our current policies toward illicit drugs, which I regard as a huge disaster and the cause of immense and needless suffering.

Those friendships do not reflect any deficiency on my part either in basic meanness or in the willingness to hold a grudge. It’s because I don’t feel wronged by people who disagree with me; who else can be counted on to point out my errors and thus improve my knowledge about the world? What I resent – what brings out my hostility – is the glibness and intellectual dishonesty that leads some drug warriors to deny that current drug policies do enormous damage and some drug reformers to deny that commercial availability almost inevitably means increased drug abuse.

Anyone who accepts as a starting premise that all policies have both advantages and disadvantages, and are to be judged primarily by their results rather than by their proclaimed intentions, and who is prepared to reason honestly from facts to conclusions in trying to figure out what policies might, on balance, have the best consequences, I take to be my ally. That we reach different conclusions testifies to the complexity and unpredictability of the world and the cognitive limits that encumber all of us: it need not be the case, when two people strongly disagree, that either of them is a fool or a scoundrel.

I’m glad to have found a new ally in Jay Bergman, and will work as hard to correct what I see as the defects in the strategies he is now pursuing as (I hope) he will work to correct the errors he sees in my reasoning. And I’m happy to wear the cap he gave me, just as I’m happy to wear the “Have You Talked to Your Parents About Drugs?” t-shirt I got when I addressed the annual meeting of the Students for Sensible Drug Policy.

–Bob Newhart

As you might imagine we’re all in a little bit of shock at this revelation. I don’t know what else to say, except that a University of Chicago tee-shirt will be made available to the funniest comment.

Postscript: We have a winner, Jeff Spross, video editor and blogger for ThinkProgress.org. He suggests over email:

“Rob Reiner is coming for your stash.”

Alternatively: “The U.S. prison industrial complex goes to eleven!”

His prize will be shipped Monday. Thanks for many worthy entries.

Last week I recommended Kansas City Confidential, a 1952 collaboration between Director Phil Karlson, Producer Edward Small and Actor John Payne. They re-teamed very successfully the following year to make this week’s film recommendation: 99 River Street.

Payne is compelling as ultra-hard-luck Ernie Driscoll, a former boxer turned cab driver. In the opening scene, which is a pre-Raging Bull master class in how to convey the violence of boxing on film, Ernie is on the verge of becoming champion when he gets a bad break. And the bad breaks keep coming for the rest of the movie, in his marriage to his ice-cold beauty of a wife (Peggie Castle, at her best), in his friendship with a manipulative aspiring actress friend (Evelyn Keyes, on fire here), and in his battles with some ruthless jewel thieves who want to destroy him for reasons he can’t understand. His only consistent source of support is his former manager, a dispatcher at his cab company (played sympathetically by Frank Faylen, who played a cab driver in many Hollywood films and apparently got promoted).

If this film noir/gangster melodrama deserves one adjective it’s brutal. There are many scenes of physical violence, filmed with unusual realism (My favorite is Payne’s torture by and knock down drag out with a karate chopping jewel thief played by tough guy Jack Lambert). The emotional violence is even more pronounced, particularly in a long, gripping sequence in which Driscoll is played for a chump by a group of “theater people”. The tragedy of Payne’s character is that while he once was a master of his violent nature, frustrations and failures have led him to become a slave to it, preventing him from being happy in his achingly simple new life ambition of moving from hack work to becoming the owner of a filling station. Payne and Karlson are well up to the challenge of bringing across Driscoll’s emotional flaws and vulnerabilities, while at the same time making him completely credible in the many physical confrontations of the story.

The movie also gives the audience a fine bunch of criminals to root against. Brad Dexter (the guy from The Magnificent Seven whose name few people can recall) is both scary and smooth as the jewel thief who frames Payne for a terrible crime. Lambert exudes the menace that served him so well in his decades as a heavy in films and on television. Eddy Waller is even scarier in a different way as a criminal who has a kindly manner but in fact is a cold-blooded killer. The final, extended confrontation at 99 River Street of the protagonists versus the villains is thrilling and satisfying.

The only weakness of this movie is the final two minutes, a tacked on “where are they now?”-style epilogue that is too upbeat and pat given the tone and content of the rest of the film (The otherwise perfect Sideways had the same flaw). It was unlike Karlson to pull a punch, but it doesn’t diminish 99 River Street as a gritty, gripping piece of cinema.

The most common account is that when President Calderon turned the force of the state on to organized crime groups, the old arrangements were overturned and a cycle of violence began. The drug kingpins used violence against government officials and citizens in an attempt to intimidate the state into giving up on enforcement. Further, as gangs were de-capitated, they broke into smaller groups warring for supremacy with each other.

But this account may be entirely wrong or only partly correct. Evidence presented this week in Bogota at the conference of the International Society for the Study of Drug Policy shows that there was another enormous shock to the criminal system concurrent with Calderon’s campaign.

Colombia shifted its cocaine suppression strategy from crop eradication to further down the production chain (e.g., laboratories and exporters), resulting in a more than doubling of cocaine seizures beginning in 2006. At this same time, the Mexican gangs became the dominant partner in their relationship with the Colombian gangs. Rather than simply receiving cocaine at the southern border of Mexico and carting it north, they moved into Central America and the edges of Colombia, giving them a larger role in transshipment and processing.

Cocaine is the biggest source of revenue of the Mexican gangs, meaning that these changes were highly disruptive to the old stasis. The cocaine flow shrank, but what was left became more valuable. This intensified competition among the Mexican gangs which may be the root of the burst of violence.

Whether this explanation is fully or partly correct is being investigated by Dr. Daniel Mejia Londoño and his colleagues at the Universidad de los Andes. He is one of a number of young Latin American scholars who are bringing new perspectives to drug policy research. Collectively, they will help policy analysts escape the trap of seeing drug policy only from the point of view of consumer countries (e.g., Europe and the USA). And in the long term, the “Calderon explanation” for Mexican violence may be only one of the received truths that this new generation of researchers overturns.

The lights changed and I started to walk across the street. In the crosswalk coming toward me was a woman in her 30s, also staring into the middle distance and taking no notice of me. She was alone, but was carrying on an animated conversation about how the big banks are ruining the country.

As I said, neither took any notice of me, but I knew them both. One works as a cashier at the pharmacy I use and the other is a long-term psychiatric patient with schizophrenia. One had on a barely visible Bluetooth, the other has been engaged in discussions with imagined others long before the technology was invented.

But without my prior contacts with these two people, I would never have known that one of them had a serious mental illness. These fortuitous encounters make me wonder if these new technologies have an unintended but welcome destigmatizing function. Where before people might have shunned a mentally ill person who seemed to be talking to himself, today they usually assume that he’s just chatting on a BlueTooth or similar device.

Note what’s missing from that list? If this were a politician I might imagine mere oversight, but Brownfield didn’t get where he is by making rookie mistakes.

It’s possible that the smart drug warriors have begun to decide that the Battle of Cannabis is lost, and are attempting to fall back to a more defensible position.

In the words of our esteemed Vice President, this is a BFD.

What’s also true is that Obama and [Kamala] Harris are longtime friends. She was a featured speaker at the Democratic Convention in Charlotte. And Harris was a guest at the state dinner for British Prime Minister David Cameron. (Full disclosure: We were at the same table that night.)

The principle behind full disclosure is a noble one: To let the reader know that the journalist may be biased by personal association with the subject s/he covers. But not infrequently it is used in a way that makes me throw up a little in my mouth: To emphasize that the journalist is important, connected and fabulous.

If you don’t believe me, ask yourself a question. If the goal of full disclosure is to completely reveal the truth, why don’t roughly half of all “full disclosures” put a political reporter in a negative light? Surely, negative feelings and experiences can bias judgment as much as positive ones. But I have never seen anything by a political journalist along the lines of “The Governor is known to have a harsh and unforgiving interpersonal manner (Full disclosure: We used to date but she dumped me because I was chronically impotent)”.

The other striking thing about some full disclosures is that the only reason they are “ethically required” is because the journalist has inserted an unnecessary detail into a story that allows parenthetical full disclosurebrag. Did for example the above story by the Washington Post’s Jonathan Capehart really need to cite the state dinner with David Cameron in order to establish the widely-known fact that Attorney General Harris and President Obama are long time friends? No.

But once that detail was in the story, Capehart was forced to do his solemn duty of letting us know that he got invited to a fancy White House event (Full disclosure: I wasn’t invited, and if I had been, I probably would not have written this post. Also, I should note, in candor, that I have published in the Washington Post, as well as other newspapers — such as the New York Times and Wall Street Journal — that are often mentioned in the same breath as the Post as highly desirable places to publish. But, for honesty’s sake, I should disclose that I haven’t done as much publishing in national newspapers as I have in academic outlets, where I have over 200 peer-reviewed papers. And several highly-regarded books. Just thought you had a right to know).

Are you looking for a prestigious internship for your teenage child? Are you worried that, despite your best efforts to make Junior respectable in public, the interview skills aren’t quite where they need to be? Do you think s/he would benefit during a college admissions interview by referring to “that time [I] interned at an energy consultancy”?

You’re in luck!

My high school, Westminster School, is offering internships at auction as a means to raise funds for its capital building projects and its Bursary Programme. On offer are internships in retail, finance, law, energy, and consultancy, among others. Fabergé? No problem. Coutts Bank? Roll up! We can serve all your needs here.

Ok, you’re interested? Great! All I’ll need is for you to 1) cough up hundreds of Her Majesty’s Pounds Sterling (I know, I know, can you really put a price on your child’s future? It’s priceless, after all. But then again, in addition to being a self-evidently valuable life experience, why not show people how valuable these internships are by making them prohibitively expensive?), 2) be a “member of the Westminster Community, aged 18 or over, unless previously notified otherwise. This includes Parents, Former Parents, Old Westminsters, Staff and Former Staff.” After all, if you aren’t somehow attached to the School, your money clearly doesn’t have the same pretty lustre to it. Marvellous, I’m glad you understand.

What’s that, you say? There might be a problem of nepotism? Some people who might otherwise be qualified might not be able to participate in the auction?  And some pupils who are attending the School on the Bursary Programme (designed as similar to a need-based stipend) for which the auction is intended as a fundraiser might themselves struggle to afford the internships?

Nonsense!

The School has already issued a clear statement that such apprehensions are unwarranted:

The option of including work placements was raised early on by our donors, and in the end it was felt that as this had for some years been a common practice by other organisations and as the places offered would be in addition to, and not in place of, existing positions, we would go ahead.  Each work placement donor was asked if they would be willing to provide 2 places – one to be auctioned and one for the School to pass along to a pupil at one of our partner state schools – and some have chosen to do so. While these places have been created solely for the auction, we are hopeful that the businesses will be inspired to maintain these new positions and will openly recruit for candidates going forward.

Fine, fine, I suppose that statement wasn’t entirely convincing for all involved. I suppose that the fact that one high-profile bank has withdrawn its internship offer in response to the bad publicity (Exhibits A, B, and C) means that we can’t please everyone. But look, at least the School has had a dedicated commitment to social mobility in the past, yes? Surely this doesn’t set back all the positive gains that have been made thus far? I really don’t think Nick Clegg’s vocal opposition to internship culture in the past has anything to do with it. Nor does it matter that he went to Westminster. Or that he acquired an internship through nepotism himself.

[Calls off, stage right]

Junior, remind me: what is it you said you wanted to be when you grow up? A lawyer, eh? Yes, yes, don’t worry. Daddy will take care of it.

Breaking character: No, I won’t be giving them money — for an auction or as part of alumni giving — until I’m convinced they have their act together.

EDIT: On reflection, the title of the post is rather OTT. But it was ringing in my ears, in the voice of my English teacher from Westminster, when I read about the auction.

I realize that University Presidents are not corporate CEOs (but do they know that?).   In the case of evaluating University Presidents, what is the right performance criteria?  In the case of public firms, their firm’s daily stock price contains information that is continuously updated.  What new information arrives about the performance of the University Presidents?  Given that a University is a bundle of a zillion things, how do you tease out the President’s value added?   On the supply side, why isn’t there more competition for University President slots?  Why can’t a tenured associate professor be named President if she has the “right stuff”?  Why must entry barriers of previous service as a Dean or Provost be introduced?

It may be proper to be vilely rude to one’s equals, but I’ve always considered it the worst of tastes to be uncivil to servants.

One of the silliest criticisms of the US government in the wake of the assault on the Benghazi diplomatic mission was that it was reluctant to describe it as “terrorism”. Initially it did not, because it didn’t know; a little later Obama did use the word. It’s now CW that it was a “terrorist” attack (a) because it was carried out by Islamist extremists, Ansar al-Sharia, (b) because two of the dead (Ambassador Stevens and Sean Smith) were US diplomats.

The Benghazi mission was basically a CIA operation, initially to support the revolution against Gaddafi and later to influence it and to pursue Islamist groups. It was a secret paramilitary operation.

How can you describe the attack on it as terrorism rather than irregular warfare? This would only fit if the attack were essentially designed as an assassination of the US Ambassador, a protected civilian, which does not seem to be the case. The militants didn’t know where he was when they set fire to the mission building, the cause of his and Smith’s deaths.

Would you call the Taliban’s 2009 attack on the CIA compound at Khost terrorism?

It was the USA that decided to define its conflict with al-Qaeda as war not law enforcement. Military operations by al-Qaeda and its associates against US soldiers and spies are therefore just that, unless they target civilians, the definition for terrorism. Collateral damage to civilians isn’t enough, as with US drone strikes. The ex-SEAL security men Doherty and Woods died bravely in battle, not as terrorist victims. (For the record, I’d better repeat that however you define it, it’s a conflict the US has to win.)

Of course you can always twist the word to mean “killing while Muslim”.

So we beat on, boats against the current, borne back ceaselessly into the past.

The novel with my favorite opening sentence is Dickens’ Tale of Two Cities:

It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to heaven, we were all going direct the other way – in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.

What are you own favorite closing and opening sentences?

Footnote Lehrer is a fine interviewer, but WNYC callers don’t average much smarter than callers on AM shock-talk in Podunk, and WNYC commenters make me proud of the RBC clan.

At one level, this is a superb heist film (which allegedly influenced Quentin Tarantino’s conception of Reservoir Dogs). A masked criminal mastermind half-recruits, half-bullies three lowlifes into pulling off an armed robbery. All of them wear masks and thus are unknown both to the police and to each other. The mastermind instructs them to hide out until the money is laundered, and gives them a secret method of identifying each other when the time is ripe for the payout. Meanwhile, an ex-con, ex-GI (Payne, playing two noir archetypes in one!) who was at the wrong place at the wrong time gets pinched by the police. He escapes their clutches and decides to pursue the gang, though whether he wants them brought to justice or just desires a piece of the pie is not immediately clear.

This film is proof-positive that you don’t need much money to make a solid, entertaining film, and the complete lack of pretension to anything else is one of Kansas City Confidential’s charms. The script has some satisfying twists and moments of delicious tension. All the performances are very good, particularly Jack Elam as a twitchy, chain-smoking criminal, Preston Foster as an embittered ex-cop with both a brutal and a soft side, and Payne as a cynical tough guy out for some sort of redemption. The camerawork, particularly in the first half, is striking, with effective use of close-ups and lighting to let the actors act and the dark mood to suffuse the audience. The film’s viewpoint is bleak: The cops are not much better than the criminals, to extent that they are even different people at all.

John Payne’s career is almost a noir story in itself. He was originally an upbeat singer and dancer in light-hearted films and was also of course a star of the heartwarming Miracle on 34th Street. But a few years after the war he changed into a tough actor with great physical presence and a clipped style of delivering dialogue. He was very smart about the film business as a business (and shrewdly cleaned up a packet in Hollywood due to wise investments) and may therefore have grasped that the war shifted filmgoers’ taste toward darker movies that would begin to supplant sunnier fare. Whatever the reasons for his transformation, he was very effective both as a smiling song-and-dance man in love with the All-American girl as well as in the hard bitten roles he later took on. Truly, an actor of significant range.

Happily, Kansas City Confidential is in the public domain and you can therefore legally watch it for free here at Internet Archive.

Her name was Giovanna degli Albizzi Tornabuoni. Both parts of her surname mattered at the time. The Albizzi were rivals of the Medici, the Tornabuoni the Medicis’ right-hand men. Her marriage two years earlier to Giovanni Tornabuoni was a political one, a burying of the hatchet between powerful clans. The Tornabuonis were clearly proud of the catch and celebrated her beauty and status in this lovely portrait.

The melancholy Grecian-Urn atmosphere created by the rigid pose and sombre background with pious knick-knacks is no accident. Giovanna died in childbirth, aged only eighteen, the year of the portrait. (Was it begun in life? I’ve suggested to the museum an X-ray to see if Ghirlandaio began with a more cheerful background of Tuscan hills or a rich interior. I’ll let you know if they take me up.)

The beautiful Giovanna can therefore represent all the young women who have paid the ultimate price for our dangerously large brain cases.
Giovanna was as high-status as you could get in the most advanced city in Europe in 1488, but that didn’t help her. Typical pre-industrial maternal mortality rates were from 1% (the rate in Chad and Somalia today) to 3%. They are two orders of magnitude lower today; rates are counted in deaths per 100,000 deliveries, and range from 2 to 50 in OECD countries.

How are some countries of interest to us doing on this metric? Here’s a table for the OECD drawn from the CIA World Factbook. I’ve added the much higher and less noisy rate for infant mortality. The rankings correlate roughly, but not in detail; they capture different aspects of health care, since infant mortality is more a matter of antenatal care, maternal death of emergency obstetrics.

Spreadsheet here, including the full world rankings. {Well, there will be once I’ve fixed the download problem.)

No surprises really. Health care in the USA maintains its resolute mediocrity on maternal mortality as on other metrics. Maternal mortality is two to three times that achieved by a substantial group of high-performing countries, infant mortality 1.5 to twice. Some of the high-performing countries on both, like Spain and the Czech Republic, are quite a lot poorer than the USA.

Could there be a genetic component to maternal mortality? A study in New York found rates much higher among African-American women, controlling for poverty and lifestyle. Cuba does better than the USA on infant mortality, but much worse on maternal. Genes or hospitals? If it were genes, you’d expect to see higher rates in West than in East Africa, which doesn’t seem to be the case. We should keep an open mind on this one.

Robert (pictured right) has been homeless for years. When I asked about his dental problems, he pulled his lips back to show the damage.  A sweet, soft-spoken man, he has unfilled cavities. He needs a crown. He is waiting on a long-overdue root canal. It would cost about $1,000, which he doesn’t have. He doesn’t have the $50 needed for a basic cleaning. So he hasn’t had his teeth cleaned in two years. All that time, he has chewed all his food on the left side: “These teeth are very weak.”

More here.

By the way, the $180 million capital costs associated with a single proton beam radiotherapy machine–a technology with highly speculative therapeutic benefits over cheaper therapies–could finance routine teeth cleanings for 3.6 million low income people.

Eight months after the attack itself, I know Republicans think there’s been a cover-up, but I haven’t the foggiest idea what it is they think has been covered up. For all the talk of a political “scandal,” no one seems capable of pointing to anything specific that’s scandalous. For all the conspiracy theories, there’s no underlying conspiracy to be found.

Steve, as a progressive blogger, is admittedly biased. But reading Andrew Stiles’ report on National Review Online I get exactly the same impression. Per Stiles, and stripping away the rhetoric and the table-pounding calls for “more questions,” the testimony of Gregory Hicks, the deputy chief of mission in Tripoli at the time, revealed the following:

(1) Susan Rice was wrong to call the attacks on the Benghazi consulate a possible result of the infamous anti-Muslim video. But Rice was describing, in real time and with proper caveats, what she thought was the case at the time, and everyone official has long since admitted that her initial, tentative take was wrong. So: who cares?

(2) The State department didn’t want Hicks to meet with a Republican congressional delegation on the subject, and an official without clearance tried but failed to horn in on the meeting. This will surprise anyone who has never read a book or article about a government agency, or known anybody who worked for one, but—really? Reading against the grain, it becomes clear that Hicks did meet with the Republican delegation, which got all the information it needed. Indeed, he told all kinds of investigators everything he had to say.

(3) Cheryl Mills, “State Department general counsel and former chief of staff to Secretary Clinton,” demanded an account of the above meeting and “sought to keep [Hicks] on a tight leash.” Now, like it or not, the U.S. has a system of political appointees in executive departments, and the Secretary of State is kind of expected to have subordinates whom she trusts. As for seeking a report of the meeting—a bit aggressive, sure, but again there was no cover-up; Hicks was able to tell whomever he wanted whatever he knew.

(4) Hicks was demoted to desk officer. He thinks it was because he was too aggressive on Benghazi. I wonder what his superiors think. In any case, this is at most hardball management but no crime.

(5) “The three witnesses present at Wednesday’s hearing were repeatedly referred to as whistleblowers” (by Republicans). But just as in that parable about calling the horse’s tail a fifth leg, that doesn’t make them whistleblowers. That word denotes someone who exposes crimes or acts of malfeasance that have been covered up. But the testimony itself, from the accounts I’ve read, exposed no coverup, and no crime.

That’s it. On the other side, we also learn, from this conservative account, that the State Department’s Accountability Review Board, which took Hicks’ testimony, absolved Clinton of any blame for poor security. (Hicks didn’t get to see the classified report, but I’ve seen no accounts from those who have, including partisan Republicans, that suggests a whitewash.) As a matter of fact, we learn—regarding the substantive matter supposedly at issue—nothing about State having even been responsible for poor security, as opposed to an ex ante decision regarding limited resources that was defensible at the time but turned out badly.

Look, I’m not a Benghazi expert. I’m willing to entertain the possibility that there’s something here that the media aren’t telling me. But before I evaluate the case, I need to see some concrete charges. My challenge to conservatives is to tell me, very simply, the following:

(1) What, in your view, was the crime? Who did what and which law did it break? No crime, no cover-up (in the usual sense).

But the idea seems to be that what was “covered up” was not crime but incompetence. (That stretches the former meaning of “cover-up,” but never mind.) So:

(2) Who failed competently to perform his or her job, in which concrete ways? Which decisions are we talking about, by whom, at what time, and on what grounds should we believe that a competent person in the job in question would have had to make a different decision? Again, failure to devote unlimited resources to guarding every consulate at all times does not constitute an incompetent decision but rather precisely a competent one. And a judgment (apparently held by the diplomats on the ground at the time) that there was a tradeoff between high security and diplomatic effectiveness is also, absent conclusive arguments to the contrary, quite defensible. We need more.

(3) What information was covered up, and how? What facts do we (a) now know to be the case that (b) were previously concealed from view by (c) illegitimate threats or undue influence (as opposed to agency politics as usual, whereby those higher up would rather sweep mistakes under the rug but grudgingly tolerate subordinates who air them)?

Unless all three of these elements in (3) are  present, there was no cover-up—at most a halfhearted attempt at a cover-up, or an honest difference of opinion about facts. And unless number (1) or (2) is present, there was nothing to cover up.

At this point in the career of a scandal, or attempted scandal, there are often disagreements over whether the charges are true. But I can’t remember the last time I’ve seen a scandal where I don’t even know what they are.  I know that this blog has a fair number of conservative readers. And perhaps other sites will pick this up. I hope so, and if so: answers, please. Specific ones, point by point. Then we’ll at least have something we can argue about.

Update: Yes, I know my  bemusement on this isn’t new. The “nothingburger” label I got from Kevin Drum’s post, which can be added to the above links and many others. But I haven’t seen the demand for specifics laid out in numbered points and subpoints before. And sometimes that helps. If nothing else, conservatives may have to ask themselves whether they’ve been sold a bill of goods by conservative media outlets selling a scandal vaguer than they realize.

Second Update: I’d like to stress that I’m engaged in an exercise in arguendum: even if the conservative slant on Benghazi is accurate, there has been no “cover up” that I can see. A less partisan account, e.g. that of the New York Times, casts doubt on that slant to begin with. For one thing, having a department lawyer be present during congressional investigation visits was, allegedly, a longstanding State policy. This should be easily verifiable (or disprovable). For another, State claims that Hicks has not been demoted but given a temporary job, at the same salary, pending a transfer he requested. I’m more dubious about this—clearly Hicks thinks he’s been wronged—but we should note that Hicks’ account has not gone unchallenged.

Reporters Dan McCrum and Arash Massoudi analyzed all the investment advice given out at one of those high-priced “meet the gurus” event. This one was called the Ira Sohn Investment conference and was held at Lincoln Center.

Crunch finding: If you acted on every tip of the top 12 speakers, you would have made less money in the stock market than did someone who simply put money into a vanilla passive index fund.

• Charges are a fantasy amount that no third party insurance company would ever pay. However, the uninsured might pay this amount (they would often be ‘charged’ this amount and go bankrupt trying).
• Payments are the amount that is actually paid for care (in the data released it is combined amount paid by Medicare, other insurers, and patients).
• Cost is a truly elusive concept in health care, but hospitals of course have systems that state their costs (and likely have many versions depending upon what is included).

Payments are sometimes greater than costs, but in other cases less; this differs by type of care and payer. And of course it depends upon what measure of cost you might use (does it include capital financing costs? If you build a new Cancer hospital, how broadly are those costs apportioned, etc.). Note that no data on costs was released. Charges and payments are an imperfect means of saying something about costs.

The table below compares the charges (fantasy) with the total payments received (actual money changing hands) by UNC, Duke and Wake Med hospitals (Duke and UNC are ~ 8 miles apart, and Wake Med is about 20 miles from each) for 3 DRGs in which I have some interest and which Aaron McKethan was tweeting (280=Heart Attack; 292 Heart Failure & shock; 638 = Diabetes; note that there are other codes relevant to these conditions, I just picked 3; this is based on my analysis).

Several points:

• You cannot easily perform a significance test on the differences here because we don’t know the standard deviation or standard error of the total payments (is Wake Med’s $5,844 in total payments significantly different from Duke’s $8,267 on DRG 638)? And the sample sizes are fairly small. You could make some assumptions, but I haven’t done that.
• The spread on total payments is much less than on charges. Payments are a more meaningful number because it includes what Medicare actually paid to these hospitals and what patients paid OOP along with what other insurers (like private Medigap, employer provided retiree gap plans, or Medicaid) paid in the way of co-pays/deductibles.
• Why do hospitals bother to greatly inflate charges if they are a fantasy in the sense that no third party payer (the uninsured might) would ever possibly pay them? Charges are likely a starting point for negotiations with private insurers for one thing, and having high charges also allows hospitals to estimate a larger value of charity care most likely.
• Were charges ever important? You betcha. In the ‘good ole days’ (from a hospital bottom line perspective, think late 60s-70s) Medicare paid hospitals on the basis of Usual, Customary and Reasonable (UCR) charges. This was essentially cartel pricing whereby the few sellers (think 3 hospitals in an area) had every incentive to elevate charges since they were typically paid a percentage of this by Medicare and private insurance.
• In the 1980s, Medicare began paying on the basis of prospective payment (average amount based on diagnosis plus adjustments for teaching, DSH payments for caring for the uninsured, capital expenses, etc. and so the rank ordering of private as highest and Medicare below was generally locked into place.
• Charges may/must have some impact on amount paid for care by different payers, but how is unclear. For example, UNC has explicit policies for the uninsured, but as you can see the discount is based on charges; so charges aren’t irrelevant.
• The real question is whether any differences in the amount paid to hospitals are related to quality? That is what we need to get after and it will be hard for both technical and political reasons.
  The ACA nudges us in that direction.
• I could imagine someone reasonably saying that the teaching mission of a hospital is a societal benefit that might not improve quality (could be the opposite). This would argue for more explicit support of this mission and not burying the indirect medical education support in each payment as is now done (there are also direct subsidies to medical schools/hospitals). Note all three of the above hospitals have a teaching mission.
• Any hospital administrator will answer when being questioned about anything related to charges/payments/costs: but we have to care for the uninsured. There is some true amount of cost shifting, that is likely smaller than many think. Expanding insurance coverage is also important for doing away with what you might think of as “the negotiating impact” of the uninsured; when hospitals answer most any question about charges/payments/costs by saying “but the uninsured”. I believe this is more consequential than actual cost shifting.
• I don’t think the release of this data is “a game changer” but I do think that it will serve to increase awareness among the public (along with this Time piece) about the opaque nature of hospital prices, and the word jumble that is charges, payments and costs.

cross posted at freeforall