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In 1998, I traveled to Moscow for the first time to teach in a summer course at the Russian Academy. The week before, we were on vacation and I heard on the radio “Today, the ruble lost 100% of its value.” This news was arresting—it meant that the ruble was worthless. That seemed unlikely. Indeed, the next day, the announcer apologized and said she meant to say that the ruble lost 50% of its value.  In the event, by the time I arrived at the Hotel Sputnik in Moscow, all the cash machines in the city were shut down. Restaurant prices changed hourly during my five-day stay, and there were sidewalk signs posting exchange rates that were written in chalk so they could easily be edited. Certainly puts our recent experience with inflation in perspective.   Over at jabberwocking.com, Kevin Drum notes that the ruble is down 30% since the war started and 20% just since September.   From the comment thread: “The problem with the Russian economy at this point is that it is basically...

I’ve read where Musk and Ramaswami are proposing a 75% cut in the federal workforce. That’s absurd.  • National security-related agencies account for roughly 70% of the civilian workforce. The largest employers were the Department of Veterans Affairs, with 487,000 workers, followed by the armed services, the Department of Homeland Security, and the Justice Department. Republicans in Congress are not going to propose a 75% cut in the Armed forces and law enforcement; • Outside of the DC area, the highest concentrations of federal employees are mostly in red states. GOP congressmen aren’t going to cut off those federal tax dollars to their districts. Like with Trump tariffs, these massive layoff threats are just bloviation.   https://www.reuters.com/world/us/who-are-us-federal-workers-that-trump-musk-want-trim-2024-11-19/?fbclid=IwY2xjawG2v5VleHRuA2FlbQIxMQABHYe6cvK1LuGGbQk1bWOJDOs5MSqbSBbKoQSDY-ZtLbqJAIUf-POaYF63Dw_aem_aMEbglKnCAfjnch0DNsIuw

Mexico buys about $300 billion worth of goods from us every year, mostly machinery, oil, autos, food and office equipment. If Trump imposes a 25% tariff on Mexican imports, you can be sure that Mexico will retaliate, at the expense of American jobs. Meanwhile, Mexico will certainly be looking to source these goods from China and the EU. Trade is global. Trump’s tariffs will devastate the US economy and drive up inflation.   I’ve seen speculation that the Trump Administration plans to use tariffs to compensate companies hurt by the tariffs. But American consumers (=taxpayers) will be hurt by tariffs, as they cause the cost of goods, both imported and domestic, to go up. I guess our compensation will be increased inflation. A lot of smart people believe these tariffs are just the economic equivalent of live wrestling. The tariffs will bring Canada and Mexico to fake-negotiate some face-saving “deal” for Trump so he can re-live his phony USMCA deal that he’s now repudiated. As for Chi...

Back when Trump rebranded NAFTA as “USMCE,” here’s what he said about it: “We have negotiated this new agreement based on the principle of  fairness and reciprocity .... This is a  terrific deal  for all of us....This new deal will be the most  modern, up-to-date, and balanced  trade agreement in the history of our country.... With this agreement, we are  closing all of these terrible loopholes.  They’re closed. They’re gone. They were a disaster.... We are requiring  a large portion of every car to be made by high-wage workers,  which will greatly reduce foreign outsourcing.... This deal will also impose new standards requiring at  least 75 percent  of every automobile to be made in North America.... This landmark agreement will  send cash and jobs pouring into the United States .... We formed a  great partnership  with Mexico and with Canada.... It’s a  fair deal  for everybody.” Now he’s going to slap tar...

If it bleeds, it leads. CNN has a piece about Ramon Rivera, who randomly stabbed three people in NYC. He was mentally ill, in and out of Rikers and mental health facilities. He’s like a drunk driver who has a history of alcoholism. “New York City Mayor Eric Adams described Rivera as a homeless man with a criminal history and “severe mental health issues,” an example of failures of the criminal justice and mental health systems.   “The seemingly random killings highlight the challenges confronting New York City and other municipalities across the country as they maneuver a delicate balancing act – how to deal with  soaring homelessness  and  mental illness  and its perceived – and actual   – impact on public safety. “We always hear something is being done but nothing changes, and every six months something unthinkable happens,” said Mary Brosnahan, who for three decades led the Coalition for the Homeless, an advocacy and service organization. “ Not unth...

  Trump has promised to deport >10 million undocumented people living in the US. He justifies this by saying they are dangerous criminals. In fact, immigrants commit crimes at a *lower* rate than US citizens. He has announced his intention to deploy US troops in US streets to capture and detain people who are claimed to be undocumented.  Trump also justifies the massive deportation on the grounds that the undocumented are taking lots of jobs from citizens. The facts and evidence don’t support that assertion: “A recent synthesis of dozens of studies found that immigration had only a very slight negative impact on the wages of less-educated native-born workers. A comprehensive overview by the National Academies of Sciences, Engineering and Medicine found modest negative effects only for some earlier immigrants and for teenagers. A paper published this spring, whose authors included Giovanni Peri, an economist at the University of California, Davis, found that immigration had ...

The United States emerged in the 20 th  century after two world wars as the world’s sole superpower. It further cemented its political and economic hegemony with the collapse of the Soviet Union. But like all empires throughout history, the American empire has a finite half-life, and its final decline is in full view. For some historians, that has been evident for years: “Some 15 years ago, on December 5, 2010, a historian writing for  TomDispatch  made a prediction that may yet prove prescient. Rejecting the consensus of that moment that U.S. global hegemony would persist to 2040 or 2050, he argued that “the demise of the United States as the global superpower could come… in 2025, just 15 years from now.”   “To make that forecast, the historian conducted what he called “a more realistic assessment of domestic and global trends.” Starting with the global context, he argued that, “faced with a fading superpower,” China, India, Iran, and Russia would all start to ...

Modern Argentina has had a problematic and sometimes sordid history. From the dirty war of the 1970s to hyperinflation, the South American nation has been ill-served by most of its leaders.  Javier Milei was elected president of Argentina in October 2023 after campaigning to overturn the status quo and transform the economy and politics of the troubled nation. He reminded some of Donald Trump: “Milei promised to end the dominance of these two main political coalitions, or what he called “the political caste.” Gaining prominence first through social media, Milei blasted his opponents as thieves and rats. He pledged to make Argentina return to the wealth of the early twentieth century by dollarizing the economy and destroying the state. His brash style and big promises gave many Argentines hope that he could end their suffering. Despite concerns that he would damage the country’s democracy, he won the runoff election with 56 percent of the vote. He carried 21 of the country’s 24 elec...

One of the phenomena that have led to increased income inequality and the hollowing out of the middle class in America is the decline of unions. Recently, it appears that some workers are trying to claw back some of that lost economic ground. Now I don’t count PCPs as middle class or working class. Yes, they are among the most poorly compensated docs, but they still make well over the median income. But I’m happy to see this class of workers press for unionization. The alternative is a further decline in the number of PCPs, which has been declining for years. “Nearly 300 primary care physicians employed by Massachusetts General Brigham have notified federal authorities that they want to join a union, citing “burnout” and the “corporatization of medicine” at the state’s largest health system.   “The doctors comprise the “vast majority” of primary care physicians employed by Massachusetts General Hospital and Brigham and Women’s Hospital, according to Dr. Michael Barnett, a primary c...

Anti-vaxxer and brain-worm afflicted RFK Jr has announced, among his priorities, to use federal money to get people to eat better. From The Palm Beach Post: "The former independent presidential candidate is a big fan of Trump but not so much about the president-elect’s fast-food diet.   "During an interview on “The Joe Polish Show,” a marketing industry podcast that aired on Tuesday, Nov. 12, RFK Jr. criticized some of Trump’s food preferences. “The stuff that he eats is really, like, bad,” he stated, describing certain items on the former president’s menu as “poison” in some cases.   “Campaign food is always bad, but the food that goes onto that airplane is, like, just poison,” Kennedy said on the podcast, likely referring to Trump's private airplane. You have a choice between — you don’t have the choice, you’re either given KFC or Big Macs.” I’m not a fan of the food-as-medicine trope, or its inversion, the food-as-poison trope. It’s the dose that makes the poison. Nobo...

Years ago, we had an MD/PhD student in our program who had Eilers-Danlos syndrome, a connective tissue disorder that causes joint laxity and frequent painful joint dislocations. After over a decade of being misdiagnosed, her correct diagnosis was made by a physical therapist, not a physician. I noted in a previous post that I’ve been seen by nurses and physician’s assistants in clinics and gotten good care. I’ve had robotically assisted surgery that worked out fine. Now that AI can read radiological images with greater accuracy than most radiologists, we can expect machines and paraprofessionals increasingly to take over jobs that used to be done by physicians. American healthcare is evolving. Diversity in healthcare delivery is a good thing and should help control costs. A PhD colleague who worked in a clinical department referred to physicians as “MDeities.” He was referring to their attitudes about their own status, but far too many patients treat their doctors as deities, too. Idea...

I remember reading the book "The Peter Principle" in high school. For those of you who didn't, or who forgot, the Peter Principle states that an employee continues to receive promotions to work in higher ranks up to that point where he reaches a level of incompetence. In simple terms, the higher the hierarchy ladder an individual goes, the more likely he is to fail in his new position. I'd forgotten about this until it came up in a comment thread over at jabberwocking.com: "One of the things that makes me more optimistic than some of my fellow liberals is based on the Peter Principle. Trump is applying the Peter Principle in an accelerated way, advancing people far past their levels of competence. While that might seem at first like a Bad Thing, it means that the Deep State Government Bureaucracy can do what it does best: Turf battles and red tape. "So while Elon Musk, et al can do a fair bit of damage, their lack of competence in government will limit what ...

America is the only industrialized nation where you can go bankrupt because of medical care. The ACA helped mitigate that risk for tens of millions, but the Trump Administration is promising to abolish the ACA.  For those with some form of health insurance (private insurance, the ACA, Medicare), there’s still the challenge of (a) finding a physician and (b) keeping their attention for more than the few minutes they could afford to spend on each patient. Now, for the privileged, there’s “concierge medicine.” A few thousand dollars on top of your regular insurance gets you more time with your doctor and easier scheduling. Of course, if you can’t afford that extra payment, you get the physician cattle call with the rest of the hoi polloi. And increasingly, you’ll be seen by a nurse or physician’s assistant.* Doctors are embracing concierge medicine because it allows them to practice the sort of medicine they trained for, without the pressure to cut every encounter short. And they make...

Trump and his minions may not believe in global warming, but people whose livelihoods depend on understanding climate change—bankers, insurance companies and the military—know it’s real. So do non-humans whose livelihoods are compromised by climate change: “Native fish populations will likely continue their decline off of Massachusetts’ coast, while species from further south will move in, scientists found. The bay will continue to get acidic and inhospitable for the many fish, plants, and shellfish that live there now.   “Oceans absorb about 30 percent of the carbon dioxide that’s released into the atmosphere. When absorbed, carbon dioxide makes sea water more acidic through chemical reactions, putting the entire food web in the marine ecosystem at risk, according to the National Oceanic and Atmospheric Administration.   “One example: Higher acidity causes shells to deteriorate, which kills shellfish. That will be an early marker of a shift in fishing ecology in Massachusetts...

No, the 1% aren’t the job creators—that’s the middle class and working class. Tax cuts for the 1%, of course, don’t create jobs, they just create greater wealth disparity: “The authors set out to examine all instances of major tax reductions on the rich in 18 OECD countries between 1965 and 2015 and identify the results . . . There was no noticeable effect on growth. Or on unemployment. So what  did  the tax cuts accomplish? “We find that major tax cuts for the rich push up income inequality, as measured by the top 1% share of pre-tax national income. The size of the effect is substantial: on average,  each major tax cut results in a rise of over 0.7 percentage points in top 1% share of pre-tax national income.   “On the income inequality side, the results  do not closely align with the theory that the rich have greater incentives to work and invest when their taxes are cut,  given that we do not find any statistically significant effects on growth, unemplo...

We had rooftop solar on our house for eight years before we moved. Half the price was paid by Ameren, the electric utility, and we got a 30% tax rebate on the balance. Even with that steep discount, we never got back our put, even in nominal dollars. Solar panels are much cheaper now, and I gather installation costs have fallen as well, but rooftop solar is still subsidized here in Rhode Island. We’ve had a couple of solar salesmen drop by, but I point out that we have too many trees to make it worthwhile. One offered to arrange to have the trees cut down. I laughed: I wasn’t going to make reducing carbon capture the price of rooftop solar. Instead, we purchase our electricity from a solar farm instead of the local utility, which generates over 60% of its electricity from natural gas. Overall, though, things are looking good for solar: “At the current rate of growth, solar capacity will reach about a thousand gigawatts by 2030, which would probably be about half of total demand. Raw co...

The Trump administration is threatening to deport >10 million people. These are people who, regardless of their immigration status, are contributing to the economy and jobs by purchasing goods and service (“job creators”) and contributing to social programs like Social Security and Medicare. Indeed, if they are undocumented, they will never see benefits to the programs they subsidize, since they use fake SS numbers. How will Trump’s deportation hurt working class Americans? From the link: “Higher prices “Deporting millions of undocumented workers would mean that businesses will need to replace those laborers. With historically low unemployment, finding people willing to work for low pay could be difficult, and companies may need to advertise higher wages to attract workers to replace deported laborers. “Job growth will slow “If huge populations of migrants are deported — or at the very least population growth slows as a result of tighter immigration policies — there will be less con...

I’ve seen some people post “Happy Veteran’s Day.” I’m not a veteran. Technically, my dad was, although he was a naval officer who did his service in the Canal Zone, nowhere close to combat. I never saw him happy on Veteran’s Day. I was never in the military, although I did carry a draft card during the Vietnam War. My number was assigned, but the draft ended before I could be called in for a physical. I do know a few who went to Vietnam and lived to tell. I’ve been to the memorial to those who didn’t live to tell. The best way to honor Veteran’s Day, in my opinion, is to commit to avoiding war whenever possible. I’m currently halfway through reading “The Sleepwalkers: How Europe Went to War in 1914” by Christopher Clark. I’ve read several books about WWI, but this focuses on how the European powers at the time perceived the situation, and how an assassination in Bosnia could have touched off a world-wide conflagration. It’s complicated, of course, but one thread that runs through the h...

Trump says global warming is a scam and a hoax. He promises to cut federal funding for green programs and to ramp up fracking and drilling. He can certainly do the former, but business controls drilling and fracking, and the price of oil is dictated by international supply and demand, not the whims of the Trump administration. “NGFS—the Network for Greening the Financial System—is a group of all the world's central banks that tries to estimate the macroeconomic effects of climate change. They published their latest report this week, and it’s grim . . . they estimate that global GDP in 2050 will be 15% lower than it would be if there were no climate change. That's only 25 years away. “Note that this is not a bunch of lefty enviro rabble rousers. It's central bankers, normally a fairly sober lot. But like insurance companies and the military, they're starting to get pretty worried.” So all the smart central bankers, insurance companies and the military planners who have s...

In 2020, I enrolled in the Moderna clinical trial of their mRNA vaccine. I got the first jab in August 2020, and have now had seven vaccinations, as the vaccine has been updated. I have contracted COVID once. Of course, the purpose of the vaccine is not to prevent COVID infection, it’s to keep you out of the ED and the morgue, as well as preventing long COVID. Worked for me and for millions of others. “A regional public health department in Idaho is no longer providing COVID-19 vaccines to residents in six counties after a narrow decision by its board. “Southwest District Health appears to be the first in the nation to be restricted from giving COVID-19 vaccines. Vaccinations are an essential function of a public health department.” Why does the Idaho Southwest District want its citizens to suffer and possibly die from a preventable condition? Why do they want to be the next source of infections for the rest of the US? https://www.medpagetoday.com/infectiousdisease/covid19vaccine/11271...

My parents retired to rural upstate NY, where they lived happily for 20 years. But naturally, as they aged, their health declined. At one point, my mom had a pulmonary embolism, and landed in a community hospital in Bennington VT, about 30 miles away. She got the care she needed, but when she was later diagnosed with multiple myeloma, she had to go to Boston for the care she needed. Vermont is a fairly rural state overall. Fine if you’re young and healthy, but Vermont’s healthcare programs are struggling:   “Rising health costs are a problem across the country, but Vermont's situation surprises health experts because virtually all its residents have insurance, and the state regulates care and coverage prices.   “For more than 15 years, federal and state policymakers have focused on increasing the number of people insured, which they expected would shore up hospital finances and make care more available and affordable.   "Vermont's struggles are a wake-up call that insuran...

  I have two dental implants, the first of which was done nearly ten years ago. They were both done after a tooth broke and the dentist told me he couldn’t save the tooth. I could have just left the hole, but elected to fill it with an implant, which was done in each case by a maxillary surgeon, not the dentist. So far, I’ve been very happy with the results. What is a dental implant? “In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use "full-arch" or "All-on-4" implants to replace all their upper or lower teeth -- or all their teeth.” It looks like dental implants are being done by dentists now. And not for the better: “Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry's fundamental goal of preserving natural teet...

I’m reading every now and then about the future of robot assisted medicine. Robots have long replaced humans in routine, repetitive tasks like auto assembly, but surgery seems like a bespoke activity beyond the reach of robots. Not so. A few years ago, I had mesh hernia repair surgery. The procedure was robotic-assisted laparoscopy. There were four small incisions in my abdomen, one at my navel. I was under general anesthesia during the operation, so I can’t say for sure what happened, but from what I’ve read, one incision is for a camera to guide the operation. One may have been for the insufflation, introducing carbon dioxide gas to create a working and viewing space by separating the abdominal wall from internal organs. Of course, a surgeon guided the procedure (or so I devoutly hope!), so the robot wasn’t on its own. So far, the results have been fine for me, and the sites of the incisions have healed indistinguishably from the surrounding skin. How many routine surgeries are amena...

When alcoholic beverages were illegal in America, drinking didn’t stop. Alcohol smuggling just became lucrative for criminal gangs. Drugs like cocaine and heroin have been illegal for decades. Consumption of cocaine and heroin didn’t stop; smuggling of these drugs just became lucrative for criminal gangs. Making undocumented migration illegal and militarizing the Mexican border didn’t stop undocumented migration. Human trafficking just became lucrative for criminal gangs. The problem of alcohol smuggling during Prohibition was solved by repealing Prohibition. Narcotics and narco gangs continue to be a huge problem in America, since the market for drugs in America amply repays the efforts of the gangs. And the labor market for undocumented migrants? That also continues to be huge in America. All that could be addressed by enforcing the use of E-Verify. As Kevin Drum notes: “[E-Verify is] 98% accurate within 24 hours and 99.8% accurate overall. And it's easy to use. Despite this, few...

When I was growing up, fluoridation of water was regarded as a commie plot by the John Birch Society wingnuts. Nevertheless, hundreds of millions of Americans (including my wife and I) have lived with fluoridated water without evidence of harm. I see where RFK, Jr is predicting that the second Trump Administration will recommend against water fluoridation. In a society where many city water supplies are fluoridated and fluoridated toothpaste is widely available, the benefits of putting fluoride in the water are less obvious than they were 70 years ago and are thus being forgotten. Yes, I understand that too much fluoride can kill you. So can too much water. As any pharmacologist will tell you, the dose makes the poison. Artificial fluoridation of water wasn’t some nefarious plot. In places where natural fluoride levels were high, the frequency of dental caries was lower. There’s plenty of epidemiological evidence that artificial fluoridation also results in fewer dental caries. Within ...

  Agriculture requires photosynthesis to make food. However, the photosynthetic mechanism is slow,  inefficient and requires a lot of resources. A recent paper describes an electro-agriculture technology that combines carbon dioxide electrolysis with biological systems to boost the efficiency of food production. If implemented at scale, such a system could reduce agricultural land use in the United States by nearly 90% and allow food to be grown in urban areas and deserts without the need for light or pesticides. It would also allow more efficient fertilizer use. “The most readily consumable carbon sources produced via CO 2  electrolysis at relatively high efficiencies are ethanol and acetate. Metabolically, ethanol is converted to acetate with alcohol dehydrogenase and acetaldehyde dehydrogenase. Both ethanol and acetate can be used to cultivate common eukaryotic organisms such as yeast or mushroom-producing fungi, which are already consumed as food. Acetate can als...