Healthcare, Electricity, and ObamaPower

I'd like throw a new thought into our current national debate about health care, by looking back in time to the Rural ElectrificationAct of 1936.  This Act was established during the Great Depression to provide farms and other rural locations with inexpensive electricity, for lighting and other purposes.  Why did Congress bother to pass this law?  We had reached the point in society where electricity was necessary, but the market cost to install and service electrical lines out from cities to rural locations was prohibitively high.  TheREA was set up as a subsidized loan program, with loans going to governments and local co-ops, but not directly to individual consumers.  These days, the REA has evolved to add pilot programs for high speed (gigabit) Internet to rural areas of the U.S.

Fast forward to the early 1960’s, and health care for seniors.  At that point, health care for senior citizens had become like electricity for rural citizens a generation earlier:  necessary, but too many were beingpriced out of the market.  The solution was Medicare, which was a subsidy like rural electrification funding, with funding being a “single payer” model to caregivers, but it wasn’t done as a loan.  Still, it was done to solve a problem that the free market was having trouble addressing, and Medicare has been viewed as a popular success since it became law in 1965.

Medicaid, which came later, and then the Affordable Care Act of 2009 attempted to address similar issues, but with a different population.  Rather than focus on groups defined by geography or age, this time the concern was health history and/or economic status.  Those with pre-existing conditions or lack of sufficient financial resources were being priced out of the market.  Medicaid and the ACA attempt to make necessary health care affordable for these groups of people.  It has been a mixed success, as we know, and now Congress is considering repealing the ACA.

But, let’s go back to the REA for a moment and imagine if that had been a more recent creation with a more recent President.  Here’s a paragraph from an alternate reality version of Time magazine: 

In order to achieve universal electrification, Obama and the Democrats passed the Rural Electrification Act.  At the time the Rural Electrification Act was passed, electricity was commonplace in cities but largely unavailable in farms, ranches, and other rural places. The Republicans branded it "ObamaPower" and did everything they could to prevent its proper implementation, including court cases, filibusters of related bills, and the famous "You Lie!" moment in Congress.  They ran on repealing ObamaPower, and remarkably won seats from the rural districts most likely to benefit from the Act.

Gaming the Constitution

Political maneuverings in recent years, in Washington and elsewhere, seem an outgrowth of the Nintendo Entertainment System era.

In current events, President Obama is preparing a nomination to replace Antonin Scalia on the Supreme Court.  However, within hours of Scalia’s death earlier this month, Senate Majority Leader Mitch McConnell announced, “This vacancy should not be filled until we have a new president”.  This launched a number of discussions, such as: the timing of such a statement, what the statement said about McConnell and the Republicans’ respect (or lack thereof) for President Obama, and how the President should respond.  It also raised the question of whether or not what McConnell stated was constitutionally valid.

Republicans have been making the following case:  Yes, in Article II, Section 2 of the United States Constitution, we read that the President has the power to make appointments to the Supreme Court “by and with the Advice and Consent of the Senate”.  But, nothing in that Section or anywhere else says that the Senate has to give Consent – that the Senate has to agree to whoever the President nominates – nor, that there is any timeline for agreeing, or not agreeing, with the President’s choice.  Even though the longest time that has ever passed from nomination to vote for a Supreme Court justice has been 125 days, there is nothing in the Constitution – the source code of our government – that requires such a vote.  That’s what the Republicans have been saying, and the argument reminds me of how Madden NFL has affected play in the National Football League.

As reported by Wired, in a Denver-Cincinnati football game in 2009, the Broncos were losing 7-6 with 28 second left in the game.  The ball was on Denver’s 13-yard line.  A dramatic play started with Broncos quarterback Kyle Orton throwing to his wide receiver Brandon Stokley, who then headed downfield to score the go-ahead, and probably winning, touchdown.  Then this happened:

Just before he reached the end zone, with 17 seconds remaining, Stokley cut right at 90 degrees and ran across the field. Six seconds drained off the clock before, at last, he meandered across the goal line to score the winning touchdown. For certain football fans, the excitement of a last-minute comeback now commingled with the shock of the familiar: It’s hard to think of a better example of a professional athlete doing something so obviously inspired by the tactics of videogame football.

Stokley’s maneuver was to delay crossing the goal line in order to take time off the clock at the end of the game and greatly decrease the chance that the Bengals would find a way to score their own touchdown to win. It was a tactic that veterans of football simulation video games knew all about, from playing games like Madden in their living rooms and man caves.  Andrew Filch has reported on other examples from sports, from soccer, NASCAR, and NFL football.  What do the they have in common?   An unprecedented move that the source code of the video game allowed (so it was not technically against the rules) and helped raise the odds of victory.

Sounds like McConnell’s scheme.

We’ve seen this play out many times over the past decade in politics.  There was the “game of chicken”on the debt limit in 2011 – unprecedented but constitutional.  In order to prevent presidential recess appointments, this clause from Article I has been used to maintain pro forma sessions:  “Neither House, during the Session of Congress, shall, without the Consent of the other, adjourn for more than three days.”  State legislatures have been exploring the meaning of this clause from Article II:  “Each State shall appoint, in such Manner as the Legislature thereof may direct …”, the voters in the Electoral College.  Well, to be more precise, Legislatures that are under Republican control in states won by Obama are considering changing their manner of appointing electors so that if a Democrat wins these states again in 2016, some of the electors will nevertheless be assigned to the Republican candidate.  (And there is more to that story.)  And, in Michigan, the Republican legislature and governor now routinely take advantage of a rule in the state constitution that prevents repeal referenda on laws that have any sort of government spending attached.  This tactic was used recently when some state election laws were changed.

So far, all the examples I have given of “Gaming the Constitution” have been due to Republicans.  But Democrats have not been completely innocent.  I’m certain the way this clause from Article I has been gamed started with Democrats when they controlled Congress:  “All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.”  President Obama’s “grant of deferred action” executive order to stop deportation of some DreamAct-eligible students is an example.  Article II states that “The executive Power shall be vested in a President …”, and later, “… he shall take Care that the Laws be faithfully executed …”, but there is nothing in the “source code” that requires the Department of Justice to follow up on every case of a federal law being violated, right? 

But, to my Democratically-biased eyes, I believe that the gaming behavior of the Republicans the past several years has differed in degree and kind, and in contemptuousness for the Democrats and for tradition.  Ironic, for a conservative party.  But not inconsistent with the idea of a living Constitution, with an evolving, progressive interpretation, which is usually considered to be in the DNA of the Democratic party.

What might we prepare ourselves to expect when it comes to future constitutional gaming tactics?  Should we brace ourselves for unprecedented application of these clauses?

• “Times, Places and Manner of holding Elections for Senators and Representatives” (Article I, Section 4)
• “Each House shall be the Judge of the Elections, Returns and Qualifications of its own Members” (Article I, Section 5)
• “No State shall, without the Consent of the Congress, lay any Imposts or Duties on Imports or Exports” (Article I, Section 10)
• “The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States.” (Article IV, Section 2)
• “The United States … shall protect … on Application of the Legislature, or of the Executive (when the Legislature cannot be convened) against domestic Violence.” (Article IV, Section 4)
• “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” (Amendment IX)
• “Whenever there is a vacancy in the office of the Vice President, the President shall nominate a Vice President who shall take office upon confirmation by a majority vote of both Houses of Congress.” (Amendment XXV)

I guess we will see.  As time passes and more and more new Congressmen arrive in Washington, raised, on video games, we may see even more gaming of the Constitution.

One last thought on this matter:  Instead of being influenced by some fanciful Washington 2016 from EA Systems, maybe the true source of all this is Ross from Friends:  “We were on a break!”

Michigan’s Proposal 1: Responsible Spending on Road Repairs?

There are a lot of cross-currents of thought regarding the upcoming Proposal 1 vote here in Michigan.  If it passes, Michigan will see an adjustment to fuel taxes, a hike in the sales (or use) tax, an increase in the Earned Income Tax Credit (effectively a tax cut for some), some new rules on the use of money in the School Aid Fund, and, hopefully, better roads and better schools.  As the lead author of The Gas Game blog, I want to take a look at the roads/gas tax piece of the proposal.

You should know, though, where I am coming from politically. I am not a conservative who is against all taxes, and the government-is-too-big-and-too-oppressive ideology is not in my wheelhouse.  I consider myself a moderate Democrat, but I’m not against Proposal 1 because Gov. Snyder is for it.  I want my government – of the people, by the people, for the people – to work efficiently and work well.  So, the question I want to consider is whether or not the roads/gas tax piece is responsible direction for our State government to go in.

I have seen on TV and have received by mail a lot of advertising in support of Proposal 1.  (It isn’t clear if the ads are making a difference, as polls indicate alack of support for the proposal.  I’ve only seen a few “NO ON 1” yard signs.)  There are many messages in the ads, but the one that caught my attention recently was this:  Michigan spends lesson roads per person than any other state.  Is that true, or at least close to true?  I decided to do some investigating.

What is wonderful about the Internet age is that information is usually available at your fingertips, as opposed to trying to track it down at a library, or not having the information available at all.  Using publicly-available data, some from the federal government, I’ve put together a spreadsheet that focuses on the “Big Ten states”.  Specifically, I’ve collected in this spreadsheet items such as number of highway miles, population, current fuel taxes, fuel tax revenue, federal spending on roads in each state, and overall spending.  (Links to the data sources are in the spreadsheet.)

My underlying assumption is that states that have Big Ten universities tend to have similar weather and traffic, and therefore similar road use and abuse.  (We can argue about this assumption, but I think it is fair to say that southern states have to deal a lot less with potholes and many of their Interstate highways were designed and built later in the 20^th century, and hence built based on the northern states’ experience.  For example, the narrow and problematic I-94 through Michigan.)

Looking over the data, I decided that the best way to compare these states is by looking at the combination of recent annual Federal and state spending for each mile of road.  As you can see, in nearby Ohio, about $24,000 is spent per year on the average mile of road.  In Pennsylvania, it is $30,000.  In Nebraska, a little more than $6000, while in Michigan, it is a bit more than $16,000 per mile of road per year.

Another comparison, for those more tax-focused, is that federal and state road spending works out to about $199 per person in Michigan, which, other than New Jersey, is the lowest in the Big Ten states.  I suspect New Jersey is lower because it has a lot more people packed into a smaller area, so the denominator in computing this number is a lot larger.

Now, I do think that Ohio and Pennsylvania are better states to compare to Michigan than Nebraska and New Jersey (hey, those states just joined the Big Ten recently!), and I come away from my study with the recognition that we do not devote tax dollars to our roads in the way that our neighboring states do.  (And, therefore, our roads are worse!)

In addition, as you see in columns F-H, Michigan’s fuel tax is below the average, and the revenue from the fuel tax isn’t exactly beating out other states.  Nor, interestingly, is the federal funds per person (column J).  So, not only are we paying less in state taxes to fix our roads, we aren’t getting the money from Washington to fix our roads like other states are!

So, what can we conclude at this point?  In comparing Michigan to other Big Ten states, we could be spending more to fix our roads, and we would have better roads.  We could become an “average Big Ten state” by increasing our gas tax and getting more money from Washington.  Despite the goal of The Gas Game to buy gas as cheaply as possible, I would support increasing the gas tax, provided that this money is clearly marked for road repairs above and beyond what we already spend.  I also support on-going adjustments to fuel taxes so that the users of the roads end up paying what is needed to maintain high-quality roads.

As far as the rest of Proposal 1, I like the idea of warranties for road projects, and strengthening the Earned Income Tax Credit.  I’m not happy about the idea of increasing the sales tax, since we just cut taxes to businesses a few years ago, so this has a shell game feel to it, with the working class and middle class getting the empty shell.  I don’t know what to believe about the School Aid Fund. 

And I’m sick of the game where Republicans cut taxes and budgets and things fall apart, and the Democrats raise taxes and budgets and fix things. As a Democrat, I want to see the Republicans, who worked so hard to get control of the state government, to have to do the responsible thing and vote for higher spending on roads in the Legislature, and not go through this Proposal 1 carnival.  Or, if they simply can’t do what needs to be done, for the people to understand this and vote them out for this reason.  I agree with this comment from “Martin Pollard” in the comment section of an article about Proposal 1:  “It's also anger directed against a legislature that refuses to do its …  job and instead punts the issue over to the voters, thereby keeping their precious hands clean.”

I still haven’t decided how I will vote on May 5.

MLB Midsummer Classic 2013

A year ago on this blog, I proposed that Major League Baseball scrap the All-Star Game in favor of a mid-summer NCAA-style tournament.  A year later, there has been no action on my proposal (and we're surprised?), but with the end of June here, it is time to announce this year's seedings for our faux tournament.

For winning pennants last October, San Francisco and Detroit get first round-byes, and they are seeded #1 and #2.  The rest of the teams are seeded based on their records as of Sunday morning, June 30.  Yes, Pittsburgh is the #3 seed!

We'll take Monday off and start with triple-headers on Tuesday, July 16 -- for each site, the two games in the list are at 1PM and 4PM, with the finale at 7PM.  Some potential intriguing matchups are 3/14 PIT/TAM, 7/10 ATL/BAL, and 5/12 BOS/NYY.

1 SFG BYE
17 COL vs. 16 WAS

25 CHC vs. 8 OAK
24 SEA vs. 9 CIN

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2 DET
18 SDG vs. 15 TOR

26 NYM vs. 7 ATL
23 LAD vs. 10 BAL

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30 MIA vs. 3 PIT
19 PHI vs. 14 TAM

27 CHW vs. 6 TEX
22 MIN vs. 11 CLE

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29 HOU vs. 4 STL
20 KAN vs. 13 ARI

28 MIL vs. 5 BOS
21 LAA vs. 12 NYY

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That will leave us 8 teams for Wednesday, July 17, so we'll play four games to get our Fast Ball Four.  On Thursday, July 18, we'll have one more triple-header -- two games in the afternoon, and the finale starting at 8PM on Fox.  Each player on the winning team gets a $1 million bonus.

Bracket contest, anyone?

What Can You Do With Your Continuous Glucose Monitor Data?

The mathematician in me has wondered what I can do about type-1 diabetes since my son was diagnosed in 2007.

If you don't know, type-1 diabetes is an autoimmune disease in which the beta cells in the pancreas are destroyed by the body's immune system.  Scientists are still trying to determine the true causes of type-1, but it is not a communicable disease.  There is evidence that there is a genetic predisposition to type-1, but something in the environment is triggering the beta cell destruction.  The incidence of new cases of type-1 is increasing worldwide.  JDRF, an organization that I volunteer for, works to prevent, treat, and cure type-1 diabetes.

Treating type-1 involves the on-going monitoring of blood glucose, and the introduction of artificial insulin to "cover carbs" in the diet and "correct" high blood sugar without "going low".  Blood glucose levels can be measured several times a day by pricking the finger and using a glucose meter.  More recently, people with type-1 diabetes are starting to use continuous glucose monitors, or CGMs, which measure blood sugar automatically every five minutes.

Beyond the on-going monitoring of blood glucose and food carbohydrates, and trying to determine how exercise and illness affects my son's numbers, I have asked myself what else I can do with my mathematical training?  Since 2009, exploring connections between mathematics and type-1 diabetes has been part of my research program as a mathematics professor.  In 2009, I learned about mathematical models of type-1 diabetes, and using a large dataset of CGM data, I worked with two students to find a way to cluster diabetic patients based on the variability of their blood glucose -- how much their CGM numbers bounce around.  In 2013, there is a lot of interest in studying blood glucose variability.

More recently, I created a calculation called the "CGM Score" that anyone can use to analyze their CGM numbers.  Simply put, the larger the score, the more the numbers are bouncing around and are out of the target range of 70 to 140.

If you use a continuous glucose monitor and would like to calculate your CGM Score and learn more about it, here are two files for you:

Article about the CGM Score
Excel spreadsheet to calculate the CGM Score

I would appreciate any feedback you have (e-mail: aboufade@gvsu.edu).

Mandating Competence ... at the Expense of Freedom

Next week in Michigan, we are voting on six ballot proposals, including Proposition 1 to endorse Michigan's current version of its Emergency Manager law.  In general, Republicans support the EM law and want the Proposition to pass, while Democrats are seeking a "No" vote so that the law won't go into effect.  But I see a number of parallels between the EM law and the mandate in Obamacare, which I think should cause everyone to pause and consider their positions.

MLive Media Group brings together most of the non-Detroit papers in Michigan, and over the weekend they endorsed Proposition 1 (while the MLive-owned Grand Rapids press endorsed Mitt Romney).  The gist of the EM law is that when a local government mismanages their finances, local elected leaders can be replaced by an "emergency manager" who can break contracts with public employees and make other decisions with the goal of stabilizing the finances of the local unit.  These units can be municipalities, school districts, or other local units.


In the Prop 1 endorsement, the MLive Editorial Board wrote, "Leaders of local government units who consistently cannot live within their means are letting down those who elected them and deserve to be temporarily relieved of their power over the purse, harsh as that is.  No one likes to see such a loss of local control, and there is one sure-fire way for elected leaders to prevent it: Make the difficult decisions needed to keep the unit solvent while delivering needed services to residents."  They also worried about, "avoid[ing] the lasting financial mayhem of bankruptcy".  To save taxpayer money and rescue those who are "let down", the EM law allows the Governor to remove freely-elected officials and replace them with someone else. The Governor basically can say:  if you can't competently manage your finances, then you have lost the freedom to do so, and we are going to do it for you.

Now, I am going to change some words in the MLive endorsement:  "Leaders of families who consistently cannot manage their health care financing are creating a 'free rider' problem for taxpayers and deserve to be temporarily relieved of their power over the purse, harsh as that is.  No one likes to see such a loss of personal freedom, and there is one sure-fire way for citizens to prevent it: Make the difficult decisions needed to have health insurance ... and avoid large medical bills paid for by taxpayers or the lasting financial mayhem of bankruptcy".  President Obama is basically saying:  if you can't competently manage the way you pay for health care, then you have lost the freedom to do so, and we are going to do it for you.

Of course, Democrats love Obamacare, and Republicans think it is the end of the world.

To me, both laws come from the same premise:  mandating competence to save taxpayer money.  Another way to say it:  abridging freedom to save taxpayer money.   Yet another way:  crap happens -- to "local units" and to individual's health.  If we as a society are going to do something about one, why not the other?  If we as a society are going to ignore one, than why not the other?

Win hearts. Win minds. Win elections.

What can a politician, or a political party, say is their mission?

I work at a university, and occasionally I find myself in a discussion about mission statements.  For example, here is the mission statement of my employer, Grand Valley State University:  "Grand Valley State University educates students to shape their lives, their professions, and their societies. The university contributes to the enrichment of society through excellent teaching, active scholarship, and public service."  I like to believe that GVSU actually tries to live up to this public statement.  As faculty, we certainly discuss whether a colleague is an "excellent teacher" or pursues "active scholarship" at tenure and promotion time.

Some people think mission statements and their friends (e.g. vision, values, strategic plans) are a lot of baloney, but there is something to be said about sitting still and thinking carefully about what a person or an organization is trying to accomplish.  If nothing else, it leads to an understanding of what to pay attention to.

So, if you are the Republican or Democratic party, what is your mission?  If you are trying to change the laws of a state or our country, to fit your ideology or philosophy, you need to win elections first.  Some politicians are too focused on this fact, and end up spending all their time fundraising and pandering, as they see this as the path to election.  Others are so purely wrapped up in their ideology that they develop an "I'd rather be right than be elected" mentality.  But if you want to govern, you have to get elected first.

Being elected is not sufficient, though.  Politics is also about persuading citizens to come to your way of thinking.  This can be done on an emotional level.  This can be done on an intellectual level.  But it must be done!  And political parties that are effective in persuasion can set the tone for decades in society.  It seems to me the Democrats, led by FDR, were great at this in the 1930's, and into the 1960's, while the Republicans have been much more effective the past thirty years, starting with Reagan and helped by Limbaugh and Fox News.

Putting all these ideas into a simple mission statement?  How about:  Win hearts.  Win minds.  Win elections.