(What’s Left of) Our Economy: Are Soaring Prescription Drug Prices Really a Thing?

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2020 elections, Bureau of Labor Statistics, core inflation, Democrats, healthcare, inflation, prescription drugs, Trump, {What's Left of) Our Economy

Prescription drug prices keep skyrocketing outrageously – at least, that’s what’s constantly reported.  And much of the evidence looks especially impressive:  Politicians who normally agree on nothing have vowed to rein them in – including President Trump and Democrats of all stripes, including many of the party’s presidential candidates.

So imagine my surprise when I checked into these claims by examining the consumer price data issued by the U.S. Bureau of Labor Statistics each month. They show that these prices have actually fallen on net since December, 2017 (by 0.43 percent).

Moreover, these figures also show that prescription drug prices have fallen during the past year (through May, by 0.99 percent), and that they’re dropping even though the rate of overall inflation and core inflation (which strips out volatile food and energy prices) has been rising (year-on-year by 1.80 percent and two percent, respectively).

Nor has there been a notable increase in prescription drug prices during this calendar year. From January through May, they’ve risen by 0.16 percent. But that’s still considerably less than the overall inflation rate (0.98 percent) and the core rate (0.51 percent).

That’s not to say that there hasn’t been a prescription drug price problem. For example, from May, 2017 to May, 2018, their prices rose by 3.71 percent – much faster than the overall inflation rate (2.74 percent) and the core (2.22 percent).

Moreover, during the last 27 months of the Obama administration, prescription drug prices increased by 11.14 percent, versus 2.67 percent for overall inflation, and 4.78 percent for core inflation. During the first 27 months of the Trump administration, however, these numbers are 2.07 percent, 4.59 percent, and 4.37 percent.

Americans still pay lofty prices for prescription drugs, and especially compared with consumers in other wealthy countries. It’s also important to point out that drug pricing is complicated. (Here are some of the reasons.) And I confess to having no idea why this pricing has been weak lately, and whether the decline will continue.

But when one of the country’s leading measures of inflation is saying that prescription drug prices have been going down, that should be pretty newsy. Even if “everyone knows” they’re soaring.

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Im-Politic: Signs of Hopeless Division or Potential Unity?

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Affordable Care Act, Democrats, election 2020, Gallup, healthcare, Im-Politic, Immigration, independents, Obamacare, Republicans, Trump

Polls like today’s Gallup survey that try to assess what national issues and problems are foremost in American’s minds are terrifically valuable, especially as big elections like the 2020 presidential race approach. Trouble is, Democrats and Republicans and independents of all kinds will struggle to find clear trends marked out in this morning’s survey, much less derive strong comfort from it.

The difficulties start with Gallup’s overall findings about how high various major issues rank on the public’s priority scale. Competing fiercely for the top spot, and mentioned more than twice as often as the next concerns, are “The government/poor leadership” (cited by 23 percent of respondents – in this case, “US adults”) and “Immigration” (cited by 21 percent). And to be more specific, the government/leadership option offered by Gallup included “Congress” and “politicians,” not simply the President. “Immigration” wasn’t further elaborated on.

In principle, some more light might be shed on who could benefit most from this poor government finding by examining the trends over time. But as the chart below shows, although the importance of the overall government issue began rising notably right after the last presidential election (indicating that President Trump is causing most of the anxiety), the ranking became unusually volatile in the middle of last year, and has stayed that way – including through 2019. This year, of course, has seen an unpopular partial federal government shutdown most often blamed on Mr. Trump, rising levels of partisan rancor, and the climax (for now) of the Russia scandals investigation. On the whole, though, it seems reasonable to conclude that this issue is cutting somewhat against the President.

Some evidence to the contrary, however, comes from the current separate figures for Democrats, Republicans, and independents. Democrats express the most concern about the quality of government and leadership, with 32 percent pegging it as the country’s top problem. But although only 21 percent of Republicans chose this option, that result was much closer to that of independents (19 percent) than the Democrats figure. Both independents and especially Republicans are much likelier than the Democrats to blame government failings on the Democrats who now control the House of Representatives, and therefore wield much more power in Washington than during Mr. Trump’s first two years in office.

Using these criteria, the Gallup immigration findings look even more promising for Mr. Trump. It’s true that using that single noun to describe the issue masks the distinction between respondents who consider current U.S. policy too restrictive or not restrictive enough.

But assuming – not too controversially – that Republicans favor more immigration curbs, Democrats fewer, and independents as a group coming down somewhere in the middle, it seems apparent that immigration-motivated Americans are likelier to be Republican and Trump voters. Indeed, only five percent of Democrats view immigration as the country’s biggest problem today, versus 18 percent of independents and 41 percent of Republicans.

As for the rest of the issues mentioned in the Gallup survey, the responses seem to offer hope for both parties. Relatively little concern is expressed about matters such as the economy in general, unemployment and jobs, poverty, and inequality – which looks like good news for Republicans and for the President, since these results clearly signal satisfaction with the so-called pocketbook issues. Ditto for the measly three percent figure recorded for climate change and other environmental issues combined, and the failure of gun violence even to make it into the rankings.

At the same time, Democrats should feel pretty pleased that “Ethics/Moral/Religious/Family decline” alarmed only three percent of respondents, and “Crime/Violence” topped the list for only two percent.

The most puzzling message sent by the Gallup results concerns healthcare – which, it’s widely agreed, helped the Democrats greatly during last year’s midterm elections, and could be a winner for them again in 2020, especially if Mr. Trump continues his war on Obamacare.

The seven percent of the public naming healthcare as the country’s biggest problem resulted in the third highest such score (behind “The government/Poor leadership” and immigration). But especially given its enormous importance for so many families’ finances no matter how the Obamacare fight turns out – and potentially into the future if the White House and both houses of Congress are won by Democrats seeking to expand coverage dramatically – seven percent is hardly astronomical.

But how should this number be interpreted? If it signals overwhelming satisfaction with the status quo, however uncertain its durability is Republicans could benefit – but probably only if they make clear that they won’t go for major change, either. Since Obamacare (officially known as the Affordable Care Act) has shaped the status quo, Democrats in principle could take heart – particularly if their most ambitious ideas on this front fall by the wayside.

And here’s the partisan split (which I don’t think undermines the above analysis): Healthcare is seen as America’s leading problem by three percent of Republicans, seven percent of independents, and 14 percent of Democrats.

This Gallup poll’s findings that so many different and even clashing concerns are troubling Americans these days – and in so many possibly different ways – could understandably be seen as evidence that Americans are hopelessly far from agreeing on national priorities. I prefer a more optimistic take: There’s a new winning consensus and lasting political realignment in the making if only the nation’s political leaders could break out of their ideological straitjackets and build it.

Im-Politic: After Mueller/Barr, Can Trump Be Trump?

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America First, Attorney General, Betsy de, budgets, conservatism, conservatives, establishment Republicans, foreign policy, globalism, healthcare, Im-Politic, Immigration, impeachment, Kevin McCarthy, Obamacare, Populism, Republicans, Robert Mueller, Ross Douthat, seasonal workers, Special Counsel, Special Olympics, tax cuts, The New York Times, Trade, Trump, Trump-Russia, visas, William P. Barr

A week ago, I posted on the likely political impact of the end of Special Counsel Robert Mueller’s investigation of what have become known as the Trump-Russia scandals and of the release of Attorney General William P. Barr’s summary of its principal conclusions – which appear to put these charges and the threat of presidential impeachment they created behind Mr. Trump.

Now it’s time to think about a related and at least equally important subject: the policy effects. They could be profound enough to redefine the Trump presidency and the chief executive’s chances for reelection – even though the early indications seem to be saying exactly the opposite in ways that are sure to disappoint much of Mr. Trump’s political base. Here’s what I mean.

Ever since his administration’s opening months, I’ve believed that Mr. Trump’s policy choices have been strongly influenced by impeachment fears. Specifically, (and I have zero first-hand knowledge here) because President Trump feared that the Democrats and many mainstream Republicans were after his scalp, he concluded that he needed to appease his remaining allies in the latter’s ranks with policy initiatives they’ve long supported even though they broke with his own much less conventional and more populist campaign promises. 

In other words, it was the Russia and related scandal charges that were preventing “Trump from being Trump.”  

Moreover, this reasoning makes sense even if the President was certain that he faced no legal jeopardy. For impeachment ultimately is a political process, and although establishing criminal guilt is clearly helpful, it’s not essential.

The main evidence for my proposition has been the early Trump decision to prioritize Obamacare repeal over trade policy overhaul and infrastructure building; his almost libertarian-like initial budget proposal (at least when it comes to non-defense discretionary federal pending); his business-heavy tax cut; and numerous foreign policy moves that more closely resembled the globalist approaches he decried while running for the White House than the America First strategy his promised.

But although President Trump now seems certain to finish out his first term in office, he still seems to be currying favor with the Republican establishment. Just look at his latest budget proposal, and decision to go after Obamacare again – the healthcare move reportedly made despite the pleas of establishment Republicans like House GOP Leader Kevin McCarthy to move on from an issue now stamped as a major loser politically and threat to the party’s 2020 election prospects across the board.

It’s true that many of Mr. Trump’s trade and immigration policies still clash with the donor-driven agenda of the Republican establishment, and especially the party’s Congressional leaders. But even on these signature issues, the President arguably could be breaking even more sharply with the longstanding Republican and conservative traditions.

For example, Mr. Trump continues to keep suspended his threat of higher tariffs on many imports from China in apparent hopes of reaching a successful trade deal even though Beijing still seems determined to avoid significant concessions on “structural issues” (like intellectual property theft and technology extortion) and on enforcement.

On immigration, the President has just raised the 2019 cap on visas for unskilled largely seasonal foreign guest workers to levels never reached even during the Obama years. His administration also has permitted visas for farm workers to hit record levels and done little to stem the growth of work permits for foreign graduates of U.S. college and universities that critics charge suppress wages for high skill native-born workers.

One intriguing explanation for this continuing policy schizophrenia comes from New York Times columnist Ross Douthat. In a piece this past weekend, Douthat made the case that, although President Trump’s actual record has been largely heretical in mainstream conservative terms, when it comes to staffing (and especially key staff positions)

“there are effectively two Trump presidencies. One offers something like what the president promised on the campaign trail — a break with Paul Ryan’s green-eyeshade approach to entitlement reform, a more moderate tack on health care, an indifference to Obama-era conservative orthodoxies on fiscal and monetary policy.

“The other offers a continuation of the Tea Party’s insistence on spending cuts and Obamacare repeal, and appropriately its present leader is a former Tea Party congressman — Mick Mulvaney, the Zelig of the administration, whose zeal is apparently the main reason that the Obamacare lawsuit now has administration support.”

And the main reason for this confusing mix? The President has relied “on personnel who are associated with 2010-era G.O.P. orthodoxy, rather than elevating the kind of conservatives who have actively theorized for a more populist right.”

It’s so hard to argue with Douthat’s facts that I won’t. But they still leave the main puzzle unexplained – why so many of the President’s personnel picks have been so un-Trumpian. And much of the answer points to a problem that was clear to me ever since Mr. Trump’s presidential candidacy achieved critical mass and momentum, and that doesn’t seem solvable for the foreseeable future.

Specifically, as I’ve previously noted, conservative populists (I’m never been thrilled with this description of “Trumpism,” but for the time being it’s convenient) have never created the institutions and therefore cohorts of first-rate policy specialists remotely capable of staffing a conservative populist administration. Even if you want to identify immigration as an exception – where organizations like the Center for Immigration Studies put out top-flight studies – it’s clear that nothing of the kind has ever existed on the trade and foreign policy fronts.

And even worse, because of the long lead-times needed to achieve these goals, Mr. Trump appears doomed to dealing with shortages of competent true-believers as far as the eye can see. In fact, he’ll face a special challenge in the next few months, as the second halves of first presidential terms tend to see the departures of many early, often burned out appointees. And of course, the Trump presidency has already experienced much more than its share of turnover.

So I’m expecting an indefinite continuation of the eye-popping sequence of events of the previous week – in which Trump Education Secretary Betsy deVos announced an end to federal funding of the popular Special Olympics program, a public outcry ensued, and the President abruptly reversed her decision.

It’s hard to imagine that this kind of zigging and zagging can win President Trump reelection. But it’s also conceivable that the post-impeachment situation will “Let Trump be Trump” just enough – especially if the Democrats err in picking an overall strategy for opposing him.  After all, nothing has been more common in recent American political history than completely off-base predictions of Mr. Trump’s demise.

(What’s Left of) Our Economy: Private Sector U.S. Jobs Increasingly Really Deserve the Name

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Barack Obama, Employment, healthcare, Jobs, private sector jobs, recession, recovery, subsidized private sector, Trump, {What's Left of) Our Economy

Although unemployment in America has hovered near multi-decade lows for most of the last year, concerns about job quality rightly persist – largely because wage gains have only recently showed signs of recovering to historically normal levels for a recovery. But the latest official data from the Labor Department demonstrate that the makeup of the country’s employment picture and how it’s changed make clear continued improvement in one key measure: Growing private sector employment increasingly reflects gains in what I’ve called the real private sector, as opposed to the subsidized private sector.

Also apparent from the employment figures: The resurgence of the real private sector in relative terms as well as in absolute terms has been a Trump era phenomenon.

As known by RealityChek regulars, this trend is encouraging because the subsidized private sector consists of parts of the economy that are often (and even officially) viewed as parts of the private sector, but whose health depends largely on government largesse. That is, its total employment and its employment gains would be much smaller without huge government payouts – i.e., politicians’ decisions. The healthcare services industry is the main example.

By contrast, the real private sector consists of parts of the economy whose health flows largely from free market forces. So without getting involved in the debate over whether the United States supports too many subsidized private sector jobs or not, it should be clear that they have little to do with the state and health of the economy as a whole – unlike real private sector jobs.

According to the Labor Department’s Bureau of Labor Statistics, from 2013 through 2016, the subsidized private sector’s share of total annual employment increases more than doubled: from 11.34 percent to 25.99 percent. And its share of annual total private sector jobs gains (that is, employment increases by the private sector as conventionally defined), soared from 11.02 percent to 28.59 percent.

During 2017 and 2018 (and the data for late 2018 is still preliminary), the subsidized private sector’s share of total annual U.S. jobs gains dropped to 21.04 percent and then to 19.90 percent. And its share of the growth of total private sector jobs fell to 21.91 percent and then to 20.74 percent.

Another way to look at the Obama-era growth of subsidized private sector employment is to examine its growth as a share of the growth of real private sector jobs. In 2013, this figure stood at 12.38 percent. In 2016? Just over 40 percent. In other words, in the last year of Barack Obama’s presidency, some four in ten of the net new jobs created in the private sector came in the subsidized private sector – meaning that they were heavily dependent on government largesse.

In 2017 and 2018, subsidized private sector jobs growth as a share of total private sector jobs growth sank all the way to 28.05 percent, and then to 26.16 percent.

Looking at the economy from a static standpoint – i.e., through snapshots taken at crucial dates – illustrates these trends, too, although less dramatically. After all, even major relative changes can take many years to show up as major absolute changes in a supertanker as big as the U.S. economy.

At the outset of the last recession the subsidized private sector represented 13.67 percent of all U.S. jobs and the real private sector’s share was 70.16 percent. And the subsidized private sector’s share of the total (conventionally defined) private sector was 19.49 percent.

By the time the recovery began, in mid-2009, these figures stood at 14.97 percent and 67.80 percent – showing that during an economic downturn that decimated the overall American jobs market, subsidized private sector employment rose not only in relative terms but in absolute terms (from 18.92 million to 19.61 million. Meanwhile, the subsidized private sector’s share of the total private sector employment had risen to 22.07 percent.

By January, 2017 – the final month of the Obama administration and eight and a half years into the recovery – the subsidized private sector comprised 15.75 percent of all American jobs, and the real private sector was back up to 68.94 percent. Subsidized private sector employment had grown to 22.84 percent of total private sector jobs.

By December, 2018 (results that are still preliminary) the subsidized private sector’s share of all American employment had kept increasing – to 15.91 percent. And the real private sector’s share grew modestly, too – to 69.11 percent, as did the subsidized private sector’s share of the total private sector (to 23.02 percent).

Nevertheless, this examination of the changing dimensions of subsidized private sector employment also reveals that the national jobs market still hasn’t returned to pre-recession normality. In particular, even though the current recovery is nearing it’s tenth anniversary, that real private sector share of total employment (69.11 percent) is still below where it stood at the downturn’s onset (70.16 percent).

Im-Politic: Want to Really Fuel Big Government? Ditch Trump’s Trade Policies

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Affordable Care Act, big government, budget cuts, Congress, conservatives, discretionary spending, entitlement spending, healthcare, Im-Politic, industrial policy, Mick Mulvaney, Obamacare, Republicans, Trade, Trump, USAToday

USA Today‘s editorial yesterday on U.S. trade policy did an excellent job of stating a major objection to tariffs and other measures that interfere with international commerce – and one that understandably resonates strongly in a nation that prizes free market values, and especially among its conservatives: These trade curbs fuel Big Government, thereby preventing the economy from achieving its full potential, and harming the nation’s society and culture as well as the economy by sapping the attractiveness of individual initiative.

The essay also understandably focused on a development that looks like a poster child for trade-fostered Big Government – the process set up by the Trump administration to decide which companies will receive exemptions from recent metals tariffs, based on claims that adequate domestic substitute steel and aluminum products aren’t available.

In the words of the editorial writers:

“[T]he administration has imposed a new tax on imported metals and then put itself in a position to decide who has to pay it and who does not.

“This is Big Government at its worst — arbitrary and capricious, if not outright political, as it picks winners and losers in business. And all this is being done without any new law being passed and while a Republican Congress, which used to stand for free enterprise and limited government, remains supine.”

One obvious rejoinder is the observation that, however cumbersome the exemptions process may or may not be, Washington actually has an impressive historical record of “picking winners and losers in business.” Examples include the information technology hardware and software industries, which were practically launched with public (largely Pentagon sponsored) research and development funds, and critically nurtured by government (again, largely defense-supplied) markets; the world-class farming sector fostered by U.S. Department of Agriculture research findings; the equally world-class pharmaceutical industry aided by the National Institutes of Health; and an aviation and aerospace industry supported by the Defense Department, by the National Aeronautics and Space Administration, and by a NASA predecessor aeronautic agency. (For an excellent summary of this historical record, see this study from the National Academies of Science.) 

But there’s another vital point missed by USAToday and by conservatives who remain devoted to preserving or renewing the expansion of the existing free trade realm: If they succeed, they’re likely to see the kind of Big Government metastasis America has never experienced before. The reason? So many renumerative Americans jobs will be lost, and so much income destroyed, that political pressures for a much more generous welfare state will positively skyrocket.

Another favorite cause of newspaper editorialists like the USAToday writers and many Big Government-phobic conservatives – the return of mass immigration – will bring the same type of outcome, for many of the same reasons.

And if you think that the nation’s leaders will unite to uphold the causes of self-reliance and much smaller government, you weren’t paying attention to the recent fight over abolishing “Obamacare.” For better or worse, the national healthcare system created at the initiative of the former President remains largely in place even though its Republican opponents control the entire federal government and a huge majority of state governments because lots of these Republican politicians recognized that eliminating this latest entitlement would be political suicide.

At the same time, standard-issue conservatives aren’t the only Americans who may need to learn these lessons. Donald Trump belongs on this list, too. Interestingly, he won the presidency after running a campaign that both promised an Americans-First overhaul of trade policy and to protect the nation’s immense middle class entitlement programs – both of which clashed strongly with conservative dogma.

But his biggest first-year push as President involved going after Obamacare – well before he had achieved any of his trade policy goals, and before he even began pursuing them energetically. And he’s so far permitted his budget director, former Tea Party stalwart Mick Mulvaney, to propose numerous deep cuts in discretionary spending and even some entitlement spending that aren’t exactly middle class-friendly, either.

This set of priorities may have been unavoidable politically, reflecting Mr. Trump’s perceived need to establish some conservative bona fides with Congressional Republicans – who mainly still strongly support the party’s old orthodoxy, but whose staunch backing he would need in any impeachment proceedings.

At the same time, a fair number of those donors-friendly, offshoring-happy Congressional Republicans are retiring – largely because they recognize that Trump-ian trade and other unorthodox policies have won over the base. And although Democratic hardliners may indeed push successfully for impeachment proceedings if the party wins the House, it’s likely that, in the absence of a major smoking gun, this campaign could alienate independent voters – who are hardly gung ho to give Mr. Trump the heave-ho. Chances are they’d be even less receptive to an impeachment spectacle dominating Washington if the President distanced himself from meat-axe public spending cuts.

If this scenario unfolds, the loudest voices complaining that Trump-ian trade policies lead to Big Government could be mainstream media editorialists and pundits. But these voices would be less important than ever.

(What’s Left of) Our Economy: America Keeps Getting More Manufacturing-Lite

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Commerce Department, finance, GDP, Great Recession, gross domestic product, healthcare, manufacturing, real value-added, recovery, subsidized private sector, value added, {What's Left of) Our Economy

The Commerce Department’s “GDP [Gross Domestic Product] by Industry” reports aren’t considered market movers by those in the know in economics, business, and finance. Still, I find them well worth following because they provide the most authoritative evidence available on whether numerous claims about the economy’s strengths and weaknesses meet the reality test.

The big takeaway here? For all the post-financial crisis talk from politicians across the political spectrum about the need to reindustrialize the U.S. economy, manufacturing remains a major growth laggard. Indeed, by two key measures, it still hasn’t recovered fully from the Great Recession.

Commerce’s latest report takes the story up to the second quarter of this year, and revises the previously published results back to 2014. For some reason, the new 2014 numbers won’t come out till next month, but we do have the 2015, 2016, and first quarter 2017 revisions. Here’s what they say.

From 2015 through the first quarter of this year, manufacturing’s inflation adjusted growth rate – according to a gauge called “real value added,” which aims at eliminating unintentional double-counting – has been a few ticks lower than originally judged. The 2015 performance was revised down by 0.6 percentage points, the 2016 growth was upgraded by a full percentage point, and the first quarter 2017 result was downgraded by 0.8 percentage points. As for the latest, second quarter 2017 number, it’s a healthy four percent at an annual rate.

Manufacturing real value added’s contributions to growth have been a little more modest, too – which means that it’s been growing more slowly than the rest of the economy. That trend comes through more clearly from the Commerce data showing industry’s actual share of GDP. The main numbers are presented in current dollar terms, meaning that they don’t factor in inflation. But they make clear that manufacturing value added has declined from representing 12.1 percent of total American economic output in 2015 to accounting for just 11.5 percent in the second quarter of 2017.

To make the point even more emphatically, when the Great Recession broke out, in the fourth quarter of 2007, manufacturing value added represented 12.4 percent of gross domestic product.

Of course, there’s a case to be made (not that I accept it) that as long as manufacturing is growing, it doesn’t matter whether it’s becoming a bigger or smaller share of American economic output. But even by these standards, U.S. manufacturing is faltering. The new Commerce numbers show that, since the recession began, manufacturing real value-added is down. It’s not down by much – 0.18 percent in toto. But we’re talking about absolute shrinkage over a period of nearly ten years.

As RealityChek regulars know, the Federal Reserve’s industrial production reports (which also adjust for inflation), peg manufacturing’s shrinkage since the end of 2007 at an even greater 4.26 percent. Only if you take price increases out of the picture does manufacturing show a real recovery. In current dollar value added terms, it’s grown by 18.26 percent during this period.

But even by these terms, manufacturing’s laggard status stands out. In fact, since the fourth quarter of 2007, it’s share of the economy’s value-added has fallen by 10.16 percent. That’s the greatest such drop in the whole economy after mining (26.09 percent) and construction (10.42 percent).

The leaders, by these criteria? The subsidized private sector (industries, notably healthcare services, whose size is determined largely by government largesse) is number one, increasing its share of value added by 16.22 percent. Next is a supersector comprising arts, recreation, accommodation, and food services (up 13.89 percent). And remember all the concern that the pre-recession, bubble-ized economy of the previous decade was too Wall Street heavy? Since it brought the entire world to the brink of economic disaster, the finance super-sector has boosted its share of value added by a healthy 5.05 percent.

(What’s Left of) Our Economy: The Dubious Labor Shortage Claims Keep Coming

Tags

BLS, Bureau of Labor Statistics, healthcare, Immigration, labor shortages, nurses, nursing, Reuters, wages, West Virginia, {What's Left of) Our Economy

Perhaps some day we’ll find out when it apparently became mandatory for journalists to write articles about supposed labor shortages in the American economy without once mentioning the word “wages.” For now, RealityChek will have to settle for citing yet another example of this phenomenon that contains an interesting twist: The reporter in question did look at some data from the Bureau of Labor Statistics (BLS), the U.S. Labor Department division that gathers and publishes employee compensation figures. But she still left out BLS numbers on wages and salaries.

According to Jilian Mincer of Reuters:

“Hospitals nationwide face tough choices when it comes to filling nursing jobs. They are paying billions of dollars collectively to recruit and retain nurses rather than risk patient safety or closing down departments, according to Reuters interviews with more than 20 hospitals, including some of the largest U.S. chains.

“In addition to higher salaries, retention and signing bonuses, they now offer perks such as student loan repayment, free housing and career mentoring, and rely more on foreign or temporary nurses to fill the gaps.”

And as indicated above, she is clearly familiar with the BLS as a reliable source of information on the American employment picture. Later in the article, she writes that “Nursing shortages have occurred in the past, but the current crisis is far worse. The Bureau of Labor Statistics estimates there will be more than a million registered nurse openings by 2024, twice the rate seen in previous shortages.”

But for some reason, she didn’t mention the BLS wage data – a crucial omission because everything we (think we) know about economics tells us that when anything, including labor, is scarce, its price (pay in this case) will rise until the greater rewards attract an adequate supply. Common sense supports this analysis, too. If employers are scrambling to fill jobs, it stands to reason they’ll offer better pay to make sure they and not their competition attract the needed workers.

And what the BLS data tell us is that no such scramble is taking place – or at least not enough of one to bid up wages. The last year for which detailed data for occupations (as opposed to sectors of the economy) is available is 2016. The numbers say that last year, the mean (average) national annual wage for registered nurses was $72,180 before inflation, and the mean hourly wage was $34.70.

Now let’s go back five years. The 2011 numbers? An annual mean wage of $69,110 and an hourly median wage of $33.23 per hour. So pay by these key measures wages rose by 4.44 percent over those five years and 4.42 percent, respectively. And again, that’s before adjusting for inflation. Does that sound like the hospitals and other healthcare providers that employ nurses are desperate for more?

Even stranger: Nursing pay has been rising more slowly than pay overall during this period. Between 2011 and 2016, mean annual wages for all occupations were up 9.73 percent, and mean hourly wages were up by 9.75 percent. That’s more than twice as fast! (See the same links that contain the national nursing figures.)

In fairness, Reuters’ Mincer looks at an additional nursing issue – the labor situation in rural areas, which she describes as especially dire. And it does seem to make some intuitive sense that small towns and farm communities would have special difficulties staffing medical facilities. But the numbers don’t seem to back up that story, either.

The author spent considerable space reporting on West Virginia. But the BLS numbers show that, between 2011 and 2016, both hourly and average nursing pay advanced by 4.50 percent. That’s only slightly more than the national rates of increase.

Yes, Mincer’s piece did talk a lot about healthcare providers offering “higher salaries, retention and signing bonuses [and] perks such as student loan repayment, free housing and career mentoring….” It’s entirely possible that she’s right. (The government doesn’t keep detailed occupational figures on these scores.) It’s also entirely possible that the data that is tracked by BLS is way off base. But when you’re claiming “labor shortage,” shouldn’t you at least mention that the most comprehensive facts available about base pay say nothing of the kind?

Moreover, buried in the article – indeed at the end of the quote immediately above – is a clue to the apparent paradox: Mincer’s observation that the healthcare industry is relying “more on foreign…nurses to fill the [employment] gaps.”

If true, that would make clear that lax immigration policies are still enabling nurses’ employers to suppress pay by easing any shortages in the domestic labor force by hiring immigrant nurses who will work for significantly lower pay than native-born workers. And it would suggest that the Cheap Labor lobby encompassing so many American businesses is still able to keep these wage-suppressing global labor pipelines open by peddling a steady stream of warnings about bogus labor shortages to gullible journalists.

Im-Politic: Fin de Trump? Again?

Tags

2016 election, Donald Trump Jr., establishment, healthcare, Hillary Clinton, Im-Politic, Immigration, Jared Kushner, Mitch McConnell, Paul Manafort, Paul Ryan, Republicans, Russia, Russiagate, Trade, Trump, Vladimir Putin

The latest Trump-Russia revelations make me feel like the Bill Murray character in “Groundhog Day.” I’ve already written posts to the effect that “[Candidate] Trump could really be in trouble this time.” I’ve also already written posts to the effect that “[Candidate] Trump could really be in trouble and this time it could be different.” Like practically everyone else I read and communicate with, I’ve been wrong on these scores, but I’ll be plowing the same fields again – if only because the circumstances are so extraordinary, and especially because so much is still unknown.

First, my bottom lines: I remain skeptical that the emails Donald Trump, Jr. released yesterday (after he was told they’d be published) will result in the end of his father’s presidency in any direct sense (i.e., impeachment and removal, or resignation). I remain equally skeptical of meaningful (and I know that’s an important qualifier, as I’ll discuss below) Trump-ian collusion with Russia’s government (which includes lots of operatives without official positions) to undermine his chief presidential opponent Hillary Clinton’s campaign.

I am, however, more convinced than I had been that what is different about the newest disclosures is that Washington will remain preoccupied with “Russiagate” for most of the rest of the President’s (first?) term, that they’ve just about ruled out any meaningful policy accomplishments through 2020, and that one reason is that Mr. Trump will have bigger reasons than ever to toe a standard Republican establishment policy line that’s highly unpopular even with his own base, but that’s still gospel with a Washington wing of the party whose loyalty is vital to his survival.

Second, let’s knock down the main talking points offered by Mr. Trump’s aides and other supporters (full disclosure: I support much of his agenda, and most of his establishment-bashing). As should be obvious, the failure of the Russian lawyer actually to produce any damaging information on the Clinton campaign does not absolve the president’s son – or son-in-law cum adviser Jared Kushner, or then campaign manager Paul Manafort, of the charges that they tried to cooperate with foreign agents to affect an American political campaign (the heart of the politically salient collusion charge).

The email exchange showed that this information was the principal reason that all three figures attended the meeting. Their motives are completely unaffected by the false pretenses under which they acted.

Just as obvious, and just as bogus, is Trump, Jr.’s claim that he and his colleagues viewed an offer from Russia as nothing special because the Russia-gate charges had not proliferated. Manafort, for example, formally joined the Trump campaign manager on March 29. Certainly by May 2 – a month before Trump, Jr. first heard about the supposed Russian information – Manafort’s longstanding lobbying for pro-Russia politicians in Ukraine was making news. As a result, even if the president’s son was politically inexperienced enough not to recognize the potential dangers, Manafort himself, a veteran Washington operative, surely knew the score.

Even more important, the Russia business ties of Trump, Sr. himself were being scrutinized and fretted about at least as early as March 15.

Have any laws been broken? Beats me. That’s now officially the responsibility of Robert Mueller, te Justice Department’s Special Counsel, to determine. But much of this uncertainty centers on how much is known about this meeting, and how much is known about similar activities. Further, neither impeachment nor the future of the Trump presidency will necessarily hinge on such legal questions. A president, as I’ve noted previously, can be impeached for anything the House of Representatives believes satisfies the definition of “high crimes and misdemeanors” – which itself is a political, not a legal, concept. The Senate, moreover, can remove a president from office for equally political reasons.

So public opinion will be crucial. There are no signs yet that Russia-related charges have significantly damaged President Trump’s support either with the general public or among Republicans. But the more such Russia-related material keeps coming out, the likelier such erosion becomes.

Nor will the president’s political support depend completely, or even largely, on politicians’ often less than steely backbones. The new Trump, Jr. emails – and the continuing and utter failure of anyone in the Trump circle (including the president himself) to provide straight, durable answers to perfectly reasonable questions – understandably revive questions of how extensively individuals associated in any significant way with Mr. Trump or his campaign worked with the Russian government to sway election results.

Until yesterday, as I’ve written, I’ve felt confident that no important collusion evidence would emerge because none had yet been leaked – even though the matter had been probed for months by several official and many unofficial investigations, and even though bureaucrats at the highest levels have been positively eager to reveal incriminating Trump information even if national security could be undermined.

In addition, it’s never been clear to me why Russian interference with the election ever required cooperation from the Trump campaign – or any other American source. As long as Moscow was so motivated, its formidable hacking and disinformation capabilities were amply capable of producing the desired results on their own. Moreover, the U.S. intelligence community’s January report on the Russian interference campaign itself reported that Russian leader Vladimir Putin was wary of praising candidate Trump too enthusiastically precisely for fear of generating a backlash.

At the same time, even the canniest political leaders and other figures don’t always behave logically or sensibly. It’s also now clear at least that many in the Trump circle have been less than canny or, when it comes to explaining controversial events, even minimally competent. As a result, as stated above, there’s now indisputable evidence of receptivity to collusion by three extremely influential Trump aides (including two family members).

If the June Trump, Jr. meeting represents the extent of the collusion, there’s still an excellent chance that the president ultimately will survive the Russia mess. After all, what kind of (serious) collusion effort, once started, would feature no follow up? But because no one close to Mr. Trump now enjoys (or deserves) much credibility on these matters outside hardcore Trump-supporter circles, Democrats now have the pretext they need to force the administration to keep trying to prove a negative – a challenge no one should relish. Special Counsel Mueller has a comparable justification for prolonging his own investigation considerably.

Yet even before the possible crumbling of the president’s political support, for either legal or political reasons or some combination of the two, the Trump administration’s Russia-related problems could profoundly impact the nation’s policy agenda – and not in a good way if you’ve hoped Mr. Trump would be an agent of serious change. Here’s what I mean.

Recall that last year, Mr. Trump did not simply assume the leadership of the Republican party after winning its presidential primaries. He engineered a hostile takeover, supplanting a party mainstream that strongly opposed him on his two signature issues – trade and immigration policies. The shocking Trump fall victory, however, gave the incoming president crucial leverage in this relationship, and for a very powerful, concrete reason. The Republicans’ establishment leaders in Congress gave his campaign, and especially the inroads he made with new constituencies, abundant credit for saving the party’s control of both the House and Senate.

Once the Russia-gate charges and Team Trump’s failures to address them adequately began gaining critical mass, though, the dynamics of this relationship began changing dramatically. President Trump’s future became more dependent on the establishment GOP’s support. Therefore, he needed to warm to its establishment agenda – notably their budget and healthcare proposals – despite the poor poll numbers they’ve been drawing. Additionally, his ability to reach across the aisle on promising areas of bipartisan agreement, like infrastructure, turned into a function of the overall party’s flexibility – which seems pretty limited to date.

Since such vast new – and, due to the Trump circle’s constantly changing responses, legitimate – investigative frontiers have been opened up by the new emails, the Trump wagon now looks to be hitched to the Congressional Republican star more tightly than ever. That’s not to say that House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell will never stray from their party’s orthodoxy. McConnell, at least, has hinted that bipartisan compromise may be needed on healthcare. Moreover, the party establishment is by no means united on all major issues, either. Consequently, intra-party divisions may widen the scope for bipartisanship (as has generally been the case to avoid or mitigate various budget crises).

But the main point here is that at this point, these decisions are likeliest to be driven by the establishment, not the president. And the tragedy, at least for anyone rooting for the president or any of his agenda, is how many of the resulting White House political and policy wounds will have been entirely self-inflicted.

(What’s Left of) Our Economy: Where the Trump Record is Looking Different

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Barack Obama, Bureau of Labor Statitics, Employment, Great Recession, healthcare, Jobs, Mainstream Media, private sector, real private sector, recovery, subsidized private sector, Trump, {What's Left of) Our Economy

Since of course there’s no Mainstream Media bubble or echo chamber, it must be a total coincidence that the press last week was filled with articles noting that the U.S. economy today (which President Trump keeps praising) looks pretty similar to the U.S. economy before the last presidential election (which candidate Trump decried).

Generally speaking, these observations are right – with one important exception that’s been universally overlooked: Job creation this year so far has owed significantly more to the “real private sector” of the American economy and less to the “subsidized private sector.” That is, more hiring is coming in the part of the economy in which employment levels generally reflect free market forces, and therefore speak volumes about the whole economy’s fundamentals. And less hiring is taking place in industries like healthcare services, where job creation largely reflects levels of government support that stems from political decisions. Therefore, however worthy their services, employment performance in these sectors says little about the state of the economy.

RealityChek observed the possible start of this trend two months ago. Now that we’re halfway through the year, it looks more solidly established. As usual, the best evidence comes from comparing job creation in the first six months of this year with job creation during the same periods in past years. (Keep in mind, however, that the statistics for May and June, 2017, are still preliminary; that is, they’ll be revised in the next two months – and then revised again early next year along with the results for all of 2017. For good measure, the Bureau of Labor Statistics will recalculate them again further down the road.)

For the first six months of this year, total U.S. net employment gains (in the “non-farm” sector that represents the Bureau of Labor Statistics’ American employment universe) came to 1.079 million. Of these, 20.95 percent came in the subsidized private sector, and 74.05 percent came in the real private sector. (The rest came in government at all levels.)

Those figures are much different than those for the first six months of 2016 – 28.44 percent and 60.83 percent. In fact, the January-June 2017 results represent the first time since 2014 when the subsidized private sector share of total job creation fell and the real private sector share rose. At the same time, the subsidized private sector’s role in total hiring is way up from January-June, 2013 – when it was only 14.22 percent. And the real private sector’s role is way down (from 92.63 percent that year).

Another way to look at hiring developments: During the first half of 2013, subsidized private sector job creation totaled 13.31 percent of job creation in the private sector as it’s conventionally defined (that is, including the subsidized industries). By the first half of 2016, the subsidized industries’ share of conventionally defined private sector net new employment had more than doubled: to 31.86 percent.

Finally, let’s see how these employment numbers have changed on a stand-still basis.

In December, 2007 – on the eve of the Great Recession – the subsidized private sector accounted for 13.22 percent of all non-farm jobs, the share of the private sector conventionally defined was 83.83 percent, and that of the real private sector was 70.62 percent.

In June, 2009 – when the recovery began – these figures were: subsidized private sector, 14.97 percent; conventional private sector, 82.77 percent; and real private sector, 67.80 percent.

And this June? Subsidized private sector, 15.78 percent; conventional private sector, 84.73 percent; and real private sector, 68.96 percent.

In other words, although the punch has slacked off a bit, the subsidized private sector is still punching above its weight when it comes to job creation. We know this because its share of new hiring for the first six months of this year (20.95 percent) remained greater than its share of total American employment as it stood in June (15.78 percent). The real private sector is outperforming, too, but the gap is much smaller proportionately.  (The – big – slacker has been the public sector.)

Also, eight years into the current economic recovery, the real private sector’s share of total American jobs is smaller, and the subsidized private sector’s share is larger, than they were at the start of the expansion.

There’s no doubt that the American job market today is in much better shape than it was at the start of the recovery – and that most of this progress took place before President Trump took office. Nor is there much reason to doubt that until the economy’s reliance on the subsidized private sector for job creation falls considerably more, it will difficult to claim legitimately that the employment scars of the recession have fully healed. But something else that’s now increasingly clear is that a crucial job quality front, the Trump economy is looking notably different – and better.    

Im-Politic: The Polls Say “Let Trump Be [Campaign-Version] Trump”

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2016 election, ABC News, budget, conservatism, discretionary spending, entitlements, Freedom Caucus, healthcare, Im-Politic, Immigration, independents, NBC News, Paul Ryan, polls, poverty, Republicans, The Wall Street Journal, Trade, Trump, Washington Post

They’re only polls and we all should remember how badly most polls blew their calls in the last presidential election. But two new surveys from the Washington Post and ABC News on the one hand, and the Wall Street Journal and NBC News on the other, are signaling to me anyway that Donald Trump has made a major mistake so far in his young presidency in tilting so markedly toward the keepers of the orthodoxy (especially the most doctrinaire versions) in his own party. Instead, he should have been focusing all along on developing a promising new American political center of gravity that he started defining (in his own imitable way) during his campaign.

As widely observed during the 2016 elections, Mr. Trump was anything but a conventional conservative – at least as the term has been understood for the last quarter century. Yes, he made frequent nods toward cutting taxes and regulations, as well as to balancing budgets (objectives that of course aren’t always consistent). He also expressed some support for social conservative positions like further restricting abortion and appointing “strict constructionists” to the Supreme Court. But as also widely observed, if that mix of views was what voters in the Republican primaries and general elections really wanted, they would have voted for an orthodox conservative.

Instead, Mr. Trump trounced his opponents even though he at least as often promised to protect massive federal entitlement programs heavily relied on by the middle class and senior citizens; to guarantee adequate healthcare for non-seniors who can’t afford it; to preserve government support for Planned Parenthood’s provision of non-abortion-related women’s health services; to uphold the rights of gay, lesbian, and transgender Americans; and of course to ignore free market dictates when they seemed to undermine public safety and prosperity by fostering unrestricted trade and immigration.

Undoubtedly, much of candidate Trump’s appeal also sprang from simple, nonpartisan voter anger at the failures and self-serving priorities of the bipartisan national political establishment. But Mr. Trump did the best job of all last year’s presidential hopefuls of identifying the combination of specific grievances that created this anger: notably, over those jobs and incomes lost to Americans Last trade and immigration policies, over those related dangers posed by terrorism and leaky borders, and over the astronomical costs and risks of fighting seemingly futile foreign wars and defending free-riding allies.

The president’s Inaugural Address – which declared his intention to fix these problems with America- and Americans’- First policies – unabashedly proclaimed that President Trump would govern like candidate Trump.

Yet although the president has by and large kept his immigration promises, and approved some (limited) measures to combat foreign trade predation, his domestic policy proposals look like they’re right out of the Chamber of Commerce and Moral Majority playbooks. Nowhere has this development been more obvious than in his endorsement of House Speaker Paul Ryan’s healthcare plan, and in his release of a budget outline that, outside of defense spending, libertarians should be swooning over.

Late last month, I ventured that the president’s support for the “Ryan Care” proposal was a head fake: He had knowingly backed a measure so draconian that he knew it would fail, in order to establish some orthodox conservative street cred with Congressional Republicans and thus enlist their support for the pivot to greater moderation he had planned all along. Something like this scenario could still unfold; according to press reports, even the hard-core anti-government House Freedom Caucus members are growing more amenable to a compromise proposal that would preserve many of the more popular provisions of President Obama’s healthcare reforms.

But Mr. Trump’s continuing insistence on a federal spending blueprint that either eliminates or greatly slashes funding for medical and other scientific research, Chesapeake Bay cleanup, and food and heating aid for the poor, is not only plain bizarre, especially since the dollars involved are trivially small. It’s also politically inexplicable, because there’s absolutely no evidence that these are viewed as priority savings among any important Trump constituencies.

And that’s where the new polls come in. As per the headline results, Mr. Trump’s popularity at this point in his presidency is much lower than the ratings of most of his predecessors early in their first terms. In fairness, the Post-ABC survey also shows that the president would beat his chief 2016 rival, Hillary Clinton, in the popular vote if a new election was held – showing that he’s even more popular versus the Democratic nominee than on election day.

But the both polls showed the president’s support tightly concentrated among his own core voters and Republicans generally. Even accepting the claim that rapid partisanship by Democratic party leaders is proving effective in limiting Mr. Trump’s appeal to their rank and file, it’s still a sign of trouble for the president that his ratings among self-described political independents is markedly on the wane according to the Journal-NBC findings (falling to 30 percent) and low (38 percent) according to the Post-ABC survey.

One main reason: The Washington Republicans President Trump is apparently still courting are even less popular than he is. The Journal-NBC poll reports that many more Americans are dissatisfied with the Republican-led Congress nowadays than in February, and Ryan’s approval ratings are even lower. Moreover, the Republican-led Congress and the Speaker, in turn, are less popular than the president even among voters identifying as Republicans.

None of these results necessarily bodes ill for the Freedom Caucus. Its members don’t care for Ryan, either – allegedly for being too moderate. But many of the latest measures of Americans’ views of major policy issues do. For example, the Journal-NBC poll found that, since February, the share of respondents agreeing that “Government should do more to solve problems and help meet people’s needs” shot up to 57 percent. Even more independents (59 percent) endorsed this position. The share of total respondents believing that “Government is doing too many things better left to businesses and individuals plummeted to 39 percent.

More pointedly, the Post-ABC poll showed Americans opposing the Trump budget proposals by 50 percent to 37 percent overall, and independents disapproving by an even wider 52 percent to 35 percent margin.

The Journal-NBC survey also found record shares of Americans viewing “free trade” and “immigration” positively – at 57 percent and 60 percent, respectively. But the abstract nature of these questions could well have tilted these answers. One reason for supposing so: The Post-ABC poll reporting that, by a strong 73 percent to 22 percent, Americans favor “Trump pressuring companies to keep jobs in the United States.” Among independents, the results are an even better 75 percent to 19 percent.

So the recipe for Trump political success seems pretty clear: Dump the Freedom Caucus under the Trump Train on the budget and healthcare; preserve (and even boost to some extent) discretionary spending programs that strengthen the economy’s foundations and provide for the needy; keep the campaign promises on entitlements so highly prized by the middle class; and take bolder measures to Buy American and Hire American (as one new set of trade-related Trump jobs programs is called).

Keeping the focus on these priorities, along with a well thought out infrastructure program, should attract and keep enough backing among Republicans and independents to offset any losses in Freedom Caucus ranks, both in Congress and at the grassroots level (where they seem modest in number). Adding new policies to combat predatory foreign trade practices, moreover, should please organized labor enough to bring into the fold many union members and leaders plus the Congressional Democrats they strongly influence. An extra bonus – this program could well give President Trump the political leeway he needs to stay his course on immigration (which of course has seen a softening of his views on the so-called Dreamers).

Often in American history, calls to “Let [name your favorite politician] be [name that same politician]” have reflected core supporters’ naive beliefs that campaign promises can easily be turned into policy by the office-seekers they elect. But as is so often the case with the current president, Letting Trump be Trump, could confound the political conventional wisdom.