Federal Government Ends Prohibition On Medical Marijuana

The Los Angeles Times reports on a surprise in the recently passed spending bill–an end to the federal government’s prohibition on medical marijuana. The was passed with support of both Democrats as well as some Republicans who opposed raid by the federal government in states which have legalized medical marijuana on states’ rights grounds:

Tucked deep inside the 1,603-page federal spending measure is a provision that effectively ends the federal government’s prohibition on medical marijuana and signals a major shift in drug policy.

The bill’s passage over the weekend marks the first time Congress has approved nationally significant legislation backed by legalization advocates. It brings almost to a close two decades of tension between the states and Washington over medical use of marijuana.

Under the provision, states where medical pot is legal would no longer need to worry about federal drug agents raiding retail operations. Agents would be prohibited from doing so.

The Obama administration has largely followed that rule since last year as a matter of policy. But the measure approved as part of the spending bill, which President Obama plans to sign this week, will codify it as a matter of law.

Pot advocates had lobbied Congress to embrace the administration’s policy, which they warned was vulnerable to revision under a less tolerant future administration.

More important, from the standpoint of activists, Congress’ action marked the emergence of a new alliance in marijuana politics: Republicans are taking a prominent role in backing states’ right to allow use of a drug the federal government still officially classifies as more dangerous than cocaine…

Some Republicans are pivoting off their traditional anti-drug platform at a time when most voters live in states where medical marijuana is legal, in many cases as a result of ballot measures.

Polls show that while Republican voters are far less likely than the broader public to support outright legalization, they favor allowing marijuana for medical use by a commanding majority. Legalization also has great appeal to millennials, a demographic group with which Republicans are aggressively trying to make inroads.

Approval of the pot measure comes after the Obama administration directed federal prosecutors last year to stop enforcing drug laws that contradict state marijuana policies. Since then, federal raids of marijuana merchants and growers who are operating legally in their states have been limited to those accused of other violations, such as money laundering.

“The federal government should never get in between patients and their medicine,” said Rep. Barbara Lee (D-Oakland).

Tony Newman, Director of Media Relations, Drug Policy Alliance, added this to his list of More Nails in the Drug War Coffin.

In addition to ending fears of raids by federal drug agents, this should also alleviate the fears of many physicians who are currently afraid to treat patients with medical marijuana even in states where it is legal. Many physicians, including some pain clinics, have been unwilling to treat patients with chronic pain who are using medical marijuana out of fear of retaliation by the DEA.

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Republicans Seek To Block Marijuana Law In Washington D.C.

Republicans, members of the party which claims to support small government, individual freedom, and states’ rights, once again shows that it doesn’t mean a word of this.  The Hill reports on one action planned by Republicans:

House Republicans next year will try to block Washington, D.C.’s, newly enacted law legalizing recreational marijuana.

Rep. Andy Harris said he “absolutely” intends to launch a push to dismantle the new law when Congress returns with an empowered GOP majority in the 114th Congress.

While technically not a states’ rights issue, the same principle should apply to respecting a law to legalize recreational marijuana which a majority in Washington, D.C. voted for.

Presumably other top matters on the Republican agenda will include attempts to restrict access to abortion and contraception, and prevent same-sex marriage.

Of course this is as expected. When Republicans speak of supporting small government, it is of a government “small” enough to intervene in the private lives of the individual. When they speak of freedom, they will defend the freedom of businessmen to evade necessary regulations. Otherwise to Republicans, freedom means the freedom for conservatives to impose their views upon others. Republican support for states’ rights is limited to states which wish to enact laws to discriminate against minorities or restrict marriage equality.

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Study Shows Reduction In Opioid Overdoses By 25% In States Which Have Legalized Medical Marijuana

A major problem with narcotic pain medications is the risk of overdose. This problem has led to the DEA announcing last week that hydrocodone combination pain medications such as Norco and Vicodin are being reclassified as Schedule II narcotics, with additional restrictions being placed upon prescribing them. Any measures to help control chronic pain while reducing the incidence of overdose would certainly be welcome. The August 25, 2014 issue of JAMA Internal Medicine presents a study of states which have legalized medical marijuana, showing a reduction in opioid overdoses by almost 25 percent:

Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time…

The study did not indicate the cause of this association. It is speculated that some people with chronic pain might use less opioid when medical marijuana is available. More study is needed to confirm this, but considering the problems faced with opioid overdoses, marijuana should be considered as an alternative. At very least, when considering any potential adverse consequences to legalization of medical marijuana, it must be kept in mind that the currently used medications for chronic pain do have a serious potential for adverse effects themselves.

Marijuana is now classified as a Schedule I drug which prevents prescribing it. (In states where medical marijuana is legal, the change in the law protects those using it from prosecution but marijuana still cannot be prescribed). Many have already questioned the classification of marijuana as a Schedule I drug as it appears to show less risk of problems from overdose compared to current Schedule II and Schedule III drugs. This study suggests that marijuana might also help protect against some of the adverse effects of narcotics.

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Media Support For Legalization Of Marijuana and Prostitution

Legalize Pot and Sex

There is a welcome trend towards support of decriminalization of victimless crimes. The New York Times recently came out for legalization of marijuana, outlining the harm done by the unsuccessful prohibition:

America’s four-decade war on drugs is responsible for many casualties, but the criminalization of marijuana has been perhaps the most destructive part of that war. The toll can be measured in dollars — billions of which are thrown away each year in the aggressive enforcement of pointless laws. It can be measured in years — whether wasted behind bars or stolen from a child who grows up fatherless. And it can be measured in lives — those damaged if not destroyed by the shockingly harsh consequences that can follow even the most minor offenses…

The costs of this national obsession, in both money and time, are astonishing. Each year, enforcing laws on possession costs more than $3.6 billion, according to the American Civil Liberties Union. It can take a police officer many hours to arrest and book a suspect. That person will often spend a night or more in the local jail, and be in court multiple times to resolve the case. The public-safety payoff for all this effort is meager at best: According to a 2012 Human Rights Watch report that tracked 30,000 New Yorkers with no prior convictions when they were arrested for marijuana possession, 90 percent had no subsequent felony convictions. Only 3.1 percent committed a violent offense.

The strategy is also largely futile. After three decades, criminalization has not affected general usage; about 30 million Americans use marijuana every year. Meanwhile, police forces across the country are strapped for cash, and the more resources they devote to enforcing marijuana laws, the less they have to go after serious, violent crime. According to F.B.I. data, more than half of all violent crimes nationwide, and four in five property crimes, went unsolved in 2012.

The sheer volume of law enforcement resources devoted to marijuana is bad enough. What makes the situation far worse is racial disparity. Whites and blacks use marijuana at roughly the same rates; on average, however, blacks are 3.7 times more likely than whites to be arrested for possession, according to a comprehensive 2013 report by the A.C.L.U.

Now The Economist has called for legalization of prostitution, partially due to the changes in the profession with prostitution increasingly being arranged on line:

Moralisers will lament the shift online because it will cause the sex trade to grow strongly. Buyers and sellers will find it easier to meet and make deals. New suppliers will enter a trade that is becoming safer and less tawdry. New customers will find their way to prostitutes, since they can more easily find exactly the services they desire and confirm their quality. Pimps and madams should shudder, too. The internet will undermine their market-making power.

But everyone else should cheer. Sex arranged online and sold from an apartment or hotel room is less bothersome for third parties than are brothels or red-light districts. Above all, the web will do more to make prostitution safer than any law has ever done. Pimps are less likely to be abusive if prostitutes have an alternative route to market. Specialist sites will enable buyers and sellers to assess risks more accurately. Apps and sites are springing up that will let them confirm each other’s identities and swap verified results from sexual-health tests. Schemes such as Britain’s Ugly Mugs allow prostitutes to circulate online details of clients to avoid.

Governments should seize the moment to rethink their policies. Prohibition, whether partial or total, has been a predictable dud. It has singularly failed to stamp out the sex trade. Although prostitution is illegal everywhere in America except Nevada, old figures put its value at $14 billion annually nationwide; surely an underestimate. More recent calculations in Britain, where prostitution is legal but pimping and brothels are not, suggest that including it would boost GDP figures by at least £5.3 billion ($8.9 billion). And prohibition has ugly results. Violence against prostitutes goes unpunished because victims who live on society’s margins are unlikely to seek justice, or to get it. The problem of sex tourism plagues countries, like the Netherlands and Germany, where the legal part of the industry is both tightly circumscribed and highly visible…

The prospect of being pressed to mend their ways makes prostitutes less willing to seek care from health or social services. Men who risk arrest will not tell the police about women they fear were coerced into prostitution. When Rhode Island unintentionally decriminalised indoor prostitution between 2003 and 2009 the state saw a steep decline in reported rapes and cases of gonorrhoea.

Prostitution is moving online whether governments like it or not. If they try to get in the way of the shift they will do harm. Indeed, the unrealistic goal of ending the sex trade distracts the authorities from the genuine horrors of modern-day slavery (which many activists conflate with illegal immigration for the aim of selling sex) and child prostitution (better described as money changing hands to facilitate the rape of a child). Governments should focus on deterring and punishing such crimes—and leave consenting adults who wish to buy and sell sex to do so safely and privately online.

More on the effects of the unintentional decriminalization of indoor prostitution in Rhode Island here.

I think  tolerance of marijuana use and prostitution will increase with the millennial generation, which is more socially liberal, and find it a good sign to see long-established portions of the media also moving in this direction. I also fear that, as with same-sex marriage, even the Democrats will lag behind the general population in acceptance of liberal views.

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This Is Not The Libertarian Moment, But Also Not The Right Moment For Democrats To Follow Hillary Clinton’s Views

Robert Draper asks, Has the ‘Libertarian Moment’ Finally Arrived? in The New York Times Magazine.

Libertarians, who long have relished their role as acerbic sideline critics of American political theater, now find themselves and their movement thrust into the middle of it. For decades their ideas have had serious backing financially (most prominently by the Koch brothers, one of whom, David H., ran as vice president on the 1980 Libertarian Party ticket), intellectually (by way of policy shops like the Cato Institute and C.E.I.) and in the media (through platforms like Reason and, as of last year, “The Independents”). But today, for perhaps the first time, the libertarian movement appears to have genuine political momentum on its side. An estimated 54 percent of Americans now favor extending marriage rights to gay couples. Decriminalizing marijuana has become a mainstream position, while the drive to reduce sentences for minor drug offenders has led to the wondrous spectacle of Rick Perry — the governor of Texas, where more inmates are executed than in any other state — telling a Washington audience: “You want to talk about real conservative governance? Shut prisons down. Save that money.” The appetite for foreign intervention is at low ebb, with calls by Republicans to rein in federal profligacy now increasingly extending to the once-sacrosanct military budget. And deep concern over government surveillance looms as one of the few bipartisan sentiments in Washington, which is somewhat unanticipated given that the surveiller in chief, the former constitutional-law professor Barack Obama, had been described in a 2008 Times Op-Ed by the legal commentator Jeffrey Rosen as potentially “our first president who is a civil libertarian.”

Meanwhile, the age group most responsible for delivering Obama his two terms may well become a political wild card over time, in large part because of its libertarian leanings. Raised on the ad hoc communalism of the Internet, disenchanted by the Iraq War, reflexively tolerant of other lifestyles, appalled by government intrusion into their private affairs and increasingly convinced that the Obama economy is rigged against them, the millennials can no longer be regarded as faithful Democrats — and a recent poll confirmed that fully half of voters between ages 18 and 29 are unwedded to either party. Obama has profoundly disappointed many of these voters by shying away from marijuana decriminalization, by leading from behind on same-sex marriage, by trumping the Bush administration on illegal-immigrant deportations and by expanding Bush’s N.S.A. surveillance program. As one 30-year-old libertarian senior staff member on the Hill told me: “I think we expected this sort of thing from Bush. But Obama seemed to be hip and in touch with my generation, and then he goes and reads our emails.”

To say that the libertarian moment has arrived based upon the views of millennials is to look at only part of the picture. Polling has showed millennials to typically be liberal on social issues, non-interventionist on foreign, policy, but far from conservative or libertarian on issues such as preserving the safety-net and providing universal health care. They are hardly likely to be attracted by either the Republican or Libertarian Party. Unfortunately the Democrats also are risking turning off such voters with the choice of Hillary Clinton:

Early polls show young voters favoring Hillary Rodham Clinton in 2016, but their support could erode as they refamiliarize themselves with her, just as it did in 2008. Clinton has been even slower than Obama to embrace progressive social causes, while in foreign policy, she associates herself more with her former Senate colleague John McCain than with noninterventionists. Nor is Clinton likely to quell millennial fears about government surveillance. Welch says: “Hillary isn’t going to be any good on these issues. She has an authoritative mind-set and has no interest in Edward Snowden, who’s a hero to a lot of these people.”

Comparing Clinton to John McCain, who seems to have never seen a possibility for going to war which didn’t excite him, might be a little extreme, but she has firmly placed herself in the Joe Lieberman camp. She is a rare Democrat who rooted for going to war with Iraq based upon false claims tying Saddam to al Qaeda. She now repudiates her past support for the war however the story of Hillary Clinton’s career has been to get the big issues wrong at the time and possibly later realize that she was wrong. As I’ve also pointed out before, in the remote chance that the Republicans do nominate Rand Paul, or anyone else with similar non-interventionist views, this could really shake up the race, putting Democrats in the position of running from the right on foreign policy. Clinton’s weakness and cowardice on social issues wouldn’t help matters.

So, no, the Libertarian Moment has not arrived. The future looks more friendly towards politicians who are socially liberal, anti-interventionism, but far from libertarian across the board. Most likely the Republicans will run a candidate who is even further to the right of Hillary Clinton on foreign policy and social issues, and as Andrew Sullivan recently argued, Clinton will try to run on vacuous statements (along with inevitability), and avoid taking controversial positions on the issues.  She will continue to try to stick with what she sees as safe answers, such as saying that the Bible is the book which she found most influential. Maybe she will get away with it, but if the Republicans shake things up and question her on more libertarian grounds on social issues and foreign policy, there is the real danger of the Democrats losing the millennials.

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Decreased Highway Fatalities In Colorado After Legalization Of Marijuana

Coloardo Fatalities

Conservatives have used scare stories of high drivers as reasons to oppose both legalization of marijuana and even use of medical marijuana. As with a recent study on prostitution reducing the risk of rape and sexually transmitted diseases, eliminating laws against victimless crimes may be beneficial, and at least typically does not do the harm claimed by conservatives. Since marijuana was legalized in Colorado, highway fatalities are at near-historic lows.

It might be the case that other factors are reducing the fatalities, but at very least it does not appear that legalization of marijuana increases the risk. It is even possible that the legalization of marijuana might directly be related to the reduction in highway fatalities:

some researchers have gone so far as to suggest that better access to pot is making the roads safer, at least marginally. The theory is that people are substituting pot for alcohol, and pot causes less driver impairment than booze. I’d need to see more studies before I’d be ready to endorse that theory. For example, there’s also some research contradicting the theory that drinkers are ready to substitute pot for alcohol.

Regardless of whether the reduction in fatalities is a result of marijuana legalization, the data in Colorado does further undermine the conservative argument for the continuation of marijuana prohibition.

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Posted in Drug Policy. Tags: . 1 Comment »

Quote of the Day: Seth Meyers on Marijuana Legalization

“The New York Times came out in favor of marijuana legalization. Apparently, someone told them that marijuana users are really into ‘buying papers.'” –Seth Meyers

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Health Care Policy Briefs: Early Retirement, The Two Americas, Sabotaging Obamacare, Marijuana Not A Gateway Drug, And The Pentagon’s Plan For The Zombie Apocalypse

zombies_01

Five  health care policy items today:

Goldman issued a report on how availability of health insurance allows people the option of retiring early (or as Republicans would put it, become takers) as opposed to waiting until they qualify for Medicare. The found that “the annual probability of retirement–i.e., what share of workers of a given age will retire within the next year–is on average between 2% and 8% higher when retiree health insurance is available.” Early retirement is seen more between the ages of 60 to 64, than in those who are age 55-59.

With Republicans blocking Medicaid expansion in twenty-four states, The Commonwealth Club looked at the healthcare differences in the two Americas:

The Commonwealth Fund’s recently released Scorecard on State Health System Performance, 2014, finds big differences between states on measures of health care access, quality, costs, and outcomes. What’s more, its authors warn that these differences could very well widen in the future. Many of the lowest-performing states are choosing not to expand their Medicaid programs under the Affordable Care Act (ACA). Some also are discouraging eligible uninsured citizens from purchasing subsidized coverage through new ACA marketplaces, though some uninsured are signing up nonetheless.

The fact that so many low-performing states are spurning the ACA’s benefits, while high-performing states are rushing to embrace them, raises profound questions for the future of our country. What would it mean if different parts of the United States find themselves on radically different health care trajectories, with some enjoying progressively better health and health care and others falling further and further behind? In other words, what would it mean if the two health care Americas grow further and further apart over time?

This is unexplored territory for health care researchers and policymakers, but we know enough to point to some possibilities.

To begin with, we know that when people have health coverage they live longer, healthier lives. Widening gaps in rates of insurance coverage between low- and high-performing states will almost certainly lead to growing differences in life expectancy and health status. This is worrisome and regrettable, but probably only part of the story.

An equally important—but much less explored—question is whether differing health care trajectories also will lead to differing economic and social trajectories. All else equal (of course, it never precisely is), will regions with poorer health care and health status suffer economically and socially as well? Will they have less productive workforces, less productive economies, and, as result, lower quality of life overall? Will they become less attractive places to live, work, and do business?

Several lines of evidence suggest that diverging regional health care systems could lead to diverging general welfare. First, untreated physical and mental health problems increase workers’ time off from work, reduce performance while at work, and lower rates of employment. In the early 20th century, infections such as yellow fever, malaria, and hookworm greatly hindered the economy of the American South. In his memoir, Jimmy Carter recalls that, while growing up in rural Georgia, “almost everyone was afflicted from time to time with hookworm,” a parasite that causes anemia, malaise, and fatigue. Eventually, public health measures and improved living conditions brought this and other health problems under control, contributing to a burst of economic growth.

A century later, chronic illness is the equivalent of the infectious illness that once disproportionately taxed the economy of the American South. In the United States, annual productivity losses from diabetes and depression alone exceed $100 billion nationally. And we know this burden can be lightened through good primary and preventive care that will be less available in regions with large uninsured populations.

Second, health insurance boosts economies by protecting people against catastrophic out-of-pocket health care expenses. These costs can lead to bankruptcy, which raises the cost of borrowing for the rest of society as lenders take into account the risk that they will not be repaid. Those avoiding bankruptcy often incur substantial medical debt, with far-reaching consequences. A 2012 Commonwealth Fund survey found that 61 percent of uninsured adults ages 19 to 64 reported problems paying their medical bills or said they were paying off medical debt over time. Among these individuals, more than half said they received a lower credit rating as a result of unpaid medical bills, 43 percent used all of their savings to pay their bills, and 29 percent delayed education or career plans. The 2006 Massachusetts health reform, which has led to nearly universal health coverage, has also led to fewer personal bankruptcies and bills past due and improved credit scores, particularly for those with limited access to credit before the reform…

The report continued to discuss further differences resulting from differing access to health insurance.

Besides blocking Medicaid expansion, conservatives are reducing the number of insured with misinformation campaigns and campaigns to outright dissuade people from obtaining coverage in the exchanges. This has led many uninsured people to fail to obtain coverage through the exchanges to based upon misconceptions spread by conservatives, such as that the cost would be much higher than it actually is. Jonathan Cohn wrote:

About half of the people who McKinsey surveyed did not end up buying insuranceeither because they shopped and found nothing they liked, or because they didn’t shop at all. When asked to explain these decisions, the majority of these people said they thought coverage would cost too much. But two-thirds of these people said they didn’t know they could get financial assistance. In other words, they assumed they would have to pay the sticker price for coverage, even though federal tax credits would have lowered the price by hundreds or thousands of dollars a year.

With a little education and outreach, many of these people will discover that insurance costs less than they thought. When next year’s open enrollment period begins, they are more likely to get coverage. But the idea was to help more of those people this year. And if the administration deserves some blame for this shortfall, its adversaries deserve more. Republicans and their allies did their best to taint the lawand, where possible, to undermine efforts to promote it. Without such obstruction, even more uninsured people would probably be getting coverage right now. As Sprung quipped in his post, “Those who deliberately spread disinformation about the ACA and actively encouraged the uninsured to remain in that blessed state of freedom can be really proud of themselves.”

Or as I put it in a recent post: Fox Lied, People Die.

The National Bureau of Economic Research looked at the effects of legalization of medical marijuana on drug use:

21 states and the District of Columbia currently have laws that permit marijuana use for medical purposes, often termed medical marijuana laws (MMLs). We tested the effects of MMLs adopted in seven states between 2004 and 2011 on adolescent and adult marijuana, alcohol, and hard drug use. We employed a restricted-access version of the National Survey on Drug Use and Health (NSDUH) micro-level data with geographic identifiers. For those 21 and older, we found that MMLs led to a relative increase in the probability of marijuana use of 16 percent, an increase in marijuana use frequency of 12-17 percent, and an increase in the probability of marijuana abuse/dependence of 15-27 percent. For those 12-20 years old, we found a relative increase in marijuana use initiation of 5-6 percent. Among those aged 21 or above, MMLs increased the frequency of binge drinking by 6-9 percent, but MMLs did not affect drinking behavior among those 12-20 years old. MMLs had no discernible impact on hard drug use in either age group. Taken together, MML implementation increases marijuana use mainly among those over 21, where there is also a spillover effect of increased binge drinking, but there is no evidence of spillovers to other substance use.

If marijuana turns out not to be a gateway drug, this would be another reason to reevaluate current marijuana laws. Further discussion at Vox.

The Pentagon has contingency plans for any emergency, including the Zombie Apocalypse. It isn’t as ridiculous as it sounds as it is actually a model plan using a fictional situation, as reported by Foreign Policy:

“This plan fulfills fictional contingency planning guidance tasking for U.S. Strategic Command to develop a comprehensive [plan] to undertake military operations to preserve ‘non-zombie’ humans from the threats posed by a zombie horde,” CONOP 8888’s plan summary reads. “Because zombies pose a threat to all non-zombie human life, [Strategic Command] will be prepared to preserve the sanctity of human life and conduct operations in support of any human population — including traditional adversaries.”

CONOP 8888, otherwise known as “Counter-Zombie Dominance” and dated April 30, 2011, is no laughing matter, and yet of course it is. As its authors note in the document’s “disclaimer section,” “this plan was not actually designed as a joke.”

Military planners assigned to the U.S. Strategic Command in Omaha, Nebraska during 2009 and 2010 looked for a creative way to devise a planning document to protect citizens in the event of an attack of any kind. The officers used zombies as their muse. “Planners … realized that training examples for plans must accommodate the political fallout that occurs if the general public mistakenly believes that a fictional training scenario is actually a real plan,” the authors wrote, adding: “Rather than risk such an outcome by teaching our augmentees using the fictional ‘Tunisia’ or ‘Nigeria’ scenarios used at [Joint Combined Warfighting School], we elected to use a completely-impossible scenario that could never be mistaken for a real plan.”

But do they have plans in case of a Dalek invasion?

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Democrats Need A Message

One reason that the Republicans get people to turn out to vote in off year elections, often to vote against their economic self-interest, is that they have a message. The message might be based upon dishonest claims and incorrect views as to how the economy and government work, but it is a message. In contrast, many Democratic voters feel less interested in turning out to vote, especially in off year elections. To some degree the Democrats have difficulty in defining a message as they are a big tent party which wins elections by appealing to a wide variety of voters, ranging from center-right to left wing. Issues which appeal to some Democratic voters might turn off others.

The Washington Post describes how Senate Democrats are struggling to define a message:

Senate Democrats’ latest effort in that regard is a 10-point plan for legislation they intend to bring to the floor over the spring and summer.

The issues are familiar ones for Democrats, and poll well among Americans generally.

Yet they are top priorities to narrower slices of the Democrats’ constituency — particularly those who showed up to vote for President Obama in 2012, but who do not have a history or voting in off-year contests.

The first items up for Senate debate will be increasing the minimum wage, from $7.25 an hour to $10.10 an hour, and a bill to assure paycheck equity between male and female workers.

Democratic pollster Celinda Lake said that those are measures that would have their greatest impact on young people, unmarried women, Latinos and African-Americans — all of whom can be difficult to turn out in years when there is no presidential election.

“This doesn’t replace a broader economic message. In the long run, we have to do that. But in the short run, this is very helpful,” said Lake, who has warned that the Democrats face a large turnout disadvantage in a year when Republican voters appear to be more motivated.

GOP pollster Neil Newhouse said the Senate Democrats’ targeted strategy echoes that of Obama’s 2012 reelection campaign, where he emphasized a number of “niche group” issues such as the Dream Act, mandatory contraception coverage under the Affordable Care Act, student loan expansion and support for same-sex marriage.

Why haven’t Democrats been pushing for legalization of same-sex marriage more strongly in the past? As Michigan and other states saw recent legal victories for marriage equality I thought that, although this is an issue far more associated with Democrats than Republicans, the victories are in the courts and not the result of actions by the Democratic Party.

Perhaps Democratic leaders did not want to be associated with bringing about marriage equality out of a fear of losing socially conservative Democratic voters. Maybe, but I also wonder how many socially liberal people who lean Democratic don’t bother to get out to vote because of not seeing a real commitment from Democratic leaders for liberal causes.

Republicans have learned that people tend to take on the other views of the party they associate with when there is a consistent message. They get social conservatives to back their economic policies by joining these as a common conservative philosophy. If the Democrats were to put out a more consistent message, perhaps those who vote for Democrats for other reasons would also “evolve,” as Barack Obama has, on issues such as same-sex marriage.

Democrats should frame this as a consistent platform of keeping government out of the private lives of individuals, along with support for reproductive rights and ideally an end to marijuana prohibition (or at least a stronger defense of medical marijuana). It is amazing that Democrats have allowed Republicans to take an advantage on issues which should be seen as reasons to vote Democratic, from size of government as it relates to private lives to support for Medicare.

Democrats also think too small on economic matters. Rather than just concentrating on issues such as increasing the minimum wage, Democrats need an economic message showing how Democratic ideas strengthen and grow the economy while Republican economic policies lead to economic stagnation and a concentration of wealth in a small minority. Income inequality is an important issue, but only when placed in an overall economic message of expanding the economy and how extreme income inequality destroys the middle class. An economic message seen as merely dislike for the rich (or the Koch brothers) will never sell.

Of course making a coherent economic message which will not only mobilize their own voters but bring in new voters will take time and cannot be done in only one election year. The Republicans have been working for years at indoctrinating the country in their type of Voodoo Economics. It will also take several years to get out the message on how the economy actually works, but the Democrats might as well start now.

Health care remains one of the strongest reasons to vote for Democrats. Even those who have a negative view of the Affordable Care Act based upon Republican misinformation still prefer to improve it over either repeal or turning to any Republican alternative. As I have written before, Democrats need to go on the offensive on health care reform, not run away from the issue. Joe Conason has the same message again, with numbers now out showing that enrollment through the exchanges has exceeded the projected number of six million:

Success for Obamacare might boost the turnout projections that Republicans have tried so hard to suppress and that Democrats have so far proved unable to resuscitate.

Dominant forces in the Republican Party — including the tea party and its billionaire financiers — have staked everything on the commonplace assumption that Obamacare will drag down Democrats across the country.

Indeed, they make almost no other argument. Bolstering that cynical bet is the Democratic hesitation to mount a powerful counteroffensive on health care, with the impulse to push the minimum wage, unemployment benefits, and other vital issues that still feel safer.

But as Clinton warns, they will find no shelter from this storm. They cannot hide from their own history; and the more they pretend to do so, the more they risk contempt. For decades, Democrats have insisted that all Americans must have health coverage — a momentous and admirable goal advanced by the Affordable Care Act.

With the numbers now on their side, they should lift their heads, raise their voices, and lean into the midterm debate. They have no better choice.

Cross Posted at The Moderate Voice

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Are Many Conservatives Really Liberals?

Liberal or conservative, opposite signs

Polls have generally showed self-identified conservatives outnumbering liberals, with a recent slight increase in the number of liberals. I have often speculated that this is largely due to the success the right wing noise machine has had in demonizing the word liberal. Americans come out more liberal than would be expected by these poll findings when we look at individual issues.

While the pendulum swings both ways, the trend has been toward more liberal policies over the years. Most people wouldn’t think of returning to the days of child labor. Medicare and Social Security are deeply entrenched, to the point that even when Republicans vote for ending Medicare as we know it they realize they have to hide what they are doing. Recent polls show increases in the number of people who support legalization of same-sex marriage and legalization of marijuana. A majority even supports the individual components of Obamacare when asked without identifying the policy as Obamacare.

John Sides reviewed a recent book to argue that many conservatives are really liberals:

In Ideology in America, Christopher Ellis and James Stimson describe a striking disjuncture. When identifying themselves in a word, Americans choose “conservative” far more than “liberal.” In fact they have done so for 70 years, and increasingly so since the early 1960s.

But when it comes to saying what the government should actually do, the public appears more liberal than conservative. Ellis and Stimson gathered 7,000 survey questions dating back to 1956 that asked some variant of whether the government should do more, less, or the same in lots of different policy areas.  On average, liberal responses were more common than conservative responses. This has been true in nearly every year since 1956, even as the relative liberalism of the public has trended up and down.  For decades now there has been a consistent discrepancy between what Ellis and Stimson call symbolic ideology (how we label ourselves) and operational ideology (what we really think about the size of government).

Looked at this way, almost 30 percent of Americans are “consistent liberals” — people who call themselves liberals and have liberal politics.  Only 15 percent are “consistent conservatives” — people who call themselves conservative and have conservative politics.  Nearly 30 percent are people who identify as conservative but actually express liberal views.  The United States appears to be a center-right nation in name only.

This raises the question: why are so many people identifying as conservative while simultaneously preferring more government?  For some conservatives, it is because they associate the label with religion, culture or lifestyle.  In essence, when they identify as “conservative,” they are thinking about conservatism in terms of family structure, raising children, or interpreting the Bible. Conservatism is about their personal lives, not their politics.

But other self-identified conservatives, though, are conservative in terms of neither religion and culture nor the size of government.  These are the truly “conflicted conservatives,” say Ellis and Stimson, who locate their origins in a different factor: how conservatives and liberals have traditionally talked about politics.  Conservatives, they argue, talk about politics in terms of symbols and the general value of “conservatism” — and news coverage, they find, usually frames the label “conservative” in positive terms.  Liberals talk about policy in terms of the goals it will serve — a cleaner environment, a stronger safety net, and so on — which are also good things for many people.  As a result, some people internalize both messages and end up calling themselves conservative but having liberal views on policy.

Ideology has two faces: the labels people choose and the actual content of their beliefs.  For liberals, these are mostly aligned.  For conservatives, they are not.  American conservatism means different things to different people.  For many, what it doesn’t mean is less government.

This idea that nearly 30 percent of self-identified conservative are really liberals would explain the increased support for liberal positions despite a majority identifying themselves as conservatives.

There are some limitations to this, largely due to problems with these labels. It seems to use a simplistic definition of liberals as being for more government and conservatives being for less, but that does not really explain the differences. There are many areas where I am for less government. There is nowhere that I support more government for the sake of more government.

I supported the Affordable Care Act because financing of health care is an area where the market has failed, as insurance companies found it more profitable to find ways to collect increased premiums while finding ways to avoid paying out claims. Conservatives opposed the Affordable Care Act based upon greatly-exaggerated arguments that it is more government (ignoring its similarities to health plans previously advocated by conservatives). Republicans widely supported an individual mandate to buy health insurance until this became part of the plan supported by Barack Obama (who ran against Hillary Clinton opposing the individual mandate). Similarly, conservatives previously supported ideas comparable to the health care exchanges.

On the other hand, conservatives support more big government when it comes to military spending, mandatory vaginal probes, and other intrusions into the private lives of individuals. Even Ron Paul, who voted no on virtually any spending by the federal government, would allow for far greater government restrictions on individual liberties if it came from the state or local level.

Republicans in office generally perform different than their rhetoric would, with big increases in the size of government under Ronald Reagan and George W. Bush. This has been described as being “ideologically conservative, but operationally liberal.” If we just go by their effects on the size of government, Reagan and Bush were the liberals while Barack Obama has been the most conservative president since Dwight Eisenhower. Part of this is because Republican rhetoric is incompatible with actually governing, leading Reagan and Bush to promote far more government spending than would be expected by their rhetoric. Many conservatives realize they didn’t get what they wanted from Bush, but continue to buy the myth of Ronald Reagan as a supporter of small government.

Another problem is a concentration on economic issues and the size of government, as misleading as those issues can be in assigning labels. How would they classify someone who wants to ban abortion, limit access to contraception, opposes same-sex marriage, and supports everyone carrying a concealed weapon, but doesn’t follow the entire Republican line on economic policy? I bet a lot of self-identified conservatives would have no real opposition to a modest tax increase on the wealthy and increasing some government economic regulations (especially if they don’t affect them personally) while holding a number of other conservative positions.

Today many are self-identified conservatives based upon social issues. This didn’t always identify conservatism. Barry Goldwater was a strong opponent of the religious right. He sure called it right in 1994:

Mark my word, if and when these preachers get control of the [Republican] party, and they’re sure trying to do so, it’s going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can’t and won’t compromise. I know, I’ve tried to deal with them.

Or maybe they just like being members of the club.  They like to listen to people like Glenn Beck and agree with what they say. However Beck has previously described himself as “a rodeo clown” and conceded, “If you take what I say as gospel, you’re an idiot.”

Cross posted at The Moderate Voice

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