Peter L. Berger's Blog, page 557

ACA Co-Ops Dropping Like Flies

Michigan’s Consumers Mutual Insurance put a notice up yesterday that it will not offer insurance in 2016, making it the 12th ACA co-op to fall—a number that’s more than half of the 23 co-ops set up by the ACA in 2014. More, via WaPo:

The dozen collapses will disrupt insurance for 740,000 individuals and small-business employees, who are being instructed by state and federal officials to choose new plans in time for them to take effect in January. In New York state, the window is narrower. Government officials have moved up the closing date of the New York Health Republic co-op, the nation’s largest, giving its more than 200,000 members just two weeks to select different coverage before it shuts down at the end of this month.

Democrats, of course, have blamed Republicans for cutting federal funding to co-ops, which they argue could have kept them afloat. But the structural causes of the closures appear to lie deeper. Every co-op’s financial situation is unique, but in the case of one early closure—Iowa’s Cooportunity Health—premiums were set too low to cover the cost of the sick patients it attracted. Another threatened co-op, meanwhile, looked at the possibility of raising premiums. In other words, there is a tradeoff between plan affordability and insurer sustainability that the ACA simply hasn’t solved. Insurers can make their coverage affordable, but then their viability is threatened. Or they can raise premiums and save themselves—but at the cost of increasing the financial burden placed on Americans, whether directly or through tax dollars.

And that, in short, is the entire story of the ACA. Increasing federal funding for health care—whether funds for co-ops or subsidies on the individual market—may help paper over structural problems or forestall some specific problems, but it won’t fix the fundamental fact that we don’t have a sustainable system that can get health care to Americans cheaply and efficiently. As long as treating sick patients remains expensive, expect to see more crack-ups like the great ACA co-op collapse.

Religious Freedom and the Vicissitudes of Power

In early October I attended an exceedingly interesting conference about religious freedom at Georgetown University in Washington, presided over by Tom Farr and Timothy Shah of the Berkley Center. I gave the keynote address dealing with the relationship of pluralism and religious freedom, based on the theory of pluralism I developed in my recent book The Many Altars of Modernity. [Over the years I acquired a deep appreciation of African wit and wisdom, so I feel free to quote my favorite Zulu proverb: “If I don’t beat my drum, who will?”] The focus of the conference was on the place of religious freedom in the foreign policy of Western democracies, notably the United States and the United Kingdom. I have no expertise in international relations, though I will make some comments about the practical issues that inevitably arise if religious freedom becomes a topic for foreign policy. But first I want to briefly outline how pluralism relates to religious freedom in my own theoretical perspective.

Pluralism means the co-existence of different religions, worldviews and moralities within the same society—if not overly amicably, at least reluctantly at peace. To maintain such peace, the role of the state is crucial. It must institute and enforce what I would call formulas of peace. There have been several in different periods and different places (such as in the conviviencia between Muslims, Jews and Christians in the better periods of the caliphate of Cordoba). In modern European history an important formula was the base of the of the Peace of Westphalia, which in 1648 put an end to the Thirty Years’ War during which Catholics and Protestants had succeeded to annihilate a substantial portion of the population of central Europe. It was a territorial formula—the ruler decided what would be the religion of the state, and those who did not like it were expelled or free to emigrate (certainly an improvement over being massacred or forcibly converted). But the territorial nature of the formula made it difficult to achieve if the contesting groups could not easily be separated geographically, in which case bloody “cleansing” became a likely scenario (as in the partition of India and the collapse of the Yugoslav state). Failing the Westphalian option, the most practical formula has been some measure of the separation of religion and the state. This could be de jure (as in France or the United States) or de facto (as in England). The state then does not define itself as strongly identified with only one religion and can therefore serve as the religiously neutral arbiter between the groups that might otherwise be at each other’s throats. Thus Queen Elizabeth II is still the head of the Church of England, with the title “defender of the faith” (originally bestowed on Henry VIII by the Pope—of course before Henry’s theological conversion in Anne Boleyn’s bed), but has recently described herself as “defender of all the faiths represented in the United Kingdom”.The separation of church and state as laid down in the constitution of the United States has been remarkably successful as a formula of peace. The history of this country is hardly an unblemished record of human rights, but in the matter of religious freedom there is good grounds for self-congratulation. One significant exception is the case of the Mormons, and not only because Joseph Smith, the founder of the Church of Jesus Christ of Latter-Day Saints was lynched by a fanatical mob in the early days of the religion. When Utah wanted to become a state of the Union, Congress at first refused. The reason was not the rather eccentric contents of the original doctrine; the many other religious movements which also originated in the same region of upstate New York (Adventists, Shakers, the Oneida Community…) did not lack their own eccentricities. Rather it was Mormon polygamy, which they called “plural marriage”, that Congress could not tolerate. Fortunately, then and now, the Presidency, the supreme authority of the LDS Church in Salt Lake City, has the authority to alter doctrine. It did so, and Utah became a state. (Mormons also became fiercely devoted to monogamy, as long as it is heterosexual. But that is another story.)  Religious freedom has not only become a fundamental principle of the constitution, but a commonly shared value of tolerance, expressed in ordinary language and behavior: “It’s a free country”, “we’ll agree to disagree”… When I first came to America as a very young man, someone advised me, if I didn’t want to do something, to say that “it’s against my religion”; I asked, “but won’t people ask just what is my religion that forbids my doing this”; I was told, “they wouldn’t dare”. Thus the typical religious institution in America has become the “denomination”, defined by the historian Richard Niebuhr as a church which accepts the right of other churches to exist. However this very cultural feature makes it unlikely that the American form of church/state separation can be universally adopted: Some form of separation, yes; but hardly a translation of the First Amendment into Russian, Arabic or Chinese.By law, Congress has mandated that the U.S. government monitor and advocate religious freedom throughout the world. This is not surprising. The United States is by any measure the most religious of all Western democracies (now that Ireland and Poland have become influenced by eurosecularity). Citizens vote their values as well as their interests. Thus no fewer than three institutions within the U.S. government are supposed to promote religious freedom:  The State Department is required to issue an annual report on the condition of religious freedom in every other country (in addition to the also required annual freedom on human rights in general). The U.S. Commission on International Religious Freedom, an independent non-governmental body supported by tax money, which issues reports on “countries of concern”, where one has to worry about religious freedom. And finally the U.S. Ambassador-at-Large for International Religious Freedom, located in the White House, a position currently held by Rabbi David Saperstein. If one believes in religious freedom as a fundamental human right (as I fervently do), one will not want to quarrel with these measures. How effective they are is a different matter.America’s enemies are of course enraged if the U.S. government criticizes their actions in the name of moral principles. But some of America’s friends may also be irritated. There is some hubris as one sovereign state arrogates to itself the right to pass moral judgments to every other sovereign state on earth. I once heard a Swiss diplomat express annoyance at the mention of his country in the annual State Department report on human rights. The mention of Switzerland was very brief and very positive. Something like: Switzerland is a democracy, in which the rule of law prevails. There are no reported incidents of… then follows a long list from genocide on down. The Swiss diplomat exclaimed, ”Who the hell are you to give me a grade of A?!” But the vicissitudes of power makes it very difficult to inject moral principles into the conduct of foreign policy. The world is full of tyrants who do terrible things. A diplomat is obliged to serve his country’s national interests, which commonly involves having polite conversations with tyrants. Is an American diplomat, in the midst of such a conversation, to inject “by the way, we think you should stop persecuting the so-and-sos”? I have no inside knowledge how this actually works. I have talked with observers who do know and are skeptical.Samantha Power published an influential book in 2002 with the title A Problem from Hell: America and the Age of Genocide. It is a moving critique of American policy in dealing retrospectively with the Armenian genocide during the First World War (the U.S. government is reluctant to annoy Turkey) and the Holocaust when it was actually occurring during the Second (and Washington rejected the suggestion of bombing the railway lines leading to death camps); the book then deals with more recent cases, such as Cambodia and Bosnia). I wonder how Samantha Power feels now, when she is the main U.S. representatives at the United Nations, as a member of the Obama administration whose major concern in the face of many horrors is to avoid “American boots on the ground”.Churchill was asked how, as a lifelong foe of Communism, he could be in an alliance with the Soviet Union. He replied: “To defeat Hitler, I would make an alliance with the devil”. I don’t think he necessarily intended to say that Hitler was worse than Stalin, but Hitler was the more immediate problem. Right now the United States is moving toward various compromises in the Middle East, with the Taliban in Afghanistan and the Assad regime in Syria (which of our friends will have to be abandoned if these compromises are achieved?). Will it be women in Afghanistan, or the few democrats in Syria? Our principal ally in the region is Saudi Arabia, our principal enemy Iran. From the viewpoint of human rights, certainly of religious freedom, the two are amazingly similar. Religious freedom in Saudi Arabia is zero, in Iran minimal (ask the Baha’is). The Saudis behead homosexuals, the Iranians hang them. There are many tyrants to have polite conversations with. Yet a purely Machiavellian foreign policy would be hard to reconcile with deeply held moral values, and in the long run would not be supported by the American public. The problem of balancing power and ethos is not new, but in the face of the unspeakable atrocities that confront us today it is especially anguished.

Iran: Arresting Journalists and Hindering U.S. Aid to Iraq

In China, they accuse journalists of “groundless commentary”; in Iran, they’re a bit clearer about the issue. From :

Isa Saharkhiz, a well-known independent journalist, was arrested by the Islamic Revolutionary Guards Corps (IRGC) on charges of “insulting the Supreme Leader, Ayatollah Ali Khamenei, and propaganda against the regime”, his son Mehdi said in a telephone interview from the United States.

The managing director of the Farikhtegan newspaper was also arrested around the same time, on security charges.

Meanwhile, the Wall Street Journal reports that the United States is having difficulty sending cash to Iraq because of fears it may end up in Iran or with ISIS:

The Federal Reserve and Treasury Department temporarily shut off the flow of billions of dollars to Iraq’s central bank this summer as concerns mounted that the currency was ending up at Iranian banks and possibly being funneled to Islamic State militants, according to U.S. and Iraqi officials and other people familiar with the matter.

The previously unreported move to stop the cash shipments pushed the Iraqi financial system to the brink of crisis and marked a climactic moment in efforts to avert the flow of dollars to U.S. foes.

Twelve years after the U.S. invasion of Iraq, it seems our intelligence and pipelines in the country aren’t very good. And noises about centrifuge reductions notwithstanding, Tehran isn’t really showing the friendlier post-deal face some thought it might.

The Next Stage of Barbarity

Hatreds between rival groups continue to deepen in Syria: Reports are filtering in that families of Assad regime supporters are being held captive in cages and are used as human shields to deter regime air raids. CNN reports:

Videos posted to social media over the weekend show trucks transporting cages filled with up to eight men or women, the opposition Shaam News Network reported.

“Rebels … have distributed 100 cages, with each cage containing approximately seven people and the plan is afoot to produce 1,000 cages to distribute … in different parts of Douma city particularly in public places and markets that have been attacked in the past by the regime and Russian air-force,” text in one of the videos says, according to the opposition network […]

Pro-regime militiamen also used opposition detainees as human shields in recent weeks, according to the Syrian Observatory for Human Rights.

We can assume that what we read about is just the tip of the iceberg. Murder, torture, and rape are now endemic across much of the country, spawning hatreds that will likely fester for generations, pushing the rest of the region that much closer to the abyss of full scale sectarian war.

Mortality Study Should Raise Doubts About Assisted Suicide

In a strong overview of the grim new study showing sharply elevated rates of suicide and drug overdose among middle-aged white Americans without college degrees, the American Prospect‘s Paul Starr writes:

Case and Deaton’s analysis, published today in the Proceedings of the National Academy of Sciences, also shows increased rates of illness, chronic pain, and disability among middle-aged whites. The findings have important implications for American politics and public policy, particularly for debates about economic inequality, public health, drug policy, disability insurance, and retirement income. The data also suggest why much of American politics may be taking on an increasingly harsh and desperate quality.

Starr is right that evidence of a worsening crisis among a population increasingly disconnected from America’s core institutions ought to (but, sadly, probably won’t) have an impact on several areas of U.S. public policy. One area of policy that did not make Starr’s list but which also ought to be scrutinized in light of the new data: physician-assisted suicide, which is legally available to more than 50 million Americans across five states and gaining in popularity nationwide.

The U.S. states that have legalized assisted suicide only permit the practice in cases where doctors determine that a person is terminally ill. But assisted suicide opponents have long pointed out that whether or not a sick person chooses to kill himself has more to do with whether he feels depressed or unsupported (feelings more common among the poor and vulnerable) than the intensity of the pain he is experiencing. Moreover, assisted suicide programs tend, by their own internal logic, to gradually expand in scope. In several European countries, doctors may prescribe fatal drugs to people who disabled or experiencing chronic pain.The new analysis on mortality, in other words, paints a picture of a population with exactly the qualities—desperation, depression, deteriorating physical condition—that we should be worried about when it comes to physician-assisted suicide. This population is killing itself at faster and faster rates—either through clear-cut suicides or through drug overdoses (which are sometimes difficult to distinguish from suicides)—and seems likely to push the boundaries on assisted suicide that are currently in effect. Widespread legalization of assisted suicide could make it easier for lower-income Americans to kill themselves—and, by changing the official designation of some of those deaths from “suicide” to “treatment”—would help sweep their misery under the rug.

Russia Leads in Syria as U.S. Falters

Russia is forging ahead in trying to broker a deal in Syria, as Deputy Foreign Minister Mikhail Bogdanov has said that his government has invited members of the regime and of the Syrian opposition to meet in Moscow next week. Moreover, this Wednesday, Foreign Minister Sergei Lavrov will meet with UN Syria Representative Staffan de Mistura in Moscow, according to Russia’s Foreign Ministry.

Russia has also reportedly shipped 100,000 tons of wheat to the Syrian regime, and perhaps as much as 120,000. Western sanctions do not prohibit the import of foodstuffs, but do impose restrictions on the financing of grain sales.Meanwhile, the coalition of U.S.-backed ground forces in Syria is not much an alliance—and not much of a force either, as front-line interviews by the New York Times make clear. One Arab commander said his forces were struggling to fight ISIS with “simple means”, and needed everything from more ammunition to more U.S. airstrikes. Most of the coalition’s power comes from the Kurdish forces, with whom the more disorganized and weaker Arab forces have a mistrustful relationship. As one Arab commander put it, “ISIS brings foreign fighters for an Islamic State, while they [the Kurds] bring foreign fighters for a Kurdish project…But if that is how they think, they’ll fail.” A Kurdish commander said when told of the comparison, “I came to bring democracy, while ISIS came to kill…That is the difference.”But idealism is one thing; getting results is another. And right now, the contrast between the high words of Americans and their allies, and the effective actions of the Russians and theirs, is on stark display.

After Elections, Erdogan Doubles Down

Turkish President Recep Tayyip Erdogan is celebrating his party’s victory in the Nov. 1 elections by intensifying attacks on the Kurds. The Wall Street Journal reports:

While Mr. Erdogan and the dominant political party he founded celebrated their victory in Sunday’s election, the Turkish military staged new attacks on Monday against the Kurdistan Workers’ Party, known as the PKK, which has been branded as a terrorist force by Turkey, the U.S. and European Union.

The Turkish military confirmed the strikes on Tuesday, and the PKK said it was clear that Mr. Erdogan and Prime Minister Ahmet Davutoglu had no intentions of resuming peace talks.“This is war,” Zagros Hiwa, a PKK spokesman said Monday night as Turkish jets were carrying out their attacks. “On election night, Mr. Davutoglu said the strikes would continue, he said our struggle will continue with determination, and I think it was an indication of these strikes.”

The government also arrested 44 accused members of the Gulenist opposition group, and shut down a left-wing magazine. Moreover, the new cabinet is stacked with AKP members who are reportedly personally loyal to Erdogan himself. While the AKP lacks the parliamentary supermajority necessary to reform the constitution, Erdogan may, it seems, be tempted to see just how far a combination of majoritarianism, war-mongering, and thuggery can take him.

And why not?  That’s what won the “do-over” election: five months full of anti-Kurdish violence and domestic crack-downs.As we noted immediately after the elections, Erdogan came into power promising to heal Turkey’s ethnic divisions and overcome its authoritarian past, but in the last year he has hung on to power by embracing division and authoritarianism. His moves after this latest victory seem to indicate Erdogan is, as Fleetwood Mac sang, never going back again.

Mismanaging the Heroin Crisis

What is driving the staggering rise in heroin use rates, addiction, and overdose deaths—all up sharply since 2008, and accelerating?

The standard answer, repeated by both the media and even some government officials, is that an earlier epidemic of addiction to prescription opiate medication led to a “cross-over” from pills to heroin following a crackdown on improper prescribing and pill mills. According to this assertion, the medical community and law enforcement unintentionally worked together to create a heroin epidemic, the former by over-prescribing opioids and the latter by acting against the problem.Why does it seem plausible? First, heroin is cheaper, and unaccountably more potent and abundant than prescription opiates (according to this account), leading those addicted to their medication to abandon the quest for pills and turn to heroin. Annual overdose deaths attributed to painkillers (16,000) have leveled over the past five years, while heroin deaths (over 8,000) are still soaring, with a near 40-percent one-year increase in deaths between 2012 and 2013.Further, some studies show that as many as 80 percent of recent heroin initiates report previous use of prescription opiates.However, a careful look at the data reveals that this narrative has been vastly oversold.No responsible person defends the over-prescription of opiates. That is a real problem, as are the misuse of opiate pills and the subsequent deaths by overdose. Nonetheless, wrongly attributing the rising heroin epidemic to the misuse of opioid medications obscures the true causes of the heroin threat and, most of all, the measures needed to counter it.It is true, as Dr. Andrew Kolodny, Chief Medical Officer of the major treatment provider Phoenix House, puts it, that “Because of the epidemic of opioid addiction, you now have markets for heroin that you didn’t have in the past.” But that fact is not sufficient to drive the current tragedy. In fact, there are two epidemics. It is the supply of heroin that drives the heroin crisis.The preferred cross-over narrative is actually composed of more than one subplot and several supposed villains. Each dimension has some truth, but none is sufficient to explain what we face. Some story lines lay the blame on pharmaceutical companies, such as Oxycontin maker Perdue, for pushing extravagant over-prescribing.Somewhat surprisingly, Dr. Tom Frieden, Director of the Centers for Disease Control (CDC), shifted the blame to physicians. As he told the Economist , “This is a doctor-caused epidemic.” To bolster the claim, the Economist notes that “in states with higher prescription rate of opioid painkillers, such as Michigan, Ohio and Indiana, the number of heroin addicts is higher too.”This statement, however, is only partially true. As the CDC itself analyzed it, ten of the highest opiate prescribing states are in the South, which has the lowest regional heroin use, while heroin use is highest in the Northeast and Illinois.Further, doctors shouldn’t take all of the blame for the over-prescription of opiates. The Food and Drug Administration (FDA) is also complicit, since they were slow to intervene in prescription abuse (which peaked in 2006, according to national surveys). More recently, the FDA even approved a new and powerful opiate formulary, Zohydro, against the recommendation of its own advisory panel.Finally, and revealingly, a popular version of this story puts the blame on the Drug Enforcement Administration (DEA) for its “war on drugs” approach to attacking drug supply. According to this narrative (echoed by California Democrat Judy Chu during a House hearing on heroin abuse), it was the DEA’s crackdown on overprescribing that drove addicts into heroin’s embrace. As a US News headline put it, “Heroin Abuse Increase May Be Due to Prescription Pain Killer Crackdown.”Such accounts nearly always end by supporting “harm reduction” approaches to “managing” the heroin crisis. They cite the familiar “balloon effect” critique of supply reduction efforts: that reducing one part of the problem just makes another part bigger, supposedly rendering all such efforts inherently futile.These narratives all support the drug control policy of the Obama Administration, which includes rejecting supply control strategies, responding to the increase in deaths by expanding the delivery of overdose antidotes (which does not solve the underlying problem), and, critically, ignoring responsibility for the mismanagement of international programs intended to curtail heroin production and the flow across our borders.How did the media and the Administration get it so wrong? Mostly by over-simplifying the data and ignoring multiple caveats, many from the CDC itself.Yes, a majority of new heroin users started with prescription pills. But those making the familiar “gateway” argument must acknowledge that the vast majority of prescription users do not move on to heroin. An even larger proportion of current heroin users first used marijuana, but again, most marijuana users do not so progress.Even though over-prescription is a problem, the misuse of opiates is not truly “doctor-caused.” Abuse of prescription drugs and marijuana use are risk factors, not causes, of heroin use.Moreover, heroin users are overwhelmingly poly-drug users. They do not so much “cross-over” from pills to heroin as add another drug to their use profile. As the CDC notes, the majority of heroin users abuse no fewer than three other drugs along with it. Fully 96 percent of people who reported using heroin also reported using at least one other drug within the past year.Finally, most overdose deaths from opiates involve a variety of substances, including alcohol and benzodiazepines. And although it accounts for only 2 percent of all opiate prescriptions, 30 percent of opiate deaths involve methadone (notwithstanding this fact, the Administration is aggressively seeking to expand its use in opiate treatment therapy).The same holds true for the small subset of prescription opiate users who begin to misuse pain pills: They commonly have a history of using multiple illicit substances, to which they add prescription misuse. The prescription pill recipient without a history of substance use problems who suddenly falls victim to heroin addiction is simply not typical.A more careful appraisal of the data reveals the true relationship of prescription pill use to heroin use.First, with regards to overprescribing: Doctors reported issuing 259 million opiate prescriptions in 2012. In a country of roughly 250 million people, that’s enough to provide every American older than 18 with 75 pain pills per year.Yet reports from Health and Human Services show important qualifiers. Only 4.3 million people reported misusing prescription opiates within the past month in a 2014 survey. Of these misusers, only 3.6 percent (that is, 155,000) initiated heroin use within 5 years, which works out to about 4 percent of an estimated 914,000 past-year heroin users (2014 data) as possible cross-over users in that year. That is, 96 percent of all heroin users came to heroin in some other manner than direct “cross-over.”The cross-over argument is stronger if we examine only new heroin initiates, of which there were 178,000 in 2011 (the most recent year available). These data suggest that 20 percent of new heroin initiates in that year could have previously been prescription users. But again, it appears that these people do not so much “cross-over” to heroin as begin to use both heroin and prescription pills at around the same time.As the CDC writes,

Although it has been postulated that efforts to curb opioid prescribing, resulting in restricted prescription opioid access, have fueled heroin use and overdose, a recent analysis of 2010–2012 drug overdose deaths in 28 states found that decreases in prescription opioid death rates within a state were not associated with increases in heroin death rates; in fact, increases in heroin overdose death rates were associated with increases in prescription opioid overdose death rates…. Thus, the changing patterns of heroin use and overdose deaths are most likely the result of multiple, and possibly interacting, factors.

Next, and crucially, the heroin use crisis was already in motion prior to whatever pill “crackdown” has been implemented. According to the CDC, “In 2013, an estimated 517,000 persons reported past-year heroin abuse or dependence, a nearly 150% increase since 2007.” (The figure for past-year use has risen, as we have seen, in 2014.) In other words, the persistent rise in heroin use and overdoses, starting in 2007 and sharply accelerating in 2010, predates the prescription crackdown, which began in 2011.1

As Dr. Kolodny points out, “there is strong evidence that heroin use was increasing before any significant federal or state interventions on prescription opioids were implemented. The idea that efforts to curb prescription drug misuse have led to a spike in heroin use or overdose has become a common media narrative, but the facts don’t support it.”The Obama Administration did preside over a raft of initiatives against over-prescription: the DEA’s crackdown on pill mills distributing massive amounts of opiates; state-level prescription-monitoring programs cutting down on doctor-shopping; the up-scheduling of the most widely used opiates, hydrocodones, to the more restrictive Schedule II (taking effect in October, 2014); and the development of an abuse-resistant version of Oxycontin. All of these produced an impact well after the heroin use and overdose epidemic was fully upon us.Importantly, the crackdown appears to have affected Oxycontin most sharply, and other opiate pills very little. This suggests that abusers had already moved on to drugs such as Opana, Dilaudid, Fentanyl, and hydrocodones, to which heroin gets added.2As the New England Journal of Medicine found, after the new formulary Oxycontin was introduced that, use decreased, but “… for other opioids, including high-potency fentanyl and hydromorphone, selection rose markedly… it appears that [Oxycontin users] simply shifted their drug of choice … [leading to] a replacement of the abuse-deterrent formulation with alternative opioid medications and heroin.”Despite the unwillingness of the White House to face the reality of the heroin crisis, and the preference politically for the “cross-over” narrative, the facts concerning heroin point to another factor, one that is still growing rapidly.The heroin epidemic now underway reflects the sharp increase in heroin availability in recent years. Measurements of the consequences of drug use—of which addiction and overdose deaths are only two—are lagging indicators of changes in the supply of heroin.Thus it is chilling to note that in 2012, the most recent year for which data on Mexican heroin production is available, the White House posted 26 Metric Tons of potential pure heroin. That is the supply driving the indicators we are seeing today. Though the production estimate for 2014 is supposed to be finished, as yet there has been no White House release, or comment, on just how bad things have gotten among the now-dominant cartels.Perhaps there are “technical issues” surrounding the release of the data, which could certainly prove discomfiting to White House international policy, if recent reports in the New York Times hold true. The Times, referring to Mexican heroin for 2014 (no one yet knows the state of 2015 activity), reports no less than a 50-percent increase over the previous year, according to unnamed Mexican and U.S. officials.Moreover, the Mexican government has already announced a stark increase in eradication of opium poppy (from 15,000 hectares to 21,000 hectares) in 2014. Historically, the poppy that Mexico claims to eradicate is often about the same amount that subsequently becomes heroin.An increase of 50 percent in production would yield nearly 40 metric tons of pure heroin from Mexico alone, a staggering amount considering that past estimates of total U.S. consumption, from all global sources, were between 18–20 metric tons. And it is possible that Mexican production may exceed 40 metric tons.The 2014 production, already being sold on U.S. streets (though the consequences are not yet recorded in official data sets), may take us well past today’s tragic toll in addiction and death. All eyes should be on the upcoming White House release of this Mexican heroin production data; they will likely portend great damage.And looming on the horizon is Afghan heroin. For 2014, the United Nations reported that the Afghan crop (measured in poppy cultivation and in opium, rather than heroin) was at a record 224,000 hectares, with 6,400 metric tons of opium (which could generate approximately 600–800 metric tons of pure heroin). It dominates all other sources of heroin for most of the rest of the world.Were Afghan heroin—already entering Canada—to reach the lucrative U.S. market, the flow would turn into an unprecedented flood of the deadly drug.The Obama Administration’s misunderstanding of the central role of the  increasing heroin supply and failure to make controlling that supply a priority now puts us at risk of a public health disaster.

1See this graph of heroin use from the CDC.

2See opiate use graph from NI2DA congressional testimony.

Porsche and Audi Join VW Emissions Scandal

It’s the scandal that keeps on giving. U.S. regulators now say they’ve uncovered dubious emissions testing results from Porsche and Audi vehicles, two luxury brands owned by the already scandal-ridden German carmaker Volkswagen. VW responded to the EPA by saying that the testing abnormalities were the result of a “software function which had not been adequately described in the application process.” In other words: Nothing to see here, folks. For its part, Porsche went with the ignorance defense, insisting that “[u]ntil this notice, all of our information was that the Porsche Cayenne diesel is fully compliant.” The NYT has more:

The new revelations escalate the potential damage to Volkswagen’s finances and reputation. Audi and Porsche are the source of most of the company’s earnings, because profit margins tend to be higher on luxury cars. In contrast to Volkswagen brand cars, which have struggled in the United States, Audi and Porsche are success stories in North America, which is the biggest market for Porsche. […]

[I]n a six-page letter explaining its findings, the E.P.A. described in detail a mechanism it says was set up to intentionally beat emissions testing. It said the devices were not described in the vehicles’ certification application and were set up to defeat a federal emission test procedure known as FTP 75.The agency said the new tests found that Volkswagen had installed the devices in some Volkswagen, Audi and Porsche diesel cars with 3.0-liter engines, encompassing model years 2014 through 2016.

From the very beginning, this scandal has had an air of “things are going to get worse before they get better” hanging over it, and the fallout has only shown the widespread deceit to be worse than it initially appeared. It’s clear that this isn’t an isolated phenomenon, either. A recent study showed a wide discrepancy in a number of makes of vehicles between measured mileage in testing and that measured on the road, while European watchdogs have long complained of unrealistic vehicle testing conditions.

But this is more than just a stark example of unscrupulous corporate cynicism. It’s a reminder that as the world comes to grips with the dangers posed by climate change and humanity’s culpability for it, the profit motive to market products as “green” and “clean” is only going to grow—and that, as that happens, we need to be wary of those looking to dupe regulators in order to make a quick buck. In the meantime, if it sounds too green to be true, it probably is.

U.S. Navy Reassessing “Global Posture” in Response to Russia

It’s not easy being the world’s policeman; you can’t just afford to focus on one issue at a time. Case in point: As the U.S. settles on a plan to conduct regular freedom of navigation exercises in the South China Sea, the head of the U.S. Navy tells the Financial Times the force is “reassessing its global posture in the face of the Russian activity.” Admiral John Richardson says the Russian navy is more active now than it has been in twenty years, and that the U.S. needs a new strategy to confront Moscow.

It’s very good that the navy is paying attention. Last week, we learned the Kremlin has been eyeing critical undersea cables that carry internet communications across the Atlantic. The free flow of goods and information are core American interests and maintaining freedom of the seas has been one of America’s chief responsibilities since World War II. The Russians would like to make that job harder—and America appear more hapless at doing it.The Navy will need support from the White House and Congress to make any new strategy work. The Admiral has spoken. Is Washington listening?