Peter L. Berger's Blog, page 588

Turkey Names Its Price on Refugees

As Europe struggles to come up with solutions to the immigration crisis, Turkey has sent some suggestions for cooperation—and a bill. Open Europe reports:

Turkish Prime Minister Ahmet Davutoğlu, wrote to EU leaders yesterday demanding bold concessions as the price for Turkey’s greater cooperation. He proposed EU and US support for a buffer and no-fly zone in northern Syria by the Turkish border, measuring 80km by 40km. This could enable Ankara to start repatriating some of the estimated 2 million Syrian refugees it is hosting. French President François Hollande urged Cameron to speed up British security plans, including a Commons vote for airstrikes in Syria. “I am waiting for Britain to take decisions concerning Syria,” he said. “It has already started acting. But we will without doubt have to increase our pressure, the reconnaissance flights that we are carrying out, then if we have targets, objectives, that will be translated into airstrikes.”

As we’ve noted before, Turkey has already spent $7.6 billion on the Syrian refugee problem, and has taken the lead in providing humanitarian assistance and shelter. So it’s not surprising they would want some help in return for making life easier for Europe, which has shouldered comparatively less of the burden.

On the other hand, as Dov Friedman has noted in these pages before, “Turkey’s efforts in support of refugees have been courageous, but they were also self-serving politically”—and the same is true now. Some of what Turkey hints at starts to look like a plan to carve out a “safe zone” in Syria—possibly at the expense of the Kurds (win-win for Ankara)—and then just to dump the refugees there. It’s hard to believe the Europeans would accept such a cynical bargain, even as their realpolitik determination to solve the crisis grows by the day.But perhaps there is some middle ground. Politico Europe reports that EU leaders have invited Turkish President Recep Tayyip Erdogan to Brussels to discuss options at the beginning of next month. Some form of aid-and-enforcement deal may be workable—if the Europeans can find a way to finesse the Syria issue.

No Cyber Deal with China?

The White House was trying to lower expectations for a cyber arms deal with China. Though reports emerged earlier this week that the United States and China were hard at work trying to hammer out some kind of accord to be jointly announced by Obama and Xi, it looks like that won’t happen. Defense One has the story:

“I don’t want to suggest that, you know, we’ve reached an arms control agreement here,” said Ben Rhodes, the White House deputy national security advisor for strategic communications.

The sentiment was seconded by Dan Kritenbrink, the senior director for Asian affairs at the National Security Council. “I would be reluctant to raise expectations about an agreement along the lines of what you just described,” he said. “That would be a long-term goal. We’re a long ways from getting there.”

The agreement, reported by the New York Times last weekend, was not expected to address the widespread hacking of private American companies. Nor is it clear that such an agreement would be anything more than symbolic, given that China and the United States are unlikely to attack each other’s critical infrastructure anyway, as James Andrew Lewis of CSIS points out. Additionally, cyber attacks are much harder to trace than conventional attacks. It would be extremely difficult, if not impossible, to verify compliance.

Still, Administration officials’ statements came as the Office of Personnel Management revealed that the hack of its databases by Chinese intelligence also seized the fingerprints of 5.6 million federal employees. As he smiles for photographers with influential American business leaders, Xi’s methods seem pretty clear: talk nice, but act tough.

Google, Apple, Facebook…and the Vatican

This morning, His Holiness Pope Francis will address a Joint Session of Congress in Washington, and then fly this evening to New York City, where he will address the United Nations General Assembly. Few heads of state other than the President of the United States could command both of these bully pulpits during time of peace; certainly, none besides il Papa would trail thousands of reporters hanging on his every word, or draw millions to open-air rallies.

This week also marks the 145th anniversary of one of the best things to ever happen to the Holy See—but which was seen at the time as one of the worst: the Capture of Rome. On 20 September 1870, the armies of the newly-united Kingdom of Italy broke through the walls of Rome and deprived the Pope of his last major temporal territory. This arrangement, wherein the Pope retained spiritual authority but only a couple of acres of real estate, was bitterly resented by Pope Pius IX and his successors; it would not be formally ratified until the 1929 Lateran Treaty with Mussolini. But from 1870 on, the Vatican’s millenium-plus temporal reign was at an end.And what great timing this was. Can you imagine if the Pope were still tied down to administering a chunk of Italy? Or if he had been committed to doing so during the horrible wars of the 20th century?Instead, the Pope wound up with a state that looks remarkably ready for the new realities of the Information Revolution in the 21st century. It owns only a small (though admittedly very stylish) headquarters complex, but has claim to intellectual property of unparalleled importance. These ideas are supported by great wealth, held both by the headquarters and by its subsidiaries (archdioceses) around the world, which the Vatican bends toward its spiritual and charitable ends. And any time it wishes to, it can command the attention of the whole world, just by calling a press conference.Not bad for a supposedly stuffy old institution. And that it happened against its will, back when people thought small chunks of Europe were more important to fight over, well—it’s enough to seem almost Providential.

New Evidence in the Marriage Debate

The most widely-quoted statistical trend from Charles Murray’s blockbuster 2012 book Coming Apart is that marriage rates have declined dramatically among white working class Americans over the last half-century while remaining constant among the elite. Murray summarized his findings in the Wall Street Journal (using the fictional “Belmont” as a stand-in for white college educated professionals, and “Fishtown” as a stand-in for blue-collar whites without a college degree) as follows:

In 1960, extremely high proportions of whites in both Belmont and Fishtown were married—94% in Belmont and 84% in Fishtown. In the 1970s, those percentages declined about equally in both places. Then came the great divergence. In Belmont, marriage stabilized during the mid-1980s, standing at 83% in 2010. In Fishtown, however, marriage continued to slide; as of 2010, a minority (just 48%) were married. The gap in marriage between Belmont and Fishtown grew to 35 percentage points, from just 10.

Coming Apart set off a vigorous and wide-ranging debate among pundits over the causes of this shift. Many conservatives saw Murray’s data as evidence that there was a strong cultural dimension to the inequality debate that had dominated the public consciousness since Occupy Wall Street came on to the scene in 2010—that it wasn’t just economic changes, but also (interrelated) changes in norms and behaviors and values, that had turned America into a more stratified society since the 1960s. Liberals, for their part, said that conservatives were getting cause and effect backwards: that the decline of working class marriage hadn’t caused economic inequality, but economic inequality had caused the decline of the working class marriage. Paul Krugman, for example, argued that the marriage trends Murray highlighted could be attributed entirely to “a drastic reduction in the work opportunities available to less-educated men,” who had been pummeled by globalization and technological change. This economics versus culture debate was never conclusively resolved, and probably never will be.

A new Brookings study, however, creates questions for materialists like Krugman who think that the inquiry into the decline of the working class family begins and ends with economic changes that have made less-educated men “unmarriageable” by dimming their employment prospects. In the study, Isabel Sawhill and Joanna Venator of the Brookings Center for Children and the Family, analyze “marriage markets”—that is, the ratio of men to women in various demographic groups. Contrary to the widely-accepted explanation that there is a shortage of marriageable men in the working class, Sawhill and Venator find that by most measures, there is actually a surplus. For example, among people aged 25-34 with no more than a high school degree, the ratio of employed men to all women is 1.07; the ratio of employed men to childless women is 1.74, and the ratio of employed, childless men to employed, childless women is 2.57. As the authors argue, it’s hard to see how a dearth of marriageable men explains the plummeting marriage rates among less-educated Americans if “marriageability” is defined (albeit simplistically) in as being employed and not having children from a previous relationship. The authors don’t deny that the transition to a post-industrial economy has been painful for working class men, but they question whether it is really responsible for the dramatic decline in marriage among that population, estimating “that the decline in male earnings for less skilled men can explain anywhere from none to almost half of the decline in marriage rates since 1970.”Now, a shortage of men could explain a decline in marriage among elite Americans—except that the marriage rate among the elite population has barely declined. As Sawhill and Venator write, “it is the group of women who have the highest marriage rates—college-educated women—who are facing the greatest ‘shortage’ of men. In fact, using the conventional measure of marriageability—the ratio of employed men to all women—there are only 85 men for every 100 women among 25- to 35-year-old college-educated adults.” Many commentators (including us) have written about how the man-shortage among young, college-educated urban professionals contributes has contributed to a thriving hookup culture and an anemic dating scene, but it’s important to remember that this population—affluent, college-educated, upwardly mobile—has not been abandoning marriage so far. That could change, but so far the evidence suggests that educated young people are just tying the knot later, not eschewing marriage altogether (or at least, not at the same rate as their less-privileged counterparts).So where does that leave us? The authors compellingly call into question the narrative, pushed by Krugman et. al., that conservative concern about the decline of marriage among the working classes is not a social crisis at all, that it is largely a product of income inequality, and that if it can be reversed, it can only be reversed through liberal economic policies. That doesn’t mean that the orthodox conservative explanation that upper-class debauchery since the 1960s has translated into an erosion of traditional norms among the less educated is right, either—but it does mean that thinkers of all ideological persuasions who are concerned about elite stratification should be thinking creatively about what combination of cultural, social, and economic changes have created the marriage gap, and how it can be addressed.

Kerry: We Swear We Know What We’re Doing in Syria

The Kremlin has been crowing that the United States is prepared to strike a deal on Syria that would leave Russian ally Bashar al-Assad in place. But that’s not true, the State Department insists. Reuters :

“There is no change to our position or our concerns about what Russia is doing in Syria,” U.S. State Department spokesman John Kirby said.

“Secretary Kerry has been clear, and he has been consistent. We would welcome a constructive role by Russia in countering ISIL, but if they are there to shore up Assad, it runs counter to any meaningful effort to bring an end to the conflict,” Kirby added, using an acronym to refer to the militant group Islamic State.

On the one hand, we certainly do not trust Putin’s government to give a straight account of things, and they have a strong interest in trying to put the U.S. in a corner through the media. On the other hand, the reason this strategy is open to them is that the Obama Administration is in a state of extreme disarray in terms of its Syria strategy right now—which, for this White House, is really saying something.

Yesterday, the President’s czar for the international fight against ISIS quit, largely, it’s thought, due to interference from the NSC and lack of support for the West Wing. In the wake of the Iran Deal, D.C. has been unable to either muster a stand against Iran in the region or reach an accommodation that delivers U.S. aims. And as other powers, including Russia and Iran, move to influence the endgame overtly, it’s becoming increasingly clear that simply running out the clock until the next Administration—i.e. sitting on the sidelines for fifteen months—will not do. The U.S. needs a new strategy in Syria, now.

President Obama Joins Climate Hedging Chorus

Add President Barack Obama to the list of world leaders expecting this December’s climate summit to fall short of the hype. In an interview he gave to Rolling Stone during his trip to Alaska earlier this month, the President downplayed the importance of specific target setting, because whatever’s decided will, as he put it, “fall far short” of what’s needed. Rolling Stone has more:

I’m less concerned about the precise number, because let’s stipulate right now, whatever various country targets are, it’s still going to fall short of what the science requires. So a percent here or a percent there coming from various countries is not going to be a deal-breaker.

Those closest to the Paris talks seem convinced that whatever the conference produces will be insufficient in limiting warming to 2 degrees Celsius as compared to pre-industrial levels, a target long ago set by scientists past which, we’re promised, we’ll start to see the effects of climate change in a big way. But UN climate chief Christiana Figueres has essentially told the world to forget about the 2C target. She arrived at that conclusion after reviewing the commitments made to date by UN member states for limiting warming at the national level. So far only 62 countries have submitted these pledges, called Intended Nationally Determined Contributions (INDCs), and those countries collectively account for some 70 percent of global emissions. Figueres warned that those pledges “do not add up to 2 degrees,” and she “guesstimated” that we’re far likelier to end up somewhere in the 3 degrees Celsius range.

The President doesn’t seem all that concerned about the specifics, and even Figueres has tried to put a brave face on the grim reality negotiators will be facing at the end of this year. The worst-case scenario—a repeat of 2009’s Copenhagen summit, a meeting Obama called a “disorganized mess” in his Rolling Stone interview—is still very much in the cards.

St. Vitus’ Dance and the Rational Actor

As I’m writing this post, Jeremy Corbyn has been elected leader of the British Labour Party. Bernie Sanders is pulling ahead of Hillary Clinton in the Democratic primary in New Hampshire. (She is still trying hard to pass as a friendly grandmother, apparently not succeeding). Donald Trump leads in the Republican primary, as he hops around the country in his private plane which has his name emblazoned on its side (so we know who is coming, about to spout politically-incorrect obscenities). Each of these developments was totally unpredicted and defies rational explanations.

Jeremy Corbyn (age 66) was elected with a large mandate (facilitated by a rule that anybody could vote right away in the leadership election regardless of any previous memberhip in the party, by just paying a small registration fee—sort of like getting entrance to a members-only club by paying at the door). Corbyn has been in politics for a long time, proudly located on the far Left of the Labour Party. His focus will be on “inequality”. He advocates a bevy of Leftist policies—heavy taxes on “the rich”, renationalizing public utilities, unilateral nuclear disarmament, pulling the UK out of NATO (possibly out of the EU as well), and supporting the Palestinian cause against Israel (he called Hamas and Hezbollah his “friends”). All experts agree that with this platform he could not possibly be elected in a general election. (Are they sure?) His most immediate foe is New Labour—the term used by former prime minister Tony Blair when he pulled the party to the center from the fever swamps of the Left. Corbyn has explained his (rather neat) beard as a protest against New Labour.Bernie Sanders (age 74) seems like an American cousin of Corbyn’s. He is an independent senator from Vermont, who votes with the Democrats in the Senate. He describes himself as a “democratic socialist” (thank you for the adjective, Senator). He too zeroes in on “inequality”, with the familiar agenda of “soaking the millionaires” (could he mean the Clintons?), expanding the welfare state, and opposing most of U.S. foreign policy (except maybe the opening toward Cuba). He too is deemed to be unelectable in a general election. Of course Republicans in the U.S. and Tories in Britain are hoping that these two men will bring about a long period of conservative rule. The hope may be premature; one ignores at one’s peril the capacity of voters to act crazy. Both men come out of closed Leftist milieus whose “red diaper babies” go through childhood with the fear of a Bolshevik uncle coming for a visit.But then there is Donald Trump (age 69), who really is a multi-millionaire. He is almost impossible to satirize. Perhaps his historic mission is to prove that voters on the Right can go politically crazy as readily as voters on the Left. His political views are incoherent, but his theme song “Making America Great Again” resonates with the Right, as do the relatively few concrete policies he has endorsed: an aggressive foreign policy, economic measures against China and India for “ripping us off”, deporting all illegal immigrants (except the ones he calls “the good ones”), building a fence along the whole U.S./Mexico border to prevent all these “murderers and rapists” from coming in (and making the Mexican government pay for the fence). I suppose that Democratic strategists are praying that Trump will be the Republican nominee. They too may be miscalculating: On the ideological map of the U.S. there are more crazies on the Right than on the Left.Political commentators are scrambling for rational explanations for the enthusiastic crowds that applaud every one of this unlikely trio. It was predicted that several economic developments would bring about a surge of Leftist ideas—the slow recovery from the recession and the changes in the labor market wiping out whole categories of blue-collar jobs that used to be avenues for social mobility. The return of traditional Leftist rhetoric by the Corbyn/Sanders pair could be seen as the result of fears of these developments. But then again, on both sides of the Atlantic, the same developments have fueled populist movements on the Right. Trump appeals to the latter, a distinctively American mix of “angry white men”, xenophobes and enraged motorcycle gangs. However, I would suggest that a general problem here is an over-estimation of the place of rationality in human affairs.So-called rational actor theory has recently become prominent in the social sciences in America. It is essentially a project to explain a wide chunk of human behavior by employing concepts derived from economics. It assumes that, consciously or not, human beings decide to behave by some sort of costs/benefits calculus, as supposedly is done by an actor in the marketplace.The theory has also been applied to religion, especially in the work of Rodney Stark. It is plausible, to a degree, when a combination of religious pluralism and religious freedom has created a sort of market situation—pre-eminently the case in America. One may of course doubt whether actors in a market really act as rationally as the theory assumes—just look at the hysterical swings on Wall Street! The concept of the rational actor is much less plausible in other religious cases. Take an individual considering whether to become an Islamist suicide bomber as a cost/benefit analysis: Cost—I’ll be killed. Benefit—I go directly to paradise and get seventy-two virgins as a reward. (I wonder whether this promise may actually serve as a disincentive for some—seven virgins maybe, but seventy-two?!)In any case, most religious behavior is hard to fit into economic categories. Minimally, I think, one should distinguish between two types of rationality proposed by Max Weber: utility-rationality, which calculates probable outcomes (which, if anywhere, applies to economic behavior), and value-rationality, which can be very rational within the context of a specific set of moral beliefs. For example, the Talmud is a highly rational system of rules, over which there have been centuries of argumentation which trained generations of yeshiva students in razor-sharp logic—but all within a religious framework that only makes sense to someone who believes in it.There is a curious case of a thinker who started out as an adherent of an idea of the rational actor (it wasn’t called that at the time), and then created a major work intended to refute the idea. It is the case of Vilfredo Pareto (1848-1923), an Italian scholar sometimes listed as one of the classical sociologists (though hardly any sociologist ever reads him today). He started out as an engineer, then became a prolific economist.I don’t know when his disillusion with all this quasi-mathematical concept of rationality came about. In his early years he was a candidate for parliament, and lost. (Possible conclusion from this experience: anyone not voting for Pareto cannot be rational!) He left Italy and lived for the rest of his life in Switzerland (if there is one country with an ethos of sober rationality, this is it!). He divided human behavior as being of two types: “logical” and “non-logical” action. It is significant that the discipline of sociology was originally invented by Auguste Comte (1798-1857) under the motto “to know, in order to predict, in order to control” (an engineer’s creed if there is one). Pareto re-invented sociology as the discipline to study “non-logical action”. The massive product of this phase of his scholarship was the work commonly known as the Trattato/Treatise of General Sociology. It was published in four volumes in 1916 (he himself wrote it in both Italian and French). It is an immensely erudite and eccentric work. [My wife Brigitte Berger wrote her doctoral dissertation on Pareto, about whose theories she was skeptical but which she interpreted as an anticipation of what later became known as the sociology of knowledge.] Two key Paretian categories are “residua” and “derivations”, respectively the non-logical motives of behavior and their dubious “logicalizations” (a Freudian synonym would be “rationalizations”). Pareto lived in a charming villa on Lake Geneva, from where his wife eloped with their chauffeur. I don’t know whether this infidelity should be classified as logical or non-logical (but then I didn’t have to live with Vilfredo as he bilingually churned out his four volumes of esoterica).I must stop now, before this post becomes a lecture on different concepts of rationality. But I would mention another concept: that of definitely irrational frenzy. I would call it the St. Vitus factor. He was a fourth-century Christian martyr, who became the patron saint of epileptics and dancers. His name has been used in modern medicine to refer to the “St. Vitus dance” (also called the “Sydenham chorea”), characterized by involuntary spasmodic movements of the body resembling a grand-mal epileptic attack. It is related to another involuntary behavior called the “Tourette syndrome”, which begins with a facial tic and is then followed by incoherent shouting (usually with obscene content). But what interests me here is not these diseases, but the cult that developed in medieval Germany around the saint’s name day. The German version of his name was Sankt Veit, so the cult celebrating him was called Veitstanz. Those engaged in this ritual were not suffering from the diseases associated with the patron saint of epileptics. But the name of the ritual can serve as a useful metaphor for various frenetic movements, especially in religion and politics.It is intellectually and emotionally comforting to think that most human actions are rational. It makes for a more predictable and potentially controllable world. The institutions of society are typically based on rational assumptions (though not necessarily those of the engineer or the economist). Institutions are dams holding at bay the howling frenzies lurking in human souls. All institutions are fragile. Sometimes the dams break.

Hillary Snubs Keystone

This weekend marked an important anniversary, but it wasn’t one worth celebrating. It has now been seven years since TransCanada applied for permission to construct the Keystone XL pipeline connecting Alberta’s oil sands with America’s Gulf Coast refineries, and the entire project is still stuck in political limbo. Perhaps to mark the occasion, Presidential hopeful Hillary Clinton followed through on her promise last week to reveal her position (which for these last seven years has been “undecided”) “soon,” and yesterday came out in opposition to the controversial project.

Hillary’s past reticence made some sense. She was, after all, the Secretary of State for four of the seven years that Keystone has languished in limbo, and it’s the State Department that’s supposed to be approving or denying the project. But now, as campaigns rev up for next year’s election, it’s time once again for the pipeline to be used as some bizarre litmus test on how “green” potential candidates might be, and thus for Secretary Clinton to revert to her political self. Hillary framed it as just that, calling Keystone “a distraction from the important work we have to do on climate change.”Predictably, greens have been falling over themselves in their rush to heap praise on Hillary’s announcement. Politico reports:

“I think she’s really coming to understand that climate is going to be a defining issue of this election,” [Bill McKibben] told POLITICO. “And maybe, if you also look at her stand on Arctic drilling, she’s concluding that the most visible way to make quick progress is to keep carbon in the ground.”

Tiernan Sittenfeld, a senior vice president at the League of Conservation Voters Action Fund, also cited Clinton’s opposition to Arctic drilling in calling the candidate’s Keystone move “inspiring and exciting.”

Again, the environmental movement misses the point on Keystone here. Sure, oil is a fossil fuel, and yes, drilling in Canada’s oil sands is particularly energy-intensive. That environmentalists are opposed to Alberta’s crude isn’t surprising—though it does reflect their naïveté that they suppose green ideals alone might trump the economic and energy security gains that resource brings to Canada.

But what is so bewildering is why greens can’t understand that Keystone XL will not make or break those Albertan projects, even after being told just that in report after State Department report. Until and unless the world decides to throw off the trappings of modern civilization, there will be demand for oil. This demand will be met by supplies like the oil sands in question, and producers will find a way to transport their product to market. Pipelines are the safest and most efficient option, and out of all discussed pipelines Keystone certainly makes the most sense, but alternatives exist.And yet, and yet…greens persist in making Keystone XL their marquee issue, letting the interests of America’s most important trading partner be crushed underneath unexamined eco-ideology. Hillary can shore up her green base by opposing Keystone, but make no mistake: she’s not saving the planet.

Putin Opens Moscow’s Newest, Biggest Mosque

Vladmir Putin opened Moscow’s newest, largest mosque yesterday. As the New York Times reports, the city’s large Muslim population means the mosque was sorely needed:

Known as the Moscow Cathedral Mosque, the grand structure holds 10,000 people on three stories and replaced a much smaller one built in 1904. The previous two-story building — with a squat dome and two stunted minarets — could hold only 1,000 people.

There are just three other official mosques in a city whose Muslim population is estimated to be as high as two million. No exact public numbers exist.

That would mean Muslims make up about 16 percent of the population in this city of 12.5 million, and that puts the capital in contention for the title of most Muslims in Europe, not counting Turkey.

Those numbers do not make all Russians comfortable. As Raymond Sontag has written in these pages, Russia under Putin has long experienced a tension between ethnic Russian and civic Russian identities. One of the ways this manifests itself is through nationalist activism against mosque-building. As a result, many thousands of Muslims in Moscow are known to pray in the street during the holidays due to the lack of mosque space; others pray in unauthorized house-mosques that some experts cited by the Times claim allow extremism to spread unchecked.

So there is some self-interest here, perhaps, in allowing the new mosque to be built. But at the same time, Mr. Putin seems to have a foreign-policy agenda in mind. At the opening, he spoke alongside Turkish President Recep Tayyip Erdogan and Palestinian Authority President Mahmoud Abbas, both in town for the occasion. More:

Mr. Putin, in brief remarks, called the new, modern mosque the biggest in Europe and said that it was a worthy addition to a capital and a country built on the idea of uniting different nationalities and faiths. The mosque is a central part of Russia’s efforts to develop its own system of Muslim religious education and training to counteract extremists seeking recruits, the president said.

“Terrorists from the so-called Islamic State actually cast a shadow on the great global religion of Islam,” he said. “Their ideology is built on hate.”

Russia’s newfound adventurism in the Middle East traces in part to two major goals: to beat back the extremist threat to the Russian homeland and to reestablish Russia as a regional player. Framing the pro-Assad coalition as anti-ISIS has been an integral part of the PR efforts for the latter, and pushing back against extremism is at the heart of the former. It looks like Putin saw an opportunity to kill a few birds with the same stone here.

Deductibles Rising, Rising, Rising

Even as the White House continues to focus on the raw number of insured Americans in the lead-up to the next ACA sign-up period, the evidence continues to mount that the fundamental dynamics of U.S. health care are still hitting Americans where it hurts: the pocketbook. A new study show that costs are rising across the system, not especially dramatically, but consistently, making care more unaffordable year by year. The New York Times reports on new research by the Kaiser Family Foundation that finds deductibles rising faster than wages:

Kaiser, a health policy research group that conducts a yearly survey of employer health benefits, calculates that deductibles have risen more than six times faster than workers’ earnings since 2010 […]

Four of five workers who receive their insurance through an employer now pay a deductible, in which they must pay some of their medical bills before their coverage starts, according to Kaiser.

Those workers’ deductibles have climbed from a yearly average of $900 in 2010 for an individual plan to above $1,300 this year, while employees working for small businesses have an even higher average of $1,800 a year. One in five workers has a deductible of $2,000 or more.

The rise in deductibles is accompanied by what experts say is a relatively modest increase in premium costs across the country (though an increase, nonetheless). But as the chief executive of Kaiser notes, low premium growth doesn’t mean individuals are seeing relief. “This slowdown is invisible to average people. They’re paying more and more,” he said.

High deductible plans are, of course, a favored policy solution of those who believe higher out-of-pocket costs will incentivize Americans to spend less on health care. And giving health care consumers more reasons to exercise spending restraint is a good idea, as long as it is also accompanied by price transparency (which our system is still poor at, even as deductibles rise).

But health care reform needs to do more than subsidize spending (the ACA approach) or restrain spending (the high deductible approach); it needs to focus on making individual procedures cost less. The cheaper the underlying services are, the better off the whole system will be, with eventual knock-on effects on premiums and deductibles—and that can’t just be fixed by controlling spending from the consumer side. Only by reforming the way health care services are delivered—experimenting with things like telehealth, remote monitoring, and new providers and care settings, like nurse practitioners and clinics, respectively—can we ultimately make our way to a sustainable health care system.