Conspiracy belief prevalence, according to Public Policy Polling is as high as 51%

And it may even be more when one considers that there is likely non-overlap between many of these conspiracies. It really is unfortunate that their isn’t more social pushback against those that express conspiratorial views. Given both the historical and modern tendency of some conspiracy theories being used direct hate towards one group or another (scratch a 9/11 truther and guess what’s underneath), and that they’re basically an admission of one’s own defective reasoning, why is it socially acceptable to espouse conspiracy theories? They add nothing to discussion, and instead hijack legitimate debate because one contributor has abandoned all pretense of using actual evidence. Conspiracy theories are used to explain a belief in the absence of real evidence. Worse, they are so often just a vehicle to direct vitriol and hate. We need less hate and partisanship. We should be able to disagree with a president without saying that he’s part of an agenda21/commoncore/obamacare/nazi/fascist/communist/North Korean conspiracy to make American citizens 3rd world slaves (not an exaggeration). We should be able to disagree with a corporation’s policies without asserting their objective is mass-murder. What is the benefit of this rhetoric? It’s just designed to poison our discourse, and inspire greater partisanship, divisiveness and incivility. Conspiracy theories are often used as a more subtle way to mask vile invective towards whichever group you hate. As you look underneath these theories you see it’s really just irrational hatred for somebody- liberals, conservatives, homosexuals, different races or religions, governments, or even certain professions. This is because at the root of the need for conspiratorial thinking is some irrational, overvalued idea, and often the open expression of the belief would result in social scorn.
I’ve found in my experience, almost everyone carries one really cranky belief that they can’t seem to shake, no matter how evidence-based their other positions are (probably because we are all capable of carrying some overvalued ideas). But it’s worth peering through PPP’s full results to see the nature of some of these associations.
For one, some of these associations I think are spurious, poorly questioned, or just reflect misinformation, rather than conspiracy. For instance:

44% of voters believe the Bush administration intentionally misled the public about weapons of mass destruction to promote the Iraq War, while 45% disagree. 72% of Democrats believed the statement while 73% of Republicans did not. 22% of Democrats, 33% of Republicans and 28% of independents believe Saddam Hussein was involved in the 9/11 terrorist attacks.

Many have questioned the inclusion of this question because, in reality, there were no weapons of mass destruction found in Iraq. So the question of whether we were “misled” or “intentionally-misled” puts us in the murky position at having to guess at the motivations of individuals like Bush and Cheney. Mind-reading is a dubious activity, and I tend to ascribe to the Napoleonic belief that you shouldn’t ascribe to malice, that which can be explained by incompetence (also known as Hanlon’s razor). Is it conspiratorial to think maybe they were more malicious than incompetent? While I think that administration really were “true believers”, of course I don’t really know for sure, and I don’t think it’s fair to describe such as conspiratorial reasoning. Instead it’s just the dubious but common practice of guessing at the intentions of others. The generally-similar numbers on the Saddam Hussein/9/11 connection, I believe, just suggests ignorance, rather than necessitating active belief in a conspiratorial framework (keeping in mind the margin of error is about 3% these aren’t huge partisan differences like over WMD).
One of the most disappointing numbers was on belief in a conspiracy behind JFK’s assassination:

51% of Americans believe there was a larger conspiracy at work in the JFK assassination, while 25% think Lee Harvey Oswald
acted alone.

That’s 51% conspiratorial belief, 24% probably showing ignorance of one of the most important events of the last century, and 25% actually informed. This is pretty sad. The movements of Oswald were so thoroughly-investigated and known, the hard evidence for his planning and involvement are so clear, the conspirators so unlikely (the mob/CIA/LBJ/KGB hiring crackpot loser communists for assassinations?), and the fabrications of the conspiracists so plain (asserting the shots couldn’t be made despite it being easily replicated by everyone from the Warren Commission to the Discovery Channel and even improved on, the disparaging of his marksmanship when LHO was a marine sharpshooter, altering the positions of the occupants of the car to make the bullet path from JFK to Connelly appear unlikely, etc.) it’s sad that so many have bought into this nonsense. The historically-bogus picture JFK, by Oliver Stone, may also play a large part in this, and is an example why Oliver Stone is really a terrible person. People that misrepresent history are the worst. If anyone wants to read a good book about the actual evidence that of what happened that day, as well as destroys the conspiracy position, Reclaiming History by Vincent Bugliosi is my favorite, as well as the most thorough.
But there is one redeeming feature of conspiracy about the JFK assassination. For the most part, conspiratorial ideas on the subject aren’t due to some dark part in people’s souls, as for many other conspiracies, but rather the very human need to ascribe more to such earth-shattering events as the assassination of a president than just the madness of a pitiable loser. The imbalance between the magnitude of the event, and the banal crank that accomplished it, is simply too much. There’s no way that a 24-year-old, violent, wife-beating, Marxist roustabout could be responsible for the death of a man like JFK right? Sadly no. The evidence shows even a man that pathetic can destroy the life of a much greater man with a cheap rifle and a simple plan.
The conspiracy theories embedded within this poll that really disturb me because I think they demonstrate the effect of irrational hate are ones such as for whether President Obama is the antichrist (although is that even really a conspiracy?). 13% of respondents believed this, 5% of those that voted for him still answered this question in the affirmative (really? you voted for the antichrist) as opposed to 22% of those that voted for Romney. Do we really need to elevate political disagreement to the level of labeling people the antichrist? Around 9% thought government adds fluoride for “sinister” reasons, and 11% believe in the LIHOP 9/11 conspiracy theory. They clearly think very little of their fellow Americans, and believe some really demonic things about our government. Our government is neither competent enough, or evil enough, to engage in then successfully cover up either of these things. Our top spy couldn’t even hide a tawdry affair.
Other conspiracy theories seem to indicate their is a baseline number of people, at about 15%, who will believe in just about anything from the moon landing being hoaxed to bigfoot. I would have actually pegged this number higher, given my pessimism about rational thought, but that seems to be what we can read from this. However, without being able to see whether or not it was the same people answering yes to each individual absurd conspiracy from reptilians to “government adds secret mind-controlling technology to television broadcast signals”, it’s possible this number is actually much larger. I would be curious to see the data on the overlap between these questions, as the phenomenon of crank magnetism is well known.
Ultimately, I read this data as saying that Americans have a big problem with conspiracy theories entering our political discourse. We should be embarrassed that as many as 37% of us believe that global warming is a “hoax”. That requires a belief is a grand conspiracy of scientists, policy-makers, journals, editors, etc., all acting together to somehow fabricate data for a single objective – often described as world-government control conspiracy to cede our sovereignty to the UN. Somehow, every single national scientific body, all those national academies, all those journals, and all those scientists, all those governments, all working in perfect secrecy according to some master plan (which I’m often accused of being a part of but I’m sure I’m missing the memo), and this is plausible how? The answer is, it’s not, unless you remain steadfastly ignorant of how science actually works and progresses.
Everyone, of any political persuasion, should be embarrassed by the conspiracy-theorists in their ranks. This isn’t healthy thinking, it isn’t rational discourse, and it only serves to divide us and make us hate. Enough of this already.

There Are Legitimate Criticisms of Obamacare – Hospitals Should not be Penalized for Readmissions

Crazy ranting about impending socialism/fascism aside, there are legitimate critiques to be made of Obamacare. One policy in particular that raises my ire is penalizing hospitals over performance metrics and penalizing readmissions in particular. The way it works is, patients are admitted to the hospital, treated, and eventually discharged, but a indicator of failure of adequate care is if that patient then bounces back, and is readmitted shortly after their hospitalization:

Under the new federal regulations, hospitals face hefty penalties for readmitting patients they have already treated, on the theory that many readmissions result from poor follow-up care.
It makes for cheaper and better care in the long run, the thinking goes, to help patients stay healthy than to be forced to readmit them for another costly hospital stay.
So hospitals call patients within 48 hours of discharge to find out how they are feeling. They arrange patients’ follow-up appointments with doctors even before a patient leaves. And they have redoubled their efforts to make sure patients understand what medicines to take at home.

Seems reasonable, right? These are things that are part of good medical care; good follow up, clarity with prescriptions, etc. It should be the responsibility of hospitals to get patients plugged into the safety net, assign social workers, and make sure patients won’t fail because they lack resources at home. However, the problem arises when the ideal of punishing readmissions as “failures” crashes into the reality of the general failure of our social safety net:

But hospitals have also taken on responsibilities far outside the medical realm: they are helping patients arrange transportation for follow-up doctor visits, get safe housing or even find a hot meal, all in an effort to keep them healthy.
“There’s a huge opportunity to reduce the cost of medical care by addressing these other things, the social aspects,” said Dr. Samuel Skootsky, chief medical officer of the U.C.L.A. Faculty Practice Group and Medical Group.
Medicare, which monitors hospitals’ compliance with the new rules, says nearly two-thirds of hospitals receiving traditional Medicare payments are expected to pay penalties totaling about $300 million in 2013 because too many of their patients were readmitted within 30 days of discharge. Last month, the agency reported that readmissions had dropped to 17.8 percent by late last year from about 19 percent in 2011.
But increasingly, health policy experts and hospital executives say the penalties, which went into effect in October, unfairly target hospitals that treat the sickest patients or the patients facing the greatest socioeconomic challenges. They say a hospital’s readmission rate is not a clear measure of the quality of care it provides, noting that hospitals with higher mortality rates may also have fewer returning patients.
“Dead patients can’t be readmitted,” Dr. Henderson said.

This is a problem with the careless application of rewards and penalties tied to medical outcomes. While I think it’s a healthy response that hospitals are taking on more of the social work that formerly would have been the arena of government programs, there is another defense mechanism used when government creates perverse incentives in health care. When you create payment incentives for good outcomes, you run the risk of patient selection, discrimination, and fraud. My favorite paper on this topic comes from the British NHS, and their attempt to reward physicians based on better clinical outcomes. My advice with this paper (and with most papers frankly) is to ignore what the authors say about their data (and the amazing success of their program!) and just look at the data for yourself. What they found with rewarding physicians based on health metrics was that doctors that treated the young, healthy, and rich did well, those with more patients, poorer patients, and older patients did more poorly. Finally, physicians that filed lots of “exception reports” to eliminate all their poorly-performing patients did great (yay, fraud!).
Metrics are good for identifying problems, but the mistake is the assumption that poor performance at a metric has everything to do with the physicians or the hospitals, or that slapping a penalty on poor performance will fix the problem. Sometimes, you’re studying society, not medical care. Incentive structures that put the burden on hospitals to take care of the most basic needs of their patients are going to penalize those hospitals that take care of the neediest, sickest, oldest patients, and reward those who treat insured, wealthy, younger, and fewer patients. Worse, if you penalize hospitals for taking care of difficult patient populations, I can predict the outcome. More bogus (and occasionally dangerous) transfers, more patients dumped on public and university hospitals, and all the other tricks of patient selection private hospitals can engage in to avoid getting stuck with the economic losses. That is, patients who are really sick, really poor, really old, and most in need of care will get transferred, obstructed, and dumped. Hospitals that are referral centers, major university and public hospitals that can’t refuse or transfer problem patients, will end up with the disproportionate amount of the penalties because they are often the healthcare providers of last resort. Not surprisingly, the early data already shows this is happening:

The second important development was the release of data on who will be penalized: two thirds of eligible U.S. hospitals were found to have readmission rates higher than the CMS models predicted, and each of these hospitals will receive a penalty. The number of hospitals penalized is much higher than most observers would have anticipated on the basis of CMS’s previous public reports, which identified less than 5% of hospitals as outliers. In addition, there is now convincing evidence that safety-net institutions (see graphsProportion of Hospitals Facing No Readmissions Penalty (Panel A) and Median Amount of Penalty (Panel B), According to the Proportion of Hospital’s Patients Who Receive Supplemental Security Income.), as well large teaching hospitals, which provide a substantial proportion of the care for patients with complex medical problems, are far more likely to be penalized under the HRRP.3 Left unchecked, the HRRP has the potential to exacerbate disparities in care and create disincentives to providing care for patients who are particularly ill or who have complex health needs, particularly if the penalties are larger than hospitals’ margins for caring for these patients.

It would be unfortunate if in the course of creating incentives for better care, we fall into the same old trap of punishing those who take care of the neediest. What we need instead is to acknowledge one major source of bad outcomes is a broken social-safety net. We can’t just keep creating these unfunded mandates that put all the onus of taking care of the uninsured, the poor and elderly on hospitals, and punish the centers that already carry the largest social burdens with responsibility for the failure of our nation to take care of its own. Unfortunately, our answer to problems like these is always to create one more shell game that hides the real, unavoidable costs of taking care of people by shifting it around. This will just result in higher bills on the insured, more crazy chargemaster fees, overburdened public and university hospitals, and ultimately, a system of regressive taxation.

Gun control Part III – Some final questions for Matt and closing remarks

Go by and check out Matt’s second response on gun control.
I think this response is a good argument. After all, my arguments are correlative. It is impossible to do randomized controlled trials on whole countries after all.
I would ask a few questions in response to this rebuttal, however. Matt, what do you think about about data that demonstrates, within our own country, higher gun prevalence correlates with higher homicide, independent of other risk factors? Can we really dismiss the potential impact of federal gun laws using local gun laws as an example? Its pretty clear from places like New York and Chicago, that any local law is undermined by whatever nearest state (or county) has the softest laws.
The issue of whether or not increasing or decreasing gun ownership is also a bit besides the point. After all, that was not the major thrust of my suggestions. Repeatedly, it seems, I am arguing against a straw man that I am advocating gun bans. Matt acknowledges this problem:

This is true, and fair enough as it goes. We gun-rights types are justifiably a bit jumpy about this sort of thing. It would be nice if Mark were the one writing the various laws being proposed in congress and various state legislatures. Unfortunately it’s people like Dianne “Turn ‘em all in” Feinstein and Carolyn “Shoulder thing that goes up” McCarthy and Andrew “Confiscation could be an option” Cuomo. It’s great for the two of us to discuss our Platonic ideals of the way things ought to be, but we also have to remember that we’re dealing with members of the world’s second oldest (and least reputable) profession. Since their stated intent is to take a mile, I’m not very willing to give them any free inches without an airtight case as to effectiveness and respect for the rights of the law-abiding.

I have emphasized in the past, I despise the stupidity and futility of the cosmetic Assault Weapons Ban as advocated by Feinstein for the twin sins of demagoguery and uselessness. But pretend for a moment I am an honest broker in this debate, and I’m not trying to land you on the slippery-slope towards gun confiscation. Do you really believe there is nothing that can be done on the supply-side to decrease either mass violence or, separately, gun homicide in this country? Or that there is nothing that can be done to prevent these guns from falling in the wrong hands in the first place? I believe we can prevent on the supply-side by preventing these guns from getting into the wrong hands, and this can be accomplished without bans.
As a closing statement on this debate, I’d reiterate the laws I advocate do not ban guns. You hear that commenters? During the entire debate, I haven’t suggested a single gun ban, so I don’t need to have this nonsense showing up in the comments. No. I believe there should be two major regulatory efforts: (1) there should me more scrutiny on gun purchasers who want to buy weapons that make mass violence easy, and (2) secondary markets need to be subjected to the same minimal level of scrutiny as the primary markets for all guns (background checks for shotguns, revolvers, bolt-action rifles etc., my higher level of scrutiny and responsibilities for purchasers of semi-automatic weapons).
I’m not talking about any kind of ban, but scrutiny on purchase of magazine-fed semi-automatics. This means people have to do some paperwork, have a check to make sure they’re not a crook (these two already exist), find a couple people to vouch they’re not nuts, demonstrate they can use and store the weapon safely, and they understand simple things like high powered semi-automatic rifles shouldn’t be used with metal-jacketed ammunition in a dense metropolis. Scrutiny, training, safety. These should be relatively noncontroversial measures.
We’ve all done this before after all, or don’t you remember the first time you showed up to the DMV to get a driver’s license? Similar theory, a car is a very dangerous machine, before you start driving you show up, they make sure you haven’t been arrested for joy-riding, you go for a little ride with an instructor to make sure you aren’t completely incompetent at operating the very dangerous machine, and you pass a little test to make sure you know the rules for safe use of the machine. Not a big deal. And how about using technology to make unauthorized use of the machine more difficult? Make it hard for the “dead-eyed killer”, as Matt calls them, to get their hands on the weapon, either from the store, or from someone’s home. Even more ideal, start working on technology to prevent unauthorized use, like the humble car key, that makes it harder for the unauthorized user to jump into your very dangerous machine, and run over a bunch of kids on the playground. Sure they can always hotwire it, but that’s hard, it takes special knowledge, and unauthorized use of the very dangerous machine shouldn’t be easy. It will invariably be argued ad nauseum that such measures can be defeated. Sure! I agree, they can be defeated. Almost any preventative measure can be defeated by a motivated, intelligent and skilled individual, but that doesn’t mean tomorrow banks will stop using vaults, or that we should give up on restricting access to grenades and C4. Barriers are just that, barriers, not perfect preventatives. All human efforts are imperfect, but these barriers may be effective strategies to decrease the likelihood or frequency of such attacks. There’s an expression, low fences keep in big animals.
And what’s so scary about such regulations for an item that kills as many as 30,000 of us a year? For years, we’ve recognized we need to regulate cars, they’re one of the single most dangerous objects in our daily existence. Automobile accidents are the most likely thing to kill you for a good chunk of your life. That’s why we make sure before people can drive, they know how. That’s why we require safety features. For years, the NRA has resisted any equivalent regulation to make gun ownership safer, they’ve resisted any attempt to incorporate safety features into weapons, they’ve resisted any scrutiny before gun purchase, and they’ve resisted scrutiny of secondary gun markets. Why is it so controversial to treat dangerous machines as something that need to be respected? Guns are machines that require training to use, they should have safety features that prevent improper use, they require safe storage when not in use, and there should be barriers and strategies in place to prevent possession by criminals and the mentally ill.
The second major thrust, and I’m not sure Matt really disagrees with me here, addresses the fact guns in the hands of criminals are coming from secondary markets. I discussed extensively in part II guns used in crime are usually fairly new guns. The generally-agreed upon sources are secondary gun markets – straw purchases, trafficking, and stolen guns – only about 10% are used in crime by the original purchaser. If we acknowledge that gun crime is a problem in this country and actually want to do something about it, we have to extend criminal background checks to all transfers of firearms. We have to make secondary markets subject to the same scrutiny as primary markets, and when guns end up in a criminal’s hands, we have to be able to track down the source of the weapon and punish them.
This is how guns get to the street. If we don’t arm law enforcement with the tools to punish gun traffickers and straw purchasers, we’re not going to be able to stop the steady flow of weapons to the streets, and into the hands of criminals. I know, 300 million guns are already out there that couldn’t be tracked by a newly-implemented system, but I’m assuming the overwhelming majority of gun owners are decent citizens who aren’t interested in selling their guns to criminals either, will gladly use the NICS system, and won’t sell their guns to criminals once the existing secondary markets are tightened. Straw purchasers, gun traffickers, and anyone else who sells guns or makes guns available to criminals should be put in jail, and treated like the accessories to crime that they are.
In these debates I’ve suggested these two overarching strategies, one to prevent mass shootings and one to decrease firearm use in crimes. For the first I admit, as does Matt, the data on viable preventative strategies is poor. The events are rare. One of the few examples of a specific response to the problem of mass violence, Australia, is consistent with a benefit to reducing mass violence by restricting magazine-fed semi-automatic weapons, but is questionable in its reduction on gun violence as a whole. I agree with Matt, making these weapons harder to obtain isn’t going to make a huge dent in gun violence as a whole, but I reiterate, increasing scrutiny of purchases of magazine-fed semiautomatics is specifically my suggestion to decrease mass violence. It is possible however, my storage and training portion of that strategy might decrease gun homicide rates modestly by decreasing the frequency of accidents and gun thefts. My second strategy, that of subjecting all gun transfers and purchases to this type of scrutiny, is specifically meant to address gun crime, based on the clear data that guns on the street are (1) usually new guns, and (2) coming from secondary gun markets 90% of the time. If we dry up the flow of guns to the street we are likely to accomplish two goals. We may decrease gun homicides, and we will arm law enforcement with the tools to track down and punish those that supply weapons to criminals.
Neither of these strategies should prevent any law-abiding citizen from obtaining any weapon that is available to them today, at the same time, they obstruct the flow of guns to criminals and erect barriers to those that might commit mass violence.

Anti-Gay Marriage Argument makes no sense

I was bewildered by this LA times article over the weekend describing the latest tactic of the DOMA defenders planning to argue before the Supreme Court, that is, that marriage is necessary for heterosexuals only because of the possibility of accidental child bearing.

Marriage should be limited to unions of a man and a woman because they alone can “produce unplanned and unintended offspring,” opponents of gay marriage have told the Supreme Court.
By contrast, when same-sex couples decide to have children, “substantial advance planning is required,” said Paul D. Clement, a lawyer for House Republicans.
This unusual defense of traditional marriage was set out last week in a pair of opening legal briefs in the two gay marriage cases to be decided by the Supreme Court this spring.

Am I taking crazy pills or does this make absolutely no sense? At the same time, I had just read (via Gawker)
this marriage announcement:

Ada Laurie Bryant and Robert Mitchell Haire were married Saturday in Hockessin, Del. Robert L. Bryant, a Universal Life minister and a son of the bride, officiated at his home.
The bride, 97, is keeping her name. She graduated from Lesley College in Cambridge, Mass.
She is the daughter of the late Ada Lee Laurie and the late Richard Laurie, who lived in Hingham, Mass.

The bride was a widow and the groom a widower.
The couple met in 2007, when Mr. Haire and his first wife, Jean, moved into Country House, a retirement community in Wilmington, Del. Mrs. Bryant had lived there since 2001 with her first husband, Leonard, who died shortly after they moved in. Mrs. Bryant and Mrs. Haire became close friends.

On Jan. 25, 2012, Mr. Haire, a hobbyist poet, slipped a sonnet vowing “friendship and affection” beneath Mrs. Bryant’s apartment door with a note that said “this represents how I feel in our relationship as a couple.” He was afraid to give it to her in person.
“I was desperately trying to strike a balance between too timid or bold. I didn’t want to mess things up,” he said about the courtship. “I can attest that it doesn’t get easier even in advanced age.”

Mrs. Bryant finally accepted his proposal on Aug. 6, and they will move into her apartment (“It’s slightly bigger,” he said) after the wedding.
She explained why she first turned him down. “There’s a great difference in our ages, as you can see,” she said. “I didn’t think it was the thing to do because I don’t have that many years ahead of me, but he said, ‘That’s all the more reason.’ I like him very much. I love him. So we’re going to be married.”

It’s all very sweet, finding love and getting married at even such an advanced age. But by the logic of the DOMA advocates, these two shouldn’t be allowed to marry because there is no chance of offspring.
Can we really defend this law by saying marriage is only for procreation when so many examples abound of how it clearly is not?

Gun Control Part II: My response to Matt Springer

I was curious to see what kind of defense Matt would put on against my suggestion of additional regulations to address the problem of gun violence and homicide in the US, and I was a bit disappointed to see that the response is largely a “no problem” argument. I had actually come into this debate thinking that both of us at least acknowledge that the US has a problem with gun homicide, but it appears as though I’ll have to backtrack a bit. So, starting with the “no problem” argument, I will describe why it is bogus, why the US does have a problem with firearm homicides (I can’t believe that’s an area of contention), and restate with some additional data why I believe my original proposals might make a dent in the two separate issues of mass violence and gun homicide.
The no problem argument usually takes a few different forms. First, describe other things we encounter in our daily lives that are responsible for as many deaths, like automobiles, or in the case of mass shootings, Springer choose lightning strikes.

In the 32 years since 1980, there have been some 513 people killed in 62 incidents of mass shootings under the Mother Jones definition (perpetrators generally included). This amounts to an average of 16 per year. Over the 12 years for which the CDC has available data, the average death rate due to lightning strikes has been 45 per year.

Some of my commentariat chose to talk about household falls, second-hand smoke, and a diet rich in bacon. These arguments almost always arise when you make an argument to do something about almost anything, and the do-nothings come out of the woodwork to concern-troll you about how there is some more important issue that should be addressed. The problem with these “no-problem” arguments is that (1) they often rely on poor analogies, and (2) they assume that almost no problem, other than maybe cancer or malaria in the third world, should be absorbing all of our attention. Nothing preventative can be done about lightning strikes. Automobiles are not only highly-regulated, titled by government, restricted from use by the under-aged and untrained etc., but also necessary to function for most people in their daily lives (also guns are almost as deadly – I’ll get to it). As are ladders, stairs, other household implements, and as far as second-hand smoke, I’m pretty sure I haven’t been exposed to that since I was last in a casino thanks to extensive government anti-smoking efforts. As far as a diet rich in bacon, sure, I’ve had more than a few patients die from heart attacks or strokes in their 60s and 70s after decades of self-inflicted harm, but the patient I think about more is the 24-year-old paralyzed from the neck down after catching a stray while standing on the wrong street corner at 5 pm. Lightning is one thing, but a 6 or 7-year-old killed by a gun, due to no action or risk they took upon themselves other than living in the same community as a mentally-defective monster with access to firearms, is a different kind of tragedy. We can’t stop lightning, but I think there are preventatives to gun violence, and we must be careful not to compare risks that one assumes for oneself, versus actions that create risk for those around us.
Springer is also concerned that a response, just for the sake of response, will create government excess similar to our excessive government overreach post-9/11. But while some anti-gun advocates may be talking in extremes, I don’t think my suggestions, or basically identical ones from the Obama administration were so over-the-top. I didn’t call for a ban on any type of weapon (although I favor a ban on large-capacity magazines), confiscation, or any other of the major bugaboos that usually terrify the pro-gun crowd. Briefly, I suggested increased scrutiny on purchases of what I consider military hardware – magazine fed semi-automatic weapons – and required safety precautions for storage and access to such weapons. To address the approximate 10,000 gun homicides in any given year, I suggested relatively minor barriers, now being advocated by the Obama administration, on private sale of firearms. This is because currently law enforcement has some ability to address trafficking by licensed gun dealers, but the paper trail ends at the first retail sale. To stop gun crime we have to get the guns out of the hands of criminals. As I’ll discuss below, some 90% of these guns come from the secondary gun market.
The second form the “no-problem” argument usually takes is minimization:

Now it’s worth taking a look at violent crime generally. While an uncommon cause of death in percentage terms, murder is a significant source of mortality in the United States. Of murders in the United States in 2011, 8,583 (about two thirds) were committed with firearms. Of firearms murders, the overwhelming majority were committed with handguns (6,220 with certainty, and likely most of the 1,587 “type not specified”). The rate of homicides (by all methods) is about 4.8 per 100,000, which is high compared to Australia (1.0) the UK (1.2), or Canada (1.6). On the other hand, it’s low when compared to most nations outside the highly developed first world, such as Russia (10.2) and Mexico (22.7). The highest, Honduras, is a staggering 91.6.

Mark dismisses any comparison to Mexico, but the comparison is more instructive than it first appears. The population of the Texas border city of El Paso is some 75% Mexican (and more than 80% Hispanic), but its homicide rate is a relatively bucolic 0.8 per 100,000. Its adjoining Mexican neighbor of Juarez is one of the most violent places on the planet, peaking at a hideous 130 per 100,000 in 2009. Do El Paso’s gun-friendly Texas laws make it so much more peaceful than Juarez? I doubt it. But it does put to bed the idea that gun laws are the primary or even a significant driver of the crime rates.

As I’ve mentioned in comments multiple times, I totally reject comparisons of the US to Mexico, or even Russia, as highly absurd given synergy of corruption and ineffectual governments present in both of those examples. Not to mention, the drug war in Mexico is practically an internecine war and is responsible for as many as 50,000 deaths since 2006. I reject the comparison to Mexico as totally meaningless just as I would reject the comparison of our country to any other war zone like Afghanistan or Iraq.
The Institute of Medicine in comparing the US to similar industrialized countries in terms of life expectancy found that our homicide rate is far in excess of comparable OECD countries, and significantly affects our life expectancy. The IOM study found our homicide rate to be 6.9 times higher than the other OECD countries, our gun homicide rate 19.5 times higher, and of the 23 countries in the study, the US was responsible for 80% of all firearm deaths. It is also useful to narrow down the problem by age. One of the worst aspects of this type of mortality is that it disproportionately affects the young. If you convert it from a mere cause of death, to a calculation of years of life lost, gun homicide is a much more striking phenomenon. In the end, our mortality rate is 100%. A comparison of the relative mortality of different mechanisms of death is not meaningful in itself unless we also consider the age at which the mechanism strikes. Firearm homicide kills at a mean age in the 30s for males, and in when years of life lost is used for comparison firearm homicide is only exceeded unintentional injuries (car accidents, falls etc), cancer, and heart attacks. Sorry if that’s old data, that’s what happens when the gun lobby prevents the CDC from studying the problem. A more recent analysis puts firearms just behind automobile accidents for decreasing our life expectancy.
We have a problem.
Finally, the “no problem” argument, especially in regards to guns, seems to fall back on these damn cat-skinning arguments. Yes, there is more than one way to skin a cat. I get it. It’s irrelevant:

The Bath School bombing in 1927 killed more than Sandy Hill and Columbine combined. Julio González killed 87 in the Bronx in 1990 with a match and some gasoline. The most lethal female mass killer in America used a Lincoln Continental. The unknown perpetrators of the Black Saturday fires in Australia killed many times more people than the Port Arthur massacre that touched off that nation’s much stricter gun laws. Now a list of anecdotes is not dispositive, but it is surprisingly hard to find comprehensive academic lists of rampage killings for the purpose of comparing across borders and between gun and non-gun attacks. At any rate the Wikipedia compendium of rampage killings internationally is striking (if not rigorous) reading – it lists 119 mass killings in the Americas and 100 in Europe.

This is not a relevant argument to making firearms more difficult to obtain. As I’ve pointed out repeatedly, the ability of killers to use more than one kind of weapon does not have anything to do with whether or not weapons ideal for commission of mass homicide should be easy to obtain. Yes, it is possible for many to create bombs from relatively common materials, after all the Columbine killers also attempted to blow up their school – which demonstrates another point, these things require expertise, much more planning, and have a fail rate more significant than a manufactured, ready-to-shoot rifle. Just because there is more than one way to skin a cat doesn’t mean you should sell industrial grade cat-skinning machines that skin 1000 cats a minute to anyone with a driver’s license and 500 bucks.
And while the list of mass killings is very hard to interpret, when sorted by year you see the European list has about 20 incidents in the last 20 years, whereas the US alone has had 31 in that time period. The list also does not include school shootings which gives the US another 12 mass incidents and Europe an additional 7. I think we’re sadly still winning in this competition at 43 to 27 (and the US has 3/7 the population of Europe).
We do have a problem (sigh).
Onto the criticisms of my proposals. This is how Matt characterized my argument:

Mark has penned his own contribution, in which he argues along four lines. First, that gun control will reduce acts of mass violence. Second, that gun control will reduce violent crime generally. Third, that specific gun control methods he enumerates ought to be put in place in view of the previous two points.

I disagree. Saying that I believe gun control will reduce acts of mass violence is a simplification, because “gun control” usually is a stand in for bans. This is not quite correct. I made the argument that since magazine-fed semi-automatic weapons are the weapons of choice in the last few dozen of these shootings that before sale the purchaser should get a bit more eyeball by authorities. Specifically in regards to the VT shooter, the Aurora Shooter, or the Giffords shooter, I suggested increased scrutiny for these purchases, law-enforcement taught training and competence testing for their use, and I also suggested the Canadian voucher system (as did Kristof immediately after Sandy Hook), which would require two other people to stand up for you and say you are responsible enough to possess such a machine. Part of the profile for a significant portion of these shooters has been they have set themselves apart from society. They are not “plugged-in” to their community, and are frankly weird. These proposals serve two purposes. They expose the purchaser to additional scrutiny to demonstrate they are competent and safe users of potentially very dangerous equipment, and they demonstrate the purchaser is not a loner weirdo who doesn’t even have two people in the world that think they’re capable of owning such equipment without turning it on the neighborhood. If you think the second restriction is too much, well, that’s kind of pathetic. If you can’t find two other people in your town that don’t think you’re too psycho to own a weapon, you probably shouldn’t have a weapon. Sure, these systems can be foiled. They won’t prevent all instances of mass violence. They are imperfect, and similar high levels of restriction have been foiled in other nations, but that doesn’t mean that obstacles to ownership for those matching the mass-murder profile won’t have any effect. We shouldn’t let the perfect ruin the good.
The second suggestion I made for mass shooting prevention is requiring owners of such weapons to store them in a safe manner, and require manufacturers of such weapons to incorporate built-in fire-locks, or user specific locks to prevent unauthorized use. The shooter in Newtown was, by accounts to date, a very mentally-disturbed individual, who accessed his mother’s own weapons to first kill her, then 20 school children. Could this have been prevented by something as simple as a gun-safe? Or could it have been prevented by an integral fire-lock mechanisms that require key or smart guns that prevent use by anyone other than the owner? We have not adequately addressed the possibility that technology can do a great deal to prevent unauthorized use, not to mention render theft of firearms, and subsequent trafficking, much more difficult or completely non-profitable. Most guns confiscated from criminals are actually relatively new guns, and the illegal gun market requires continuous inputs of new weapons either stolen from homes or straw-purchased from legitimate owners or dealers.
Which brings me to my third point, to deal with gun homicide generally, I did not describe “gun control” per se, but rather adequate record keeping and background checks for private sales. Again, “gun control” suggests bans or limits. I would not ban private sale or forbid it at all, but simply require such sales to undergo the same type of background checks as at an FFL, and require owners to keep records of such sales. The issue of gun trafficking is actually quite difficult to address, as the data on it is quite poor (of course). However, the evidence from gun-traces conducted by the ATF is intriguing:

ATF trace data

More recent data (usually not cited by gun control advocates-likely since it shows more guns coming from NYC):
2011 trace data
This data is suggestive, but by no means conclusive, that the lax gun laws of other states have a detrimental impact on New York’s ability to prevent gun crime in the city, as a significant portion of guns confiscated are coming from out-of-state sales. Problems with this data are that not all guns confiscated are traced (or traceable), and determining if a gun is purchased for trafficking, or was stolen and subsequently trafficked (without a report) can not be determined with current tools available to the police. This data is also not going to contain untraceable weapons that have had serials defaced – an important and illegal step for traffickers to take to ensure their activity isn’t easily tracked.
Sadly, more recent data on trafficking is hard to come by, and atf publications in their “historical” section contain some of the most comprehensive data on the types of guns being used by criminals. Data from these reports that suggest that trafficking from private buyers are a major input into the illegal market likely have not changed in the last 10 years however, as, if anything, congress made it more difficult to trace weapons via the Tiahrt amendments which have hampered the ability of law enforcement to prevent trafficking.
Interesting facts from the most recent publication include (1) 77% of guns used in crime are handguns and 50% of all guns used in crime are semi-automatic pistols (2) the quality of records is so poor that fully a third of the time traces failed due to inaccurate records or absent records kept by the dealers, and 10% of the time from “problems” with the serial numbers (alteration or defacement likely) (3) fully a third of crime guns are under 3 years old, and half less than 6 years old – time to crime being an correlate of trafficking (4) 88% of the time the crime gun was not originally purchased by the criminal – that is 88% of guns in crime have entered a secondary market.
This is the problem as described by the ATF:

Tracing from Purchaser to Possessor. Transfers of a firearm beyond the initial purchase by a retail customer usually cannot be followed to the criminal possessor using serial numbers and transfer documentation alone. Federal law does not require unlicensed sellers to perform Brady background checks or maintain transfer records for tracing, and firearm owners are not required to keep a record of the serial number of their firearms or to report lost or stolen firearms. Therefore, it is generally impossible for a National Tracing Center (NTC) crime gun trace alone to identify purchasers beyond the initial retail purchaser. If a crime gun is not recovered from its original purchaser, it has been transferred at least once in the secondary market, that is, by someone other than an FFL. These transfers may be lawful or unlawful. The crime gun may have been illegally transferred by a straw purchaser; resold by an unlicensed seller or as a used gun by an FFL; borrowed, traded, or given as a gift; stolen by its criminal possessor; or stolen and trafficked, among other possibilities.

As described in my original post, the major source of guns for criminals is the secondary markets – either straw purchased, gun show purchased, or privately-sold firearms which require no background check, and no records (not that the licensed dealers are doing that great a job of it). Some criminologists, such as Gary Kreck have criticized the idea there is a large source of trafficked guns in this country and that most crime guns are stolen weapons. However, while criticizing over-interpretation of trace data, I think Kreck under-interprets it. He arrives at the bizarre number of only about 1.6% of guns originating from some kind of organized trafficking. However, he does this by dismissing any trafficker that does not have a large (> 100/year) operation, and by suggesting the only real valid indicator of a trafficked weapon is evidence of a defaced serial number. Considering not all guns collected in crime are traced, and there isn’t much point even trying to trace a gun without a serial number (an exercise in futility – correct me if I’m wrong), I believe the trace databases are going to be subject to an under-reporting bias. Not to mention, in the report I’m working from, 10% of the weapons had serial number issues, and only a very small minority correlated to a report of a stolen gun. Likely the problem is the serial numbers in crime guns aren’t destroyed as much as altered, to prevent accurate tracing by creating an incorrect number. We can discuss Kreck more if needed (he’s often the goto-guy for those trying to suggest guns make us safer), but I don’t think his analyses have held up against other criminologists’ criticisms (please read this paper, and this paper before defending Kleck’s survey studies).
Given these data however, I think a powerful case can be made that tighter control of the secondary markets, as well as safety controls like integrated gun locks, will make trafficking more difficult, more costly, more risky, and in the case of stolen guns, potentially impossible. If we want to impact gun crime, these are the steps to address the overwhelming majority of guns found in the hands of criminals. This also negates the common critique of such measures that there already 300 million guns in circulation. Most gun owners are not interested in selling their guns into the criminal market, and the preponderance of new guns in crime shows there is a need or demand for a continual supply of new weapons into the criminal market.
Now let’s address some of Matt’s specific points:

We could begin by looking at whether or not semi-automatic rifles are actually a particularly heinous implement of death (we will discuss handguns in the “crime generally” section). In 2011, the United States experienced a total of 2,437,163 deaths. Of these, 12,664 were victims of murder. So for every 192 people who died in the United States, one was a victim of murder. Of those 12,664 murder victims, 323 were killed by a rifle. Thus for every 40 people who were victims of murder, one was shot by a rifle. This comes in well behind knives or blunt objects or even bare hands. In terms of death toll, rifles are roughly on par with falling off ladders (which killed 404 in the year 2010). And this category comprises all rifles, from bolt-action deer rifles to AR-15s to .50-caliber Barretts.

It should be noted from my original article that I was not suggesting the control of magazine-fed semi-automatics as necessarily being effective against gun homicide in general, but as a tool of mass homicide. Although, it should be noted, I included handguns in my suggestion and they represent more than 50% of crime guns. To prevent gun homicide I suggested regulation of secondary markets, not bans.
Fortunately Matt cites one of the best examples of a gun control policy that appears to have worked, and addresses it:

The best example on the pro-gun-control side is that of Australia, in which guns are regulated under a regime which has been a near ban since the Port Arthur massacre in 1996. There has nonetheless been at least one school shooting since then, though fortunately it only resulted in two deaths. A mass shooting of 4 or more victims has not occurred since 1996. The total rate of mass killings by arbitrary methods did not change significantly, and overall homicide rates were unaffected[1]. It is a matter of conjecture as to what extent this quite modest success in a island nation of a very different culture and just 10% of the US population can be extrapolated to the US. (Here’s a data point for the difference in firearms culture: the Australian buyback program after Port Arthur brought in 631,000 firearms. US citizens bought almost three million last month alone.) In summary, mass violence, despite its considerable press, is exceptionally rare, not particularly reliant on guns, and not particularly preventable by gun control.

I however, come to different conclusions, and not just about Australia being a continent. For one, in yesterday’s NYT, John Howard, the PM that passed their gun control legislation, describes the effect of the laws and the difficulties we might face replicating their effort. For one, Howard notes, “Almost 700,000 guns were bought back and destroyed — the equivalent of 40 million guns in the United States.” It seems like a smaller number, but for a smaller population, that’s a big dent. Also his interpretation of the post-gun control homicide rate appears different:

In the end, we won the battle to change gun laws because there was majority support across Australia for banning certain weapons. And today, there is a wide consensus that our 1996 reforms not only reduced the gun-related homicide rate, but also the suicide rate. The Australian Institute of Criminology found that gun-related murders and suicides fell sharply after 1996. The American Law and Economics Review found that our gun buyback scheme cut firearm suicides by 74 percent. In the 18 years before the 1996 reforms, Australia suffered 13 gun massacres — each with more than four victims — causing a total of 102 deaths. There has not been a single massacre in that category since 1996.

Further, in reading the source material cited (Evaluating Gun Policy: Effects on Crime and Violence, P 121-156, 2003, Philip J. Cook and Jens Ludwig) I found the authors reached a different conclusion than what Matt stated. Rather than being “unaffected” the rates were decidedly lower, however, the significance given the already low numbers of gun homicides is questionable. It should also be noted that Australia already had significant control of handguns. Here’s a snippet from Google books:

Additional research, readily available suggests a significant drop in the rate of gun violence after the ban. This suggests to me, both in the specific intervention, and overall given their tight regulation of handguns, that Australia is quite a strong example of gun control working. Although, for some of the same reasons Howard cites, the Australian method is not easily ported to the United States. The idea that gun control in general can never work is also prima facie absurd, just look at Japan. Yes, I know, we could not ban guns here, but it goes to show when guns are truly, effectively banned, even the criminals don’t have guns.
Matt also suggests my proposals, “come close to banning civilian handgun ownership”, which is amazing since I think I’ve beat that horse to death. Every time you talk gun regulation at all it seems to become a ban in the pro-gun side’s mind. However, at no point, for any currently available weapon, have I suggested a ban. Just paperwork. It’s not the end of the world people. It should be noted one suggestion I had, that owners should provide a legitimate need for ownership, is actually untenable. It was tried in Maryland and subsequently overturned by a federal judge. I will drop that suggestion, and it strengthens the “non-banning” aspect of my proposal as it was the only subjective criteria that government could use to prevent ownership. The proposals I have left result in a ban on nothing, just some hoops, just some paperwork. I think we can grow up on this issue and realize that reasonable measures to monitor secondary gun markets, and additional scrutiny for purchase of these weapons is nowhere near a “ban”.
I do have to take issue with Matt dismissing owner responsibility for misuse of guns:

Criminal penalties for having your guns misused more generally are not reasonable. Locks and safes are breakable, often with something as simple as a sledgehammer (of course locks and safes are still a good idea, but far from infallible), and it is unacceptable to put people in jail for being the victim of a crime.

This is, of course, nonsense. I never suggested a gun owner should be responsible for the criminal use of their gun if someone breaks into their gun safe and takes their weapons. On the other hand, if you leave your gun on the dashboard of your car and it’s stolen, you should be jailed for criminal stupidity and negligence. We require people to put up fences around their swimming pools because we know they are dangerous and an attractive nuisance. Minimal barriers to gun access in the home, like gun locks, should be expected for anyone with children, or reasonable expectation of the unauthorized having access to their firearms. This should be common sense, but also we need to increase barriers to access at guns in the home to prevent accidental gun death, and gun theft – a major source of trafficked guns. Maybe we should show Stray Dog in schools. That’s how you should feel if you lose your gun.
Finally I will take exception with Matt’s defense of the “good guys with guns” argument:

In vast majority of cases, mass shootings are stopped when the perpetrator is shot, either by suicide or police. But we have almost no data on the possibility of concealed carry permit holders stopping mass shootings. This is not surprising. Mass shootings are extremely rare, concealed carry is rare in percentage terms (around 2% have a permit in Texas), and mass shootings almost exclusively occur in places where concealed carry is prohibited by statute or the property owner. On the other hand, in terms of raw numbers millions of permit holders rack up billions of man-hours carrying every year. Permit holders outnumber police 7 to 1 in Texas, for instance. It is unreasonable to expect that extension of concealed carry to schools will result in catastrophic movie shootouts when it has not done so anywhere else – including many college campuses. I would not suggest concealed carry in schools as a panacea in view of its lack of a track record and the small percentage who would actually do it, but I would also not suggest we automatically discount it.

In the vast majority of cases, mass shootings are stopped when the perpetrator is shot…by themselves. Do we have evidence of police or armed citizens interrupting even one of the mass shootings in the last 20 years? Do we have any evidence of good guys with guns making a dent except after the shooting is done? Nope. We do have the example of Columbine, with a good guy with a gun, on the scene, in the school, exchanging fire with the shooters and…not preventing anything. Then there is this joke of a case of the Portland Mall shooting where apparently the presence of citizen with a concealed piece hiding behind cover made the shooter kill himself. And the cases Mother Jones cites where the armed citizen made things worse. Or how about the cops responding to a shooter at the empire state building and successfully stopped the shooting by shooting a bunch of civilians? The idea that your average schmuck is going to stand up to rapid fire from a lunatic with a semi-automatic is still just a fantasy, it’s hard for cops to respond to these incidents without shooting a handful of innocents. You’re not going to do it unless you’re a cop or ex-military, and even then, it’s questionable if you’ll do anything more than create a deadlier crossfire. Sorry, this strikes me as one of the stupidest arguments in the pro-gun portfolio. It’s not as easy as it looks in the movies, and the usual creepy fantasist gun lover who buys into this myth is not John McClane, he’s Walter Mitty.
The way to stop this problem is prevention, not escalation. If guns were the solution the country with the most guns wouldn’t be having this problem.

A gun control debate with Matt Springer

Given that Matt and I are both gun enthusiasts, scientists, and bloggers, and we’re both interested in something being done to prevent mass shootings such as in Newtown, Aurora, and almost one dozen other locations in just the last few years, we decided to host a more formal debate on the issue. I’m taking the side of a more stringent policy specifically on certain types of firearms that I don’t believe should be freely-available to citizens, that is, magazine-fed semi-automatic handguns and rifles. This doesn’t mean I believe in a ban, but simply more barriers to purchase, and simple safety measures to prevent unauthorized use such as in the Newtown shootings. I will start, and Matt will respond in a few days.
A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.
Sandy Hook, Aurora, Virginia Tech, Tucson, and now Webster, among other mass shootings, have brought the issue of gun control regulation back into the public consciousness, and reignited what appeared to be a dead political debate on the issue of gun regulation. During the presidential debates, questions on gun control resulted in non-committal answers from both candidates, and a universal affirmation of 2nd amendment rights. In the face of 20 dead 6 and 7-year-olds, we can no longer deny that more needs to be done to prevent mass murder by guns. I say this as a gun owner.
The issue of gun control needs to be tailored to address two distinct types of gun violence. One is the mass killing that we have seen at unconscionable frequency over the last decade, the second is the “routine” gun violence associated with violent crime and murder that we experience every day. This gun violence has been tracked more intensively since Newtown, and one estimate from aggregation of news stories is that since Newtown, an additional 588 gun deaths have occurred as of 1/5/13, largely homicides (suicides are more rarely reported). That is approximately one Newtown of deaths daily, but less obvious as the deaths are spread out geographically.
To address these two problems I would propose two major federal restrictions on gun ownership.
(1) Significant restrictions on civilian ownership of magazine-fed semi-automatic weapons is the best way to decrease the frequency, and severity of mass violence.
A criminal background check would be only the start of an evaluation for ownership of these types of weapons, which I believe should include both magazine-fed rifles and magazine-fed handguns, such as used at Virginia Tech, in which a shooter managed to kill almost 30 people in about 10 minutes. These weapons should be restricted to adults over age 21 (or possibly older – Israel restricts possession to 27 if the owner has not served in the military). Sale should require gun safety training certification that is provided by law enforcement (I have received such training and it is useful), or a history of military service, and a subsequent license to own such weapons. These licenses should require renewal every three to five years with repetition of criminal background check, and verification that the weapons are still in the licensee’s possession. Purchasers should have to provide a reason for ownership. It doesn’t have to be a great reason but it has to be better than “I want one.” Sport shooting, hunting, etc., would be legitimate reasons. Preparation for an incipient race war should raise red flags. When not in use the weapons must be stored in a gun safe or trigger locked (or built in fire lock) with civil and criminal liability if the gun is then used by unauthorized persons (children, criminals etc.) who obtained the guns without some minimum barrier to access. Additionally, we should consider adopting strategies used by other countries, such as requiring two other adult, non-criminal citizens known to the individual to “vouch” in a sworn statement that the individual seeking the weapon is an upstanding citizen, not a criminal, and not obviously dangerous (this might have prevented Virginia Tech, Aurora, or the Giffords shooting). Magazines larger than 10 rounds should be illegal, period. Round-stamping technology should be required for all newly manufactured firearms that allows shells to be traced to the weapon that fired it. New weapons should be manufactured with built-in fire lock mechanisms to prevent unauthorized use.
(2) All transfers of firearms should be accompanied by the same level of scrutiny as purchase of a firearm from a federally licensed firearms dealer (an FFL). Guns, like cars, should effectively be titled, so that transfer of firearms results in a background check of the purchaser, paperwork accompanies transfer, and when guns end up in the hands of criminals, as they do every single day, the source of the firearm can be effectively tracked, and the supplier of the firearm to the criminal market punished. Right now, every day, firearms are purchased for sale into the black market. There is almost no investigation of guns back to their source because the NRA has effectively lobbied to make such tracking impossible. This only serves to benefit gun manufacturers, it does not benefit public safety, or law-abiding gun owners, to make it so anyone can dump a gun onto the criminal market with impunity. There is no federal requirement for such background checks, or requirements for records of such sales, and most states do not require any scrutiny of private sale of firearms. While it is illegal to sell weapons to felons, or to the underaged, it’s only illegal to do so “knowingly”, and without background checks, and without a paper trail, these laws are virtually unenforceable. Hence, a thriving illegal gun market that ensures no one, even a criminal, has any difficulty obtaining a firearm. Finally, all gun thefts must be reported to law enforcement (currently not required in all states).
First, let’s address the issue of mass violence.
While it’s true that madmen will always find ways to hurt others, it is clear that ready access to machines designed to kill masses of people have increased the severity of these incidents. A concurrent incident in China, in which a man attacked schoolchildren with a knife, and stabbed 22, was notable for no fatalities. It should be common sense, that machines designed for easy and rapid killing will make mass killing easier, hence safeguards should be in place to prevent easy access to such machines. Such safeguards will not prevent all killing. And much is made by gun rights lobbyists of this fact, but that is not the point. The point is decreasing the severity of such assaults; making it harder, making it rarer for the deranged to kill en masse.
Mass violence is not just a problem in the United States. Similar incidents have occurred in other countries, even mass shootings in countries with significant restrictions similar to what I would advocate. However, the experience of other countries is less in frequency and severity. Yes, other countries have mass violence despite strict gun control, even countries like Norway. However, no other comparable industrialized country has gun violence similar to ours. No you can not compare the United States to Mexico. No, gun control is never perfect. No, we can not prevent all murder, all mass murder, or all violent crime, but we can decrease the death toll.
The recent mass shootings have been had one factor in common. The shooter had access to a magazine-fed semi-automatic weapon (see this google spreadsheet for a summary – the overwhelming majority of the time, semi-automatic weapons have been used for these shootings in the last decade). Fully-automatic weapons – weapons that fire automatically as long as the trigger is depressed – have been banned since 1934. This is an example of a legal, constitutional, federal restriction of a class of arms deemed too dangerous for civilian use. Now we see that semi-automatic magazine-fed weapons are clearly too dangerous for unregulated civilian ownership. These are the same weapons, after all, that we use to equip our military. They have only very questionable sport use, and no sport use requires the use of massive clips or the 100 round drum used by the Aurora shooter.
Restriction of these weapons, barriers to access, civil and criminal liability for negligent storage allowing access of the firearms to the unauthorized may not prevent all mass shootings. Considering how many are already out there, it may even be years or decades before there is an impact, but if that is the case so be it. The deaths from these mass murders, specifically using these types of firearms, is simply unacceptable, and unwillingness to do anything about access to these weapons is no longer a tenable position. It is total denial that we have a problem with access to death machines. We have to change the culture that considers easy access to such weapons acceptable, or civilized.
Second, the issue of guns in violent crime.
The gun lobby in the United States exists to serve gun manufacturers, not gun owners. Hence, they have lobbied extensively to prevent any laws that would result in loss of revenue from sale into illegal gun markets. Yes, I am that cynical about this. There is no good reason that every time a gun is used in a crime, that we shouldn’t be able to track that weapon back to it’s original purchaser. It wouldn’t even require some scary national gun registry that would have every gun nut crying 1984. It’s simple. Manufacturers sell a given firearm to a distributor or dealer. They know which weapons go to which dealer by a serial number which should be on multiple parts of each weapon, internally, (there also needs to be significant improvement in technology to prevent easy defacement of serial numbers, or other mechanisms of unique gun identification – this is possible with multiple existing technologies). One could even conceive of a system in which accessing an interior serial number results in permanent damage to the weapon rendering it useless if so disassembled. Whenever a gun is then used in a crime by someone who has no legal right to own or carry such a weapon (felons, minors, etc.), the police should send the serial number to the manufacturer, who identifies the dealer. The dealer will then have a record of the sale, and who the entry point into the criminal market is.
If a given dealer has a large proportion of weapons they sell entering the criminal market, they should undergo additional scrutiny, or possibly even lose their license. And this should be international. If Mexican drug cartels are found with weapons supplied by american distributors (which they are), those distributors should lose their ability to sell weapons. We have to stop acting as if we aren’t also enabling crime in other countries by the careless dumping of military hardware into other countries as well.
If private sale requires individuals to keep records (hell, you have to keep your tax records for 7 years, we could do as well with guns), and also to require a NCIS background check, any new gun could be traced to point of entry into the criminal market. If you can not explain where your gun went, you should be criminally liable for the act in which your gun was used as an accessory after the fact. To say we can not do this with existing technology, or that we should not devote serious effort for identifying the sources of the illegal gun trade, is simply pro-criminal.
Guns enter the streets every day after legitimate purchases from FFLs, gun shows, straw man sales and private sales. They also leave the streets every day from confiscations, warranted searches, and arrests. The illegal gun market needs continuous inputs of new guns to meet demand. It should also be noted the most recent Webster shooting was by a felon, who by definition has obtained these weapons illegally. I hope they track down whoever is responsible for him getting those guns, and they get put in jail for the murder of 4 firefighters.
We will never stop the routine gun violence we see in cities every day until we permanently disrupt the sale of firearms into the black market. Yes, older guns, guns before implementation of such regulations etc., will be impossible to track, but we can stop new firearms from entering the market, which they do, every single day, likely from a limited set of distributors and straw purchasers. Further, citing all the guns that are already out there as proof no restrictions will work assumes that most of the millions of law-abiding gun owners would routinely sell their firearms to criminals for profit – a notion I reject. These kinds of regulations will also put an additional onus on individual gun owners to take more responsibility for preventing the sale of weapons to criminals, and may even change the culture to reflect that transfer of a gun should be taken very seriously. This should not be a point of contention for gun owners, it should be a point of pride. People that supply weapons to the illegal market should be jailed for the same crime the criminal committed with the gun they bought.
Neither of these two strategies will prevent all gun crime, or all mass shootings. But they will make it harder. Making access more challenging, and giving those who seek access more scrutiny, will dissuade those who seek to do harm from even trying to obtain these weapons. It will not stop the most motivated of individuals, it will not stop all crime, but it will reduce the frequency and severity of the problem, as well as inject some much-needed responsibility into the existing gun markets. No other product that has potential for so much harm is sold with so little oversight, or even liability for misuse, theft or loss.
Finally, some arguments which I will not even acknowledge as worthy of attention:
1. The only thing that stops gun violence is “good guys” with guns – the argument we should arm teachers, arm principles, or place armed guards to prevent mass shootings in school. Or the even more obnoxious “when seconds count” argument.
This is a NRA fantasy. The idea that anyone who is not specifically trained in acting while under fire will prevent these types of shootings is absurd. The people that promote this have seen too many movies. The fact is, even trained police have enormous difficulty facing armed gunmen, hence SWAT teams. Previous incidents, such as the Columbine shootings, had armed individuals on site (an off duty deputy at Columbine), and they failed to stop the shooting, despite exchanging fire with shooters. One also recalls recent firefights with trained police against shooters in which the police ended up shooting more victims than the shooter. The fact is, some minimum-wage schlub, or teacher with a pea-shooter, will be more likely to shoot more kids than hit a gunman, and will not realistically stop this kind of shooting. You are not going to be able to equip all the schools in the country with adequately-trained armed individuals that have a snowball’s chance at stopping some armed lunatic with a semi-automatic. And don’t forget a shooter like in Aurora, who was wearing body armor.
Worse, this assumes the answer to this problem is an arms race, where we respond to the problem of too many guns with more guns, more fences, barbed wire, and higher walls. I don’t want to live in a country where the only solution to problems like these is imprisoning ourselves behind greater and greater security. This is a move in the wrong direction. The paranoid gun fantasy becomes self-promulgating in this situation, eventually the gun crazies will create the world the believe already exists, by virtue of putting guns in every corner, and barbed wire on every building. Yes, then it might become necessary for even teachers to be armed. What a sad world that would be.
2. You can kill someone with a frozen banana, hence assault weapons shouldn’t be banned.
I’m not kidding. I got this one on my blog. It generally goes, “well, you could just use a knife, people are going to kill people.” Well, ok then. Why shouldn’t we legalize C4 then? Fully automatic weapons? Tanks? Anthrax?
No, this is stupid. Making killing easy makes killing easy. Killing should be hard. It’s harder to kill with a knife than an AR-15. It’s harder to kill 20 schoolchildren in 10 minutes with a frozen banana than an assault weapon. Just because there’s more than one way to skin a cat doesn’t mean everyone should own an industrial cat-skinning machine that skins 1000 cats a minute.
3. The 2nd amendment protects us from tyranny.
Again, total fantasy. This is the big lie. There are any number of countries that don’t have our gun craziness that are not run by dictators. Tyranny is yelled so soon, and so often in these discussions that it’s meaningless. On my gun control thread the same person said that guns prevent tyranny and a minute later was talking about how Obama was a tyrant. Anyone see a problem with this? The idea that the US is anywhere near a tyrannical dictatorship is a joke. You people who think this are unreasonable and not worth arguing with, and should really consider looking at countries that actually have tyranny before getting on your free internet, in your free society, where you are free to buy hand cannons, monster trucks, and everyone has the right to vote, and you can chose any job you want, and go anywhere you want or even leave when you want, and start crying tyranny (and guess what – real tyrants don’t let you call them tyrants).
Also, the idea we can stand up to the US military? This is a legitimate threat to the military in the year 2013? Our military so far outclasses us that there is no chance some 10, or 100, or even 1000 person militia armed with AR-15s will be anything but a passing inconvenience. If a truly immoral tyrant came to power, in charge of a nuclear arsenal, sky robots, tanks and aircraft carriers, you aren’t going to stop them with your rifle. Red Dawn was not a documentary people, and you’re again in a fantasy world.
4. It’s crazy people that’s the problem, we need to track them, institutionalize them etc.
Well, maybe we need to swing the pendulum back towards more institutionalization for the mentally ill that are violent, Webster may be an example of this, but this is ultimately extremely challenging. Already, any psychiatrist who encounters someone who they believe is an imminent threat is allowed to notify police, or commit a person against their will. This is then subjected to oversight by a judge etc. We already have systems in place to deal with the mentally-ill and maybe this needs to be tightened. However, are we really capable of identifying who has this potential among the millions with mental illness in this country? Aren’t we scapegoating the mentally-ill who are more likely to be victims of violent crime, and in general, are less likely to commit violent crimes than sane people? I also find it interesting that the NRA, which considers itself a civil-rights organization, is so ready to deny what they consider the most important civil right to the mentally ill(? What kind of due-process is going to go into this?
The mentally-ill as a whole don’t deserve to be grouped with these killers any more than white people, or 18-20 year-olds. The overwhelming majority of the mentally-ill have no capacity for violence like this. It is also extremely difficult to prospectively identify people with this potential, so more than likely attempts to pin this on the mentally-ill are just going to victimize thousands of innocent people who already are demonized, marginalized, and ignored by our society. Now I know the gun crazies are going to say I’m suggesting they should be “victimized” like they’re criminals too. No, I’m saying you should have to do some goddamn paperwork, not that you should be institutionalized for being different, or unfortunate.
5. They already had an assault weapons ban, it didn’t work.
As Matt and I both have pointed out, the assault weapons bans as promoted by demagogues like Feinstein are a joke. They ban scary-looking guns but have no real effect on function or killing-capacity of a given weapon. They are political ploys, not real effective legislation. Anyone who thinks the 1994 assault weapons ban was going to do a damn thing wasn’t paying attention that the bill only regulated cosmetic features of these weapons, not the semi-automatic function, and not the rapid-reloading function, beyond banning clips with > 10 rounds.
6. It’s unconstitutional!
No, it’s not unconstitutional to regulate firearms, the words “well-regulated” are in the freaking amendment. The 1934 automatic weapons ban is constitutional. The stupid 1994 assault weapons ban was constitutional. The Supreme Court only seems to mind when you make it totally impossible to own almost any type of gun. I’m talking about making what is essentially military hardware harder, but not impossible to access, by civilians. Further I think it’s fine for any non-felon, sane civilian to own revolvers, breech-fed rifles and shotguns, and bolt-action weapons without these restrictions. You can still do harm with these weapons, true, but it’s much more difficult than with semi-automatic weapons that can take large-capacity magazines, or even 100-round drums as used in Aurora (which thankfully jammed after 30 rounds).
7. But Israel lets everyone carry guns and they don’t have school shootings.
You don’t know anything about Israel. I actually cribbed most of my suggestions from their gun laws, which require re-registration every 3 years, military service for ownership (before age 27), ammunition limitations etc. They have a great deal of regulation, however, and their citizenry have almost all served in the military – they might actually be able to do something about a shooter, unlike the the NRA fantasists who have most likely never faced a shot fired in anger.
8. It’s because we don’t have school prayer, the students should have rushed the gunman, it’s because God isn’t in schools, it’s video games, it’s feminists, it’s doctors, it’s anti-depressants, it’s the FBI using mind control etc.
Every time there is an incident like this the usual suspects gather to use tragedy to ghoulishly grind their favorite axe. These arguments are unhelpful, and just show how warped some people are by ideological agendas. I have no interest in engaging people who promote these theories as if they have anything valuable to say and I’m not having it on this thread.

Maryland how I love thee

I’m so proud of my home state for affirming equality for all in the ballot box rather than in the courts. I was born and raised in Maryland, although I’ve spent more of my adult life in Virginia, one of the big things I’ve noticed in the divide between the two states (and I love both of them) is that Marylanders do a better job at taking care of each other, and running an effective state with high quality services. Marylanders believe government can work, and generally (outside of Baltimore) it does. Marylanders also reject bigotry, and with question 4 (the Maryland Dream act) and question 6 affirming the rights of LGBT to marry, I’m so proud of my state for rejecting bigotry and electing to give everyone a chance at the dream.
Another lesson learned from this election is to follow Lincoln’s advice, “it’s better to be quiet and be thought of a fool than to open your mouth and remove all doubt.” Moron fundamentalists’ ideas of how lady parts work and divine rape plans have been extraordinarily costly for the Republicans, and provide hope for the future that voters will reject some of the truly contemptible unscientific beliefs of these bigoted old men running our government. I’m pleased to see there might be an actual limit on the incredibly stupid things one may say, and still expect election to congress. So remember Republicans, you can’t piss off the ladies and expect to keep winning elections. They need to shape up, or at least keep their incredibly stupid ideas to themselves. As women represent more and more of our delegations to congress, hopefully statements like Akin’s and Mourdock’s will just be embarrassing historical footnotes. Although, the continued presence of Michelle Bachmann is reminder that being female is, of course, no protection from believing incredibly stupid things.
Did anyone else snort when Romney mention the “enduring principles on which our society is built” and the first he listed was honesty?
Finally, I’m very curious to see the effect of the decision by Coloradoans and Washingtonians to openly defy Federal law and legalize, not just decriminalize, marijuana use. In this second term of a moderate Democratic president, will this showdown over drug laws finally result in a pull-back in the drug war? The amount of money, time, and jail-space devoted to criminalizing marijuana use is a national disgrace. Maybe these state reversals of marijuana prohibition will result in a more mature national conversation on drug policy?
This election has left me optimistic we will take the right steps to shore up our economy, make the right policy on healthcare, and increase the investment in science and research, which are my priorities. It’s been a good day.

Holy cow, yet another conspiracy theory!

This has been a year of some wonderfully crazy new conspiracies. Birtherism is actually looking pretty banal next to the “Obama is gay-married to a Pakistani” conspiracy, the “Obama is a Jihadist sleeper agent conspiracy, the Aurora conspiracies, job numbers conspiracies, polling conspiracy theories from America’s least-accurate pollster Dick Morris, and, my former favorite, the Obama is buying bullets for the Social Security Administration to kill all Americans conspiracy theory.
Now the American Spectator is publishing a new crackpot conspiracy theory that I think rivals my former favorite. It’s “the media has a secret backchannel where they discuss their plans to get Obama re-elected conspiracy”. And who is the proof this conspiracy theory is at work? Candy Crowley!

Shortly after Obamacare was passed and signed by the President, Michael Tanner of the Cato Institute noted a sudden plethora of articles that had begun to appear in a wide variety of MSM outlets about the probable ill-effects of “reform.” This prompted him to ask, “Where were these reporters before the passage of the health care bill?” The answer to this question is now pretty obvious. They were colluding, via JournoList and other such forums that we don’t know about, to make sure that no one screwed up and told the truth before that morass of taxes and regulations became the law of the land. To the nation’s cost, their self-censorship succeeded.
Today, we face a similar but much more dangerous situation. The “reporters” of the establishment news media are engaged in a concerted campaign of misinformation to get Barack Obama re-elected. This has been evident for some time, but the breathtaking mendacity of this effort was writ large by Candy Crowley during last Tuesday’s presidential debate. Everyone has by now seen the video clip: the President made the preposterous claim that he had identified the attack on our Benghazi consulate as an act of terrorism as early as September 12. Then, when Romney called him on this egregious whopper, Crowley repeated the lie.

Wowzers. It’s hard to continue to debate with a conspiracy theory that is dependent on questioning such an easily verifiable fact. For the record, the transcript from Obama’s speech on the 12 reads:

No acts of terror will ever shake the resolve of this great nation, alter that character, or eclipse the light of the values that we stand for. Today we mourn four more Americans who represent the very best of the United States of America. We will not waver in our commitment to see that justice is done for this terrible act. And make no mistake, justice will be done.

or you can watch the video:

To believe that Obama was talking about some other act of terror other than Benghazi is highly disingenuous as the very next sentence refers to “four more Americans” that died as a result of this “terrible act”. But I suppose it’s possible, if you are reading at a fifth grade level or something, you could think he was still referring to 9/11. That might make sense, and Romney then might have a valid claim about “14 days” until the relatively meaningless distinction is made, except the very next day Obama says it’s an act of terror again.

Let me say at the outset that obviously our hearts are heavy this week — we had a tough day a couple of days ago, for four Americans were killed in an attack on our diplomatic post in Libya. Yesterday I had a chance to go over to the State Department to talk to friends and colleagues of those who were killed. And these were Americans who, like so many others, both in uniform and civilians, who serve in difficult and dangerous places all around the world to advance the interests and the values that we hold dear as Americans.
And a lot of times their work goes unheralded, doesn’t get a lot of attention, but it is vitally important. We enjoy our security and our liberty because of the sacrifices that they make. And they do an outstanding job every single day without a lot of fanfare. (Applause.)
So what I want all of you to know is that we are going to bring those who killed our fellow Americans to justice. (Applause.) I want people around the world to hear me: To all those who would do us harm, no act of terror will go unpunished. It will not dim the light of the values that we proudly present to the rest of the world. No act of violence shakes the resolve of the United States of America.

Talking about these deaths he again describes it as an act of terror, unless of course, you think he just threw that in there as a red herring. He just randomly inserts “act of terror” into speeches about healthcare I’m sure. But why this is my favorite new conspiracy theory is because there actually are people who think a defunct online Google forum is evidence of left wing journalists’ attempts to rule the world.
For those that are interested, the reference to “journolist” is this now defunct chat group of which many prominent left-leaning journalists shared often impolitic statements about people in the news. Ezra Klein even tried to bring in Tucker Carlson just to allay the crank conspiracy fears about journalists *gasp* socializing online. We even used to have one here at scienceblogs where we would, yes, even coordinate posts, but mostly it was a forum for invective, like most online forums. Snore. Anyway, for the conspiratorial mind the existence of such a group combined with a few cherry-picked offensive statements is proof enough for an illuminati-style conspiracy of the MSM to rule the world. At worst, it seemed to include what I thought were appropriate reactions to the Jeremiah Wright story, which could be summed up by, “this is crap, we shouldn’t even cover it, it makes us all stupider.” The most obvious question raised by such a non-parsimonious conspiracy theory is do you really think that if journalists were engaged in a conspiracy to control the MSM, would the gateway to this super-secret and all powerful Google group be a mouse-click by Ezra Klein? And would Ezra Klein, being the mastermind of this great conspiracy, be exercising good judgment by inviting Tucker Carlson to join and telling him all about it?
I have something for people who think this is proof of a conspiracy:

The tinfoil hat!

Mitt Romney is the wrong choice for healthcare

It seems every day brings a new, glaring falsehood about medical care from Romney, who has bizarrely decided to run against his own healthcare plan in order to appease right wing voters. Now he’s claiming Americans don’t die from lack of healthcare coverage. His reasoning? The unfunded mandate and healthcare-of-last resort stopgap that is EMTALA. For those of you who don’t know the function of the Emergency Medical Treatment and Active Labor Act, it’s law passed in the Reagan era to stop hospitals from dumping patients who were acutely ill and needed emergency care. It prevents hospitals from refusing or delaying treatment of an emergency condition if the patient is uninsured or their ability to pay is unknown. It only obligates hospitals to provide enough care to stabilize the patient, and then the patient is discharged or transferred to another center if a higher level of care is needed. Despite the mandate that such patients be cared for, the federal government did not prescribe a method of reimbursement for such patients, making it an unfunded mandate, and as a result, some 55% of emergency room care goes uncompensated. EMTALA also doesn’t protect you from hospitals attempts to recoup their losses, and those that can pay often receive a surprisingly large bill that can easily bankrupt those living on the edge of solvency. But besides being a cruel and stupid thing to say for someone who proposes to lead our country, it’s also wildly false. Not only does the Institute of Medicine estimate these deaths at about 20,000 a year, but we also see it in admissions that aren’t due to prolonged illness or chronic medical conditions, for example we see a 40% higher trauma mortality among uninsured patients even after accounting for age, race, sex, and severity or mechanism of injury. If you are injured in a car accident, you are 40% more likely to die just by virtue of being uninsured, because the fact is, many hospitals will treat you differently if you can’t pay for your care.
As someone who has done almost all of my medical training at medical centers that are the highest level of care in the region, I’ve seen many of these patients and transfers. Often at such centers you hear griping that a patient’s condition had been exaggerated to suggest that the patient was sicker than they actually were, in order to initiate the transfer of a patient that would be costly to treat, but perfectly within their means to care for. Sometimes you hear complaints the referring hospitals could have done a better job stabilizing a patient before transferring them, it’s impossible to know the motivations of the referrers in any given instance, and I generally believe that the physicians are acting in their patient’s best interests, but we can’t ignore the fact that EMTALA creates a conflict of interest between physician and patient interests by creating a financial incentive for transfer. I suspect such patterns are the reason why you find such a huge disparity in medicare reimbursements and imaging and procedure costs between hospitals. In order to recover the costs of their “mission” expenditures, hospitals that care for more uninsured have to charge medicare and insurers more to reflect their “cost of doing business”, whereas smaller private hospitals that manage to deflect more of these patients can offer elective services cheaper.
In the end, it’s all one big stupid cost-shifting game that ignores the central problem. No matter what, we end up paying for people’s medical care! There is no avoiding it. You can either pay for it prospectively, thoughtfully, and humanely by giving people care in primary care offices, or you can wait for them to get really sick, not to mention really expensive to care for, and pay for it then. But there’s no avoiding the bill. The type of care advocated by Romney here is also just plain stupid. For example, what is the point of stabilizing a patient with COPD and asthma as they come in the hospital in crisis every month, rather than just paying for their medications as an outpatient? ICU admissions, intubation, medications, doctors fees and nursing are all far more expensive (not to mention hard on the patient) than a couple of inhalers a month. Or how about the uninsured patient with a mental illness that requires constant stabilization with inpatient admissions because no one will pay for their anti-psychotic medications? You see it happen like clockwork, a patient is discharged “plugged in” with a month of medications, plans for follow up etc., and then as they can’t pay for medications after that time is up they start missing appointments, losing their job or their housing arrangement, then they’re back in the ER in crisis. Or think about the risk involved in all those transfers, which the current system encourages referring hospitals to engage in even if the patient might not benefit, because it allows them to unload a patient that will just create uncompensated costs for the hospital?
This is leadership on healthcare? I don’t think so.