Obamacare and Mortality Rates

I’ve heard a lot of people talking about how many lives have been saved by Obamacare, and how many lives will be lost if it is repealed. So I decided to look at the mortality statistics for the United States before and after passage of the Affordable Care Act. The data for 2009-2014 is taken from the Age-Adjusted Death Rate table on page 22 of this PDF and the data for 2015 comes from the Key Findings on page 1 of this PDF. (I originally started writing this post before the 2015 data came in, and had to update the data before publishing.)

The ACA was passed in 2009 and took effect in 2010 (although parts were not phased in until 2014).

My chart starts in 1980 because that’s when the table starts doing year-by-year data rather than decade by decade data. It ends with the 2015 data because those are the latest available.

I included a couple of trend lines after 2009, to show what the age-adjusted death rate would be if it had continued to change at the average rate from 1980-2009 (30 years) or the average rate from 2000-2009 (10 years).

If the ACA were saving a significant number of lives, one would expect the death rate to decline faster than those trend lines.

Instead, as you can see from the graph, the decline in the death rate slowed after the ACA passed. If the death rate had continued to decline at the same rate as the previous decade, then about 175,000 fewer people would have died in 2015 (based on a U.S. population of 319 million in 2015).

Now, of course, I am not asserting that Obamacare is the cause of the slowing decline in mortality rate.  Correlation does not imply causation. There are a lot of things that can affect the death rate, and it’s quite possible that other factors — factors that by pure coincidence became more significant after Obamacare passed — have overwhelmed the impact of Obamacare. But if Obamacare is, on average, saving lives, that’s not showing up in the basic mortality statistics.

A Smattering of Post-election Thoughts

On November 4, 2008, I made the following blog post:

Congratulations to President-Elect Obama

While I didn’t vote for him, I wish him well in doing what is best for our country.

It was succinct, but heartfelt. No matter who is President, I want them to do what is best for our country.

With that in mind, I post the following:

Congratulations to President-Elect Trump

While I didn’t vote for him, I wish him well in doing what is best for our country.

Note that I’m not saying I will support him in doing what he thinks is best for our country. When I think he’s wrong, I will oppose him. When I think he’s right, I’ll support him.

Part of me is relieved that there’s at least a chance of getting a constitutional conservative appointed to the Supreme Court to replace Scalia.  Frankly, I wish we could go back to having both parties confirm qualified nominees even in the face of ideological differences. But the Democrats’ refusal to confirm Robert Bork set us down this path, and I don’t see a way back — short of significant numbers of liberals/progressives coming to realize that having a powerful central government unconstrained by the Constitution is a really bad idea and working together with limited-government conservatives to make the Supreme Court (and the rest of the federal government) far less important in our lives. So, for the foreseeable future, Supreme Court appointments are going to be highly partisan affairs. With that in mind, any bets as to how long it takes the New York Times editorial board to flip back in favor of filibusters for nominations?

I’m guessing it’ll happen in 2017.

Then, of course, there’s the elephant in the room.  You can’t always blame a candidate for who supports them. But Trump hired Steve Bannon as his campaign manager (and now wants him to be a senior advisor in the White House), and Bannon has deliberately courted the support of from “alt-right” groups. I don’t know if Bannon is personally an anti-semitic white nationalist — I find the evidence somewhat weak — but there is no doubt that after taking over Breitbart News, he made the alt-right his target market. To me, this is very troubling.  It’s one thing to be the main party one side of the political spectrum and end up receiving the support of some unsavory people because they consider you at least marginally better than the other main party. It’s quite another to deliberately court their support.

Going back to at least Reagan, Republican campaigns have tended to focus on freedom — that we can solve our nation’s problems by enhancing people’s freedom. Trump barely mentions freedom, and his proposed solution to most problems seems to be “Make me President and I’ll fix it” — which seems more like a cult of personality than a principled approach. Coupled with that, Trump’s seeming admiration for dictators who are “strong leaders” becomes even more troubling. His proposals at various times in his campaign for things such as forcing Muslims to register or even banning them from entering the country seem to me to be treading into very dangerous waters.

Of course, I was wrong about Donald Trump’s electability. So I may be completely wrong about how he’ll govern.

Shortly after I moved back to the U.S. in 1983, my family watched the TV miniseries The Winds of War, based on the novel by Herman Wouk. I remember thinking it was very good, but after 33 years I don’t really remember anything about the plot.

Except for one scene: As I recall it, some Jewish characters are trying to get out of Nazi-controlled territory, and they are with a group of non-Jewish Americans. The Nazi border guards say that the Americans are free to cross the border, but that, naturally, any Jews must identify themselves and be detained. One of the Americans then declares that he is a Jew, everyone in his company is a Jew, and they must either all be allowed to cross the border or they must all be detained. Unsure how to handle this, the border guards finally allow everyone to cross. (I probably have some of the details wrong, but I’m pretty sure that was the gist of it.)

The simple heroism in that scene has stuck with me even after the rest of the miniseries has faded from my mind.

That’s why, even before I saw others suggesting this course of action on social media, I decided that if Trump actually implemented registration of Muslims (or any other minority group, for that matter), I would would register as an act of solidarity. (I am under no illusions that such action would require the same level of heroism shown by people who protected Jews during World War II, but I feel it would be the right thing to do.)

I sincerely hope that in four years time, people will look back at the aftermath of this election and realize the fears about a Trump presidency were tremendously overblown, and that his election wasn’t a step down the road to fascism.

I sincerely hope that, as one Trump supporter told me, Trump’s extreme positions were merely for negotiation, and that he would moderate his positions and lead his extreme supporters to be more moderate.

But I will remain watchful.

Unlikely but Possible Outcomes for the Presidential Race

Obviously, our next President will almost certainly be either Hillary Clinton or Donald Trump. Most likely, that will happen because one or the other won enough states with enough electoral college votes to have at least 270.

And I’ve already discussed the unlikely event that McMullin wins Utah’s six electoral college votes and neither Trump nor Clinton has 270, so the election would be thrown to the House of Representatives, which would choose between Trump, Clinton, and McMullin. (There’s a similar scenario if Gary Johnson wins a state and McMullin does not.)

But I want to talk about some even unlikelier scenarios that are still possible:

  1. On Election Day, Clinton wins 270 votes to Trump’s 268 (or another very slim margin). However, one of Washington’s Democratic electors has already announced he will not vote for Clinton. It’s possible there could be more. If enough electors refuse to vote for her, that would take Clinton below 270 EC votes. The election would be thrown to the House of Representatives, to choose between Clinton, Trump, and whoever the defecting elector(s) choose to vote for. (Most likely: Bernie Sanders. Absent a huge post-election scandal for Trump, it’s hard to see how Sanders could win in the House, but it’s technically possible.)
  2. On Election Day, Trump narrowly wins in the electoral college, but one or more Republican electors announce they will not vote for him, reducing him below 270. The election would be thrown to the House of Representatives, to choose between Clinton, Trump, and whoever the defecting elector(s) choose to vote for. (Most likely: I’m going to say Mitt Romney, because he’s a known quantity and because he’s old enough that, if elected, he would not run for re-election, so he wouldn’t interfere with other candidates planning to run in 2020. Second most likely: Paul Ryan.)
  3. On Election Day, Clinton and Trump tie at 269. (Or announced defectors from one or both parties, or a McMullin win in Utah and/or a Gary Johnson win somewhere, will reduce both candidates below 270). Knowing that she cannot win in the Republican-controlled House of Representatives, Clinton decides to do what she can to block Trump and start a civil war within the Republican Party: she instructs enough of her electors to vote for Mitt Romney (or Paul Ryan) that he is in third place in EC votes (beating out Bernie Sanders, who would have almost no chance in the House.)  There are some possible sub-scenarios here:
    1. The Republicans in the House reject the attempt to manipulate them and choose Trump.
    2. Romney or Ryan (RoR) initially has enough support from Republicans to prevent Trump from winning 26 states in the House, but not enough to win 26 states himself.
      1. The Senate has flipped to Democratic control.  Since the Vice President is chosen by the Senate from between the top two EC vote recipients, Tim Kaine is elected Vice President. (Or, because electors didn’t defect from Kaine, he was elected in the normal way regardless of who controls the Senate.) Democrats have no incentive to get involved in the fight between Trump and RoR, because if the deadlock continues, Kaine will become acting President. As the deadline to Inauguration Day nears, the Republicans who support RoR have no incentive to give up, because they’re committed to blocking Trump. Faced with a choice between sticking by Trump and letting Kaine become acting President, or voting for RoR, Republicans in the House elect RoR as President. Trump voters are livid.
      2. The Senate stays in Republican control. Since the Vice President is chosen by the Senate from between the top two EC vote recipients, Mike Pence is elected Vice President. (Or, because electors didn’t defect from Pence, he was elected in the normal way regardless of who controls the Senate.) Trump’s supporters in the House are now willing to hold out as long as necessary, because they don’t object to Pence as acting President. However, Democrats figure out they have some leverage: they can offer their support for RoR in exchange for some concessions, while also foreclosing the possibility that Trump eventually wins enough support in the House. So RoR is elected President by a coalition of anti-Trump Republicans and Democrats. Trump supporters are even more livid, branding RoR and his Republican supporters as traitors.


Electoral College Maps

This is what I hope will happen:

Click the map to create your own at 270toWin.com

This is my prediction for what I think will happen:

Click the map to create your own at 270toWin.com
Of course, in 2008 I underestimated the Democrat’s victory margin in the Electoral College. I did so again in 2012, although by less. Maybe I’m overcompensating this time.

Why Evan McMullin winning Utah does not help Hillary Clinton become President

I’ve seen a lot of people claiming that Evan McMullin winning Utah just helps Hillary Clinton get elected.

That is false, and I’m going to explain why.

First, McMullin winning Utah makes a difference in who is elected President in only one circumstance: if neither Hillary Clinton nor Donald Trump manages to get to 270 electoral college votes. It’s highly unlikely that will happen, but it is possible. Fivethirtyeight.com’s model currently puts the chances of a deadlock at 0.5%, and the probability of Utah being a tipping-point state at 0.1%.

But let’s assume that it happens: McMullin wins Utah’s 6 electoral college votes and is in third place in the electoral college. That means the U.S. House of Representatives gets to choose the president from among the top three electoral-vote recipients: Hillary Clinton, Donald Trump, and Evan McMullin.

However, under the Twelfth Amendment to the Constitution, in the House each state gets one vote, and 26 votes are needed to choose the new President. That means Wyoming has just as much weight as California in the voting.

Currently, the Democrats control 14 House delegations. Three are split evenly between Republicans and Democrats. And Republicans control 33 delegations. Those number may change a little after the election, but unless there’s a wave of support for Democrats (which would mean a Clinton victory in the electoral college anyway, so it would never have gotten to the House) the Republicans will control a significant majority of the House delegations, and the Democrats will be several states short of the 26 needed.

Now, here’s the point where people who know enough to get this far tend to make their big mistake: “But the Democrats will be united behind Clinton, while the Republicans will be split between Trump and McMullin. That will allow Clinton to pick up the extra states she needs.”

Here’s the reason that won’t happen: the Republicans will get to write the rules about what determines whether a state is voting for a particular candidate. Because they are not completely stupid, and because they hate Clinton, they will write the rules so that it requires a majority of a state delegation to vote for one candidate, or else the state’s vote isn’t counted. So, if the Republicans in a state they control are divided between Trump and McMullin, Clinton doesn’t get that state’s vote.

Therefore, it is politically impossible for Clinton to be elected by the House.

So, even in the extremely unlikely event that McMullin wins Utah and blocks the other candidates from getting an electoral college majority, it does not help Clinton get elected.

Why I’m switching from Johnson to McMullin for President

Forty days ago, I explained why I would be voting for Gary Johnson, the Libertarian candidate for President. Now, I’m going to explain why I’ve changed my mind.

On the issues, ISideWith.com shows I agree with McMullin (97%) about the same percentage as I do with Johnson (96%). I still think Johnson’s experience counts in his favor, but at this point it’s become clear that he’s not going to be competitive in Utah. He’s actually fallen in the polls over the past month. Meanwhile, McMullin is doing far better than I expected, with the latest poll putting him in second place, just 1% behind Trump (and 1% ahead of Clinton).

Now, it’s possible to envision an elaborate scenario in which McMullin wins Utah, neither Trump nor Clinton get 270 electoral college votes, and McMullin is chosen as president by the House of Representatives. The political science major in me would love to see that happen.

Realistically, though, there’s currently about an 85% chance Hillary Clinton will win the election. Nothing that happens in Utah, including a McMullin victory, is likely to make a difference to the outcome of this election.

But a McMullin victory would send a clear message to the Republican Party that Donald Trump was an unacceptable candidate, and hopefully the party will get the message and implement changes to their nomination process in order to avoid a repeat of this year’s fiasco.

Why I’m voting Gary Johnson for President

UPDATE 10/17/2016: I have since switched to supporting Evan McMullin, as outlined in this blog post.

Over the past month and a half since resigning as precinct secretary/treasurer for my local Republican Party because I oppose Trump, I’ve done some serious thinking about who I will vote for.

After going to the Gary Johnson rally a few weeks ago, I was ready to commit to him as my candidate, but then Evan McMullin announced his candidacy the Monday after, and I felt I should give him a chance. But I’ve decided that McMullin really isn’t experienced enough, he started too late, and he doesn’t have the resources necessary to make a real impact in this campaign. (He managed to hit 9% in a Utah poll, compared to Johnson’s 12%, but isn’t even getting 1% nationwide even when the poll lists him as a candidate. And the anti-Trump super-PAC that was supposedly going to help him get on the ballot is shutting down.)

Yes, there are some important issues on which I have some differences with Johnson. In some cases, I’m actually more libertarian than he is. But I side with him on a lot of issues and he’s proven his competence to govern. (On ISideWith.com, Johnson sides with me 80%, which is the best of any of the remaining candidates.)

So I’ve decided to support Johnson. If he can get in the debates, I think he might be able to win some electoral college votes, and there’s a slim chance he could deny both other candidates an Electoral College majority. (Fivethirtyeight.com’s projections currently say about a 0.5% chance.) The recently published Washington Post/SurveyMonkey poll of every state found Johnson at 23% in Utah, to Clinton’s 27% and Trump’s 34%, so there may be an opportunity for Johnson in my state (although the poll didn’t include McMullin, so his impact is uncertain).

Now, to deal with some objections:

    1. But a vote for Johnson is a vote for Clinton! (Or: But a vote for Johnson is a vote for Trump!)
      No, it’s not. Let’s imagine Clinton and Trump are tied, and I get to choose who I vote for. If a vote for Johnson were equivalent to a vote for Clinton, then my voting would break the tie in Clinton’s favor. But it doesn’t break the tie. It has exactly the same effect on a tie that not voting at all would have. Which means that, from the perspective of those who claim that a vote for Johnson is a vote for Clinton, everyone who doesn’t vote is equivalent to a vote for Clinton. And since about 40% of Utah’s voting-age population doesn’t vote, all of them should count as votes for Clinton. Added to the about 25% who will actually vote for her, that gives Clinton about 65% of the vote. Trump might as well give up now. (Substitute Trump for Clinton in the above and adjust the numbers, and the same argument applies.)
    2. OK, but if you don’t vote for Trump, Clinton might win! (Or: If you don’t vote for Clinton, Trump might win!)
      Well, if you don’t vote for Johnson, Trump or Clinton might win!
    3. But Trump says he’ll implement [policy that I like]!
      I feel sorry for you because you think Trump can be trusted.
    4. But Johnson can’t win!
      It is highly unlikely. But it is possible. However, voting is not always about winning. If it were, then there would be no point in voting for candidates who are way down in the polls. Right now, I think the Republican Party (and the Democratic Party, for that matter) need to be sent the message that when it comes to candidates, they chose . . . poorly. I think voting for Gary Johnson is the best way to send that message.
    5. But Johnson isn’t a conservative!
      No, he’s not. But he’s generally in favor of limited government and fiscal responsibility, and against crony capitalism, all of which are relatively conservative positions — especially compared to Trump and Clinton.
    6. But what about the Supreme Court?
      This. And this.
    7. But Johnson is pro-abortion!
      Johnson believes Roe v. Wade was wrongly decided, and that the issue of abortion should be left to the states. I believe he’s correct as to how the Constitution should be interpreted.
    8. But Johnson smokes marijuana!
      He’s stopped for the campaign, and he’s promised not to smoke it if elected President. Besides, it’s been a while now since I decided the War on Drugs has been a failure, with costs and unintended consequences that far exceed any benefits. I favor decriminalizing drugs and dealing with drug addiction as a public health problem, not a criminal matter.

I’m sure some people will have other objections, but I think that covers most of them.

If you are enthusiastic about voting for Trump or Clinton, then I doubt I can say anything to persuade you to vote for Johnson. But if you’re looking at the choice of Trump or Clinton with distaste, then I suggest you give serious consideration to Johnson.

One Drop

The 1880 U.S. Census recorded a John Oberlander living in Fon du Lac, Wisconsin. His wife is listed as Isabella Oberlander, a white female, age 30.

Isabella’s maiden name was Jones, and in the 1870 census she was recorded as a mulatto female, age 20.

Isabella was my great-great-grandmother. My family did not know about these census records until less than 10 years ago, and we were not certain to what extent they were reliable. But a few years ago I had my genes sequenced at 23andme.com, and it showed I had 1.7% Sub-Saharan African ancestry. That would correspond to my being about 1/64 black, and Isabella being about 1/4 black — which is presumably what enabled her to pass as white.

Through much of the 20th Century, some states classified people as black or white using the “one-drop rule“: if you had any black ancestry, you were considered black. The Supreme Court finally struck down those racial classification laws in Loving v. Virginia, the case that legalized interracial marriage nationwide. That case was decided on June 12, 1967 — about three months after I was born. So, for a brief part of my life, in some states, I would have been legally classified as black.

At the time I was born, the Church of Jesus Christ of Latter-day Saints, of which I am a member, did not allow anyone with any black ancestry to be ordained to the priesthood. Fortunately, that was changed by Official Declaration 2, on September 30, 1978 — about six months before I was old enough to be ordained a deacon.

Of course, since my great-great-grandmother Isabella passed as white and did not let her descendants know of her black ancestry, no one would have known I was legally black in some states or that I could not be ordained to the priesthood in the LDS Church. It wasn’t until my DNA test in 2013 that I knew for sure. However, that knowledge has certainly made the issues of slavery, racial segregation, and the priesthood ban for blacks feel a lot more personal to me.

Legally, the question of how much black ancestry is required for someone to claim to be black appears to be open. The U.S. Census Bureau allows you to self-identify your race.

However, because I look white and was brought up as white, I don’t feel like I really have any right to identify myself as black on the basis of 1/64 ancestry.  So you probably won’t see me on any lists of black science fiction authors. (It’s different when it comes to identifying as Hispanic, because I did spend a significant portion of my childhood in Latin America, I was brought up bilingual in Spanish and English, and I knew my father was born and raised in Argentina.)




Earlier this year, I was elected to the position of voting precinct secretary/treasurer for my local Republican Party. I have worked and volunteered for Republican candidates over the years, but this was the first time I was elected to a party position.

I have considered myself a Republican from the earliest time I can remember knowing about the existence of political parties. In 1976, when I was in fourth grade, I supported Gerald Ford over Jimmy Carter when my class voted on who we wanted as President. (Ford won in my class.)

I regret I was only 17 in November 1984, so I didn’t have a chance to vote to re-elect Ronald Reagan. In 1988 and 1992, I voted for George Bush. In 1996, I voted for Bob Dole. In 2000 and 2004, I voted for George W. Bush. In 2008, I voted for John McCain. In 2012, I voted for Mitt Romney.

None of those candidates perfectly aligned with my political views. All of them were flawed men, who made mistakes I wish they hadn’t made, did things I wish they hadn’t done, and said things I wish they hadn’t said. As someone who is generally conservative in outlook, I found most of them were not conservative enough for my taste. However, all those candidates were clearly qualified by experience and temperament to become President of the United States of America.

The Republican Party has now officially picked Donald Trump as its nominee.

Therefore, I have sent the following email to my voting precinct chair, cc-ing the chair, vice-chair, secretary, and treasurer of the Utah County Republican Party:

Dear Mike,

I was very pleased when you nominated me for the position of Secretary/Treasurer in the Orem 21 precinct, and I was glad to be elected by the caucus members. It has given me a chance to serve the party I have been loyal to all my life.

However, the Bylaws of the Utah County Republican Party specify that “All elected and appointed Party officers, including … all Voting Precinct Chairs, Vice-Chairs, Secretaries, Treasurers, and Committee Members…, upon assuming office, agree to: … [p]ublicly support only Republican candidates for partisan public office.”

Given that the Republican candidate for President is now officially Donald Trump, I find that I can no longer abide by that agreement. By nominating him, the Republican Party has chosen to take the wrong path, and I refuse to follow. I will be publicly supporting a presidential candidate of another party.

Therefore, I hereby resign the post of Voting Precinct Secretary/Treasurer for the Orem 21 precinct.

Eric Stone

For now, I have decided not to change my party affiliation on my voter registration, because I still think the state Republican Party is doing good things at the state level, and for the most part our Republican Congressional delegation is doing good things at the national level. However, if “Trumpism” spreads within Utah Republicans, then I will change my affiliation.

My Republican Party was a party that believed people should be treated as individuals, rather than ethnic blocs. But that’s not Trump’s Republican Party.

My Republican Party was a party that believed that a candidate’s character mattered. But that’s not Trump’s Republican Party.

My Republican Party was a party that believed in free trade. But that’s not Trump’s Republican Party.

My Republican Party was a party that believed in free speech and a free press. But that’s not Trump’s Republican Party.

Some of you may say I was naive. And I probably was. I thought most other Republicans thought as I did, that they held their political positions for the same rational reasons I did.  Trump’s successful campaign has proven I was wrong about that.

So, which presidential candidate of another party do I plan to support?

I cannot vote for Hillary Clinton. She is a prime example of the sort of crony corruption that is dragging our country down.

Right now, I’m leaning toward Gary Johnson, the Libertarian Party nominee. On ISideWith.com, he is the closest candidate to my personal political beliefs on the issues. As a two-term governor of New Mexico, he seems to have sufficient experience. He has his flaws, but I would not feel ashamed of myself if I vote for him. If you do not feel that you can support either Trump or Clinton, I suggest you look into Johnson.

Awards Reading Post

Edited to add: The story has just been named one of four short fiction nominees for the Association for Mormon Letters Awards.

If you’re nominating for awards, I have a short story that I’m quite proud of that is eligible this year: “An Immense Darkness“, which was published in the March 2015 issue of Analog Science Fiction & Fact.  Here’s what some reviewers have said about the story:

“An Immense Darkness” is the most intense five pages I’ve read in quite a while. . . . This is everything I want in science fiction.

Daniel Craig Friend, Troublemaking Editor [source]

Very interesting look at possible future ethics.

Sam Tomaino, SFRevu [source]

This [story] is timely, very much so.

–Lois Tilton, Locus [source]

A good, moving and thought provoking story.

–TPI’s Reading Diary [source]

I’m making “An Immense Darkness” available for free here. A free audio version is available on StarShipSofa.

Also, a quick note about eligibility for my novel Unforgettable: Baen’s ebook version was published in 2015, but the novel is not eligible for the Nebula or Hugo awards because I self-published an earlier version of the novel back in 2011.