Is it "Schlocky" to Compare Life Expectancies Between Countries?

Greg Mankiw writes:

The next time you hear someone cavalierly point to international comparisons in life expectancy as evidence against the U.S. healthcare system, you should be ready to explain how schlocky that argument really is.

He points to the following claim by Gary Becker:

National differences in life expectancies are a highly imperfect indicator of the effectiveness of health delivery systems.for example, life styles are important contributors to health, and the US fares poorly on many life style indicators, such as incidence of overweight and obese men, women, and teenagers. To get around such problems, some analysts compare not life expectancies but survival rates from different diseases. The US health system tends to look pretty good on these comparisons.

Becker cites a study that finds that the U.S. does better than Europe in cancer survival rates and in the availability of hip and knee replacements and cataract surgery.

It makes a lot of sense to think of health as multidimensional, so that some countries can do better in life expectancy while others do better in hip replacements and cancer survival.

But I disagree with Mankiw's claim that it's "schlocky" to compare life expectancy. If the U.S. really is spending lots more per person on health care and really getting less in life expectancy compared to other countries . . . that seems like relevant information.

To put it in statistical terms: much of our quantitative analyses are essentially comparisons. And, once you're comparing, it makes sense to consider other factors (for example, Americans are less likely than Europeans to smoke, and more likely to be obese). But the overall outcome is important in its own right. Becker mentions cancer survival rates, and, cancer survival is definitely important--more important than all the research I've ever done, that's for sure--but a large change in cancer survival rate does not necessarily correspond to a big increase in life expectancy. And the same can be said for joint replacements and cataract surgery. What's missing in Mankiw's discussion is the connection between the huge cost differences between the U.S. and other countries, and the very specific cases where our system works better.

The funny thing is, I think my former co-blogger Robin Hanson would probably agree that government-funded healthcare is a bad thing--but for an opposite reason from Mankiw's! Hanson would oppose government health care, I think, because he would fear that it would lead to political pressure to spend even more on healthcare that, as he sees it, doesn't actually do much of anything to improve net health outcomes. In contrast, I think Mankiw is opposing a government system because he fears it would lead to cost-cutting and a move to a European-style system with lower cancer survival rates, fewer hip replacements, etc.

In summary, I am sympathetic to Mankiw's frustration with people who draw sweeping conclusions from raw comparisons. If policymakers are interested in moving the U.S. to a medical system more like France's, or Taiwan's, or whatever, they ultimately should be looking not at static comparisons but at how health and cost outcomes might change here under different proposed policies.

That said, life expectancy is important. If you're going to make a raw comparison, I'd rather compare countries on life expectancy than on cancer survival rates or the availability of hip replacements and cataract surgery. Or, to put it another way, if health care doesn't matter, if the main driver of life expectancies in America is the way we eat and live, then maybe it would make sense to spend 50% less on our health care system.

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Public Support for the Public Option

UPDATED at 5:45 PM to include Lake/HCAN poll

A major, though by no means the only, substantive point of debate regarding health care reform is whether the plan considered by Congress will include a "public option" -- a government-run insurance program that would compete with private plans. Barack Obama's plan on the campaign trail included a public option: "any American will have the opportunity to enroll in the new public plan or an approved private plan," it said.



Inclusion of a public option is a sine qua non for many progressives, who believe it would lower costs by increasing competition, or who may have an objection to the notion of requiring that people (since health care would have an individual mandate) purchase something through a private, for-profit entity. On the other hand, the public option has drawn the ire of conservatives and industry groups, who believe that it would gobble up profit margins from private industry and that it might have unfair competitive advantages. Both liberals and conservatives seem to acknowledge some possibility that a public option might gradually evolve into a version of a single-payer system; for liberals this is a big plus and for conservatives a big minus. The revised plan released by Max Baucus's Senate Finance Committee on Thursday did not include a public option, although the House's latest version does.

It is worth evaluating polling on the public option, which has begun to be widely cited in the blogosphere, particularly by liberals who believe most of the polling favors them. The balance of this post contains a summary of the five six polls that I am aware of on the public option, which produce widely disparate results and all of which require careful interpretation.

1. Kaiser Family Foundation Tracking Poll

Who They Are / What's Their Angle: A California based non-profit founded in 1948 by Henry J. Kaiser. The Foundation no longer has any association with Kaiser Permanente, which operates hospitals and insurance programs mostly in the South and the West. KFF released numerous materials on the candidates' positions on health care in advance of the 2008 election which generally took a neutral tone. KFF itself has not given money to political candidates, although its employees collectively donated $11,700 in 2008 and $9,550 in 2006 to Judith Feder, a public policy expert who is an adviser to KFF and ran unsuccessfully for Congress as a Democrat in Virginia's 10th Congressional District.

Specifications: 1,205 American adults, including cellphone and Spanish-language samples, conducted from June 1-June 8. The sample was split in half, however, for the two formulations of the public option question as expressed below, and so sample sizes for each one are closer to 600.

Question Wording and Results:

"Now I'm going to read you some different ways to increase the number of Americans covered by health insurance. As I read each one, please tell me whether you would favor it or oppose it [...]

"Creating a public health insurance option similar to Medicare to compete with private health insurance plans."

Favor: 68% (40% strongly favor)
Oppose: 28% (17% strongly oppose)

"Creating a public health insurance option to compete with private health insurance plans."

Favor: 65% (32% strongly favor)
Oppose: 29% (17% strongly oppose)

Discussion: One suspects that KFF is pro-reform, but they seem to have taken care to frame their materials in ways that avoid partisan scrutiny. Their question wording is fairly straightforward but does not include the phrase "government", which might provide more clarity to the respondent about exactly what the public option is. Note, however, that they phrase the question in two different ways: to half their sample they include the phrase "similar to Medicare" and to the other half they don't. Responses were about the same between the two question wordings, although the half that had the Medicare language included were notably more likely to strongly favor the public option. Including a sample of cellphones and Spanish-language interviewers are nice perks. Although the sample sizes are not huge, particularly since the sample was split into halves, KFF found nearly identical results in their April tracking poll.

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

2. Employee Benefits Research Institute (EBRI)

Who They Are / What's Their Angle: A Washington, D.C. - based nonprofit, which is focused -- as their name implies -- on research on employee benefit programs. I can find no evidence of lobbying activities or campaign contributions by ERBI. They are funded by a largely corporate set of donors such as American Express, Chevron, IBM, Shell Oil and Towers Perrin, although they also receive financing from noncorporate groups like AARP and Blue Cross Blue Shield. An issue brief that EBRI prepared on the public option was neutral to slightly skeptical about it. The poll was conducted in conjunction with Mathew Greenwald & Associates.

Specifications: 1,000 American adults aged 21 and over. Interviews conducted from May 8th through June 2nd.

Question Wording and Results:

"Creating a new public health insurance plan that anyone can purchase."

Support: 83% (53% strongly support)
Oppose: 14% (9% strongly oppose)

Discussion: Information about this poll was a little bit harder to come by than it probably should be. For example, I had to look in a separate press release to find details about its sample size. Nor is it clear that the entire battery of questions was released in ERBI's summary brief. The selection of adults 21+, rather than 18+, is also unorthodox, and is a strange enough choice that I wonder about the other decisions ERBI made in constructing its sample. EBRI's poll was also the only one which did not specify that the public option would be designed to compete with private plans.

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

3. Consumers Union

Who They Are / What's Their Angle: Not a labor union; Consumers' Union is instead a Yonkers, NY-based non-profit group and the publisher of Consumer Reports. They take a somewhat unabashedly liberal view on health care reform and the poll was released in conjunction with Democratic Senator Chuck Schumer. The Consumers Union' generally spends several hundred thousand dollars on lobbying activities each year.

Specifications: 2,009 American adults aged 18 and over. Interviews conducted from April 2nd to April 6th, 2009.

Question Wording and Results:

"Congress is discussing several ideas to address healthcare reform. One proposal provides everyone, whether insured or uninsured, an additional choice: the option of a public health plan that people can count on to cover what they need at more affordable rates. This option would allow people with good insurance that they like to keep it. Those without good insurance can gain access to reliable healthcare, regardless of preexisting medical conditions, and obtain a consistent menu of benefits. This public plan would be paid for by enrollees. Those that cannot afford to pay the full premiums would be subsidized based on their income.

Please rate your level of support for this proposal."

Support: 66% (33% strongly support)
Oppose: 16% (8% strongly oppose)

Discussion: This is more or less an explicitly partisan poll, both in terms of the organization backing it and in its question wording, which is leading and highly favorable to the public option. The large sample size is nice, but Consumers Union' should have picked more neutral phrasing.

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

4. Rasmussen Reports

Who They Are / What's Their Angle: Regular readers of this website will be very familiar with Rasmussen Reports, a standalone polling firm that releases a prolific amount of polling data on elections and public policy issues. Past FiveThirtyEight.com analyses have generally found Rasmussen's electoral polling to be quite reliable. However, some observers have questioned its issue-based polling, which frequently tends to elicit responses that are more conservative than those found on other national surveys. Rasmussen Reports' founder, Scott Rasmussen, is a Republican, although neither he nor Rasmussen Reports have appear to have contributed to political candidates in recent years. Nor to my awareness does Rasmussen Reports conduct a significant amount of polling directly on behalf of political candidates.

Specifications: 1,000 American adults on June 12th and 13th. Assuming that procedures here were the same as for other Rasmussen polling, surveys were conducted via the IVR ("robocall") method and were weighted for partisan identification and other factors.

Question Wording and Results:

"Would it be a good idea to set up a government health insurance company to compete with private health insurance companies?"

Yes: 41%
No: 41%

Discussion: I am not particularly fond of this question wording. For one thing, unlike the other polls, it focuses on the action of setting up the "government health insurance company" rather than the choice of insurance plans this ultimately presents to the consumer. For another, it is not clear that a new program would have to be "set up" in order to provide for a public option (i.e. an existing program like Medicare could be expanded), nor that any such entity would properly be described as a "company". The poll seems designed to juxtapose the terms "government" and "company" in a way that might elicit a negative response. (Note that I actually like the inclusion of the term "government" in conjunction with, or perhaps instead of, the term "public". The problem is not with the term "government" itself but instead with the overall way that the question is phrased.)

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

5. NBC / Wall Street Journal

Who They Are / What's Their Angle: Presumably you are familiar with NBC News and the Wall Street Journal. The NBC/WSJ polls themselves are conducted by Hart/McInturff, a pairing of Democratic pollster Peter Hart and Republican pollster Bill McInturff. Likewise, the NBC/WSJ pairing itself is a collaboration between a somewhat left-leaning and somewhat right-leaning news organization. This is an excellent model to avoid partisanship, both in appearance and in practice.

Specifications: 1,008 American adults on June 12th-15th, including a cellphone sample.

Question Wording and Results:

"In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance––extremely important, quite important, not that important, or not at all important?

Extremely Important: 41%
Quite Important: 35% (76% Extremely or Quite Important)
Not That Important: 12%
Not At All Important: 8% (20% Not That or Not At All Important)

Discussion: I have no problem with the formulation of the question; in fact, I particularly like the wording "a public plan administered by the federal government" which makes clear that the public plan is in fact government-run. But I have a big problem with the choice of answers. "Importance" is a notoriously vague concept in public opinion polling and may be separate and distinct from asking someone whether or not they support a particular policy. How might someone respond to this question, for instance, if they had particularly strong feelings against a public option? Would they say that it was "not at all important", or would they say that it was "extremely important"? Conversely, how would someone respond if they had a weak preference for a public option, but didn't consider it an especially important component of health care reform? The 1,008 random adults that NBC/WSJ surveyed are going to interpret these dilemmas in a variety of different ways. In addition, the particular category of "quite important" is somewhat ambiguous and probably falls somewhere in between a favorable response and a neutral one.

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

6. Lake Research / HCAN

Who They Are / What's Their Angle: Lake Research Partners is a Democratic polling firm. Their poll was conducted on behalf of Health Care for America Now! (HCAN), an advocacy group that wants comprehensive health care reform and strongly favors the public option.

Specifications: Sample of 800 likely voters from January 8-13th, 2009.

Question Wording and Results:
"Which of the following three approaches to health care reform do you prefer: one, everyone getting health insurance through private health insurance plans; two, everyone getting health insurance through a public health insurance plan; or three, everyone having a choice of private health insurance or a public health insurance plan?"

73% choice of public or private
15% private only
9% public only

Discussion: Celinda Lake is an excellent pollster, but she is a Democratic pollster and this is a Democratic poll. I don't hate the question wording, but it really emphasizes the option part of the public option and somewhat de-emphasizes the public part; in this sense, it is sort of the alter ego to the Rasmussen poll. As in some of these other polls, it also may not be immediately obvious to the respondent that "public" means administered by the government. A couple of additional points of critique: the use of a likely voter model (as opposed to all adults or registered voters) is a bit unusual this far out of an election cycle, particularly when it regards how the public feels about a particular policy rather than how they want their elected officials to vote on it. And the poll is now a bit outdated, having been conducted in January.

Non-partisanship rating:
Question wording:
Sample size, sample selection and disclosure:
Overall informativeness:

Summary: The only poll I have a particularly high degree of confidence in is the Kaiser Family Foundation poll, which finds that between 65 and 68 percent of the public support a public option depending on how the question is phrased. The only thing I would change about their poll is to specify, as NBC/WSJ does, that the public plan would be administered by the government.

The other polls have one or more characteristics that give me pause about them. The question wording in the Consumers Union' poll is push-y and explicitly partisan; the question wording in the Rasmussen and Lake/HCAN polls is strange and probably implicitly partisan. The NBC/WSJ poll is otherwise terrific, but very difficult to interpret because they ask people about the importance of a public option, and not necessarily their support for one. I might be more comfortable with the ERBI poll if I learned more about it, but the comparative lack of disclosure coupled with the unusual choice to exclude adults 18-20 from the sample and a result that appears to be a mild outlier gives me some concerns about it.

Overall, polling points toward the public option being at least mildly popular and indeed perhaps quite popular. But more polling is required on this question, particularly by the news organizations and other unaffiliated groups like Pew and Gallup, and more care should be taken to frame both questions and answers in a neutral and informative way.

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The Ayatollah's Flawed Logic

I don't know how many people caught this expression of logic from Ayatollah Ali Khamenei in his call for an end to the protests over the electoral outcome in Iran. As reported by the BBC:

Responding to allegations of electoral fraud, the ayatollah insisted the Islamic Republic would not cheat.

"There is 11 million votes difference," the ayatollah said. "How one can rig 11 million votes?"

This particular argument is not unique to the Ayatollah. It has also been used by some Western observers such as Flynt Leverett (emphasis mine):

SPIEGEL ONLINE: Still many people, including in Washington, have expressed skepticism as to the validity of the results.

Leverett: I am a little surprised by the margin, too. But that makes me more comfortable about the overall validity of the election. Look at the irregularities Mousavi is citing now: that they ran out of ballot paper in some polling precincts, that they did not keep some polls open long enough. There is no way such things could change the overall outcome which is clearly in favor of Ahmadinejad. If you compare this to the flaws of the presidential election in Florida in 2000, it seems very insignificant.

Leverett and Ayatollah are arguing from an ironically Western conception of how to rig an election. In the United States, it is actually rather difficult to steal an election: because of our federalist system, elections are monitored and voting totals are reported by hundreds or thousands of individual officials at the state, county, and precinct levels. There is therefore a rather substantial marginal cost to stealing additional votes: you have to recruit some number of additional people into the conspiracy, and hope they don't rat you out or leave some kind of paper trail that makes obvious your intention. It is probably not that difficult to find a few corrupt (but competent) stooges who will help you out, but for each additional vote that you want to steal, you have to go lower down the food pyramid, soliciting the help of people who are less loyal and might undermine your plan.

But this is simply not the case in Iran. All votes are counted are reported by the Interior Ministry. There is no other source of information. There are no election monitors. Nor does the fraud alleged involve any sort of physical process (e.g. stuffing ballot boxes). It is simply a matter of changing numbers on a spreadsheet. Under these conditions, it is essentially no more difficult to steal a thousand votes than one, a million than a thousand, or 11 million than one million.

The only constraints, rather, are perceptual: certain vote totals might be more or less likely to trigger protests and unrest. It is probably easy to identify those voting margins that are most likely to trigger unrest: one would be to claim to have won the election (or secured enough votes to avoid a run-off) by exactly one vote; the other would be to claim to have won the election with 100 percent of the vote. In the former case, you would almost certainly wind up being subject to a recount, and any one report of irregularities could undermine your claim. In the latter, your claim would a laughable on its face, and every single Iranian who had voted against you would know that his vote had been stolen and would take to the streets.

It is less clear the margin of victory that minimizes the risk of unrest. But one can posit a curve that looks something like this:



I'd imagine there's a fairly broad sweet spot somewhere between about 55 percent of the vote and 75. Totals below 55 percent might trigger piecemeal scrutiny of irregularities and/or otherwise embolden your opponents, either of which could ultimately cost you the "victory". A claim to having won more than 75 percent of the vote would stretch credibility in an ethnically diverse country where there is clearly a lot of political disagreement; you'd have gotten too greedy. Ahmadinejad's claim to have won 63 percent of the vote falls somewhere in this sweet spot. That doesn't mean he stole the election -- but it also doesn't mean that he didn't.

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Iranian Leadership Split On Response

In the wake of the contested election, the top leadership of the Iranian regime has been harshly criticized, both inside and outside the country. Portrayed in many cases as the decayed and out-of-touch remnants of the 1979 revolution, they have been accused of collectively posturing to maintain power, and deny a democratic win for reformers.

The truth is actually much more complex. Rather than a unified block, the various chief political actors in Iran have had shifiting positions in response to the election and the accompanying public unrest. While the official message coming from the top has been consistent, with the Supreme Leader continuing to urge restraint and an acceptance of the official results, behind the scenes, chaos reigns.

The following table summarizes the positions of four main institutions. While there are several addition advisory bodies, such as the "Discernment and Expediancy Council" and the Iranian Judiciary, these four institutions have taken public action.

In theory, the word of the Supreme Leader is final on issues such as these, provided that the Constitution of Iran is obeyed, and the Assembly of Experts do not take action to impeach/dismiss the Leader - something they have never done. However, the Guardian Council, which plays a significant role in the electoral process, has accepted challenges to the results by all three candidates, undermining Khameni's proclamation of Ahmadinejad's victory.

At the same time, Chairman of the Assembly of Experts Hashemi Rafsanjani, a former two-term President and rival of Ahmadinejad, has publicly declared his belief that Mousavi is the true winner, and that significant fraud was perpetrated by the Ahmadinejad camp. As Chairman of the Assembly, Rafsanjani has used his mandate of "supervision of the Supreme Leader" to challenge the official declaration.

Finally, the Majlis - the Iranian Parliament - has taken issue with the harsh treatment of demonstrators by authorities in the days after the election. While most of the chamber issued their congratulations to the incumbent immediately after the vote totals were released, many have since pulled back. While the least influential of the institutions, the Majlis has supported the opposition protests and calls for democratic redress more directly than any other.

In summary, the key question will be if the Supreme Leader can regain order among the top leaders before the political dialogue shifts towards a serious challenge to the system. If the protests can be stopped, and Ahmadinejad's victory is seen as inevitable, many political leaders who would prefer to see reform will pull back from their opposition in order to protect themselves from retribution. If, however, public outcry and internal fighting in the regime continues following today's proclamation, some change in the leadership, though likely minor at first, may be on the horizon.
---
Renard Sexton is FiveThirtyEight's international columnist and is based in Geneva, Switzerland. He can be contacted at sexton538@gmail.com

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Are Republicans Undercutting Themselves On Blame For Deficits?

Today is Deficit Mania Day in the chattering classes, with two new polls coming out (NBC/Wall Street Journal and CBS/New York Times) showing a spike in public concern about the federal government’s fiscal condition.

The subject is getting an extra boost in attention because the polls coincide with higher-than-expected cost estimates (see Nate’s last post) emanating from CBO regarding the fiscal impact of health care plans undergoing work in two Senate committees. Will wavering congressional Democrats pull the plug on Obama’s commitment to secure real action on universal health care this year out of fears about the cost? We’ll soon find out.

But meanwhile, there’s a finding on fiscal politics in the NBC/WSJ poll that provides some real comfort for the administration, along with a bit of a puzzle. Five months into the Obama administration, and after weeks of steady Republican hammering of the president as a big spender, only 6% of Americans primarily blame Obama for the budget situation, while 46% primarily blame George W. Bush. (Another 21% percent blame "Democrats in Congress," while seven percent blame "Republicans in Congress" and 13% blame everybody). We don’t have crosstabs on this poll just yet, but the number is so low that you have to figure that relatively few rank-and-file Republicans blame Obama for the level of deficits, despite the energetic efforts of their leaders in Washington to do just that. That's the "bit of a puzzle."

Now it’s possible that millions of Americans (including many who don’t necessarily support the president) have donned green eyeshades and personally conducted the analysis necessary to establish that yes, Obama inherited most of the current and projected budget deficits from the Bush administration.

But I have a more plausible theory: the vast torrent of words that Republican politicians and activists have uttered since November attributing their 2008 and 2006 defeats on Bush’s “abandonment” or “betrayal” of “conservative fiscal principles” are having the perverse effect of insulating Barack Obama from blame for big deficits, even among Republicans.

The blame-Bush-the-spender rhetoric meets a variety of deep psychological needs for conservatives. It is frankly the only explanation for 2006 and 2008 that does not risk raising the abhorrent thought that conservative ideology itself is unpopular or ineffectual. Moreover, finding some way to repudiate the Bush legacy is essential for any Republican “fresh start” that does not involve telling the American people they made a big mistake last November. Given their huge emotional stake in the proposition that America remains a “center-right nation,” and their determination to keep a tight grip on the GOP, conservatives are pretty much forced to identify Bush as a president who strayed from the true faith. Since red ink is the most convenient explanation, the collateral reinforcement of Bush’s responsibility for the budget deficits that Republicans are now screaming about is probably a price they are willing to pay.

For Obama, this is a political asset of real but limited value. Even though Americans don’t blame him for deficits, if they ultimately fear them more than they want universal health coverage or additional economic stimulus, his agenda could be in trouble. It’s another reason that he must soon deploy the bully pulpit to shape public opinion—certainly on health care, as Nate and others have suggested--but also on the broad outlines of the direction he seeks for the country, and the decisions and tradeoffs he's asking Congress and the people themselves to make.

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Congress: A Good Place for Health Care To Die

While most of the world's attention has been focused on Iran, health care reform has had a rough couple of weeks. First, in a move that was not entirely unexpected, the AMA came out against a public option in the Democrats' health care plan. Secondly, a draft version of the bill from the Senate's Health, Education, Labor, and Pensions Committee -- a very incomplete draft, which didn't include key provisions like the public option -- was scored poorly by the CBO, as was a preliminary version advanced by the Finance Committee on Tuesday. Thirdly, some centrist Democrats have begun to rally around a watered-down bill created by North Dakota's Kent Conrad -- a bill which Conrad said he created because more sweeping versions lacked the votes to pass. And fourthly, the Finance Committee and the HELP Committee increasingly seem to be running along separate, and possibly competing, tracks, as the Finance Committee delayed the markup of its own bill until after the July 4th holiday.

So far, there is no sign of erosion in the public's support for health care reform. And the Administration appears poised to begin doing some more explicit advocacy for the legislation, beginning with a one-hour national forum on June 24th. But it had better be prepared for that town hall meeting to be a start of a trend, because history suggests that leaving a health care bill unattended before Congress is just about the worst place for it to be.

A comparison to the Clintons' failed efforts to pass health care reform in 1993 and 1994 may be instructive. It is somewhat commonly believed that the problem the Clintons had is that they were too hands-on and oversold the bill. Looking back at the polling, however, suggests something else.

The chart below presents Bill Clinton's Gallup approval rating throughout 1993 and 1994, in conjunction with the major events of the health care debate. In the absence of specific polling on health care itself, this is perhaps the best barometer of the bill's political fortunes.


The approval polling suggests that Clinton was benefiting when he was doing the most direct salesmanship of the bill. A joint address to Congress on September 22, 1993 was met with a sudden jump in Clinton's approval rating. Although that bounce was short-lived, his approval rating then continued to improve throughout the balance of 1993 as a health care bill was presented to Congress in November. It was only when the bill was left to linger before Congress in the spring of 1994 that both its fortunes and those of Clinton began to suffer. Clinton's approval rating hit a nadir at 39 percent on August 16, 1994, the lowest it would be for the rest of his Presidency, which is right about when George Mitchell was making it clear that no bill had the votes to pass the Senate.

This is, obviously, a simplified re-telling of a complex time in American politics. But the Congress is never a popular institution, and with Ted Kennedy ailing and Hillary Clinton heading the State Department, the Democrats are notably lacking the sorts of charismatic leaders who know how to pitch legislation to the public. Polling suggests that 58 percent of the public trusts Obama to sell health care, but just 42 percent trust the Congressional Democrats -- a figure that puts them down in the gutter with the pharmaceutical companies, although ahead at least of the Congressional Republicans.

A more recent and perhaps equally relevant precedent is that established during the selling of Obama's most significant achievement to date, that of the economic stimulus package. That bill, initially rather popular, came dangerously close to failing when the White House went dark as it tried to navigate the Tom Daschle mini-crisis and let Congress take the lead; only some last-minute salesmanship efforts by Obama may have resuscitated it. And the stimulus package was simple as compared with health care -- it was really just a matter of agreeing on two numbers, the overall amount of the bill and the proportion devoted to tax cuts.

In contrast, the health care debate is multidimensional, requiring the resolution of a series of disputes ranging from the presence or absence of a public plan, to the best way to pay for it, to the wisdom of an employer mandate. There are an effectively infinite number of possible health care bills based on the way these parameters are resolved, and indeed there seem to be dozens of permutations on health care reform working their way around the Hill: a non-exhaustive list would include the HELP Committee's partially-unformed version, the Finance Committee's largely unformed version, Conrad's version, Max Baucus's version (which might or might not be different from the Finanice Committee version), the Dole-Daschle compromise, the Schumer Plan, the Rockefeller Plan, the House Democratic version (of which there may be several), Wyden-Bennett, AmeriCare, Mike Enzi's quasi-serious Republican alternative, and Olympia Snowe's "trigger". Notably absent seems to be any version from the White House itself, even though Obama campaigned on and won with a health care framework that offered relatively specific proscriptions to many of these questions.

Perhaps the Administration takes a different lesson from Bill Clinton's failure: that it was not so much the public salesmanship of the bill that was the problem, but rather, the the Clintons' inflexibility in the face of the political realities faced by the Congress. But the Doomsday Scenario for the White House is probably not that health care fails a straight up-or-down vote, but rather, that no individual version of the bill has enough votes to pass as legislators convince themselves they can hold out for an alternative more to their liking, while all the while the industry is having time bought for it to lobby against the bill, or to watch any of several political contingencies unfold (another crash in the stock market; the incapacitation of Senator Kennedy, which would deprive Democrats of a vote until a special election were held in Massachusetts) that could weaken the Democrats' position.

This has been an extremely cautious White House to date; they have scrupulously avoided doing anything that might ruffle Congressional or public feathers and they are probably afraid of gambling on a specific plan and losing. But as Neville Chamberlain learned long ago, and Spock learned in the latest version of Star Trek, caution does not always equate with safety. It is time for the White House to take hold of this debate and not let go.

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Karroubi's Unlucky 7's?

Does a statistical property named Benford's Law point toward fraud in the Iranian elections? That's one possible reading of a new paper (.pdf) by Boudewijn Roukema of Nicolaus Coprenicus University in Toruń, Poland. I think the paper is intriguing, but like Andrew (yes, we're both writing on the same subject), I also have one or two reservations.

First, let me explain in a bit more detail what Benford's Law is. Or actually, let me let Wikipedia explain:

Benford's law, also called the first-digit law, states that in lists of numbers from many (but not all) real-life sources of data, the leading digit is distributed in a specific, non-uniform way. According to this law, the first digit is 1 almost one third of the time, and larger digits occur as the leading digit with lower and lower frequency, to the point where 9 as a first digit occurs less than one time in twenty. This distribution of first digits arises logically whenever a set of values is distributed logarithmically [...]

This counter-intuitive result has been found to apply to a wide variety of data sets, including electricity bills, street addresses, stock prices, population numbers, death rates, lengths of rivers, physical and mathematical constants, and processes described by power laws (which are very common in nature).

The specific distribution of first digits (in the number 2,684, two is the first digit) that Benford's law forecasts is as follows:



Wikipedia calls this property counter-intuitive, but I don't know that it's entirely so. For instance, think about the number of daily visitors to the millions of websites that are out there in the world, which classically follows a power-law distribution. There are a lot more websites that have 1,000-some visitors a day than 9,000-some visitors a day, and there a lot more websites that have 100-some visitors a day than 900-some visitors a day. For that matter, there are a lot more websites that have 1 visitor a day than 9 visitors a day. Website traffic very probably obeys Benford's law or something approaching it.

Or, to give you an example where I actually have some numbers to show you, let's look at the first digit for all places (cities and down) in California as of the 2000 Census.



This distribution obeys Benford's Law almost perfectly.

Benford's Law is sometimes useful in detecting fraud. For example, suppose you have a company policy that requires all expenses over $100 to be approved by the HR department. Chances are that you'll have a lot of employees magically finding things which cost $99 or $90 or $87 to expense -- and relatively few that cost $102 or $110. This would radically violate by Benford'd Law and could be easily detected by it; of course, it could be detected in a lot of other ways too. But even when you don't have a specific constraint like the $100 threshold I described above, Benford's law is sometimes useful in these cases, because human beings intuitively tend to distribute the first digits about evenly when they're making up "random" strings of numbers, when in fact many real-world distributions will be skewed toward the smaller digits. Something to keep in mind when you're cheating on your taxes!

What Roukema set out to do, then, is to test the distributions of the vote totals for the four candidates across the 366 reporting units that Iran's Interior Ministry has published numbers for. Here's what he found when looking at Mehdi Karroubi's vote totals:



As you can see from the graph, there are a lot more totals beginning in '7' than you'd anticipate from Benford's Law. The odds of this occurring by chance alone are extremely remote -- about 10,000 to 1 against. The odds of an anomaly of this magnitude occurring for any of the nine leading digits for any of the four candidates are also quite remote -- about 140 to 1 against.

Mahmoud Ahmadinejad's vote totals also look a little funny -- there are more numbers beginning with '2' and '3' and fewer beginning with '1' than you'd anticipate -- although the level of statistical significance is not nearly as high as in Karroubi's case.



Roukema speculates that Iranian officials could have been taking cases where Ahmadinejad's vote total began with a '1' and switching it to a '2' -- for instance, in some town where he received 1,954 votes, they would report his having received 2,954 votes. This hypothesis may take on more meaning in light of new and as yet unverified allegations that reported turnout exceeded 100 percent in several dozen Iranian towns.

The reason I'm holding back from fully endorsing this is because it's not clear to me whether this particular distribution should indeed obey Benford's Law in the first place. For instance, let's take a look at the distribution of votes for Al Franken (before the recount) in last November's senate race in the 4,131 precincts in Minnesota.



This hugely violates Benford's Law -- there are not nearly enough totals beginning in 1 and too many beginning in numbers like 5, 6 and 7. The odds of these anomalies having occurred by chance alone are greater than a quadrillion to one against.

Of course, some people think the election in Minnesota was rigged too -- so perhaps this is a poor example to use! But the reason this pattern emerges is because precinct sizes in Minnesota are not truly random -- once a precinct has to serve more than a couple thousand voters, it is liable to become too crowded to do so adequately and a new one will be created. There seems to be a particularly large number of precincts in Minnesota that are designed to serve between 1,000 and 2,000 voters; since Franken won about 42 percent of the votes statewide, this leads to a relatively high number of instances where his vote totals are in the high single digits (672, 704, 588, etc.)

It's not clear to me whether the voting units that Iran's Interior Ministry reported on behave more like towns, in which case we might expect the voting distinctions to obey Benford's Law, or more like precincts, in which case we probably wouldn't. The way the units are described to me in the spreadsheet I'm working from are "city/county", which implies that sufficiently large cities are treated as their own units, whereas smaller ones -- it looks to me like perhaps those that have fewer than about 15,000 people -- have their results aggregated at some level resembling American counties. If there are these sorts of artificial constraints placed on the size of the reporting units, we might expect some anomalies from a Benford's Law perspective.

Still, I don't know that we'd expect the particular anomaly where a lot of
Karroubi's vote totals begin with 7's; we'd probably expect to see something more like the Franken vote distribution where there are a lot of 7's but also a lot of 6's and 8's.

Then again, I'm not sure what particular strategy is accomplished by taking one of the minor candidate's vote totals and having them begin with 7's. Perhaps, if there was tampering, what Iranian officials feared was not precisely Ahmadinejad losing but his winding up with less than 50 percent of the vote, which would send things to a run-off, presumably against Mousavi. Since Karrobui's voters are, somewhat self-evidently, less well organized than Mousavi's, perhaps it was easier to take votes from them to accomplish this goal.

Overall, I'm a bit less skeptical than Andrew, in part because, as we've been reporting on, Ahmadinejad performed oddly well in areas where Karroubi had been strong in 2005. But I still consider Roukema's evidence to be somewhat circumstantial -- it's far from clear to me that Iranian voting totals should be obeying Benford's Law in the first place.

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Unconvincing (to me) Use of Benford's Law to Demonstrate Election Fraud in Iran

Benford's law is an amusing mathematical pattern in which the first digits of randomly sampled numbers tend to have a distribution in which 1 is the most common first digit, followed by 2, then 3, and so forth. It's the distribution of digits that arises from numbers that are sampled uniformly on a logarithmic scale.

In our Teaching Statistics book, Deb and I describe a classroom demonstration where we show how Benford's law applies to street addresses sampled randomly from the telephone book. In a more serious vein, Walter Mebane has written about the application of Benford's law to vote counts.

In the past several days, a few people have asked me about applying these ideas to the recent Iranian election. Today, someone pointed me to an article by Boudewijn Roukema, which states:

The results of the 2009 Iranian presidential election presented by the Iranian Ministry of the Interior (MOI) are analysed based on Benford's Law and an empirical variant of Benford's Law. The null hypothesis that the vote count distributions satisfy these distributions is rejected at a significance of p < 0.007, based on the presence of 41 vote counts for candidate K that start with the digit 7, compared to an expected 21.2-22 occurrences expected for the null hypothesis. A less significant anomaly suggested by Benford's Law could be interpreted as an overestimate of candidate A's total vote count by several million votes. Possible signs of further anomalies are that the logarithmic vote count distributions of A, R, and K are positively skewed by 4.6, 5.8, and 2.5 standard errors in the skewness respectively, i.e. they are inconsistent with a log-normal distribution with p ` 4 × 10−6, 7 × 10−9, and 1.2 × 10−2 respectively. M's distribution is not significantly skewed.

I don't buy it. First off, the whole first-digit-of-7 thing seems irrelevant to me. Second, the sample size is huge, so a p-value of 0.007 isn't so impressive. After all, we wouldn't expect the model to really be true with actual votes. It's just a model! Finally, I don't see why we should be expecting distributions to be lognormal.

Maybe there's something I'm missing here, but that's my quick take. This is not to say that I think the election was fair, or rigged, or whatever--I have absolutely zero knowledge on that matter--just that I don't find this analysis convincing of anything. I will say, though, that Roukema deserves credit for presenting the analysis clearly.

P.S. In response to comments: let me emphasize that I'm not saying that I think nothing funny was going on in the election. As I wrote, I'm commenting on the statistics, I don't know the facts on the ground. To move my comments in a more constructive direction (I hope), let me pull out this useful comment from Roukema's article: "One possible method to test whether this is just an odd fluke would be
to check the validity of the vote counts for candidate K in the voting areas
where the official number of votes for K starts with the digit 7." Further investigation could be a good thing here.

I did not find Roukema's argument convincing; that does not mean that I consider it a bad thing that the article was written. The article is a first draft of an analysis; it might end up leading to nothing, or it might be unconvincing as it stands now but lead to some important breakthroughs. We can see what further analysis turns up. Again, my verdict is not a Yes or a No, it's an "I'm not convinced."

P.P.S. A commenter on our other blog pointed out this analysis of the Iran vote counts by Walter Mebane, who's the expert in this area.

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Who Wants School Vouchers? Rich Whites and Poor Nonwhites

As part of our Red State, Blue State research, we developed statistical tools for estimating public opinion among subsets of the population. Recently Yu-Sung Su, Yair Ghitza, and I applied these methods to see where school vouchers are more or less popular.

We started with the 2000 National Annenberg Election Survey, which had responses from about 50,000 randomly-sampled Americans to the question: "Give tax credits or vouchers to help parents send their children to private schools--should the federal government do this or not?" 45% of those who expressed an opinion on this question said yes, but the percentage varied a lot by state, income level, and religious/ethnic group; These maps show our estimates:

Vouchers are most popular among high-income white Catholics and Evangelicals and low-income Hispanics. In general, among white groups, the higher the income, the more popular are school vouchers. But among nonwhites, it goes the other way, with vouchers being popular in the lower income categories but then becoming less popular among the middle class.

You can also see that support for vouchers roughly matches Republican voting, but not completely. Vouchers are popular in the heavily Catholic Northeast and California, less so in many of the mostly Protestant states in the Southeast. We also see a regional pattern among African Americans, where vouchers are most popular outside the South.

See here for more, including maps from 2004.

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Ahmadinejad's Rural Votes

You have probably heard it asserted that Mahmoud Ahmadinejad principal strength is in rural areas, whereas Mir-Hossein Mousavi did relatively better in Iran's cities. However, it is not clear that this is true. Moreover, in 2005, it is demonstrably false. On the contrary, Ahmadinejad did much better in urban areas in that election.

I was finally able to track down data on the urbanization of each of Iran's 30 provinces, as listed on the website of the Statistical Center of Iran. Although Iran is a fairly large country, most of its population -- about 68 percent -- lives in cities. Its population density is quite comparable to that of the continental United States.

The percentage of Iranians living in urban areas in each province follows below:



Now, let's compare that to the percentage of the vote that Ahmadinejad received in each province in the first round of the 2005 election:



This is, obviously, a rather strong correlation. In 2005, Ahmadinejad was a man of the cities. Iran's most urban province, the small province of Qom (or Ghom), is also where Ahmadinejad got his largest share of the vote (55.2 percent) in the first round of the 2005 elections. Ahmadinejad's performance was quite not as strong in Tehran province, where he got 30.1 percent of the vote, but that was still better than the 20.3 percent he got overall, which was just enough to place him second and qualify him for the run-off.

Now, let's contrast that to what happened on Friday:



The correlation disappears, although it does not actually reverse itself. While Ahmadinejad did relatively poorly in some urban provinces like Tehran and Yazd, he did well in others like Qom and Ishafan.

So it's not exactly correct to say that Ahmadinejad's strength was in rural areas. What we certainly can say, however, is that almost all of the improvements that Ahmadinejad made over his 2005 totals came in rural areas. What was once a weakness of his turned into another strength.

This means that at least one of two things must be true. Either the urban-rural dynamics of Iran have changed significantly over the last four years -- at least insofar as it they affected perceptions of a candidate like Ahmadinejad. Or, alternatively, the election was rigged, and those who rigged it for some reason decided that rural votes were easier to steal.

Gallup polling conducted in 2008, incidentally, found that rural Iranians expressed much more confidence in the integrity of Iran's elections:



Again, I don't think this proves much of anything in and of itself; both explanations I outlined above are entirely plausible. But if you're going to steal votes, it is probably advisable to do so people who are less likely to notice that you're stealing them. In Iran, that means people in rural areas.

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Personal Democracy Forum, June 29th-30th

I'll try and keep this to a minimum since I know there are bigger fish to fry today, but I'll be appearing at the Personal Democracy Forum in New York City on June 29th and 30th with an impressive panel of guests including Frank Rich, Ana Marie Cox, Baratunde Thurston, Joe Rospars, Karen Tumulty and Mark McKinnon, among many others. Basically, it's going to be a bunch of smart people talking about the intersection of politics, media, and this thing we call the Internet. The organizers of this conference have generously offered a $100 discount to fivethirtyeight.com readers; to get this you should Personal Democracy Forum with the coupon code Natesilv100 (note that is case-sensitive). Hope to see some of you there.

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Don't Expect Ensign to Resign

Nevada Senator John Ensign today disclosed that he'd had an extramarital affair with a campaign staffer. This will make for plenty of interesting water-cooler gossip, particularly since Ensign has a penchant for calling on people to resign for various and sundry moral and ethical lapses -- notably Larry Craig, Bill Clinton and Ted Stevens (but not David Vitter).

It seems unlikely, however, that Ensign will resign himself. Although Nevada's governor is a Republican and could appoint another Republican to replace him, that would nevertheless trigger a special election in 2010, when Democratic incumbent Harry Reid is also on the ballot. Nevada Republicans have a very poor bench right now and are already having trouble recruiting a credible candidate to run against the unpopular Reid. They might have a lot of difficulty retaining Ensign's seat in the event of a special election, or alternatively, might compete for it at the price of giving Reid a free pass.

Remember, senators don't have to govern, or to preside over any legislature. They don't have any particular use for political capital, and other than their ability to be re-elected, they don't have any particular reason to popular. That's why Eliot Spitzer resigned and David Vitter (whom many Louisanans seem to have forgiven) didn't. It's why Roland Burris is still in the Senate.

Still, whether Ensign runs for re-election or not, this certainly would seem to give the Democrats a leg up on the seat in 2012, a cycle in which they'll have few other opportunities to play offense as they try to defend the gains they made in 2006. And Ensign's is a valuable seat at that: only one state more Democratic than Nevada currently has a Republican senator. That's Maine, which has two of them. But whereas Susan Collins and Olympia Snowe are moderates, Ensign is a staunch conservative who chairs the Senate Republican Policy Committee.

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If He Did It

In the first round of voting in 2005, the three conservative candidates for Iran's presidency -- Mahmoud Ahmadinejad, Ali Larijani and Mohammad Baqer Qalibaf, got a collective 41 percent of the vote. Last Friday, ostensibly, Ahmadinejad got 63 percent of the vote. Where exactly did those extra votes come from?

One way to address this question is by means of multiple regression analysis. We can take the vote shares for the seven candidates in 2005, and compare in each of Iran's 30 provinces to the share of the vote received by each of the four candidates this year. I will weight this regression by the square root of the number of votes in each province, to give more emphasis to those with larger vote totals.



The way to read this table is from left to right. If we look at the second row down, for example -- those votes which went to Ali Larijani in 2005 -- we estimate that 83 percent of his voting block went to Ahmadinejad, 16 percent went to Mousavi, and 1 percent went to Karrobui. Those results are not surprising; Larijani was a conservative, and so is Ahmadinejad.

Likewise, Ahmadinejad apparently picked up most of the vote from Mohammad Baqer Qalibaf, the conservative former mayor of Tehran. He also kept most of his own vote. Mousavi, meanwhile, picked up most of the vote from Mohsen Mehralizadeh and Mostafa Moeen, two reformist candidates. Those results aren't surprising either.

Let me warn you, before proceeding further, that the margins for error on this type of analysis are quite high. It should not be considered definitive. We would need to look at city-level data to come up with more robust estimates.

But with that disclaimer, at least one result is rather surprising. Namely, Ahmadinejad appeared to pick up most of the vote from Mehdi Karroubi, who is routinely described as the most liberal of the candidates. This is in spite of the fact that Karroubi himself was on the ballot this year; he appeared to retain only about 5 percent of his own vote.

Renard already detected this pattern, so I am not really telling you anything new. But it seems to me to be the key to explaining the Iranian election -- whether it was legitimate or whether it was rigged. Ahmadinejad won all of the provinces that Karroubi won in 2005, and his cumulative share of the vote in these 11 provinces was 66 percent, exceeding his overall total. In the province where Karroubi did best in 2005, his home province of Lorestan, Ahmadinejad got some 71 percent of the vote.

Now, most of those provinces where Karrobui did well in 2005 are rural, and it's possible that the rural tilt toward conservative candidates was greater in 2009 than in 2005. As I mentioned earlier, Ahmadinejad actually didn't do that badly in Iran's most urban province, Tehran, in 2005, but he performed relatively poorly there last week. If Ahmadinejad won the election, he did it by winning over these rural Karrobui voters. And if he stole it, those were the votes he stole or intimidated.

A secondary factor in Ahmadinejad's purported success was his ability to capture most of the vote from Akbar Hashemi Rafsanjani, a moderate (by Iranian standards) whom Ahmadinejad defeated in the 2005 run-off. Rafsanjani won three provinces in the first round in 2005: Kerman, Zanjan and Gilan. Ahmadinejad ostensibly won all three, grabbing 78 percent of the vote in Kerman, 77 pertcent Zanjan and 68 percent in Gilan. Kerman, indeed -- Rafsanjani's best province in 2005 -- was Ahmadinejad's best in 2009.

This is arguably a bit easier to digest than Ahmadinejad's success among Karroubi voters. Rafsanjani was Preisdent of Iran between 1989 and 1997 and was the closest thing the voters had in 2005 to an incumbent; Ahmadinejad, of course, was the incumbent this year. However, Ahmadinejad and Rafsanjani have quite a rivalry, with Ahmadinejad calling Rafsanjani a "puppet-master" and Rafsanjani calling Ahmadinejad a liar on the eve of the election.

But this is Mahmoud Ahmadinejad's story, and we're guessing that he's sticking to it.

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Placer is the New Orange

No single geographic locale is more closely associated with the iconography of modern American conservatism than California’s Orange County. In the narrative of conservatism’s rise from the ashes of Lyndon Johnson’s 1964 landslide to its dominance four decades later of the White House, Congress and the federal courts, Orange County holds the near-mythical status of conservative ideal and idyll, a repository of all things noble and good: unapologetic anti-communism, embrace of the military-industrial complex, strong Christian family values, suburbanization, bootstrap entrepreneurialism, and a fierce resistance to big government, new taxes and the welfare state. The county, which boasted about 13,000 people in 1890, grew tenfold by 1940 and then increased another sixfold to surpass 700,000 residents by 1960.
In Suburban Warriors, historian Lisa McGirr provides a fascinating account of Orange County’s rise to economic and political prominence:

This suburban heartland was not only home to Walt Disney’s visionary new park, to thousands of new California families and new towns and cities; it was also the birthing ground of a powerful grassroots political movement. A revitalized and militant Right--fueled by a politics of antistatism, virulent anticommunism, and strict normative conservatism--burst onto the scene nationally in the early 1960s, and nowhere more forcefully than Orange County. At living room bridge clubs, at backyard barbecues, and at kitchen coffee klatches, the middle-class men and women of Orange County “awakened” to what they perceived as the threats of communism and liberalism … The characteristics of Orange County’s development--its specific form of economic growth, the domination of its politics by an antiliberal and anti-eastern business elite, and the experiences of the people who settled there--created a favorable context for virulent right-wing beliefs.

This was the Orange County that gave root to Goldwater’s turning-point presidential campaign and proceeded to deliver strong Republican majorities for four decades.

No such political treatments have been written about California’s Placer County, a narrow, east-west horizontal strip of land about 80 miles northeast of Sacramento that borders Nevada. But today Placer County is more emblematic--or symptomatic, to be precise--of the state of American conservatism than Orange County.
Familiar to many today as home to the California side of the Lake Tahoe ski-and-summer recreational area, Placer County remains a largely pastoral county. Of the county’s six incorporated cities and towns, Roseville (pop. 109,000) has the largest population and none of the other five are even half its size. But Placer has experienced a population explosion of late. Since 1998 its population has increased by almost half, and a 2007 Census Bureau report ranked Placer as California’s fastest growing county and the fifty-fifth fastest nationally. Much of this boom has been fueled by the relocation inland to Placer and its neighboring mountain counties of native Californians who abandoned coastal areas they deemed too crowded or cosmopolitan for their tastes. The county is a major beneficiary of white flight caused by the arrival in California of Hispanic and Asian immigrants, and the in-migration of white Americans from other parts of the country. Though Placer’s minority population has inched up steadily in recent years, non-Hispanic whites still account for 80 percent of the county population and the minority growth rate is far slower than almost every other county or region in California. Every year this decade net migration has accounted for at least three-quarters of Placer’s population growth, more than triple the statewide average. Placer County has become a magnet for exurban growth and development.

The growth of counties like Placer has transformed California’s historic north-south divide into an east-west one or, more accurately, a new political struggle between the state’s coastal and inland counties. Sadly, racial dynamics are an important engine in this geo-demographic transformation. “As the state’s coastal region has become more urbanized and diverse, new and highly homogeneous white residential developments have appeared in inland counties that until recently were almost exclusively rural,” write Frederick Douzet and Kenneth Miller, authors of The Political Geography of California. Most counties in the Mountain region are 80 to 90 percent white, including seven of California’s thirteen whitest counties. Placer is among the thirteen.

Placer County politics are unabashedly conservative. Though 2008 GOP presidential nominee John McCain carried California’s Fourth Congressional District, which includes Placer, by just 10 points, four years earlier George W. Bush won it by 24 points. In November 2008, 60 percent of Placer voters supported the state’s Proposition 8 gay marriage ban in November 2008, two points higher than Orange County. The county was recently cited as the state’s “worst offender” in the disgraceful practice of homeless dumping, wherein homeless people are rounded up and driven to neighboring counties and left there so the county can avoid any social or financial responsibility for them. Tom McClintock, an arch-conservative who boasted on his 2008 campaign website that his district is “widely considered to be California’s most conservative,” is the new congressman representing the Fourth District. McClintock is avowedly anti-choice and opposed to same-sex marriage--typical positions for conservative Republicans. He opposed the so-called “Lilly Ledbetter Act”--named for a female manager at a Goodyear tire plan in Alabama who learned that men with same position were paid significantly higher salaries--and bucked his own Republican Governor Arnold Schwarzenegger’s call for higher vehicle emission standards.

Compared to Orange County, Placer today is less diverse, less densely populated, older, and more rural. It also has higher high school graduation rates, and higher home ownership rates; in fact, its homeownership rate exceeds the average statewide and even in Orange County. Placer’s per capita building permit rate in 2007 was thrice that of Orange’s. The median home value in Placer now exceeds the statewide median and, although it lags slightly behind Orange County’s, when cost-of-living is taken into account any real difference evaporates. Likewise, Placer’s slightly lower median household income is compensated by its lower cost-of-living.

Meanwhile, the changes occurring in Orange have caused a steady retreat from its traditionally strong Republican roots. Carried by a Democratic presidential candidate just twice--by Franklin Delano Roosevelt in 1932 and 1936--Orange is fast becoming a purple county. In 2008, Barack Obama almost won it.

In the story of modern American conservatism, Placer is the new Orange. But that replacement is symptomatic of conservatism’s decline, because Placer is simply too small and remote to effect the kind of conservative revolution Orange County did a half a century ago. A rural outpost, Placer is a place to escape from, not push back against, the political changes occurring in America. The most fitting testament to this reality is the story of Tom McClintock himself, the man who in 2008 replaced the disgraced John Doolittle in Congress in California’s Fourth District. McClintock only beat Democratic candidate Charlie Brown by about two thousand votes in this Republican-leaning district. That he won so narrowly is almost certainly because McClintock, like so many other residents of Placer County and the Mountain region, is himself a carpetbagger. After representing Southern California’s coastal Ventura County in the state senate, when the Fourth District seat opened up McClintock moved north to run for the seat. Downstate, along southern California’s coastline, there was no district left for a state senator of his ideological bent to run.

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On Health Care, Who's Hooked on Special Interest Money?

Last week, we documented how the American Medical Association, which probably a the reputation among the laypublic for being a sage council of doctors, in fact is a rather aggressive lobbying organization, which has a history of giving mostly to Republican candidates for office.

The AMA, however, is hardly the only player in the health player game. Based on data collected from OpenSecrets.org, I've tallied the amount of contributions that each of the 99 current senators have received from Political Action Committees -- PACs -- from the health care industry since 1989. This includes PACs associated with pharmaceutical companies, hospitals, HMOs, health services companies, medical supply companies and physicians', dentists' and nurses' groups. It does not include any money collected from individual contributors -- only money collected from PACs.

For comparison, we've provided the overall amount of federal campaign funds each Senator has collected over the same period from all sources -- including PACs, individual contributions, and self-financing. The senators are ranked by the percentage of their overall bankrolls that they've received from health industry PACs; the top 10 follows below. We've also listed each senator's position on the public option -- a government-run health care policy that would be established to compete with private policies -- which vigorously supported by progressives and many health care wonks but is generally opposed by industry groups.



This is an interesting list -- five Democrats and five Republicans, with some surprising names (Sherrod Brown?) but mostly predictable ones. The senator who has been most dependent on special interest money is Mike Enzi of Wyoming, who has gotten about 12 percent of all of his campaign funds from health care lobbying groups. Enzi, who is quite conservative overall, has been more proactive and moderate on health care, where he is the ranking Republican member of the Committee on Health, Education, Labor and Pensions. Whereas Enzi routinely describes his ideas as bipartisan, however, many Democrats regard them overly industry-friendly: Enzi's plan would not mandate coverage, for instance, nor prevent insurers from denying health care on the basis of pre-existing conditions.

The Democrat most dependent on health care lobbying money is Kent Conrad of North Dakota. This might give one some pause when evaluating Conrad's co-op plan or his skepticism about the Senate's ability to pass a public option.

Several other Senators who are regulars in the health care debate, like Democrat Max Baucus and Republicans Orrin Hatch and Chuck Grassley, also rank in the top 10 in their dependance on health care lobbying money.

In general, indeed, those Senators whom the health care industry seems most inclined to give money to are not necessarily those who are complete deadweight on the issue. Rather, it's those like Enzi and Conrad who are pushing solutions which are invariably described as bipartisan but which are in fact likely to lock in an industry-friendly plan. The industry appears to be resigned to the strong likelihood that a health care reform bill will eventually pass through the Congress, and knows that whatever does get passed, for better or for worse, will be hard to undo. They want to make sure it's a good one -- for them.

A complete list of all 99 senators follows below.



Overall, health care PACs have given an average of $482,870 to Republican senators and $407,979 to Democrats. There is a larger discrepancy, however, when the contributions are taken as a share of overall campaign funds -- the average Republican senator has gotten 3.6 percent of his funds from health care PACs, while the average Democrat has gotten 2.1 percent of hers.

Senators in favor of a public option have received, on average, $335,308 or 1.8 percent of their total campaign contributions from health industry PACs. Senators opposed to it have received an average of $486,629 or 3.5 percent. Undecided senators have gotten $530,968, or 2.9 percent of their total campaign funds, from health industry PACs.

Ranking relatively low on the list -- 61st of 99 -- is Ted Kennedy of Massachusetts, who has gotten $492,129, or 1.4 percent of his total campaign contributions, from these PACs. Ranking somewhere in the middle are Ron Wyden of Oregon and Bob Bennett of Utah, who have pushed a somewhat eccentric plan which lacks a public option but is nevertheless rather favorably reviewed by many health care economists and policy wonks.

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Recount in Iran?

The BBC is reporting that Iran's Guardian Council has announced that a "re-count" of Friday's votes will take place, following incredible protests and an official challenge to the results by Mousavi and Karroubi.

Commentators have rightly questioned whether a recount would provide any actual relief to the Iranian electoral process. Indeed, Mousavi and his supporters have demanded that Friday's balloting be invalidated, and a new vote held. The question is, under what circumstances would each option provide a better gauge of the Iranian public's actual will? It depends on the type of irregularities that actually occured:

1. Intimidation and electoral violence: Reports of activities of the Iranian Revolutionary Guard and paramilitary forces have been widely discussed. If Nate's hunch is correct, perhaps 15% or more of the population was willing to abstain from voting.
Recourse: New round of voting

2. Deliberate misreporting of vote totals: The blogosphere has been buzzing with reports of Mousavi's camp receiving word from the electoral commission that he had won the upwards of 60% of the vote, which was then retracted. If this was simply manipulation of the totals by loyalists in Tehran, and the political winds have shifted, the real total could possibly emerge.
Recourse: Recount

3. "Lost" ballots": Allegations have also abounded that a significant number of votes were disposed of from areas of strength for Mousavi and Karroubi (probably Rezai as well, but few reports).
Recourse: New round of voting

4. Khameni decided ahead of time: There are commentators, expert and not, that have suggested that the whole electoral process in Iran is a sham, with the results dictated long in advance by the Supreme Leader. Similar allegations were leveled in 2005, when then-unknown Mahmoud Ahmadinejad won a surprising second place in the first round.
Recourse: Rioting in the street; move to London

Of course, we suspect that one, two, or perhaps all occurred during the course of the campaign, to varying degrees. The key question is really whether the top leadership has in fact decided to pull back from their support of Ahmandinejad for fear of more serious civil unrest, or if the recount offer is simply a measure to save face before recertifying Mr. Ahmadinejad.

UPDATE: Iranian authorities have instituted new measures to "clamp down" on foreign media correspondants in the country. The BBC reports that the promised recount is looking more like "just a political ruse to try and wrong-foot the opposition." Nonetheless, a huge opposition rally in Tehran has begun again today, against Mousavi's pleas to avoid an encounter between rival groups.
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Renard Sexton is FiveThirtyEight's international columnist and is based in Geneva, Switzerland. He can be contacted at sexton538@gmail.com

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Polling Predicted Intimidation -- and Not Necessarily Ahmadinejad's Victory

Ken Ballen and Patrick Doherty, who work for a nonprofit group called Terror Free Tomorrow: The Center for Public Opinion, are out with a comment in today's Washington Post which claims that their poll of 1,001 Iranians conducted last month predicted Mahmoud Ahmadinejad's victory.

Ballen and Doherty are doing admirable and important work. Regular readers will know how difficult it is to conduct a good poll in the United States. Take that difficulty to the fifth power, and you'll have some sense for how difficult it is to conduct a good poll in Iran.

Unfortunately, while the poll itself may be valid, Ballen and Doherty's characterization of it is misleading. Rather than giving one more confidence in the official results, the poll raises more questions than it resolves.

Ballen and Doherty wrote in the Post that their poll showed "Ahmadinejad leading by a more than 2 to 1 margin -- greater than his actual apparent margin of victory in Friday's election." But let's look at what their poll (.pdf) actually said:



Well, indeed, Ahmadinejad has more than twice as much of the vote as his next-closest rival, Mir Hossein Mousavi. But he also only has 33.8 percent of the total vote. Between them, indeed, Ahmadinejad and Mousavi only have 47.4 percent of the vote. Where does the rest of the vote go?

Not to the other candidates, Karroubi and Rezai. The poll -- correctly, apparently -- predicted that they would only account for a small fraction of the vote.

Some 7.6 percent of the respondents said they weren't planning to vote for anybody. There's nothing particularly suspicious about this; turnout in Iran, while high by American standards, is certianly not 100 percent and this poll was not screened for likelihood of voting, as most American-based polls are. An earlier question, Q25, asked people directly whether they intended to vote in the June elections and 6.8 percent said no, closely matching this figure.

It's the other two categories, however, which give one pause.

Firstly, some 27.4 percent of Iranians told TFT they were undecided. By comparison, a month before the U.S. presidential election, about 5-9 percent of respondents generally claimed to be undecided. Perhaps it is folly to try and extrapolate the Western experience to Iran -- but for 27 percent of the voters to claim to be undecided one month before a high-profile, high-turnout election strikes me as unlikely. Iran is a relatively sophisticated and dare I say stubborn country where people debate politics regularly and vigorously. They might not have told TFT whom they were planning to support -- but that doesn't mean they were truly undecided.

And indeed, the next category speaks directly to this. Some 15.1 percent of respondents refused to disclose who they were voting for. This is not mere modesty; indeed, the Iranians in TFT's survey were very forthcoming about a whole host of controversial issues, ranging from their perception on Iran's governance structure to their feelings about the United States and Israel to their opinions on Iran's nuclear program. On these questions, just a couple percent of the respondents refused to answer -- but the number shot up to 15 percent for the Presidential tally.

Ballen and Doherty claim that the forthcoming and surprisingly liberal responses to these other sorts of questions give their poll more credibility:

Some might argue that the professed support for Ahmadinejad we found simply reflected fearful respondents' reluctance to provide honest answers to pollsters. Yet the integrity of our results is confirmed by the politically risky responses Iranians were willing to give to a host of questions. For instance, nearly four in five Iranians -- including most Ahmadinejad supporters -- said they wanted to change the political system to give them the right to elect Iran's supreme leader, who is not currently subject to popular vote. Similarly, Iranians chose free elections and a free press as their most important priorities for their government, virtually tied with improving the national economy. These were hardly "politically correct" responses to voice publicly in a largely authoritarian society.

Ballen and Doherty's point would be worthwhile -- if support for Ahmadinejad was as robust as they were claiming. But instead, the presidential preferences of almost half of their survey cohort are unaccounted for -- 42.5 percent either refused to answer the question or said they were undecided, and another 7.6 percent said they weren't planning to vote at all.

While it is dangerous to make inferences about the preferences of undecided voters, the fact that the Iranians in their survey did tend to favor reformist positions on most issues, and had generally tepid reviews of Mr. Ahmadinejad performance, would seem to provide a few hints. For example:

* 68 percent of respondents said they favoried Iran working with the United States to end the Iraq war;
* 77 percent favored normalized trade relations with the United States;
* 76 percent favor having the Supreme Leader be directly elected, rather than undemocratically appointed.

And on Mr. Ahmadinejad's performance:

* 45 percent said Ahmadinejad's policies had succeeded in reducing unemployment; 44 percent said they had not succeeded;
* 28 percent said Ahmadinejad had fulfilled his promise to "put oil money on the tables of the people themselves"; 58 percent said he had not succeeded.

The Iranians were more conservative on other issues -- they overwhelmingly favored the development of a nuclear energy program, for instance, although were more evenly split about nuclear weapons. They had a quite negative perception about the United States government, although they were largely sympathetic toward the American people themselves.

Overall, however, the poll revealed that Iranians gave Ahmadinejad tepid reviews on the performance of the economy, and favored a much less bellicose foreign policy than he has pursued. One would think that under those circumstances, the incumbent would be in a fight for his political future.

Let's accept the poll's contention that about one-third of Iranians -- or about 36 percent of those who were planning to vote -- are hard-core supporters of Mr. Ahmadinejad. There are certainly conservative elements in Iran, and I have no particular reason to doubt this figure. That still leaves Ahmadinejad far short of the margin he would need to carry the election, however.

But here's the catch. If you have 15 percent of the electorate refusing to say whom they'll vote for, and if probably about half of the 27 percent in the "don't know" category are in fact "soft" refusals who are similarly reluctant to reveal their preferences, those votes won't necessarily have wound up in Mr. Mousavi's column. If these Iranians were too intimidated to reveal their preferences to a pollster, they may also have been too intimidated to vote as they really pleased on Friday.

The swing votes in Iran are not those blue-haired ladies who take 40 minutes in the ballot booth and call the election clerk over every few minutes. They are rather the perhaps 30 percent of the population who were trying weigh the potential risk to their persons or their standing in the community in voting against Mr. Ahmadinejad, against what might be a relatively small benefit in voting for Mr. Mousavi, whose reforms could be easily vetoed by the Ayatollah. These swing voters may also have been worried that their votes wouldn't have been counted anyway: about one-third of Iranians in the survey didn't believe, didn't say or didn't know whether they expected to have a free and fair election.

If you take that 30 percent swing vote and add it to Ahmadinejad's 33 percent base, he could have won the election with 63 percent of the vote, as he ostensibly did on Friday. If you take it and add it to Mousavi's column, Ahmadinejad would have gone down to a solid defeat.

The point that few commentators are realizing -- Al Giordano is an exception -- is that this story really isn't about the way that the votes were counted. It's about whether Iran is capable at this point of having an election in which the democratic will of its electorate is properly reflected. If Ahmadinejad hired a bunch of thugs to hold every Iranian at gunpoint while they were casting their ballots, it would not have been difficult for him to get 63 percent of the vote -- indeed, he'd probably have wound up with very close to 100 percent. This would be an election -- and there would be no need at all to tamper with the results. But it wouldn't be an expression of democracy. We need to separate out those two concepts. Ahmadinejad, as far as we know, did not go so far as to hold anyone at gunpoint. But the tentacles of fear in Iran run deep.

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