Andrew Sullivan's Rightly Worried About Immigration, Trans Advocacy

Two very good essays by Andrew Sullivan at New York magazine's "Intelligencer" column, the first about immigration:

Courts have also expanded asylum to include domestic violence, determining that women in abusive relationships are a “particular social group” and thereby qualify. In other words, every woman on the planet who has experienced domestic abuse can now come to America and claim asylum. Also everyone on the planet who doesn’t live in a stable, orderly, low-crime society. Literally billions of human beings now have the right to asylum in America. As climate change worsens, more will rush to claim it. All they have to do is show up.

Last month alone, 144,000 people were detained at the border making an asylum claim. This year, about a million Central Americans will have relocated to the U.S. on those grounds. To add to this, a big majority of the candidates in the Democratic debates also want to remove the grounds for detention at all, by repealing the 1929 law that made illegal entry a criminal offense and turning it into a civil one. And almost all of them said that if illegal immigrants do not commit a crime once they’re in the U.S., they should be allowed to become citizens.

How, I ask, is that not practically open borders?

Then, trans advocacy sinking the ship of lesbian/gay civil rights successes. The polling numbers are earthshaking:

The number of Americans 18 to 34 who are comfortable interacting with LGBTQ people slipped from 53 percent in 2017 to 45 percent in 2018 — the only age group to show a decline,” according to the annual [GLAAD] Accelerating Acceptance report.

Sullivan rests this sad state of affairs squarely on the shoulders of the trans advocates, who he imagines (I think correctly) will not readily relinquish their newfound power:

...[T]here is almost no chance that the gay-rights Establishment will relinquish the “LGBTQ” label. They, like most extensions of the Democratic Party, have completely embraced postmodern critical gender and queer theory. My fear is that this will fail to win support and that, as the trans movement keeps pressing and pressing, the backlash will grow and gays and lesbians will become collateral damage. The T activists, having embraced an extremist theory of gender, could undermine not just their own case but also equality for the Ls, Gs, and Bs. They could swiftly reverse the gains we have won. They sure have made a good start in turning the next generation against us.

Physicians Per Capita Continues Up In 2016 FSMB Survey

Good news on a subject I've harped on before: physicians per capita as a fundamental cause of the cost of medicine. Absent adequate supply, it almost doesn't matter what kind of payment system we have: medicine can't get cheaper without a bigger workforce. Accordingly, the Federation of State Medical Boards has published their 2016 survey results (PDF). The topline figure of 953,695 alleopathic and osteopathic physicians represents a 12% increase since 2010, and a 4.09% increase from 2014. This is a 2.01% annual growth rate, which is slightly off the pace of 2.14% rate I calculated in January, 2017 based on the 2014 survey (no longer available). Given the overall US population rate appears to be growing at about 0.7% annually, this is more than keeping pace with overall population growth, a good thing.

Physician immigration continues to be important, with Indian physicians, and physicians studying in the Caribbean countries, being the two most important sources:

India by itself provides about 23% of the immigrant physician population, and 5.1% of all US physicians. A majority of doctors studying in Caribbean countries are US citizens, and this has been true for years:

The largest single age group of physicians is those in their 60s, something that will have consequences as this group nears retirement — and as modern medicine becomes more bureaucratic:

Women physicians under 40 are now nearly double the number of men in the same age cohort, reducing available physician hours:

In all, mostly good news, but there's still an obvious iceberg ahead with pending retirements, Trumpian immigration restrictions, the crisis of part-time physicians, and Medicare internship throttling.

Why Don't Federal And Texas Homicides By Illegal Immigrants Match?

I recently encountered a piece at American Thinker purporting to show that illegal immigrants murder at much higher rates than the general US population. Randall Hoven's piece starts with a March, 2011 GAO survey (PDF) estimating the number of murderers among the ranks of "criminal aliens" (a group that includes people legally in the United States) in state jails under the DOJ's State Criminal Alien Assistance Program, or SCAAP) and ones in the Federal Bureau of Prisons (BOP) committed over two periods:

To determine the number and nationalities of criminal aliens incarcerated, we analyzed BOP data on criminal aliens incarcerated in federal prisons from fiscal years 2005 through 2010 and SCAAP data on criminal aliens incarcerated in state prisons and loca l jails from fiscal years 2003 thorough 2009.

Hoven takes 2009 DHS estimates of 10.8 million illegal aliens in the United States, and a total alien population of 25.9 million, from the GAO study. Given there are two periods and two prison populations studied by the GAO, this leads to obvious problems with coming up with the right numerator and denominator. Over the study period, on page 21 (PDF page 27) they claim 25,064 criminal aliens were imprisoned for homicide. Assuming a static population over the longer of the two terms studied (which is clearly false but will serve to increase the rate otherwise), that means

Let’s take homicide as an example. The GAO estimates “criminal aliens” were arrested, convicted and incarcerated for 25,064 homicides. If non-citizens committed them over seven years, the annual rate would be 14.2 per 100,000 non-citizens. If illegal aliens committed them over four years, the annual rate would be 58.0 per 100,000 illegal aliens. Either way you compute, those are high rates.

So far, so bad (at least for what this means). We should expect to see similar figures from the states. Yet this hasn't materialized. Texas, according to the DHS, had 1.9 million illegal immigrants as of 2014 (PDF). The Texas Department of Public Safety records only 225 homicide convictions over a seven-year period from 2011 through 2018. This correlates with an annual homicide rate of around 1 per 100,000, which is dramatically lower than the general US population figure of around 5/100,000 — more than an order of magnitude of those calculated by Hoven, in fact.

So why the discrepancy? Digging deeper into the Bureau of Justice Assistance website, it turns out SCAAP eligibility (PDF) is contingent upon

Each applicant government is to provide detailed information about the individuals —

(1) whom the applicant government “incarcerated” for at least four consecutive days during the “reporting period,” and
(2) who the applicant government either knows were “undocumented criminal aliens,” or reasonably and in good faith believes were “undocumented criminal aliens.”

Which is to say, there's a considerable financial incentive to overreport such individuals. This isn't the end of this discussion, but it bears substantial further investigation, especially given the policy stakes.

Update: One interesting comment on this comes from the National Council of State Legislatures, which mentions that SCAAP eligibility changed starting in 2012: "SCAAP payments will only be made to states and localities only for those inmates that DHS can verify as illegal aliens. DHS will no longer reimburse states for “unknown” inmates (58 percent of the program in 2010)." Indeed, looking at the 2010 data (Excel spreadsheet, the closest year available before the 2011 GAO report, more years available here), 43% of the total presented to UCA for SCAAP reimbursement (21,831 of 50,402 total from Texas) fell into the "unknown" category. This seems ripe for exaggeration, as well.

Update 2: It would appear that SCAAP data would also admit illegal aliens, suspected or actual, who had been jailed in preparation for a trial in which they may have been exonerated. So the "crime" listed might entirely be speculative.