On health care policy, a personal story

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I’m not watching C-Span today:

Consider this, published by a team of U.S. health care researchers in 2004: “Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States.”

That was five years ago. The quiet tragedy associated with a lack of health insurance has continued, the numbers growing in the half-decade since a team from the Institute of Medicine, our leading national health care think tank, published that statistic.

Perhaps 18,000 is too abstract to get your head around. To make this more concrete, let me introduce you to Virginia Heineman.

Severely asthmatic, chronically ill, and as a result chronically underemployed, Virginia — “Ginnie” to those of us who loved her — lived on society’s margins.

She was my wife Lissa’s beloved younger sister. She was one of 2002’s 18,000 unnecessary deaths.

 

Reduced releases from Lake Powell: no going back

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It rained kind of a lot in the intermountain west this month, which raises a fascinating question about the tools we use for Colorado River management, and the tendency of water managers and management institutions to base significant actions on median flow forecasts rather than managing with a flexibility that considers the probabilistic nature of the information forecasters are giving us.

Black Canyon during construction of Hoover Dam, courtesy USBR

Black Canyon during construction of Hoover Dam, courtesy USBR

In August, the Bureau of Reclamation announced that, for the first time ever it would curtail releases from Lake Powell on the Colorado River, reducing flows downstream through the Grand Canyon to Lake Mead and thence to the fountains of Las Vegas and Phoenix and the alfalfa fields of the Imperial Valley. Now it’s rained a whole bunch, and Lake Powell has a lot more water in it than we expected – enough, under a more flexible policy, to erase the need for curtailment. But it appears there’s no going back. In water supply terms, the Upper Basin appears to be the winner in the execution of this forecast-policy-weather edge case.

In water volume, the difference between a full release and a curtailed release was marginal, but the symbolic and therefore political implications are huge.

The decision was based on a rigid, cookbook-like formula contained in the 2007 interim guidelines for operating Mead and Powell. Once a month, the U.S. Bureau of Reclamation takes the information giving to the agency by NOAA’s Colorado Basin River Forecast Center and updates its “24-Month Study“, which is basically a bunch of tables estimating inflows and reservoir levels for  12 Colorado River Basin reservoirs. Four times a year, in addition to the 24-Month Study, Reclamation also produces two additional reports, parallel “what if” sets of tables showing what would happen under the “wet” and “dry” ends of the probabilistic forecast issued by the CBRFC. But it’s important to note that, for purposes of the legally mandated interim guidelines, those wet and dry scenarios are not incorporated into the decision-making. The decisions are, by law, made based on the median forecast, without any flexibility to respond to what the forecasters might say about wet and dry.

These guidelines set decisions related to interstate water allocation and reservoir operations to the median forecasted inflow volumes. Unfortunately this approach does not consider the range represented by the forecast distribution, which leads to large uncertainties when a forecast distribution straddles important threshold values.

That’s from “River Forecast Application for Water Management: Oil and Water?“, an interesting new paper by the CBRFC’s Kevin Werner and colleagues looking at how forecast information is used by the water management community.

The operating guidelines also lock in a decision in August, based on median forecasts of the system’s behavior at the end of December:

The August 24-Month Study projections of the January 1 system storage and reservoir  water surface elevations, for the following Water Year, shall be used to determine the applicable operational tier for the coordinated operation of Lake Powell and Lake Mead as specified in the table below. (emphasis added)

This is one of those edge cases, ” “straddl(ing) important threshold values,” that Werner was talking about. In August, the median forecast’s projected level of Lake Powell was straddling the crucial elevation level of 3,575 feet come Jan. 1. If it’s above, that mark, the guidelines call for a full release from Powell in 2013-14. If it’s below, curtailment happens. The August 24-Month Study (pdf) found that, with a full release, Lake Powell would be 1′ 4″ below the crucial 3,575 foot elevation level. So curtailment it is.

As I read the Interim Guidelines (and please, Bureau people and others in the audience, correct me if I’m getting this wrong) the “shall” in the guidelines means that we’ve made our decision based on the August 24-Month Study, and there’s no going back now.

Even though, as a result of what one of my water management friends has dubbed “the September to Remember,” Lake Powell is now five feet higher than the median forecast on which the curtailment decision was based. That would seem to put us safely above 3,575, meaning a policy that didn’t lock us into a decision each August might mean a bigger release this year.

To be fair, even the forecast at the high end of the CBRFC’s probabilistic range (pdf) wouldn’t have put us above 3,575 come Jan. 1. This storm was an outlier. So maybe I’ve just wasted a lot of your time on an argument that’s too clever by half. But it’s an interesting exercise for looking at the gaps between forecast, weather and policy.

 

 

Federally subsidized California farm water

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I loved this boldly written line in Bettina Boxall’s Los Angeles Times story last Sunday on the question of who will pay, and how much, for a proposed multi-billion dollar pair of water supply tunnels beneath the Sacramento Delta:

Much of California agriculture is accustomed to vast amounts of cheap, federally subsidized water in the form of deliveries from the Central Valley Project, the nation’s largest water supply program.

No need for backup or detail, right? We all know that’s true. But should you be curious about the details, here’s some grist for the mill, via the Department of Interior’s Office of Inspector General earlier this year (pdf):

We found that USBR’s water ratesetting policies do not ensure that an appropriate share of capital costs and prior-year funding deficits are repaid annually. Water deliveries to the CVP contractors have been highly variable from year to year. When actual water deliveries are less than projected deliveries, revenues are insufficient to recover the Federal investment in the project. When actual water deliveries exceed projected deliveries, however, existing contract provisions stipulate that excess revenues collected by USBR must be refunded to the contractors. As a result, USBR has not demonstrated steady progress toward recovery of Federal investments in the CVP.

Ansel Adams cheated?

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Winter Sunrise, Sierra Nevada, by Ansel Adams

Winter Sunrise, Sierra Nevada, by Ansel Adams

Arrayed on the left-hand hillside of the Alabama Hills were the large letters LP spelled out in white-washed rocks that stood for Lone Pine. Driving through the town, you can still see the letters, which are refurbished by locals in a ritual familiar to many communities in the Western states. Ansel Adams was so disturbed by what he considered to be an ugly scar in the landscape that he spot-toned out the letters in his prints with a small brush, and in the 1970s finally had them eliminated from the negative itself by his assistant.

– William Fox, Camera Obscura: A photographic history of the LA Aqueduct, in Boom

Stuff I wrote elsewhere: the flood that wasn’t

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There’s a newsroom joke that “we don’t write about planes that don’t crash,” but I think it’s important to think carefully about societal systems that succeed, because lessons learned matter:

The flood pulse was impressive. But it is instructive to look at how much larger it would have been if not for a pair of flood control dams built in the second half of the 20th century to protect us from our habit of building our cities in flood plains. On Sept. 13, they were two dams in the right places at the right time.

Importantly, one of the lessons is that there are always tradeoffs. Flood control success did not come without cost:

Authorized by Congress in 1960 and completed in the mid-’70s, Cochiti is one of the largest and arguably the most controversial dam in New Mexico. Its completion drowned farmlands, summer homes and culturally significant sites at Cochiti Pueblo, and seepage beneath the dam waterlogged remaining pueblo farmlands downstream. In addition, the way it altered the Rio Grande’s flows has caused lasting environmental problems downstream, depriving the riverside ecosystem of natural floods.

But on Sept. 13, it did the job we gave it when we built it, which was to protect the Middle Rio Grande Valley from flooding.

Pat Mulroy retiring

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Here’s Henry Brean:

Long-time Southern Nevada Water Authority chief Pat Mulroy is preparing to retire but won’t make a formal announcement until “she’s ready,” Clark County Commissioner Steve Sisolak said Monday.

And Conor Shine:

Southern Nevada Water Authority General Manager Pat Mulroy is planning to retire after 22 years on the job.

Reached Monday evening, Mulroy said she had not set a date for her departure and was instead working to prepare an “orderly transition.”

“I think it’s time to have that discussion about ‘Where do we go from here?’” Mulroy said. “I have not set a date. It will be when all of that is teed up.”

This totally screws up the last chapter of my book.

California groundwater: bring on the social scientists

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Writing in Science four years ago, the late Elinor Ostrom outlined a number of characteristics of necessary for sustainable development and use of what’s called in the literature “social-ecological systems”. These are complexes of humans and resources where the success of each depends on the interplay with the other, like forests and fisheries and, for purposes of today’s topic, groundwater.

Elinor Ostrom

Elinor Ostrom, courtesy Wikipedia

Ostrom’s genius lay in the way she grasped the need to generalize from the welter of specific cases of groups of humans succeeding or failing at the task of sustaining community-resource interactions in situations where there is a risk of irreparably depleting a resource on which your community depends. Her doctoral thesis dove deep into one such case, in which a group of communities in coastal Southern California banded together to develop the necessary institutions to avoid overpumping their aquifer. But that was just one case. By the end of her career, she’d been at the forefront of the search for a set of general principles.

I was reminded of this as I read Jay Famiglietti’s op-ed in this morning’s Los Angeles Times about California’s groundwater depletion race to the bottom:

In the Central Valley, falling well levels and subsiding land are curtailing food production, damaging ecosystems and threatening the livelihoods of the thousands of area residents employed by the water-dependent agricultural sector. A recent report on the Coachella Valley documented decades of groundwater depletion there as well, despite local and regional efforts at managed recharge and water banking.

Clearly, this is a problem. And yet it doesn’t happen everywhere. Ostrom’s Southern California case studies show examples of communities that long ago built the necessary social infrastructure to master their groundwater overpumping problems. My question for the social scientists in the room: What’s the difference?