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FAQ’s About Our New Patient Portal, HellthChase

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Dear Patient,

In our continual efforts to provide you with the confusing level of treatment you’ve come to expect, we’d like to introduce you to HellthChase, our new cumbersome and contactless check-in solution.

HellthChase invites and obligates you to engage in the unpaid data entry of your health information. Once you’re set up, you can complete a variety of other activities online without having to interact with a human regarding important medical care.

What kinds of activities can I complete on HellthChase?
You can attempt such tedious tasks as:

  • Ask questions or request prescription refills from doctors and staff who might read and respond within one day or never
  • Regularly scan and upload your insurance card and driver’s license because we’re not sure we believe you that you are who you say you are
  • Sign forms with a pre-selected online signature in the font of an eight-year-old child’s writing
  • Be gaslit into thinking you can schedule appointments online easily
  • Examine some HIPAA forms you signed but never read and don’t give a shit about
  • Opt in by default to receive texts about balances due, with no billing or insurance detail

Are my records secure?
Yes. All personal data entered online is completely hacker-proof. Did you know that prior to web-based recordkeeping, paper records were constantly being snagged from doctors’ offices by cat burglars?

Is that true?
No, but it’s a narrative that HellthChase says inspires instant cooperation from technophobic patients.

Given that I can complete forms at home before my appointment, will HellthChase save me time?
Oh, god, no. HellthChase convinced us to purchase off-brand digital tablets that our receptionists will hand you at check-in. The tablets love to freeze and time out, which allows you to mindfully watch a digital hourglass (HellthChase likes to say they put the “patient” in “Patient Portal”). Once our Wi-Fi has caught up and the screen refreshes or starts over at the beginning, you will get a chance to confirm or re-enter any information you previously completed before your appointment.

Wait, if I have to hold a tablet… didn’t you say it was contactless?
Well, you don’t have to touch the receptionist’s hand; you just have to take the tablet. Technically, you aren’t making contact with a human, which is our ultimate goal. However, holding a tablet that was held moments earlier by another ill person allows you exposure to healthy germs that will keep your immune system robust.

Will this system connect with patient portal systems my other doctors use so I can have one login?
No. As an American with healthcare, you must have unique passwords for at least twenty bespoke portals, none of which connect with one another.

Did my previous online health records migrate over?
Ha ha ha, what? No. Those were lost in a cloud fire. You can declare yourself at the beginning of a fresh start of your health, or if you were a really anxious nerd and you printed your previous records, you can try entering them on your own (but remember the character limit). Or you may give them to your provider, who will just throw them in the trash.

Two days ago, I requested a prescription refill, but I have not heard back. Should I request a refill via my pharmacy?
No. This double-dipping will create confusion and delay. Just be patient. Doctors may take twenty-four to forty-eight hours to respond, but sometimes take 1,204 hours due to regular software updates to the portal.

I received a scary test result via the portal. Can I please speak with a doctor to confirm I’m not dying?
What are you doing trying to interpret your own test results? Those are not meant for your eyes. Wait for your doctor to message you that everything is fine.

Isn’t the point of the portal to access my information?
The point of the portal is that it’s cool and proves we aren’t afraid to stay on the cutting edge of technology, even when it’s not helpful yet. There are definitely notes our doctors make and see, and you will never know about anything you don’t have access to. You really shouldn’t be looking at anything. Except the HIPAA forms.

I’d prefer not to be texted balances due. Can you mail me a bill instead?
No. One hundred percent of ill Americans, you included, are criminals who plan to never pay their medical balances, so for efficiency, we omit sending detailed paper bills. Instead, the portal bombards you with a series of texts with balance reminders, which is not unlike the harassment of debt collectors. Just trust that the amount we say you owe is correct. Pay immediately, or you will be texted repeated threats and insults, you lazy sack of disease-riddled bones.

Can I opt out of this bullshit?
No, you are obligated to take charge of your well-being with HellthChase. Sign in today to take an active role in getting actively frustrated by your healthcare. Your username is your social security number, and your default password is SucKeR.

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mareino
10 hours ago
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hannahdraper
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San Francisco police bought drones illegally despite warnings

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San Francisco police have been using drones to catch car break-in suspects and investigate sideshows for months but internal emails show they knowingly broke the law by buying the crime-fighting tech.

Now the San Francisco Police Department is asking city leaders to approve the drones after it ignored warnings from within its ranks that it should have held off. Newly unearthed SFPD emails show the first call for caution came months ago from one of its own policy experts. 

About a week before the March 5 election, the SFPD was planning what drones to buy if voters expanded police powers by passing Proposition E. But an SFPD analyst noted that Prop. E alone did not grant the department authority to add drones to its arsenal.

Asja Steeves, SFPD policy division manager, said that even if voters passed the law, it doesn’t excuse the department from abiding by Assembly Bill 481. Authored by then-Assemblyman David Chiu, the 2021 law requires police to get the blessing from city electeds before using new surveillance tools.

“Prop. E does not supersede state law,” Steeves wrote in a Feb. 28 email to department leaders obtained by the Electronic Frontier Foundation and shared with The Standard. 

Another concern, which Steeves didn’t address, is that evidence gathered through unauthorized technology could give defense attorneys grounds to challenge cases — including those the SFPD highlighted to justify its drone use.

Steeves also told her colleagues that rushing to buy drones could put the SFPD in the middle of a political controversy. 

“If we want to stay out of the political fray and buy drones in order to use them in efficient ways that help the department,” Steeves advised, “we may want to wait until after the election to start the AB 481 approval process.”

The top brass didn’t wait. 

Prop. E passed, drones were bought, and the SFPD began openly touting its new gadgets. In a press conference last month, Mayor London Breed and SFPD Chief Bill Scott cited the arrests of suspected car burglars as proof that voters were right to give police more leeway.

But civil liberties advocates say the SFPD is proving Steeves right, too, by now scrambling to get into compliance with state law through a proposal from Supervisor Matt Dorsey, a former police communications boss, that would retroactively legalize the department’s drones.

Matt Guariglia, a policy analyst with the Electronic Frontier Foundation, said the department is trying to quietly correct a mistake it knew full well it was making. 

“This email from Feb. 28 is kind of a smoking gun,” he said, referring to Steeves’ warning. “Their own policy person told them ahead of time to pump the brakes on the drones because they’d need prior approval, yet they immediately started buying these drones despite that warning. Everything they did afterwards was in violation of state law.”

SFPD has yet to respond to The Standard’s request for comment. But it made its case for Dorsey’s proposal at the Sept. 9 Rules Committee and is set to resume that conversation in a continued hearing Monday.

Acting Lt. Eric Batchelder kicked off the discussion last week by rattling off the ways a drone’s-eye-view has helped police. He said the department has six drones that were used in 65 missions — 18 of which led to arrests.

Supervisor Shamann Walton brought up some of the same concerns as the Electronic Frontier Foundation, but struggled to get a straight answer.

“So right now, the drones are in use — are we operating in violation of state law?” Walton asked. 

Deputy City Attorney Brad Russ affirmed that state law requires city supervisors to sign off on drone use, but argued that when voters passed Prop. E “they stood in the shoes of the board for approval — at least for the first year.”

Yet the department is still seeking retroactive approval, which must pass through the Rules Committee before going to the full board for a vote.

Until then, according to state law, it can’t legally use drones — but SFPD apparently can’t be penalized for that either. AB 481 has no enforcement mechanism beyond admonishment from state authorities or pressure from the public. 

John Lindsay-Poland, a writer who advocates for demilitarizing the police through American Friends Service Committee, said SFPD appears to be the only agency in California to use drones without prior approval since AB 481 became law. 

That’s more than just a black mark on its reputation, he told supervisors at last week’s hearing.

“A law enforcement agency violating the law sets a bad example for the community,” Lindsay-Poland said, “and puts at legal risk the prosecutions in which drones were used.”

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mareino
12 hours ago
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Stuff like this is so easy, if prosecutors just had guts. If someone makes a knowingly unlawful purchase you just make that person pay for it out of their own paycheck. There is literally a 1000 year legal history to back up this policy; we've just forgotten it because we're afraid to bother cops.
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acdha
2 days ago
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Laws are what they do to you
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The Baliocene Apocrypha

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So if my historical sources are telling me the truth…

…and I’m synthesizing the history properly…

…then, in fact, the entire edifice of Western civilization – all the cultural, social, and philosophical structures that define the world in which we live today – can be traced back to a stupid loophole in Roman inheritance law.

NOTE: Everything here is taken either from Francis Fukuyama’s The Origins of Political Order or from a Livejournal post by the Infamous Brad that I am currently unable to find.  I get credit for absolutely nothing, except noticing the connection between Section II and Section III. 

I.

What do I mean by “the entire edifice of Western civilization?”

Here, I mean the vague-but-enormous memeplex that can be summed up in the word “individualism.”  The thing where each person is understood to be a social unit unto himself, with his own destiny and with rights to his own person, capable of charting an independent path through life.  The thing where you pick your own job and your own mate and your own friends and your own hobbies and your own ideals.  The thing where “freedom” is even a meaningful concept because we conceive of humans as being potentially free of each other. 

Obviously, this whole individualism thing has both a lot of sources and a lot of ramifications.  But an absolutely central part of it, something without which it cannot survive or cohere, is economic individualism: the idea that an individual person can own property in his own right, with full and complete title to it, including the right to alienate (sell) it as he pleases.  Without that, well, people can’t really act as free individual agents unless they’re prepared to give up all their resources, because all their resources are at least partly controlled by someone else. 

[Within any kind of historical economy, anyway.  Let’s leave complicated ideas about the post-scarcity future for another discussion.]

The main alternative to individualism is the tribe.  Within a tribal system, an individual basically isn’t a meaningful social unit, he is a component of his kinship group.  The tribe owns all the property, and you can’t sell it off, because everyone in the tribe (including all those yet to be born) have a claim on it.  You have duties to the tribe, and those duties define your life, even if maybe you personally would rather do something else.  You are bound to work, and marry, in a way that advances the tribe’s interests.  If you have wealth or power, it is incumbent on you to use it in a way that advances the tribe’s interests.  You get the idea. 

This tribe thing is the default social setup for humans.  It dominated most of the great premodern civilizations.  In India, pretty much all of society was built around kinship groups (jatis).  In the Arab world, tribal ties were always paramount – so much so that basically every successful Arab empire had to use slaves to run the government and the military, just on the grounds that foreigners without families wouldn’t funnel all the empire’s resources to their tribes.  The situation in China was a little different, since the kinship groups got kicked in the teeth early by Qin Shi Huangdi’s massive centralized bureaucratic state, but they were always there and always fighting to hang onto what power they could.  Etc.

But not in Western Europe.  Individualism took root in Western Europe really early.  You had contracts, and common law, and alienable property, going back to at least the early Middle Ages.  Same goes for the primacy of the nuclear family over the extended family, and cultural models of the non-family-defined free man.  The Enlightenment was building on a very firm foundation. 

When people talk about the importance of the Hajnal line, this is the thing that they’re trying to get at. 

II.

Why Western Europe, and not anywhere else?

Because, right from its inception, the Roman Catholic Church – and only the Roman Catholic Church, not (for example) any of its Eastern Orthodox counterparts – engaged on a systematic campaign to destroy the family.

…I say that in in a funny way, but it’s true.  There were a staggering number of major rulings issued by the early Church that amounted to “kinship groups aren’t allowed to do the things that make them function.”  Most famously, cousin marriage was banned, which meant that it was extremely difficult for kinship groups to avoid diffusing into each other and that they couldn’t shore up the most important alliances across generations with family ties.  Less famous but also very important was the banning of “Levirate marriage” (the marriage of a widow to her husband’s brother), which is a really useful technology if you want to keep all your tribe members within the tribe.  The very fact that the Church pushed hard for the legitimacy of female-owned property was a big part of this, since it meant that kinship groups were risking losing some of their stuff whenever one of their members got married.  And all sorts of rules about priestly behavior, including clerical celibacy, meant that priests couldn’t continue to serve as useful assets to their clans. 

(Insofar as this stuff didn’t come from the Church directly, it mostly came from lawmaker monarchs like Charlemagne, whose agendas tended to be intertwined with the Church’s agenda.)

OK.  So, uh, why was the RCC such an implacable enemy of the kinship-group system? 

The short answer is “because it was closely allied with the social subclass of wealthy widows.”  Widows tended to give lots and lots of money, and land, to the Church.  This didn’t work so well if a widow’s stuff would all just get reappropriated by her husband’s clan.  So the Church did everything it could to support a woman’s right to keep her dead husband’s property, and the women reciprocated by donating a hefty proportion of that property. 

The question remains, though…why did this particular form of mutual back-scratching manifest only in Catholic territories?  Why weren’t the Orthodox churches, or the various Hindu temples, doing exactly the same thing? 

III.

It turns out that upper-class Roman men liked younger women.  Much younger women.  The average patrician wedding involved a man in his late twenties or thirties, or even forties, and a girl in her early teens. 

(Brief explanation: as a rule, everywhere, aristocratic men get married when their financial and political prospects have been firmly established.  Why would a bride’s family choose to roll the dice?  In Rome, for various reasons, this didn’t happen until fairly late.  But Roman medicine was super shitty and nutrition was poor, so it was generally desirable to marry the youngest possible woman for fertility-maximizing reasons.) 

This meant that, if an upper-class Roman wife managed to avoid dying in childbirth, she was almost certain to outlive her husband by quite a lot.  Aristocratic Roman society was filled with youngish widows.  There was at least one in basically every patrician family. 

The result: as civilizations go, Rome was slightly more concerned than average about the plight of women who’d lost their husbands.  Which is important, because traditional kinship-group-based inheritance law is ridiculously terrible for widows.  All the husband’s stuff gets reclaimed by the tribe, the widow is left dependent on the mercy of a family that isn’t even her family (as such things are understood), and she is very likely to die or to be functionally enslaved. 

So the Romans came up with a kludge.  Widows were, technically, allowed to keep their husband’s property in their own name…but there were a ton of restrictions on what they could do with that property.  The idea was to keep the great estates intact until the women in question either died conveniently or found a way to get married again. 

One of the very few things that propertied widows could do with their money was donate it to temples.  Unimpeachably respectable, right? 

…except that Rome was infested by this up-and-coming, wildly expansionist cult that was desperate for cash and upper-class recognition. 

A whole bunch of the early Roman bishops got their churches off the ground essentially by serving as money-laundering operations for rich widows.  The patrician women in question would “donate” vast fortunes to the Christians, with the explicit understanding that they would continue to control most of the money.  Even so, the churches were getting vastly more support from this system than they were going to get anywhere else.  And some of the widows in question even came to decide that they were actually pious. 

So the Church fathers arrived at the conclusion that wealthy widows were their best friends.  And the rest is, as they say, history.

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Santa Ana benches a teacher for too much transparency

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In mid-August, with parents prepping children for the new school year and classrooms being swept and decorated to welcome them, Brenda Lebsack was thinking about advertising. 

Lebsack, a Santa Ana teacher, wants parents to know that most kids in Santa Ana’s public schools can’t read or do math at grade level. 

“My message is, ‘70% of SAUSD students are not meeting reading standards and 80% are not math proficient, yet we have a 91% graduation rate,” Lebsack says. “Our graduation rates keep going up while our academic scores keep going down.”

So, she called a phone number on the city’s bus stops and asked about advertising that fact in Spanish and English on bus benches and shelters. She even proposed including a QR code for a quick link to the government data supporting her claim.

The woman on the other end of the line “told me some of the basic parameters and rules of the ads, basically that they cannot be political,” Lebsack recalls. “She said she would email me information within a day. 

Lebsack says she “waited and waited, but the call never came.” So she called again and left a message. The advertising representative texted back, “Good morning, unfortunately the topics are political and we are unable to move further. Thank you for the inquiry. Have a great day!”

It’s unclear how letting parents know that their schools are failing is “political” – Lebsack’s ad copy doesn’t mention a candidate or campaign. But it’s very clear that the First Amendment prohibits Santa Ana – prohibits every American government – from censoring speech, especially when it’s political. 

The First Amendment declares, “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”

From the earliest days of the republic, the courts have said that clear limit on government power applies to every level of government in America – not just to Congress or the president, in other words, but also to state and local governments and districts, from Washington, D.C. to Sacramento and all the way down to Santa Ana and the bus benches Santa Ana owns on the streets of the fourteenth-largest city in America’s most populous state.

Isn’t Brenda Lebsack’s message about her city’s schools protected by the First Amendment?

I put that question to Focus Media Group, the Florida-based company that manages bus bench advertising for Santa Ana and governments all over the country. In an email, Focus Media’s director of municipal relations replied, “We do not set the advertising standards or determine what is deemed acceptable for our clients’ advertisements.”

Who does? “These guidelines are dictated by our municipal contracts, in this case, specifically with the City of Santa Ana,” the spokesperson said. “Currently, we are seeking additional guidance from the city to ensure our actions are fully compliant with their requirements.”

I followed with a question about how Focus makes these decisions. “Does your company interpret those guidelines in order to determine whether advertising content is permissible?” I asked. “Or do you send all advertising content to city staff for their direct approval?”

“Please refer to the comments in my previous email,” he replied. “We have no further comments at this time.”

That time was two weeks ago. After telling me they’d look into the matter, Santa Ana city officials ignored multiple requests for comment. 

In the meantime, school has started and Lebsack worries that she’s lost what parents and educators like to call “the teachable moment,” in this case the time just before classrooms opened – when Lebsack might really have drawn the public’s attention to the city’s failing schools. 

Santa Ana’s 2022 advertising contract with Focus is available on the city website. And it shows what sure looks like a straightforward violation of the First Amendment. In one place, the contract says bus bench advertising is banned if “the City in its sole discretion deems it offensive to community standards of good taste.” In another, the contract asserts the city’s right to prohibit “messages that are political in nature, including messages of political advocacy, that support or oppose any candidate or referendum, or that feature any current political office holder or candidate for public office, or take positions on issues of public debate.”

For good measure, the contract also bans “images, content or copy related to religion or religious ideas or viewpoints.” 

These would seem to be clear violations of the First Amendment, says Julie Hamill, president of the California Justice Center.

“The First Amendment does not allow city officials to exercise unbridled discretion to deny a sign permit on the basis of ambiguous or subjective reasons,” Hamill said. “Santa Ana’s standards include a number of unconstitutional provisions, including a prohibition of signs that ‘promote material which the City in its sole discretion deems offensive to community standards of good taste.’”

As for the city’s “blanket prohibition on religious signs,” Hamill says that’s also bound for a collision with the courts. “That’s a content-based restriction that will not survive a First Amendment challenge,” she says – and then, because she’s an attorney, she helpfully adds a citation (Reed v. Town of Gilbert, 2015) and an explanation of that decision (“Content-based restrictions that target speech based on its communicative content are presumptively unconstitutional and may be justified only if the government proves that they are narrowly tailored to serve compelling state interests.” 

And you can practically hear the opening to The Good, the Bad, and the Ugly – the spaghetti western surf guitar over Mexican rhythms – when Hamill concludes, “I could highlight every unconstitutional provision in the City’s sign standards but I don’t have all day. I encourage the city to retain a First Amendment lawyer to assist them in revising their sign standards.” 

The problem of poor-performing public schools and government censorship isn’t limited to Santa Ana, of course. California ranks No. 1 in per-student spending but near the bottom of student achievement. Hoping to hide that fact, state superintendent of public instruction Tony Thurmond, facing a tough re-election campaign in 2022 delayed the release of nationwide testing until after Election Day. Lance Christensen, Thurmond’s opponent in that race (and my colleague at California Policy Center) told EdSource, “The fact that the department is not willing to publish now suggests that scores will be lower and the current state superintendent does not want to be held accountable for the results.” 

Facing public criticism for what looked like a transparently bad magician’s trick, Thurmond released the test results just days before Election Day, but late in the voting cycle. “Monday’s public release of the data almost didn’t happen,” reported the Los Angeles Times. And now that it had, the data showed that “two out of three California students did not meet state math standards, and more than half did not meet English standards.” 

More baffled than angry, Lebsack says “it’s just really insane that they just shut us down like that.” She can’t understand why Santa Ana wouldn’t want locals to know what government officials already know – because the data is on government servers, and it shows that the public schools we pay for are failing our children.

Will Swaim is president of the California Policy Center and co-host of National Review’s Radio Free California podcast.

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mareino
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freeAgent
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Can new data solve an immigration puzzle?

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Today we have a guest post from Jed Kolko, an economist who recently completed two years of service as the Under Secretary for Economic Affairs in the Department of Commerce, where he oversaw the Census Bureau and the Bureau of Economic Analysis. He was previously chief economist at Indeed and Trulia.


Immigration has long been among the most contentious topics in US politics. And this year, the data nerds have joined the fight. 

In late 2023 and early 2024, government agencies released wildly different estimates of 2023 net immigration: 1.1 million people, said the Census Bureau, and 3.3 million, said the Congressional Budget Office (CBO). This huge gap caused economists to scramble to reinterpret existing data and create new alternative forecasts, and that matters for the most important economic policies: for example, the Fed adjusted its view of the labor market based on higher CBO immigration estimates.

Today, Census released annual survey data that are the key input into its immigration estimates:

  • These new data will probably lead Census to revise its 2023 immigration estimate upward by 300,000 people. That closes only a bit of the gap with CBO, though, so the data fights will continue. 

  • The data also provide the first glimpse at who recent immigrants are and where in the US they live. 

  • Finally, this entire debate over measuring immigration highlights many of the features and bugs of government statistics, and the challenges that data users and the statistical agencies face.

But before we get to the new numbers, it’s important to understand how immigration is estimated and why these estimates matter so much for getting an accurate read on the economy and setting economic policy.

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Why are there multiple immigration estimates, and how could they be so far apart?

Numerous government agencies estimate the population. Annual Census population estimates guide the allocation of federal spending and also serve as the “population controls” for essential demographic surveys. (This turns out to be a big deal. More on this, below.) These annual estimates help bridge the gap between full-count decennial censuses, and they are revised to reflect new information each year. Other agencies produce population estimates and projections for their own purposes — CBO estimates and forecasts the population as inputs into their outlook for federal spending, revenue, and deficits. 

Immigration is an essential part of estimating the size and growth of the population, and the trickiest. 

Different agencies take different approaches to estimating immigration. Census immigration estimates are based primarily on its own survey data. The Census Bureau asks respondents about birthplace, citizenship, and residence one year ago in two key surveys: the large, annual American Community Survey (ACS) — whose 2023 data came out today — and the smaller, monthly Current Population Survey (CPS), which tracks the unemployment rate and other key labor market measures and is co-sponsored by the Bureau of Labor Statistics (BLS).1 

The critical input into the Census immigration estimate is ACS data on foreign-born residents who lived abroad one year ago. Importantly, Census uses lagged survey data in its estimate. The 2023 population estimate was published in December 2023, incorporating 2022 ACS data released in September 2023. The 2023 ACS data released this morning will in turn be the basis for the immigration component of Census’s 2024 population estimate, due out in December 2024; Census will also revise its 2023 population estimate then, including the immigration component. In periods when immigration patterns change quickly, including during and after the pandemic, using lagged data can be more problematic.

In contrast, CBO immigration estimates incorporate administrative data alongside survey data. Administrative data track immigration-related actions, such as applications, visa issuances, and border encounters, which include apprehensions and expulsions. Widely reported Customs and Border Protection data showed a spike in border encounters in 2022 and 2023 and a drop in 2024. For its estimates, CBO uses survey data from the CPS, which is more recent but has a much smaller sample size than the ACS, and border-encounter data from Customs and Border Protection.

These different methods led to a huge divergence between Census and CBO immigration estimates in 2022 and 2023, as well as in their projections for 2024. 

What accounts for this huge gap? Census’s use of lagged ACS data from 2022 probably made its 2023 estimate too low, though today’s release of ACS 2023 data might lead to only a modest upward revision in the 2023 estimate, as I’ll explain below. Also, Census 2023 estimates are for the year ending June 30, whereas CBO uses the calendar year, so Census 2023 estimates don’t include a possible spike in the second half of 2023; however, if you compare Census 2023 estimates to the average of CBO’s 2022 and 2023 estimates, there’s still a huge gap.

There are deeper reasons. Survey and administrative data have different purposes, strengths, and limitations, and they often disagree. Surveys might undercount immigrants, especially recent immigrants, and especially if they live in temporary or short-term housing. In contrast, administrative data could overstate migration if the same migrant is encountered at the border multiple times.2

How have economists coped?

Economists need an accurate view of immigration because immigrants are part of the workforce — or in econspeak, the labor supply. When labor demand runs ahead of labor supply, firms compete harder for workers and bid up wages, and the economy risks “overheating” with higher inflation. When labor demand falls short, the labor market softens, unemployment rises, and the economy risks sliding into recession. Maintaining the right balance between labor demand and labor supply starts with a clear view on labor supply. With an aging population, the native-born workforce grows slowly but predictably. Immigration is the wildcard for estimating and forecasting labor supply.

The Census immigration estimate may be too low, but it is baked into key data points. The Current Population Survey — also known as the household survey in the monthly jobs report — is “controlled” to the Census population estimates, which means that the weights assigned to each of the 100,000-ish individuals in the monthly survey add up to equal the national population estimate.3 If the CPS is controlled to a population estimate that includes an immigration estimate assumed to be too low, then ALL the levels and even some changes in levels that are generated from the CPS — including for native-born workers! — could be too low.4

To cope, economists have used higher immigration estimates than Census’s to recalculate data points that are controlled to Census population estimates. They have also paid close attention to data sources that are not controlled to Census population estimates and therefore might more fully incorporate an immigration surge, like the establishment survey in the monthly jobs report that asks businesses how many workers they have on payroll. 

For instance, Hamilton Project researchers incorporated CBO’s higher assumptions in estimating the contribution of immigration to employment growth, consumer spending, and GDP. The Goldman Sachs research team has used an estimate closer to CBO’s than Census’s. And the Fed has used higher immigration assumptions in its own estimates of the size of the labor force than the baseline estimates that incorporate Census’s lower immigration numbers. If the Fed is paying attention, you know it’s not just an academic issue. 

Here's how this plays out. Immigration makes the labor supply grow faster, increasing how many jobs need to be created in order to keep labor supply and labor demand in balance. The Hamilton Project paper estimates that the level of job creation today that would keep pace with the labor supply is around 160-200 thousand jobs under CBO immigration assumptions, versus a range of 60-100 thousand underlower Census immigration assumptions. Therefore, when the economy added 142,000 jobs in August, that either means the economy added too many jobs relative to labor supply growth and risks overheating, if Census immigration estimates are right, or the economy added too few jobs and is weakening, if CBO immigration estimates are right. And that’s why the Fed cares: they are more inclined toward rate cuts if it looks like the labor market is weakening than if it’s overheating.

Getting immigration estimates right matters for projecting government finances, too, since immigrants spend money, pay taxes, and use public services. Higher immigration levels would boost GDP and reduce the federal budget deficit. Furthermore, if the true level of immigration is higher than the Census estimate and closer to the CBO figure, some other economic data puzzles start to make more sense. For instance, higher actual immigration might explain the faster employment growth reported in the monthly establishment survey than in the household survey. 

But what if economists have gone too far in assuming higher immigration than the Census estimate? A wide gap between estimates calls for lots of uncertainty and, ideally, humility. After last Friday’s jobs report, economist Julia Coronado quipped “I don't know who needs to hear this but you can't use immigration to explain everything you don't understand in the data.” 

And that’s the cue for today’s new Census survey data. You’ve waited long enough.

At last! What do we learn from the new Census data?

The brand-new 2023 American Community Survey reports that the number of foreign-born U.S. residents who lived abroad one year ago was just under 1.7 million in 2023, the highest level since at least 2010 and an increase from 1.4 million in 2022.

Another way to look at net international migration is the change in the foreign-born population year-to-year. The ACS reported that the foreign-born population in 2023 was 47.8 million, an increase of 1.6 million from the 2022 level. That year-over-year increase in the foreign-born population was also the largest since 2010, excluding the pandemic years when comparable data were not available.

Strikingly, the strong majority of net new immigrants to the U.S. in 2023 came from Latin America. Of the 1.6 million increase in the foreign-born population between 2022 and 2023, 76% of the increase was people born in Latin America: 49% from Central and South America, and 27% from Mexico and the Caribbean. That’s a large jump in Latin American immigration from the earlier years of the pandemic period (2019-2022) and a huge increase from the 2010s, when Asian immigration dominated. 

Within the US, immigrants are geographically concentrated. In California, 27% of its 2023 population was foreign-born, the highest among all states. The foreign-born share was above 20% in New Jersey, New York, and Florida, as well. At the other extreme, less than 3% of Mississippi, Montana, and West Virginia residents were foreign-born. Larger and more urban states tend to have higher foreign-born share, though North Carolina, Pennsylvania, Michigan, and Ohio have foreign-born shares well below the national average of 14.3%.

Since 2019, the foreign-born population has increased notably in the southern states of Alabama, Georgia, and Tennessee, as well as in Indiana and Pennsylvania. But the foreign-born population was almost unchanged in Arizona, California, Nevada, and Oregon over this period.

Next month, we’ll get a lot more insight into the characteristics of recent immigrants when Census releases the real goldmine -- the microdata -- which supports more customized analyses. 

Sorry. The immigration data puzzle isn’t resolved, and it could take years

Today’s new ACS data will be the basis for the immigration component of Census’s 2024 population estimate, due in December, along with revised 2023 population estimates. 

The 2023 ACS reported 1.7m foreign-born residents who were abroad one year ago, which is the key input into the Census immigration estimate. That key input has been highly correlated with the final revision of the Census immigration estimate since 2010 (the correlation is .91). If this strong prior relationship holds, I estimate that the new ACS figure of 1.7m foreign-born, abroad one year ago, implies that the Census population estimate for 2023 will be revised to over 1.4m. That’s 300,000 more than the original Census 2023 immigration estimate of 1.1m published in December 2023, but still way below the CBO’s 2023 estimate of 3.3m.

In other words: Using concurrent 2023 ACS data rather than lagged 2022 ACS data doesn’t do much to close the gap between the Census and CBO estimates. 

The fact that new high-quality ACS survey data probably won’t raise Census’s 2023 estimate much makes me put more weight on the Census estimate than I did yesterday. But it also raises my uncertainty about what the actual level is. I’d love more careful research about how much surveys might undercount immigrants and how much might administrative data overstate immigration, but in the meantime I, and other economists, need to update our beliefs.

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I also have nagging questions about the feedback loop between ACS survey data and Census population estimates. 

Remember that ACS survey data are controlled to Census’s population estimates — not just to the overall population estimates, but also to estimates for specific groups based on age, sex, race, and Hispanic/Latino ethnicity. Today’s new 2023 ACS results are controlled to the 2023 population estimates, whose immigrant component was based on 2022 ACS results, which were controlled to 2022 population estimates, whose immigrant component was based on 2021 ACS results… and so on. I don’t have a guess and don’t know how to calculate how much this recursive interdependence between the ACS survey data and the population estimates might cause any big, sudden change in actual immigration levels to be reflected more slowly in ACS data than it should. (Remember, ACS data and sample weights, unlike the population estimates, do NOT get revised.) 

Still, the new ACS data can help study the effect of immigration in other ways. Economists sometimes look at the variation across states or occupations or industries to make conclusions about overall patterns. Correlating new ACS data on changes in states’ foreign-born population, for instance, with state job growth or unemployment rates or wages could help assess the impact of immigration on the economy and, implicitly, the level of immigration. 

And the Census Bureau is researching how to incorporate short-term fluctuations in migration more quickly and to reduce any undercount of immigrants in living situations that are more challenging to survey. There might be methodological improvements coming — and lots of research about how they change the estimates. 

Economists will keep busy.

What the immigration puzzle shows about how the statistical sausage gets made 

Estimating immigration looks like a mess: multiple raw data inputs generated far-apart estimates, published by different agencies in different data products, that need to be triangulated, reconciled, and revised. 

But, it’s amazing that this debate can happen at all, and it’s only possible because of the wealth of statistics that are collected, disseminated, and documented. For each of the most important economic and demographic indicators — not just immigration — the statistical system creates multiple measures that often disagree and need to be reconciled. 

For the most part, having multiple ways to measure things is a feature not a bug. The many measures of a given indicator often differ in speed, comprehensiveness, or granularity. Initial estimates based on early available data get revised when more comprehensive or detailed data become available; employment, GDP, and population estimates all work this way. Different measurements also reflect conceptual differences. Just as Census surveys of the foreign-born and border-patrol encounter data are intended to measure different aspects of immigration, the two leading inflation measures are answering slightly different questions about the prices consumers face.

Furthermore, it’s a feature, not a bug, that federal statistics are often published at multiple levels of detail. 

The 2023 American Community Survey data was released this morning as a set of hundreds of tables on pre-selected topics, and the microdata will follow next month for researchers who want to dig deeper. Most major data releases include a narrative summary, charts, tables, and detailed data. This offers something for everyone, at all levels of data familiarity; it also reinforces transparency. You can’t fudge the numbers in a press release for long if researchers can see the underlying data.

Of course, the wealth of data can be maddening. The burden is on the data user to decide which measure to use, how to combine them, and how to interpret them. But even this burden is, in part, a feature rather than a bug. The statistical agencies are reluctant to steer users toward interpretations or conclusions, in an effort to maintain their independence from politics and partisanship. As BLS describes their just-the-facts stance on their website: “If asked, ‘Is the glass half empty or half full?’ At BLS, we see an 8-ounce glass containing 4 ounces.” 

In other ways, though, the burden on data users is definitely a bug. The agencies’ sites can be hard to navigate, and specific data are often tricky to find. I happen to know that the key data point from today’s ACS release for estimating immigration is the number of foreign-born residents who lived abroad one year ago, and that data point is on line 28 of table B07007. But I know that only after closely reading methodology documents, talking to staff, and digging through pages of search results and table shells.

The fragmentation of the U.S. statistical system adds to the challenge. There are thirteen principal statistical agencies, including the Census Bureau, BLS, and the Bureau of Economic Analysis (BEA). They are in some ways independent and in other ways interdependent, often relying on each other for key inputs into their own products, and sometimes seem to overlap. Both BLS and BEA produce inflation data, all three publish wage or income data, and so on. Statistical agencies — and sometimes even divisions or products within one agency — use different conceptual definitions, different geographic definitions, or different occupation and industry taxonomies. There’s typically detailed documentation for individual data products and releases, but much less documentation and guidance about how to compare, contrast, or combine data from different programs or agencies.  That’s left to users to figure out.

Occasionally the agencies flub. In recent months, BLS has had multiple instances where some users ended up getting access to data or technical explanations earlier than others. Census users have had their own frustrations, over plans and communications around new respondent-privacy protections that would make data less accurate and usable. The statistical system needs to invest more in user experience and in collecting and incorporating user feedback. Data users should take advantage of every opportunity to be heard, such as commenting on Federal Register Notices and participating in user groups and advisory committees.

All that said, the statistical agencies face real and serious external challenges. Rising costs and tight budgets threaten critical data products; declining survey response rates require new approaches; and the risk of inappropriate political interference is always near. Still, they produce an immense range of data, are widely trusted, and are careful and transparent. The US statistical agencies are global leaders in many areas of international coordination. And the technical staff at Census, BEA, and BLS who have answered my technical questions over the years are, without exception, responsive, patient, knowledgeable, and dedicated.

Measuring immigration and everything else that matters is messy, hard, and important. We are fortunate to have data and experts we can trust to help solve these puzzles.

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1

Questions about birthplace and citizenship are not currently asked on the decennial Census.

2

Here’s a good overview comparing survey and administrative data on immigration. See also detailed explanations and comparisons by CBO and Census. Census “routinely cautions against” using CPS survey data for immigration estimates because of its small sample size, as CBO does; note that this is a Census staff working paper rather than the official views of the U.S. Census Bureau.

3

ACS, like CPS, also is controlled to the Census population estimates. That means neither survey yields an independent estimate of the level or growth of the population.

4

This doesn’t mean that the rates and percentages from the CPS are too low. The key statistics from the CPS, like the unemployment rate, are rates or percentages. Economists know about this issue and rarely use level data from the CPS.

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mareino
1 day ago
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Kids, don't go into AI, go into data collection and analysis. It's the input that everything else lives off of.
Washington, District of Columbia
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Get your hand out of there!

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mareino
4 days ago
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