Posts Tagged ‘David Leonhardt’

Health Care Reform: Choice and Security

Tuesday, July 28th, 2009

There’s been a lot of commentary and puzzlement in the opinionsphere about exactly how Obama is trying to sell his health care reform. Part of the problem is that our system is messy – and Obama does not feel it is feasible to try to start anew. So, instead, Obama is seeking to accomplish two goals with his reform: to “bend the curve” of overall spending on health care; and to provide some form of health insurance to those Americans without it. The problem is that each of these problems seem to be inherent parts of our status quo – as the health insurance industry has sought to drive down medical costs not by incentivizing cheaper effective treatments as in most industries, but by purging the sick from its coverage. Ezra Klein describes this business model most vividly:

Private insurance is a bit like a fire department that turns a profit by letting buildings burn down.

But, as medical professionals swear an oath to provide aid to those who need it, hospital emergency rooms and the government then are forced to pick up the slack. Thus, the health insurance model does not reduce the cost of health care but merely pushes these costs onto the rest of us. This is at least part of the reason America pays about $6,500 more for health care per person – as David Leonhardt writes:

We may not be aware of this stealth $6,500 health care tax, but if you take a moment to think, it makes sense. Over the last 20 years, health costs have soared, and incomes have grown painfully slowly. The two trends are directly connected: employers had to spend more money on benefits, leaving less for raises.

In exchange for the $6,500 tax, we receive many things. We get cutting-edge research and heroic surgeries. But we also get fabulous amounts of waste — bureaucratic and medical.

One thing we don’t get is better health than other rich countries…

This isn’t the only thing causing health care costs to rise so quickly – but it is the most obviously flawed compenent of our system and one of the drivers of the escalating costs and declining level of care. And it is very unclear what benefits – if any – our health insurance model provides. It is an industry which seems designed purely to create profits for a select few and disburse costs to the population at large.

Obama has done rather well in making this case – in attacking the status quo. But the question is: What is he offering? Matt Yglesias suggested, “Health care security” and I think that’s about right. Obama expressed the same idea:

Reform is about every American who has ever feared that they may lose their coverage…

At the same time, as Ezra Klein points out, most people are currently satisfied with their health care – and want more choices rather than less. Klein suggests:

The answer, put simply, is that you don’t institute rapid change. You don’t take what people have. But you give them the option to trade up to something better. As the theory goes, if the current system really is so inefficient, and your alternative really is so much better, then the lure of lower costs and better quality will persuade Americans to switch to the new system of their own accord.

The policies to address these issues are there – in some form in the plans being discussed. The measures that deal with these should be strengthened. And the positive case for health care reform should be simple, always repeated the words choice and security:

Health Care Reform: Delivering Security and Choice to the Middle Class

[Image by dmason licensed under Creative Commons.]

The Federal Reserve, Henry Gates, Popular Policies, Health Care, Krugman on Cap and Trade, and High Times

Friday, July 24th, 2009

1. Down with the Fed! William Greider suggests we “dismantle the temple” that is the Federal Reserve in a piece this week. Greider is not only one of my favorite authors and one of the best writers on economics, he is also one of the foremost experts on the Federal Reserve. They key problem for Greider is that the Federal Reserve is an essentially anti-democratic institution:

The Federal Reserve is the black hole of our democracy – the crucial contradiction that keeps the people and their representatives from having any voice in these most important public policies.

Ezra Klein gives the piece a symapthetic audience, but then explains his reservations:

[F]or a period of time, Ben Bernanke ran our economy under a monetarist’s version of martial law. And the really problematic thing is that it probably worked. It may be all that saved us. You could argue that in the absence of the Federal Reserve, Congress would have been a whole lot more aggressive and responsible because Bernanke wouldn’t have been there to backstop them. But would you really want to bet the U.S. economy on it?

2. Sanity on the Henry Gates Controversy. Jacob Sullum in Reason‘s Hit ‘n’ Run blog gives what I think to be the essential take-away from the Gates fiasco:

[E]ven if we accept the facts as presented by Crowley, it’s clear he abused his authority, whether or not the color of Gates’ skin had anything to do with it.

Let’s say Gates did initially refuse to show his ID (an unsurprising response from an innocent man confronted by police in his own home). Let’s say he immediately accused Crowley of racism, raised his voice, and behaved in a “tumultuous” fashion. Let’s say he overreacted. So what? By Crowley’s own account, he arrested Gates for dissing him.

3. The Appearance of Bipartisanship Creates Popularity. Matt Yglesias has an interesting piece exploring the difference between how the media treats the relationship between public opinon, Congress, and policy issues and how that relationship actually works.

4. Imitation is the Sincerest Form of Flattery. Ezra Klein points out that one passage from Obama’s speech Wednesday night seemed to be taking arguments directly from articles by Steven Pearlstein and David Leonhardt this week that got a lot of traction in the blogosphere. Both columns are worth reading even independent of their apparent influence on the Obama administration’s tactics.

5. Krugman on Cap and Trade Speculation. Paul Krugman takes on doubters encouraged by Matt Taibbi’s piece describing cap-and-trade as a giant scheme:

The solution to climate change must rely to an important extent on market mechanisms — it’s too complex an issue to deal with using command-and-control. That means accepting that some people will make money out of trading — and that yes, sometimes trading will go bad. So? We’ve got a planet at stake; it’s crazy to cut off our future to spite Goldman Sachs’s face.

6. A Laid-back Beat. Lastly, I came across this song in an episode of the British series Skins this week:

[Photo by me.]

Mirror Neurons, Iran’s Fissures, Yglesian Insights, The Deficit Crisis, Rare Minerals

Friday, June 12th, 2009

Once again, it’s Friday, so it’s time for my weekend reading recommendations.

1. Mirror Neurons. Daniel Lametti explains the importance of mirror neurons in the Scientific American.

2. Iran’s Fissures. Roger Cohen has been prominently writing about Iran for the past year or so – predicting and pushing for a thaw in relations. Now, on the cusp of an important election, Roger Cohen discusses Iran:

Iran, its internal fissures exposed as never before, is teetering again on the brink of change. For months now, I’ve been urging another look at Iran, beyond dangerous demonization of it as a totalitarian state. Seldom has the country looked less like one than in these giddy June days.

3. Yglesian insights. Matt Yglesias’s blog has long been on my must-read list – but he’s offered some especially insightful observations in various contexts about the free market in recent weeks. Here Yglesias speculates about the advantages of non-profit-maximizing corporations in a free market:

After all, profit-maximization is not a natural form of human behavior. I think it’s best understood as a very idiosyncratic kind of pursuit. It happens to be one that’s economically rewarded because with money to invest tend to want to invest it with would-be profit-maximizers. Thus, in fields of endeavor where the ability to raise large sums of capital on reasonable terms is a huge advantage, a profit-maximization impulse winds up being a huge advantage.

In a later post about health care, Yglesias makes a related point:

[P]art of what’s wrong with the world is that the very same people who spend a lot of time cheerleading for free markets and donating money to institutions that cheerlead for free markets—businessmen, in other words—are the very people who have the most to gain from markets being totally dysfunctional. The absolute worst place on earth you can find yourself as a businessman is in the kind of free market you find in an Economics 101 textbook. As a market approaches textbook conditions—perfect competition, perfect information, etc.—real profits trend toward zero. You make your money by ensuring that textbook conditions don’t apply; that there are huge barriers to entry, massive problems with inattention, monopolistic corners to exploit, etc.

4. How to tackle the deficit crisis. Set off by David Leonhardt’s excellent look at the forthcoming deficit crisis, the Opinionsphere quickly took this up as a theme of the week. Noah Millman at The American Scene had the best take on how to tackle the deficit crisis – once we decide to get serious. One of the main ways he suggests is to reform the tax code:

We have an income tax that is riddled with deductions that undermine its purported progressivity, and we rely on increasingly steep progressivity to justify every additional change to said code. A 1986-style reform that eliminated many deductions and lowered rates would not only be a likely booster of the economy, but would probably raise revenue – certainly on the corporate side.

5. China’s Great Game. And of course, the Financial Times reported that China has almost cornered the world market in rare minerals needed for most high tech products. I’m looking forward to some analyst really following up on this and explaining what implications – if any – this has.

Obama’s Grand Bargain (as a necessary response to the deficit problem)

Wednesday, June 10th, 2009

David Leonhardt has a typically excellent piece in the Times with a helpful graph explaining the deficit problem. Leonhardt tells the story of how the $800 billion surpluses left by Bill Clinton have turned into $1.2 trillion deficits – or what he calls the “$2 trillion swing.” He identifies four categories of spending accounting for the swing in descending order of significance:

the business cycle, President George W. Bush’s policies, policies from the Bush years that are scheduled to expire but that Mr. Obama has chosen to extend, and new policies proposed by Mr. Obama.

Leonhardt identifies only 10% of the current deficit as resulting from either Obama’s stimulus package or new spending (which is only 3%). 20% of the deficit is traced to Bush policies set to expire that Obama is continuing – for example, a large portion of Bush’s tax cuts and the Iraq war. 33% comes from legislation signed by Bush – like the Medicare prescription act. And Leonhardt attributes 37% of these enormous deficits – the single largest factor – to the combination of increased counter-cyclical spending (on food stamps, unemployment, etc.) and a decrease in government revenues resulting from the downturn.

This math is a large part of what made those Tea Parties – as well as so much of the Republican opposition – ridiculous. First, these Tea Parties – and most of the opposition – was silent while George W. Bush pushed through legislation account for 53% of the current deficit – but suddenly was up in arms once a Democrat proposed 10% in spending to stimulate the economy and fix some significant problems. At the same time, many of those conservatives who were strong opponents of Bush continue to propose more tax cuts. In fact, during the debate over the stimulus bill, Republicans denounced the deficits being caused by government spending while proposing a tax cut bill that would create even large deficits.

What Leonhardt describes is a nation that has been subjected to the conservative “starve the beast” strategy of cutting taxes and increasing spending. This deliberate policy has brought us to the brink of disaster – as George Will describes:

For years, many conservatives advocated a “starve the beast” approach to limiting government. They supported any tax cut, of any size, at any time, for any purpose, assuming that, deprived of revenue, government spending would stop growing. But spending continued, and government borrowing encouraged government’s growth by making big government cheap: People were given $1 worth of government but were charged less than that, the balance being shifted, through debt, to future generations. In 2003, Republicans fattened the beast with the Medicare prescription drug benefit (Cooper opposed it), which added almost $8 trillion in the present value of benefits scheduled, but unfunded, over the next 75 years.

Liberalism’s signature achievement — the welfare state’s entitlement buffet — will, unless radically reduced, starve government of resources needed for everything on liberalism’s agenda for people not elderly. Conservatives want government limited, but not this way.

Leonhardt quotes Alan Auerbach, an economist at the University of California, Berkeley,

Bush behaved incredibly irresponsibly for eight years. On the one hand, it might seem unfair for people to blame Obama for not fixing it. On the other hand, he’s not fixing it.

And not fixing it is, in a sense, making it worse.

I think Andrew Sullivan has the right tack on this:

I don’t blame Obama for failing to turn all this around in five months, and for running a debt this big right now. I willblame him if he does nothing serious to tackle this in the next year.

Leonhardt has been a reporter with good access to the White House in these early days of the presidency. Which suggests that this article is not coming out of the blue for this administration. In fact, shortly before taking office, Obama talked about the “Grand Bargain” he would need to negotiate to deal with precisely this issue. It seems to me that this piece begins to set the stage for what Obama is looking to do after cap-and-trade and health care are passed – to tackle the issues of tax reform and entitlement reform.

All this makes his continued and extraordinary attempts to woo members of the House and Senate – and his efforts to give them a role in determining policy (as described in Matt Bai’s new article) – essential. As Bai describes:

“One of the mistakes of the past is that when presidents arrive on Capitol Hill with legislation chiseled into stone, it’s not well received,” says David Axelrod, one of Obama’s most influential advisers. “You have to give people a sense of ownership.”

Obama seems to have decided early on that his model for pursuing legislation would be something closer to Ronald Reagan, a president whose political savvy he has often expressed admiration for. Partly by necessity, because he had to work with a Democratic Congress, Reagan was known for providing broad policy frameworks while delegating the details to lawmakers. In this way, he managed to fundamentally reform the tax code and shore up Social Security during his first year in office — achievements for which he gladly took credit, even if Congress didn’t give him precisely what he wanted. To this end, Obama’s chief health care adviser, Nancy-Ann DeParle, has been all over Capitol Hill, consulting with various members and soliciting their advice, but the administration has been careful not to weigh in with too much authority or to make any public pronouncements on the negotiations.

Obama may have been able to push through health care and cap-and-trade with his Democratic majorities and personal popularity. But he needs the Congress and Senate to work with him on tax reform and entitlement reform once the financial crisis has been dealt with. Or perhaps sooner – as the bond market pressures the administration to set a clear path which involves a return to fiscal sanity.

To do this, Obama needs the trust and support of a large majority of Congressmen and Senators. And he needs to mobilize public and elite opinion to support a significant change in our tax and spending policies. This article by David Leonhardt strikes me as an attempt to set the stage for this soon-to-be debate.

[Picture by Peter Souza courtesy of the White House.]

Obama & Trade

Thursday, November 13th, 2008

I’ve heard from a few people that there is a growing concern that Obama is anti-free-trade.

This concern has a basis in Obama’s record – mainly from his rhetoric in Ohio during the primary fight with Hillary Clinton and to some extent the fact that he is a Democrat and needed the support of the labor unions. But to a large degree the exaggerated fears of many businessmen comes from comments made by the Republicans during the campaign – as John McCain’s campaign was first (ridiculously) calling Obama “the most protectionist candidate that the Democratic Party has ever fielded” before his campaign went on to call Obama a supporter of comprehensive sex education for kindergartner, a Marxist, a socialist, and a friend to terrorists.

This has led to a series of conflicting impressions of Obama and his position on trade – from statements during the Ohio campaign that “we can’t keep passing unfair trade deals like NAFTA that put special interests over workers’ interests” to his later point – when asked about his rhetoric about NAFTA during the Ohio campaign that, “Sometimes during campaigns the rhetoric gets overheated and amplified.” Indeed – despite the appeal of populist protectionist rhetoric (some 60% of Americans think free trade and NAFTA have been bad for people like them), Obama chose to attack protectionism in the general campaign: “[n]ot only is it impossible to turn back the tide of globalization, but efforts to do so can make us worse off.” At least in part, Obama’s friendlier stance towards free trade has to be understood as a tactical move on his part as he was certain to be to the left of McCain on this issue. McCain has never even made an issue out of any labor or environmental protections relating to the issue and would have had serious problems with economic conservatives if he moved to the left on this issue as they never trusted him to begin with.

Even aside from the change in rhetoric, there is considerable evidence that has led numerous reasonable observers to believe Obama is, in fact, in favor of trade even as he is concerned with some of free trade’s side effects on American workers and the economy. Obama, for one, described himself as a “pro-growth, free-market guy.” Even the arch-conservative Weekly Standard was forced to concede in the midst of the general election campaign that Obama’s two main economic advisors Jason Furman and Austan Goolsbee, while liberals, were “centrist, pro-free traders.” George F. Will, my favorite columnist and a paleo-conservative – described Goolsbee as the best sort of liberal economist his conservative leanings could imagine:

Goolsbee no doubt has lots of dubious ideas – he is, after all, a Democrat – about how government can creatively fiddle with the market’s allocation of wealth and opportunity. But he seems to be the sort of person – amiable, empirical and reasonable – you would want at the elbow of a Democratic president, if such there must be.

Naomi Klein attacked these two herself as ideologically impure in a piece in The Nation magazine – and while I find Klein to be provactive, I think a pro-free trader could hardly have a better endorsement than an attack by Klein.

Obama’s official position on trade has remained consistent – even as his focus has changed over the course of the campaign. What has struck me about all of Obama’s positions is the extent to which they begin with an appreciation of conservative ideas – as his health care plan works within the market rather than by goverment fiat; as his stance on affirmative action reflects traditional concerns about whether we are trying to ensure the equality of oppurtunity or equality of the ends. His views on trade seem similar – as he embraces free markets and free trade – but wants to mitigate the negative side effects.

The Council on Foreign Relations, a group with a considerable interest in free trade, vouched for Obama’s support:

Sen. Obama (D-IL) generally supports free trade policies, though he has expressed concern about free trade agreements that do not include labor and environmental protections.

Tim Hanson and Nate Weisshaar of the Motley Fool probably best described the most reasonable concerns about Obama’s record on trade in their piece asking “Will Obama End Global Trade?” (the answer was, “Nope.”):

While Obama’s campaign literature will tell you that his goals are fairer trade, more assistance for displaced American workers, and greater global environmental protections, there is some global worry that an Obama administration might impose and sustain protectionist policies in order to reward labor union support for his campaign and get our economy back on its feet.

As private sector labor unions have been decimated in the global economy, and as Obama and the liberal consensus views them as part of the solution rather than a major problem, it’s hard to see exactly what steps Obama can take to rejuvenate unions.

In the end, the best way to understand and predict Obama’s trade policies is as part of his view of economics in general. Obama’s economic positions are consistent with a broad Democratic consensus that has emerged in the past decade – bringing together the two warring sides of the Clintonian era, short-handed as Robert Rubin versus Robert Reich for Clinton’s Labor and Treasury Secretaries. The Rubin school believed in expanding free trade, reducing deficits, encouraging overall growth without regard to it’s distribution, and deregulation. The Reich school believed in protecting labor unions, mitigating the effects of globalization through an expanded safety net and job-retraining programs, environmentalism, and was concerned with inequality. Over the past decade, many figures on both sides of this ideological divide have found worth in the ideas of their one-time competitors – as David Leonhardt’s New York Times Magazine piece called “Obamanomics” explained.

This Democratic consensus views free trade as a positive force in the world – but one that has numerous side effects that are negative. The role of government in this picture is to try to mitigate the negative effects of free trade – especially those temporary effects of the transition to a more globalized economy. Most of Obama’s domestic agenda is designed to accomplish these purposes – from the investment in a green energy industry to investment in infrastructure to health care reform to financial reforms. His nuanced position on trade reflects this same desire – to mitigate the destabilizing effects of globalization while acknowledging it’s benefits.

Obamanomics

Tuesday, August 26th, 2008

In the past ten years, a Democratic consensus has emerged from opposing poles represented by Robert Rubin, Secretary of the Treasury under Clinton, and Robert Reich, Secretary of Labor under Clinton.

The consensus stems from a shared conclusion:

In the past generation, the American economy has been benefiting the vast majority of Americans less and less; and the trends that are causing this cannot be stopped.

There are many factors that have caused, worsened and continued to escalate this core problem:

  • the demise of America’s manufacturing base;
  • the increasing gap between the pay of CEOs and top corporate officials and the average worker;
  • the way the tax code has begun to tax labor at a far higher rate than it taxes capital;
  • the shrinking of organized labor;
  • the increasing instability due to globalization.

All of these are the symptoms and all of these are the causes.

Our economic system is breaking – the middle class is being squeezed; we are transferring a tremendous amount of our wealth to autocracies and our rivals around the world because of our dependence on oil; budget deficits are burdening our government which now practices a nefarious for of socialism, only for the rich; globalization is creating insecurity; our society is becoming more stratified1, with many traditionally class-conscious European countries becoming more socially mobile; our infrastructure is eroding.

Barack Obama’s answer to this – accepting the Democratic party consensus – is a mix of short-term and long-term measures.

  • To alleviate the squeeze on the middle class as certain industries leave America looking for cheaper labor, he proposes to create jobs with infrastructure improvements and to push the development of a green energy industry.
  • To aid small businesses and to reduce the instability created by the greater turnover in jobs in a globalized marketplace, he proposes a universal health care plan that combines a government plan open to all citizens, various incentives for businesses to offer coverage, and various incentives for individuals to get coverage on their own.
  • With regards to taxes, he proposes tax cuts (graph) to those who need it and tax increases to those who have benefited most from our society – those making over $250,000.00.
  • To prepare the next generation for the globalized marketplace, Obama proposes various improvements to education.
  • Barack Obama is also the only candidate who has pledged to protect the foundation of the internet. (John McCain has recently come off the fence to support a policy that directly undermines the architecture of the internet since it began.)

For a more in-depth and reflective look at Obamanomics, check out David Leonhardt’s cover story this weekend in the New York Times Magazine.

Addition: What Obama and the Democrats have been struggling with is a way to frame this in a visceral way that can be easily understood. Here’s my proposition:

McCain and the Republicans want to give big corporations whatever they want – even if it hurts American in the long term. (Offshore drilling; telecom immunity; free trade without sensible provisions regarding labor and environmental regulation; tax cuts on corporations and the wealthy while the government needs more income; opposing the protection of the basis of the web, net neutrality, so that internet providers can make a bigger profit.)

Obama and the Democrats want corporations to do well, but at the same time, they want to protect American society from the destabilizing forces of globalization and to protect what has made America the most prosperous nation on earth – including a stable middle class and social mobility – both of which we are in danger of losing due to reckless Republican policies.

That’s the narrative – it’s not class warfare. It’s about protecting what has made America great against the forces of globalization, overly greedy corporations, and rapid change.

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