Posts Tagged ‘Mark Schmitt’

Health Care Lie #492*: A Government Takeover of 16% of the Economy

Wednesday, August 19th, 2009

*I’ve stopped counting, so that number is made up.

[digg-reddit-me]We’ve all heard this claim – that Obama’s health care reform – specifically the public option – is really a stealth attempt to socialize America and have the government take over a significant portion of our economy.

This claim isn’t true. However, unlike the fearmongering that is the invocation of “death panels,” there is a bit more substance to this accusation. But like so much of this debate, it has little to do with the bills currently under consideration which have rather weak public options. What this claim is based on are the hopes of progressives that the public option could prove to the country how great and effective government health care is and thus lead to a single-payer, Medicare For All type system.

According to Mark Schmitt of The American Prospect, the public option was latched onto by progressives early on as a potential “stealth” tool to gradually move America into a Medicare-for-all type system – as they assumed that given the choice, most citizens would prefer government-run health care. As Ezra Klein summarized Schmitt’s piece:

The reason the idea managed to catch the liberal establishment’s imagination was that it was sold as a way of achieving single-payer, or something close to it, within the current constraints of the political system.

Those on the right wing saw the fervor that accompanied discussions of the public option and soon identified it as a potential target. But the public option wasn’t designed to work as a stealth tool. Its main designer and earliest promoter, Jacob Hacker saw his policy “as an alternative to single payer” and “as a competitive alternative to private insurance” – in other words, as a way to maintain some of the advantages of the system a large number of Americans currently have while offering a different model of competition to keep insurance companies honest. The initial design of the public option – which remains intact today – would create a self-sustaining, non-profit agency that competes with private plans on a Health Insurance Exchange. Perhaps the best explanation of why this would work comes from Michael F. Cannon of the Cato Institute who – while trying to attack the possibility of a public option – made this observation:

Any payment system creates perverse incentives…which is why we need competition between different payment systems to temper the excesses of each. So if Kaiser Permanente is skimping on care, which is the perverse incentive its payment system creates, there are fee-for-service insurers on a level playing field that can lure patients away from Kaiser. That tempers the rate at which Kaiser succumbs to those perverse incentives…

This understanding of how markets work – and how a competing payment system could improve health care for all – is exactly the reason so many people were in favor of a choice between a public option and private ones before the current fear-mongering campaign.

Hacker’s policy is what President Obama has decided he wants in a public option, as he explained Time‘s Karen Tumulty:

It shouldn’t be something that’s simply a taxpayer-subsidized system that wasn’t accountable, but rather had to be self-sustaining through premiums and that had to compete with private insurers.

Tumulty later described Obama’s position on the public option:

Obama has never presented the public option as anything other than a means to an end — one that he would be perfectly willing to achieve through other avenues if necessary. His goal is twofold: to provide a low-cost alternative to the private system that already exists and to assure competition in a health-care market where it is generally lacking.

Further demonstrating that the goal of Obama’s health care reform is not to stealthily push America into a Medicare For All program, he has signalled he would be willing to accept a co-op in place of the public option. However, while Republicans had promoted the idea of co-ops as an alternative to the public option, they now are quickly moving away from this position. Ezra Klein explains:

This is a dynamic we saw in 1994. A compromise is offered, and after great anguish and infighting, Democrats grudgingly move toward it. Then the compromise is yanked away. The famous example of this is Bob Dole voting against two bills that had the name “Dole” in the title.

Someone here is acting in bad faith and has a secret agenda. It doesn’t seem to be the Democrats.

Conclusion: The public option could become a stealth path to single-payer. Just like Medicare could. Or Medicaid. Or S-Chip. Or any other legislation that has ever dealt with the serious problems in our market for health insurance. But what we’re seeing now isn’t a stealth option – as much as both progressives and right wingers may want to pretend it is. If our nation is moving towards a single-payer Medicare-for-all-system, this legislation isn’t what will get us there. That fight will come later.

And for what it’s worth: the public option isn’t the most important part of health care reform. The Health Insurance Exchange (on which the co-op or public option would sit along with private companies) is more important – as are the various reforms of the health insurance industry.

(Some other resources on the public option are this Slate magazine piece from 2006 and this report by Jacob Hacker on the advantages of allowing the public to choose a public option.)

[Image not subject to copyright.]

Right wingers, desperate to return to power, turn to the man they demonized, Saul Alinsky

Thursday, August 13th, 2009

[digg-reddit-me]A while back, I described what I saw as a characteristic of reactionaries to “internalize” an exaggerated view of their enemies’ ideology and tactical supremacy. Because of this, I wrote:

What ends up happening in many of these reactionary groups is that they construct themselves on a model based on their worst fears of their enemy.

I cited a few examples – from the John Birch Society organizing in self-sufficient cells like they imagined the Communists did to Dick Cheney’s presumption that terroristic violence was supremely effective. Now, with the rise of the anti-health insurance reform movement, we see another example of a reactionary movement that has internalized an exaggerated view of their enemy – and then adopted it for themselves.

As David Weigel firmly establishes in a piece for the Washington Independent, the tactics and strategies behind these town hall disruptions and other attempts to block health insurance reform are linked to the right-wingers’ reading of Saul Alinsky – who many right-wingers see as Obama’s closest mentor (though Obama never met him.) Alinsky and his methods were widely discussed by right wingers in the lead up to the election – and they took on the air of a biblical text after it – as every word or action by the Obama administration has been explained by reference to an obscure reference to something Alinsky wrote. The interest of the right-wing in Alinsky has actually caused his books to jump up the book charts. (Tellingly, Amazon’s reccomendation engine demonstrates in its “Users Who Purchased This Item Also Bought” section that the buyers are mainly right-wing.) And a new book will be coming out soon adopting Alinsky’s techniques for right-wing activists.

Though these right wingers have taken to calling themselves “Alinsky-cons,” one thing these right wing activists seem to have missed about Alinsky was his focus on community organizing and engagement with power. This is the part of Alinsky that Obama has adopted – as he has sought to demonstrate his good faith to his opponents, and to engage them as if they were acting in good faith – in other words, to use civility and respect as political weapons. As Mark Schmitt wrote in  piece for The American Prospect:

One way to deal with that kind of bad-faith opposition is to draw the person in, treat them as if they were operating in good faith, and draw them into a conversation about how they actually would solve the problem. If they have nothing, it shows. And that’s not a tactic of bipartisan Washington idealists – it’s a hard-nosed tactic of community organizers, who are acutely aware of power and conflict. It’s how you deal with people with intractable demands – put ‘em on a committee. Then define the committee’s mission your way.

But these right wing protesters are not trying to demonstrate their good faith efforts to engage with reality and to win over undecideds. Instead, they are seeking to stop debate and discussion and to deliberately simulate that their opinions are common. They offer no solutions to the problems health insurance reform addresses – only chants to be used to overpower those who want to discuss the solutions they are offering.  One veteran community organizer and a student of Alinsky’s method described his response to the right wing adoption of Alinsky:

“They polarize,” said Galluzzo. “They’ve got that part down. They do direct action. But that’s not the kind of organizing we do. We end up building relationships with the people we oppose. I’m not going to go up to Mayor [Richard] Daley and say ‘you’re just a Nazi.’ I want to end up working with him.”

But according to Galluzzo, if Alinsky could take a look at the Alinsky-cons, he’d call them “petty protesters” who want to destroy the system without offering solutions. “If you just go around calling people assholes,” Galluzzo said, “you’re not going to get anything done.”

While Alinsky’s methods were designed to force those in power to be accountable to the people they have power over, these Alinsky-cons have adapted Saul Alinsky’s methods to simulate a large opposition. As an influential memo by one of the right wing groups organizing these sessions advises:

Spread out in the hall and try to be in the front half. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington.

And while Alinsky’s methods are supposed to start a conversation with those in power, the methods of the Alinsky-cons have a different aim – as Paul Grenier quoted a right wing organizing memo in the Baltimore Sun:

Try to rattle [the congressman], not have an intelligent debate.

The deliberate method of these Alinsky-cons is to distract the public from the actual reforms at issue – by combining Rovian fear-mongering with Alinsky’s disruptive methods. And what you get is a big mess – and the preservation of the unsustainable status quo.

Obama and the Technocrats

Monday, August 3rd, 2009

[digg-reddit-me]Last week I wrote about Obama’s focus on using technocratic institutions to tackle the nation’s most intractable problems. I attributed to Obama a particular attitude towards our current media-political system – one consistent with many reformists – and then explained how Obama was seeking to push the change he had campaigned on, the difficult choices, onto these technocratic institutions, thus solving his political and policy problems at once. But by outsourcing significant authority to these bureaucratic and independent (and thus not quite accountable) organizations – from IMAC to the Federal Reserve to the National Infrastructure Bank – Obama was bleeding authority from elected institutions. At the same time, I tend to agree with the reformist critiques that recount the massive failures of our current media-political system to tackle most (if not all) long-term structural problems.

But since I’ve written this, I have come across a number of pieces challenging this idea from various perspectives on the left.

Mark Schmitt, an editor for the progressive The American Prospect, saw Obama’s approach as the opposite of what I did – though he focused on national security and justice issues. Schmitt agrees with the reformist attitude I attribute to Obama, writing:

[T]he idea that America’s “existing democratic institutions are strong enough to deliver accountability” flies in the face of all observed reality. For at least eight years, those institutions consistently failed to deliver accountability, and the Department of Justice and courts likewise failed to punish some of the greatest abuses of power in our history.

But he is himself frustrated that Obama does not share it. He concludes:

It takes some discipline to understand that organizational culture, not organizational structure, determines success or failure. And it takes a lot of patience to wait for an organizational culture to turn around and resist the temptation to add a commission here, a new agency there. Obama’s organizational discipline was the hallmark of his campaign, and we can only hope that his unyielding insistence that “our existing democratic institutions are strong enough” will eventually make them so.

Benjamin Wallace-Wells writing in The New Republic strongly disputes any attempts to link Obama’s technocrats with Kennedy’s technocrats (as I did) – writing that the Kennedy men weren’t brought down by their knowledge and rationality, but instead:

Their error was an excess of ideology; they were not empirical enough.

He concludes that the brilliant men of the Kennedy administration are different from the brilliant individuals of Obama’s:

Kennedy chose as his defense secretary the president of a car company. Obama chose the sitting secretary of defense. Obama’s brainiacs–people like Larry Summers and Tim Geithner and Peter Orszag–come from a different meritocracy than Kennedy’s did. They are not brilliant generalists. For better or for worse, they are experts.

It is clear that Obama’s technocrats are of a different sort than Kennedy’s – and I made that point as well. It also seems that many of them are students of history and have attempted to learn the lessons of their predecessors – from John Kennedy’s and Lyndon Johnson’s “best and brightest” to Clinton’s New Democrats. But I’m eager to see some commentary dealing with the fact that Obama has found an elegant solution to many of these intractable and politically fraught problems – from global warming to health care to financial regulation to infrastructure spending – an independent, technocratic institution that removes political considerations from these decisions and thus receives relatively broad bipartisan support. (I believe the independent agency proposed to tackle each of these problems has some bipartisan history.) And then to tease out what the potential implications and pitfalls of this are.

Because while Schmitt and Wallace-Wells make good points in disagreement with my thesis – their supporting facts do not undermine my point, just their broader generalizations from these facts.  Clearly – Obama respects existing institutions more than I gave him credit for – especially in the areas of national security and justice (and even financial regulation you could argue.) But it’s also clear that Obama’s solutions to many difficult domestic policy questions are to outsource the hardest decisions to incrementalist, technocratic, independent institutions.

[This image is not subject to copyright.]

What Do Matt Yglesias, Ezra Klein, and Che Guevera Have in Common?

Friday, July 31st, 2009

[digg-reddit-me] Answer: Not much.

But Democracy in America’s anonymous blogger seems to think that some of liberal bloggers Ezra Klein’s and Matt Yglesias’s recent posts suggest a new and profound (indeed revolutionary) disenchantment with our means of governance. DiA cites Klein who recently wrote:

[Health care] like climate change, is a litmus test for our government. Both are serious, foreseeable and solvable threats to our society. One threatens to bankrupt the country. The other threatens irreversible damage to the planet we live on. Responding to such threats is the test of a political system. And our system will fail it. We will not avert catastrophic climate change. We will not protect ourselves from health-care inflation.

Yglesias recently wrote this post I’ve noted before explaining how our current media-political system can be manipulated so easily by people acting in bad faith – and how that leads to bad policy outcomes.

DiA tries to summarize this generation of pundits and policy wonks – led by Klein and Yglesias:

Mr Klein exemplifies the generation of young left-leaning policy wonks, journalists and activists who have been formed politically by the reaction against Bush-era conservatism, and for whom the Obama presidency represents the first experience of wielding political power. Like Mr Klein, many of these young progressives are fundamentally moderate, process-oriented wonks who, long before the Obama campaign even began, had accepted that the pragmatic limitations of real-world American politics rule out any utopian, or even first-best, solutions to most public-policy problems. They have happily dedicated themselves to figuring out what kinds of reform are possible within the constraints of corporate and interest-group lobbying, ideological and partisan divisions, and America’s kludgey, creaking 220-year-old machinery of government.

But now, DiA suggests, they have abandoned this moderation and want a revolution – that they have become disillusioned about our media-political processes due to Obama’s lack of success.

Certainly, Klein and Yglesias are extremely critical of the processes by which policy is created and by which the public views and understands policy debates. They believe that this system is broken. But both believed this before Barack Obama’s recent troubles – as Yglesias himself pointed out in response to DiA.

What DiA is missing is that reformists (towards both the right and left, but here I will look only at the left) have long been extremely critical of our media-political process works. Just two days ago, in The American Prospect, executive editor Mark Schmitt wrote:

[T]he idea that America’s “existing democratic institutions are strong enough to deliver accountability ” flies in the face of all observed reality. For at least eight years, those institutions consistently failed to deliver accountability, and the Department of Justice and courts likewise failed to punish some of the greatest abuses of power in our history…

As Al Gore wrote in his book describing The Assault on Reason:

American democracy is now in danger—not from any one set of ideas, but from unprecedented changes in the environment within which ideas either live and spread, or wither and die. I do not mean the physical environment; I mean what is called the public sphere, or the marketplace of ideas.

It is simply no longer possible to ignore the strangeness of our public discourse. I know I am not alone in feeling that something has gone fundamentally wrong.

Or look at Lawrence Lessig’s lecture on Corruption – which eloquently makes the case for “disinterestedness” as one of America’s key founding principles which has been since lost. Read Glenn Greenwald’s blog – which constantly points out the deep and serious faults in our media-political processes. Obama himself made a number of these arguments. Virtually every intellectual reformist has a “theory of what’s wrong” – and what none of them seem to disagree with is that something is wrong.

While in other times, reformers may have focused more on accomplishing something regarding important issues – temperance, Wall Street greed, environmental issues, discrimination – today, the central problem facing reformers is how to reform the system itself. This is the essence of the reform movement today – from Obama to Gore, Lessig to Yglesias, Klein to van Heuvel.

Reformers have presented compelling critiques of how the media presents issues; of how Congress deals with issues; of how long-term problems such as an increasing number of uninsured, spiraling health care costs, climate change, copyright expansion, and many others are ignored or marginalized because any attempt to address these issues involves significant obstacles and risks in the present for an uncertain future benefit. One of the key beliefs that makes reformers reformers today is their understanding that America’s political system is broken and that our traditional democratic institutions just aren’t up to the job of managing serious and difficult areas and making rational, long-term decisions when the payoff only comes after policy-makers are out of office.

This idea was the basis of my post yesterday discussing Obama’s focus on outsourcing authority to independent, technocratic institutions as a way of getting around our broken media-political system.

(more…)

How Obama Uses Civility and Respect as Political Weapons

Monday, June 22nd, 2009

[digg-reddit-me]Jonathan Chait describes “The Obama Method” in a not-yet posted piece on The New Republic. He tries to explain the eerie similarity between how Obama has reached out to moderate Republicans and independents at home while marginalizing right-wingers and how Obama reached out to the majority of Muslims while isolating the extremists in his foreign policy (and specifically the Cairo speech.) Chait also tries to tie this in to different critiques of Obama:

Democratic partisans think the enemy is vicious and must be met with uncompromising force. That’s exactly how conservative foreign policy hawks feel about the world. Unsurprisingly, the right-wing foreign policy critique of Obama today sounds eerily like the partisan Democratic critique of Obama during the primary.

Let’s call this method in foreign policy – which assumes every foreign rival is a reincarnation of Nazi Germany – the Bush doctrine; and in domestic policy, in domestic politics – assuming that all Republicans lie about their goals and probably hate the poor and downtrodden and merely want to aid the rich in getting richer – we can call this the Krugman doctrine. (On the Republican side of this, it would be the Rove doctrine, but that’s not relevant here.) The Bush/Krugman doctrine – in assuming that all opponents are acting in bad faith – is rather simple.

  • Identify your opponents.
  • Tell everyone what you believe and call your opponents names (your skill at name-calling is the only way to demonstrate your moral clarity).
  • Everyone will see how right you are.

This isn’t that bad of an approach for a newspaper column – it can be downright entertaining and sometimes even enlightening. As a basis for foreign policy or domestic political agenda though, it is poisonous – and though it may work for a time, the results diminish rapidly. Obama’s method operates differently:

  • Demonstrate one’s respect for one’s opponent.
  • Start with the assumption they are acting in good faith.
  • Invite them to a conversation about what needs to be done to solve the problem(s) on which they are opponents.
  • If they are acting in good faith, they can be worked with.
  • If they are not, “by demonstrating [one’s] own goodwill and interest in accord, [one] can win over a portion of [one’s] adversaries’ constituents as well as third parties.”

I disagree with Chait that Obama’s method “entails  small acts of intellectual dishonesty in the pursuit of common ground,” though. Chait, for example,  cites the line I criticized in Obama’s Cairo speech in which he called the Middle East the region where Islam “was first revealed.” In this case, I think Chait is right – that this line is intellectually dishonest. But his appreciation for Reagan which Chait also cites seems perhaps a bit exaggerated, but consistent with the rest of Obama’s beliefs – which tend to find a balance between Reaganesque individual responsibility and Kennedyesque calls for national responsibility.

Chait traces this method back to a Obama’s training as a community organizer. He cites a Mark Schmitt piece in The American Prospect which describes the community organizer method of dealing with opponents acting in bad faith:

One way to deal with that kind of bad-faith opposition is to draw the person in, treat them as if they were operating in good faith, and draw them into a conversation about how they actually would solve the problem. If they have nothing, it shows. And that’s not a tactic of bipartisan Washington idealists – it’s a hard-nosed tactic of community organizers, who are acutely aware of power and conflict. It’s how you deal with people with intractable demands – put ‘em on a committee. Then define the committee’s mission your way.

Chait explains why Obama’s approach is so successful:

The rhetoric removes the locus of debate from the realm of tribal conflict – red state versus blue state, Islam versus America – and puts it onto specific questions – Is the American health care system fair? Is terrorism justified? – where Obama believes he can win support from soft adherent of the opposing camp.

Obama’s method seems designed to short-circuit the dynamics of moral outrage that lead to polarization, extremism, and even violence. He illustrated this in his campaign – as he tried to calm his supporters down, defending pro-life demonstraters and on the eve of the election, as his crowd booed McCain, chiding them: “You don’t need to boo. You just need to vote.” And now, in reaching out to the Muslim world he is demonstrating this same grasp of how to defuse the escalating cycle of moral outrage – by treating his opponents with respect and as “people of goodwill.”

A little bit of civility will not remake the world – but it can go a long way in calming tensions.

[Image from the White House at Flickr.]

  • Larger Version (Link now works.)
  • Tags

  • Archives

  • Categories