Categories
Barack Obama Health care Politics

Our Unhinged Debate on Health Care Reform

Or, Large Majorities of Americans Support the Specific Reforms Obama Is Proposing, But the Debate Going On Now Has Confused Them Into Opposing It

[digg-reddit-me]Andrew Sullivan provides a pretty good summary of the policy questions at stake in the health care debate – slightly modified by me to make it a list:

  1. Should we demand that insurance companies provide policies to anyone regardless of pre-existing conditions?
  2. Should we help the working poor buy that insurance with subsidies?
  3. Are competitive exchanges for health insurance a good or bad thing?
  4. Would a public option or a co-op help bring down healthcare costs?
  5. Does it make sense for the government to study the effectiveness of various treatments as a guide for doctors?

These are the basic questions Democrats are trying to answer. The only real presumption Democrats made in creating these policies is that the government can be effective. The proposals on the table now are modest – tinkering even – in which market mechanisms, government regulation, and a government plan together are designed with three goals:

  • to provide more security and choice to those Americans already covered by banning abusive insurance company practices and allowing individuals to buy insurance on a health care exchange;
  • to institute certain incentives that will hold down the growth of health care costs – using market mechanisms in the Health Insurance Exchange, spreading information with the Independent Medical Advisory Committee, and with the public option;
  • to cover the 47 million Americans without health insurance (whose use of health care, which we already provide as a matter of right, creates a de facto $1,100 tax on each individual).

The various bills under consideration are so long and complicated because they attempt to make slight adjustments to the system we have – and to remain true to Obama’s promise that if you like your health insurance you can keep it.  They prohibit certain practices by insurance companies, they set up a Health Insurance Exchange, they may or may not allow citizens to choose a publicly run health care plan, they subsidize individuals who currently cannot afford insurance, they set up committees to study best practices. What they certainly do not do is attempt radical change.

This isn’t about the free market versus communism, or radicalism versus moderation. The anger at Obama’s health care reforms has little to do with what he or other Democrats are proposing. There are those with reasoned objections. But the Republican Party has instead embraced and encouraged the inchoate rage of people frustrated with the direction our country is headed, with the various moral dilemmas George W. Bush left for his successors, with the massive failure of the markets that caused our current recession, with the failures of the visceral politics and policies of George W. Bush. On Slate’s Political Gabfest today, this exchange captured pretty well the essense of the hyperbolic debate going on now:

DAN GROSS: In college, we had the primal scream where at a point in time people would open their windows and just yell randomly. It was done to relieve stress but you weren’t yelling a set of statements about how your workload was too high. You were simply yelling. And it strikes me…that the things they are yelling are not the reasoned case for doing health care reform in a different way. They’re saying things like, “Let’s take our country back!” or “Lies, lies, and socialism, communism, fascism.”

JOHN DICKERSON: Yea – it is a sort of Tourette’s of the political…

I want to repeat that there are reasoned cases to make against the various policies Obama is proposing – but aside from an odd blog post by a libertarian economist every now and then, I don’t see them made. Instead, we get the approach Jon Stewart described: “You know, the individual mandate is going to hurt small businesses by…aw, fuck it: YOU’RE ALL GOING TO DIE!!!”

That’s what we’re dealing with: cynical manipulation of an inchoate public anger by entrenched interests and the primal screams of a minority of people frustrated with the direction of the country – both of whom are trying to scare the majority into indecision and intimidate the Democrats into submission. Then there are the many – some of whom are wary of action on health care right now; some of whom are concerned about government spending;  some of whom support reform, but aren’t clear on the issues; some of whom are frustrated with Obama’s moderation. Very little of the public debate has to do with the issues addressed above. Instead, we have anonymous lies spread by email, we have right-wing organizations claiming that “Obamacare=Gov’t Funded Abortion and Euthanasia,” we have Sarah Palin claiming Obama would make her son go before an evil “death panel,” we have Senator Jim DeMinto comparing America under Obama to Germany under Hitler, we have people on the streets and in town halls  and on the radio claiming that Obama is instituting Nazi policies, we have protestors deliberately trying to shut down debate (pdf) and silence those in favor of reform. And I’m not cherry-picking the most egregious examples here – these are the tactics used by mainstream opponents of health care reform.

The response and the debate going on now is unfortunately unhinged from reality and has very little to do with any bill being considered. Americans started out in favor of Obama’s health care proposals – expressing support for both him and the policies he had campaigned on. Polling shows they still support the policies: 72% of Americans are in favor of the public option; 74% of Americans believe that health insurance companies should not be allowed to exclude those with pre-existing conditions; 71% of Americans believe that the fact that 47 million Americans are uninsured is a “very serious” problem, with 49% willing to accept higher taxes to cover these individuals. When Obama’s plan was described in neutral terms, 56% of Americans still supported it today (with 38% opposed). But as Obama and Republicans and Blue Dog Democrats all raised concerns about deficit spending and soaring health care costs, many in the public became wary of increased spending. And as Republicans and entrenched interests began to spread rumors of the health care reforms being proposed, Obama’s support dropped.

But now this debate has broken out into the open – and amid  all the accusations of Nazi policies and “death panels” and rationing and socialism! and “killing Granny” the American public can see what is really going on. Republicans will soon learn the truth of Abraham Lincoln’s aphorism:

You can fool all of the people some of the time, and some of the people all of the time, but you can’t fool all of the people all of the time.

[Image not subject to copyright.]

Categories
Barack Obama Health care Politics The Bush Legacy The Opinionsphere

Gog et Magog, Hypomania in the White House, Reuters!, The Most Interesting Man in the World, and the NRLC

1. Gog and Magog. James A. Haught breaks some news – at least in American papers – explaining one line of “reasoning” George W. Bush attempted to use to convince Jacques Chirac to support the invasion of Iraq:

Gog and Magog are at work in the Middle East… The biblical prophecies are being fulfilled… This confrontation is willed by God, who wants to use this conflict to erase his people’s enemies before a New Age begins.

Chirac was so confused by this reasoning that he actually called in a Swiss theologian to explain. Just last week, Chirac confirmed this in an extended interview in France.

2. Hypomania in the White House. John Gartner for Psychology Today profiles Rahm Emanuel and the Emanuel family that shaped him. He describes Emanuel as hypomanic – which he stresses is not a psychological disorder, but a condition. Some of the more interesting tidbits:

Emanuel says f*ck more frequently than “if, and, or but,” insists political scientist Larry Sabato. Obama himself regularly jokes about Emanuel’s profanity: “For Rahm, every day is a swearing-in ceremony.”

Gartner also discusses how Emanuel’s family shaped him:

Stuck with each other, the brothers created their own subculture—unlike most gifted high-energy kids, who must deal with the confusing feelings that come with being different. Like the X-Men at the Mutant Academy, the brothers felt most normal in one another’s presence, where they could be themselves—with a vengeance.

The brotherhood may have been instrumental in curbing another hallmark of hypomania. If you’re hypomanic and gifted, you always have the feeling of being the smartest guy in the room. But if you have two other guys just as smart and aggressive in the room who say, “That’s a stupid idea” and start to pound you, it’ll knock some of the grandiosity out of you.

And this:

While Rahm has called the verbal combat that took place there “gladiatorial,” Zeke described it to me as more of a Talmudic debate—the Jewish tradition of argument where one’s opponent is viewed as an ally in the search for truth. “It’s a sign of love to take someone’s view seriously,” says Zeke, who has fostered at NIH a style modeled directly on the Emanuel dinner table; he calls it “combative collegiality.”

3. Reuters! Reuters believes in a link economy. Suck on that AP.

4. The Most Interesting Man in the World. I was going to link to an article at AdAge by Jeremy Mullman on Dos Equis’s spectacularly successfuly “Most Interesting Man” campaign – but as the article went viral, AdAge has apparently attempted to limit its distribution and now placed it behind a firewall. Google does have a cached version here. For now. It’s an interesting story of how the ad campaign broke all of the rules of beer advertising – and led Dos Equis to buck the trend of declining imported beer sales and actually notch a double digit rise.

5. The NLRC: Not about abortion any more. William Saletan explains why certain pro-life Democrats are having their loyalty questioned by the National Right to Life Committee despite their unchanged anti-abortion stance:

In 2007, Ryan began to flunk the scorecard because the scorecard was no longer primarily about abortion. It wasn’t Ryan who changed. It was NRLC.

[Image by me.]

Categories
Economics Health care Politics

A Distinctly American Health Care System

Jacob Weisberg in Slate has an interesting take on health care systems as reflecting the society of which they are a large part. The piece is worth checking out. Here’s his short description of America’s health care:

America’s evolved, undesigned system is also an expression of our culture at its best and it worst. Health care in the United States is innovative, entrepreneurial, expensive, litigious, and wasteful. It is decentralized, driven by self-interest, excellent at the high end, and increasingly unequal. It resists acknowledging trade-offs or limits and is characterized by shocking gaps in basic care.

Categories
Economics Environmental Issues Health care Politics Videos

Health Care Reform To Stimulate the Entrepreneurship

[digg-reddit-me]

Paul Gigot of the Wall Street Journal editorial page makes the same argument many Obama critics have been making – beginning with Rush Limbaugh who attempted to blame the financial collapse on the fear markets had at the prospect of an Obama victory in the 2008 election to the present, as Gigot attempts to blame any lingering effects of this financial collapse – and its economic aftereffects – on fear of “the Obama agenda.”

But neither Gigot nor Limbaugh nor any other right-wingers seem to give any consideration to those drags on risk-taking that our current status quo creates.

Gigot apparently thinks that raising taxes on a handful of powerful individuals has a greater effect on reducing risk-taking than the prospect of global warming, than the lack of a health care safety net has on potential entrepreneurs.

The difference between Gigot and myself is that Gigot is concerned that this handful of powerful people will be less likely to take risks with their vast sums of money – along with a dozen or so major corporations having less ability to generate major profits by externalizing costs for pollution and health care to the society at large. If a corporation has to pay for the damage it causes, then it is – by Gigot’s standards – less free. This is true only in the sense that a tyrant is less free than an ordinary citizen because he is no longer able to impose his way upon others.

If one wants to stimulate the economy by encouraging small businesses and entrepreneurship, there are few better ways to do it than to pass some sort of health care reform that makes it cheaper and more available outside of large employers. As Daniel Gross, financial columnist for Newsweek and Slate, explains:

An affordable national health care policy, which could allow people to quit their jobs and launch businesses without worrying about the crippling costs of premiums or medical costs, might be a better spur to risk-taking than targeted small-business loans.

I say this as a former small business owner and entrepreneur myself. One of my biggest concerns in working outside of an established business was that I was not able to get my health care through my job – which meant astronomical monthly premiums for a service I did not use – but which I could not be sure I would not badly need.

Gigot and other right-wingers are not focused on small business and entrepreneurs – although they does invoke them as a fig leaf for political reasons. If they were they could see the advantage of a public health care option. Instead of defending the free market, Gigot and other right-wingers seek to defend a corrupt status quo in which decisions are made by a princely few rather than being made in the competition and varied decision-making bodies of a free market. Health care reform – if done right, with a public option – will remove a major obstacle to individuals taking their own risks, starting their own businesses; it will be a small step to diversifying decision-making and creating a more free market.

Gigot – by taking the dogmatic position he does – proves he is not serious about protecting the free market; he is only interested in protecting the interests of his cronies among the monied elite.

Categories
Economics History The Opinionsphere

The Reagan Revolution (cont.)

I’m a bit annoyed at the fact that Krugman’s book – which I have not read – makes almost precisely the same point I’ve been making – but which I thought was mine independently, though inspired a bit by a phrase Stephen Metcalf tossed off in an essay on Tom Cruise:

The ’80s did for money what the ’60s did for sex.

Instead, from that phrase – likely inspired by Metcalf’s reading of Krugman – I reconstructed the view of history Krugman was advancing. I wrote:

This stability of the 1950s and 1960s came at the expense of tamping down certain social and economic forces. The social stability was torn apart by the Civil Rights movement, feminism, free love, and the later radicalisms of the late 1960s and early 1970s. This culture war has been dominating politics since then.

The economic stability of this period was destroyed by the forces of extreme capitalism, greed, deregulation, and other economic radicalisms of the 1970s and early 1980s – as labor unions were undermined, executive compensation grew exponentially, social mobility was impeded, and economic power concentrated in a handful of large corporations.

Lindsey quotes Krugman’s book in his essay:

For a generation after World War II, fear of outrage kept executive salaries in check. Now the outrage is gone. That is, the explosion in executive pay represents a social change…like the sexual revolution of the 1960’s—a relaxation of old strictures, a new permissiveness, but in this case the permissiveness is financial rather than sexual.

Categories
Barack Obama Criticism Law Politics The Opinionsphere

Conservative Empathy

Doug Kendall and Dahlia Lithwick take on the conservative attacks on empathy by pointing out the hypocrisy of the position:

Every time Justice Antonin Scalia writes a habeas opinion that begins with the depiction of a gruesome murder, he is evincing empathy toward the victim. When Chief Justice John Roberts battled for the rights of white schoolchildren facing arduous bus trips and educational hardship due to school integration programs in Seattle and Kentucky, he was evincing empathy for the white “victims” of affirmative action. It’s a patent falsehood that liberal judges weep and bleed for their plaintiffs while conservative jurists treat plaintiffs with stony indifference. And smart advocates on either side, knowing that, seek out “sympathetic plaintiffs” for litigation precisely because they are attempting to appeal to some part of the court’s lizard brain; the part that does more than mechanically apply the law to the case.

I think that’s about right.

Categories
History Humor Iraq Morality National Security Reflections The Bush Legacy The Opinionsphere The War on Terrorism

Must-Reads This Weekend

Nuclear Porn. Ron Rosenbaum writes about how hard-core our nuclear fantasies have become in an essay for Slate:

I love airport best-sellers because I see them as our Nostradamuses, the literary canaries in the dark coal mines of our paranoia. They sniff out and serve up fictionalized but “realistic” prophecies of coming doom of one sort or another. Perhaps it’s that in their visions of total world immolation they diminish in the mind of said traveler the possibility of something so trivial as a 757 engine malfunction.

The Awakening. David Rose investigates the Sunni Awakening in an article for Vanity Fair. The big news: apparently the initial approach by the Sunni insurgents offering to work with America came in 2004 – but was rejected as a result of turf battles and ideology. 

Happiness. Joshua Wolf Shenk tells the story of the most significant longitudinal study in history (so far). He reveals that one of the participants in the study (all of whom were chosen while they were in college) was John F. Kennedy. The study itself is fascinating – and Shenk’s piece was reflective and probing:

“I’m usually callous with regard to death, from my father dying suddenly and unexpectedly.” He added, “I’m not a model of adult development.”

Vaillant’s confession reminded me of a poignant lesson from his work—that seeing a defense is easier than changing it. Only with patience and tenderness might a person surrender his barbed armor for a softer shield. Perhaps in this, I thought, lies the key to the good life—not rules to follow, nor problems to avoid, but an engaged humility, an earnest acceptance of life’s pains and promises…

Torture and Truth. Ali Soufan testified in Washington – but while he was constantly interrupted by an edgy Lindsey Graham, his written statement is a testament of a man who was there: 

The issue that I am here to discuss today – interrogation methods used to question terrorists – is not, and should not be, a partisan matter. We all share a commitment to using the best interrogation method possible that serves our national security interests and fits squarely within the framework of our nation’s principles. 

From my experience – and I speak as someone who has personally interrogated many terrorists and elicited important actionable intelligence– I strongly believe that it is a mistake to use what has become known as the “enhanced interrogation techniques,” a position shared by many professional operatives, including the CIA officers who were present at the initial phases of the Abu Zubaydah interrogation. 

These techniques, from an operational perspective, are ineffective, slow and unreliable, and as a result harmful to our efforts to defeat al Qaeda. (This is aside from the important additional considerations that they are un-American and harmful to our reputation and cause.) 

Categories
Financial Crisis Humor National Security Pakistan Politics The Bush Legacy The Opinionsphere The War on Terrorism

Must-Reads of the Week

1. Inhuman. Andrew Sullivan, who has been one of the most insightful commenators on torture, discusses the term “inhuman”:

It’s odd, isn’t it, that we use this word to describe abuse and torture of prisoners. The reason it’s odd is that I’m not sure any animals torture. Yes, they can kill and maim and inflict dreadful suffering in the process of killing, eating or fighting. But the act of intentionally exploiting suffering, of lingering over some other being’s pain – using it as a means to an end – is not an animal instinct, unless I’m mistaken.

And so torture is in fact extremely human; it represents in many ways humankind’s unique capacity for cruelty.

2. 30 Rock. Jonah Weiner discusses 30 Rock’s odd conservative streak at Slate. The explanations he posits for this conservatism are perhaps beside the point, but interesting nonetheless:

Of course, 30 Rock was conceived during the reign of George W. Bush, which might help explain its ideological complexity. The show has been consistently critical of Bush, but perhaps 30 Rock began as a way to explore—and mine for gallows humor—the crisis of identity many liberals began to feel in his second term, when the Karl Rove playbook had seemingly replaced the laws of physics, when the “reality-based community” (including Liz Lemon’s Upper West Side) felt like an island populated by the marginal, flip-flopping, arugula-munching few.

3. Animal Spirits. Chrystia Freeland writes for the Financial Times that the Obama team seems to have accepted the premise of a recent book by behavioral economists about economic crises:

Judging by the upbeat economic message we have been hearing from the White House, the Treasury and even the Federal Reserve over the past six weeks, that is a shrewd guess. The authors argue that “we will never really understand important economic events unless we confront the fact that their causes are largely mental in nature”. Our “ideas and feelings” about the economy are not purely a rational reaction to data and experience; they themselves are an important driver of economic growth – and decline.

4. A Taliban Strategist Speaks. To The New York Times. Perhaps the most interesting article I have read about the Taliban’s plans in the Af-Pak region – though I have to wonder why this man would be speaking to a Western newspaper about the Taliban’s strategy. That said, you can judge the article for yourself. I pass it on as it seemed plausible to me:

One Pakistani logistics tactician for the Taliban, a 28-year-old from the country’s tribal areas, in interviews with The New York Times, described a Taliban strategy that relied on free movement over the border and in and around Pakistan, ready recruitment of Pakistani men and sustained cooperation of sympathetic Afghan villagers.

His account provided a keyhole view of the opponent the Americans and their NATO allies are up against, as well as the workings and ambitions of the Taliban as they prepared to meet the influx of American troops.

It also illustrated how the Pakistani Taliban, an umbrella group of many brands of jihadist fighters backed by Al Qaeda, are spearheading wars on both sides of the border in what for them is a seamless conflict.

5. Fool’s Gold. This one is actually a must-listen podcast of a talk given at the London School of Economics. Gillian Tett is a journalist for the Financial Times who recently wrote a book about the financial crisis and what led to it from her view as someone with a background in anthropology reporting who was reporting on derivratives before it was an exciting beat.

Bonus: Polar Insanity. Tim Wu writes in Slate about the perplexing desire of so many people – including himself –  to make the expensive trips to the polar regions:

Every so often, an iceberg floats by that is grander and more beautiful than any cathedral, though it lacks any history or even a name. What’s almost as shocking as its appearance is its anonymity: beauty untainted by fame. Most of these perfect objects will never be seen by human eyes. They float around and slowly melt by themselves, unappreciated and utterly indifferent to that fact.

Unnamed, plentiful beauty feels unearthly and almost decadent, like Sinbad the Sailor’s cave. It is alien to the typical human experience of finding everything we really desire to be scarce, expensive, or behind some temple curtain. It has always struck me that no one bothers to build museums in places of extreme natural beauty, and in Antarctica the effect is magnified. If an iceberg the size of Manhattan showed up outside town one day, why would you bother going to an art exhibit?

Categories
Humor The Media

Richter’s Deferential Robin & Conan’s Absurdist Batman

Troy Patterson of Slate revealed (to me) that Andy Richter will be rejoining Conan for his Tonight Show debut. And suddenly I am looking forward to the Tonight Show with anticipation rather than mild interest. Patterson explains Richter’s challenge:

So now it’s left to Richter, coming in from the cold, to revive the dying art of the late-night-show sidekick…Richter, meanwhile, has been and should be the deferential Robin to Conan’s absurdist Batman, a Boy Wonder with a Wonderbread deportment. Holy subordinate!

Categories
Economics Financial Crisis Humor Politics Videos

The Real Scandal of AIG

[digg-reddit-me]Eliot Spitzer, in what is becoming a must-read column for Slate, gets to the nub of the real scandal of AIG:

The AIG bailout has been a way to hide an enormous second round of cash to the same group that had received TARP money already.

As I’ve quoted former Governor William Weld before:

There’s no one so brave and wise as the politician who’s not running for office and who’s not going to be…

Yet it is almost as likely that former Governor Eliot Spitzer is following an alternate path that seems similar but has a different conclusion. Let me propose a corollary to Weld’s statement:

A bit braver and a little less wise than the politician who’s not running for office and who’s not going to be is the chastened politician who seeks redemption in the form of speaking truth to power from his exile until he has established his moral bona fides enough to be allowed back in.

A bit less snappy though. Meanwhile, Jay Leno has his own suggestion for how to deal with the AIG bonus issue (the one that Spitzer points out is a side issue):

You have to appreciate the subtle balance Jay manages here – and the craft and delicate political sensibility that goes into a joke like this. Aiming for a mass audience, he can’t offend either Democrats or Republicans. Yet a political joke that is offensive to no one just isn’t funny. So Jay manages to cram two alternate jokes into one – with one interpretation for Democrats and the other for Republicans, and a certain cognitive dissonance allowing both interpretations.

On a superficial level, Leno is chastising the Obama administration and saying that it should emulate the Bush administration. 

But he undermines this suggestion by invoking as a fact – which it is, even if the mainstream media does not often acknowledge it – the lawlessness of the Bush administration – and perhaps even mocking their oft-used Jack Bauer defense.

Yet on another level, what he is proposing – that Obama just forget the law and go after AIG – has a certain elemental satisfaction to it – and would probably be a popular move. There would be a catharsis there, instead of the interminable responsibility of the Obama administration. 

As I mentioned above – there is a certain craft to this. Often, Leno’s monologues are seen as without edge but when they work, they allow multiple edges such as this joke does. 

As a side note to all of this – once something becomes the premise of a joke by Jay Leno, you know it has been popularly accepted as true – or true enough. The fact that the premise of this joke was Bush administration lawlessness is pretty significant in that regard.