Categories
Health care Politics

Zeke Emanuel on the Health Insurance Exchange

Noam Scheiber profiles the man he calls the nicest Emanuel brother, the eldest,  Zeke. Zeke is one of the nation’s leading bioethicists and works – along with Cass Sunstein and Peter Orszag in the Office of Management and Budget. Even with all the intellectual firepower in that normally staid department, Zeke stands out – and as someone who has been working for health care reform his entire life, he is one of those taking the lead on this issue. His focus – unlike most progressives – is not on the public option, but on the Health Insurance Exchange:

[N]ot surprisingly, Emanuel digs deepest into his healthy reserve of enthusiasm for the parts of the plan that dovetail with his own ideas. At the top of this list is a so-called insurance exchange – a regulated market in which people who lack coverage through their employer (and maybe people who work at small companies, though that’s still being negotiated) could choose from a variety of private plans, which would offer at least a minimum level of benefits and could not discriminate by health status. “He’s a key thinker on the exchange. How it operates. How it interacts with insurance market reform,” says the administration official.

On the one hand, the exchange is absolutely central to the Obama plan–it’s how the uninsured get covered. So it’s worth having Emanuel’s considerable brainpower on the problem. On the other hand, one can imagine a future in which the employer-based system gradually withers away, leaving everyone to purchase insurance on the exchange. Though Emanuel scrupulously avoids such discussions, it’s hard to believe the thought has never occurred to him.

I’d like to hear more about his thinking on “How [the exchange] operates. How it interacts with insurance market reform.”

Categories
Politics

The Perks of Princes

Randy Cohen – as an ethicist writing for the New York Times – tackles the vexing question of Congressional vacations. He comes down hard – and while I don’t endorse his message, I think that if more people expressed this attitude, our country would be better off:

In an egalitarian society, lawmakers do not exploit their office to vote themselves lavish perks but live much like the people they represent. Congress should get the same health coverage enjoyed — can that be the right verb? — by a typical American. Congressional pay should be pegged to the median for a family of four, currently $70,354. And Congress will receive the same vacation time as an average American, which right now is 37 days. No, wait, I’m thinking of France, that terrifying example of all that is to be shunned — attractive clothes, delicious meals, widespread human happiness. American workers average 12 days a year of vacation.

Categories
Criticism Politics The Opinionsphere

Stop Whining, Congressman Issa

[digg-reddit-me]Congressional Republicans got their knickers in a bunch this week sending off a quite nasty letter in response to what they allege (citing the Politico) to be hardball political tactics of Rahm Emanuel pushing back against Senator Jon Kyl.

This all supposedly started when Senator Kyl on This Week With George Stephanopoulos took on the stimulus bill:

KYL: Yes. And with respect to the stimulus, I think it’s now acknowledged, it hasn’t done what it set out to do.

STEPHANOPOULOS: But your government says it has in Arizona.

KYL: No. What our – look, all governors like “free money” coming to the state. My governor is no different. But the reality is that it has added to our deficit. We’re now going to have a $1.8 trillion deficit this year.

It seems more plausible that these rather mild remarks aren’t what started this, but the general push by Senator Kyl to cancel the stimulus bill that included an op-ed published a week before this in which he explained:

With the results now in, it’s not a surprise that a recent Rasmussen poll found that 45 percent of Americans want to cancel the rest of the stimulus spending.  I agree.

In response to Kyl’s attempts to cancel the stimulus bill, Rahm Emanuel – according to Politico – had several department heads responsible for distributing stimulus funds write to the Republican Arizona governor, who is on the record as supporting the bill and saying it is working for her state, asking her if she agreed with Senator Kyl and wished to cancel any future funding from the stimulus. In some variation or another, the letters made this point:

On Sunday, Arizona Senator Jon Kyl publicly questioned whether the stimulus is working and stated that he wants to cancel projects that aren’t presently underway. I believe the stimulus has been very effective in creating job opportunities throughout the country. However, if you prefer to forfeit the money we are making available to your state, as Senator Kyl suggests, please let me know…

Darrell Issa, a California Republican Congressman, accepted Politico’s characterization that it was an “assault” on Kyl, as well as a “fist to the nose,”  and a message to “Back off.” In a letter to Emanuel (pdf), Issa asked:

At what point do you believe your practice of Chicago-style politics violates a public official’s right to speak out in favor of alternative policies?

All of this seems fair and good to me – it’s politics. If Issa thinks he’ll win points whining, then all the power to him. If Emanuel thinks he can get the Republican governor of Arizona and potential presidential candidate and Senator from Arizona Jon Kyl squabbling, then all the power to him.

But on style points, Issa loses. His letter which implies that Emanual is violating the right of public officials to speak out in favor of alternative policies. This is the same Issa who sided with Dick Cheney’s office after they outed an undercover CIA agent because her husband spoke out against the Iraq war; and the same Issa who obstructed debate on the reauthorization of FISA until a fellow Congressman withdrew his comments that the Bush administration had broken the law. Over his career then, not much attention given to the right of public officials to speak their minds – unless they agree with him. Blatant hypocrisy while whining about objective standards always loses you style points.

I have a question for Congressman Issa (congressman.issa@mail.house.gov): At what point does your arugula-sniffing, California-style oversensitive, politics of umbrage idiocy get old?

You’re in Congress. Grow up. If you’re in Washington trying to play hardball, don’t whine when someone on your team takes a hit.

[Image not subject to copyright.]

Categories
Health care Politics

A Jumble of Health Care Related Points

I’ve been collecting a number of interesting points regarding health care that I haven’t yet found a way to incorporate into a post. So to stop lugging this paper around, here’s a jumble of different facts, arguments, and stories:

Robert Borsage explains one argument for “going all in” on health care reform. He explains that bringing everyone into the health insurance system would remove the hidden tax the uninsured levy on the rest of society:

This removes the hidden charge – estimated at $1,100 per person – we each pay for the 47 million who aren’t insured and are forced to use the emergency room as their doctor, often putting off treatment that results in higher costs when the untreated illness becomes critical.

The Boston Globe points out that the Romney-backed health reform there is actually working, despite headlines that seem to suggest the contrary:

In the myth that these critics have manufactured, this state’s plan is bleeding taxpayers dry, creating nothing less than a medical Big Dig.

The facts – according to the Massachusetts Taxpayers Foundation – are quite different. Its report this spring put the cost to the state taxpayer at about $88 million a year, less than four-tenths of 1 percent of the state budget of $27 billion. Yes, the state recently had to cut benefits for legal immigrants, and safety-net hospital Boston Medical Center has sued for higher state aid. But that is because the recession has cut state revenues, not because universal healthcare is a boondoggle. The main reason costs to the state have been well within expectations? More than half of all the previously uninsured got coverage by buying into their employers’ plans, not by opting for one of the state-subsidized plans.

Ezra Klein follows up to say that the Massachusetts plan “has come in at about the cost predicted” and – in the most important point for him: “Doing coverage actually pushed Massachusetts to begin addressing cost.”

Greg Mankiw questions the need for a public option in an interesting post.

Several progressives have pointed out the irony of seniors angrily telling Congressmen to “keep the government’s hands off of their Medicare.” Harold Pollack in taking on the euthanasia scare tactics of the right muses:

The irony of yammering to seniors about the evils of government-financed care is always notable, as is the selfish appeal. In 1965, liberals enacted Medicare, perhaps the most radical social engineering project in American history.

Paul Waldman in The American Prospect makes a similar point:

Forty-four years after its passage, the success of Medicare — just to review, a big-government program that has provided health care to tens of millions of seniors who would not have otherwise had it, does so more efficiently than private insurance, has seen costs grow at a slower rate than private insurance, and is smashingly popular with its recipients — has not seemed to fundamentally alter the public’s receptiveness to anti-government arguments. Ditto for Social Security. Ditto for the Veterans Administration, which is the only truly socialized health-care system in America, and one that is considered by many health-care experts to provide the best health care in the country.

Ezra Klein points out that our media-political system does not respond in the same way to all types of grassroots pressure – and that the right is benefiting from this now. He explains how single-payer advocates are organized, loud, and present (and have been present) at these town hall meetings and other health care events for years. Yet no one seems cowed by them – and they get virtually no media coverage. On the other hand, complain about socialism and you’re the story of the day… Klein reflects:

[It’s] worth keeping in mind as people begin to focus on the anti-health-care tea parties. The political system does not have some sort of consistent reaction to grassroots pressure. Rather, it picks and chooses when it wants to listen to the views of the very, very non-representative groups of people who sit through at town halls and panel discussions

Paul Krugman details a story with a similar message:

I was tentatively scheduled to be on a broadcast dealing with — well, I won’t embarrass them. But first they had to find someone to take the opposite view. And it turned out that they couldn’t — which led to canceling the whole segment.

In a way this goes beyond my original point, which was the unwillingness of the news media to referee a controversy by actually reporting the facts. Now it seems that a fact isn’t worth reporting unless someone is prepared to deny it.

And finally, I’ve already linked to this post by Ezra Klein maybe two or three times, but I haven’t cited this passage yet which almost but didn’t quite fit into my the Health Insurance Exchange is like ebay post:

The Health Insurance Exchange, combines the benefits of choice that are theoretically available on the individual market with the bargaining power and scale that’s generally accessible only in large employers (and the exchange will, in theory, have more bargaining power than even the largest employers, as it will have a much larger base of customers). You also have a space to test out innovative ideas that might make the market better, like Sen. Jay Rockefeller’s (D-W.Va.) insurance rating agency, or the public insurance option. You can standardize billing and payment methods and force the adoption of electronic medical records.

[Image by romanlily licensed under Creative Commons.]

Categories
Iraq National Security Politics The Opinionsphere The War on Terrorism

Censoring the Truth About the Crusader Prince?

[digg-reddit-me]Scott Horton apparently reported on several declarations filed in Federal Court in Eastern Virginia that included explosive allegations regarding the military contractor Blackwater and its owner Erik Prince. Andrew Sullivan linked to him – but between Sullivan’s linking and my clicking on Sullivan’s link, the article was taken down. A search of The Daily Beast for Scott Horton’s article turns up nothing except a link to Jeremy Scahill of The Nation‘s recent piece on the same subject. Andrew Sullivan had excerpted this summary of the charges contained in the Declarations on his blog:

  • Both men requested anonymity to avoid mortal threats. “It appears that Mr. Prince or his employees murdered, or had murdered, one or more persons who have provided information, or who were planning to provide information, to the federal authorities,” said John Doe #1. John Doe #2 says he received personal threats after leaving Blackwater.
  • Prince “views himself as a Christian crusader tasked with eliminating Muslims and the Islamic faith from the globe.” He “intentionally deployed to Iraq certain men who shared his vision of Christian supremacy, knowing and wanting these men to take every available opportunity to murder Iraqis.”
  • Blackwater “employees openly and consistently used racist and derogatory terms of Iraqis and other Arabs, such as ‘ragheads’ or ‘hajis.’”
  • Blackwater deployed to Iraq individuals who (a) made “statements about wanting to… ‘kill ragheads’ or achieve ‘kills’ or ‘body counts,’” (b) drank excessively, (c) used steroids, and (d) failed to follow safety and other instructions governing the use of lethal weapons. Mental-health professionals who raised concerns about deployment of such individuals were fired.
  • Prince obtained “illegal ammunition… designed to explode after penetrating within the human body” and smuggled it into Iraq for use.
  • Prince distributed other illegal weapons for use in Iraq.
  • Prince was aware of the use of prostitutes, “including child prostitutes,” at Blackwater’s “Man Camp” in Iraq, which he visited.

The actual declarations can be found here – John Doe 1 (pdf) – and here – John Doe 2 (pdf). These papers were part of opposition to a motion – the complete set of which can be found here. (Beware – it’s a few hundred pages of pdfs). I have emailed Scott Horton to see if he has any comment/explanation for why his article is no longer up on the Daily Beast.

Edit: The Daily Beast still has not gotten back to me. Mr. Horton replied telling me that he was looking into why his article was taken down himself.

[Image by John Rohan licensed under Creative Commons.]

Categories
Foreign Policy The Clintons The Opinionsphere

Did Kim Jong Il Apologize for Calling Hillary A “Funny Lady”?

David Rothkopf asks an interesting question:

I wonder how our former president and Kim Jong Il handled the “funny lady” who looks like a “pensioner going shopping” comments at dinner tonight?  And however they handled it, if only we could have gotten a glimpse of the “Annie Hall” subtitles that would have revealed what they were really thinking.”

Categories
Barack Obama Domestic issues Health care Politics The Opinionsphere

Lies About Health Care Reform

[digg-reddit-me]The August War for Health Care Reform has begun. The forces for health care reform and those against it (working with those who are against it right now) have both begun to wage the battle for public opinion and to influence Congress. Many on the pro-reform side are not sure if they are happy with the plans being considered – and are frustrated with what they see as the lack of forthrightness in selling the plan. There are currently multiple versions of the legislation in Congress – and the president has yet to state what he will require to be in the bill. This all seems part of a strategy, but it makes organizing more difficult. In the end, there is little choice but to trust that if given the proper space and pressure politically, Obama and the Democratic Congress will do the right thing.

But while this may be frustrating what has become very clear is that the opponents of reform are willing to lie outrageously in order to turn the tide in this fight. And those people who favor reform must beat back these complaints vigorously. Here’s a roundup of recent lies told by the opponents of reform:

1. Last week in an opening volley, I received a charming email from Townhall.com stating that “ObamaCare=Gov’t Funded Abortion and Euthanasia.” This is clearly not true.

2. Then, this morning, I opened up the Drudge Report and found as his main link a heavily edited video claiming that it showed Obama “IN HIS OWN WORDS” saying his health care plan will eliminate private insurance. Even in its heavily edited version, it didn’t show this. Instead it showed Obama endorsing the generally accepted idea that we should gradually end our employer-based health insurance. Obama’s views on single-payer health insurance have been gone over repeatedly. His campaign website gave three examples of him using the same formulation – which incidentally he also used in at least one debate that I recall:

If you’re starting from scratch, then a single-payer system’-a government-managed system like Canada’s, which disconnects health insurance from employment-‘would probably make sense. But we’ve got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that’s not so disruptive that people feel like suddenly what they’ve known for most of their lives is thrown by the wayside.

So, what we have is a obviously edited video of Obama at various times in the past ten years saying that he supports a single-payer system (cutting out the second half of the statement) and his admission that he believes we should move away from employer-based health insurance. The video though is being promoted as proving that Obama is admitting that his plan would secretly impose government insurance on everyone. The video very clearly shows no such thing.

Yet, even so, the Libertarian sub-reddit was fooled and promoted the video.

The White House has helpfully provided the videos with some context in what I think is an excellent effort to combat this smear.

3. The hysteria over Obama’s health care reform even bled over into my walk home through Midtown Manhattan. On the way, I passed a booth run by the LaRouche PAC with a picture of Obama with a Hitler mustache (similar to this one) and an older black woman explaining to passers-by that Obama was seeking to kill older Americans just like Hitler did. Everyone knows the LaRouchites are a bit crazy. But how different is this from what Rush Limbaugh says? Or Fox News? I took a flyer from the women – though not before telling the person she was preaching to that Obama really wasn’t actually trying to kill her. The flyer explained (the PDF linked is slightly different version from what I received):

U.S. President Barack Obama delivered a nationally-televised press conference at 8 p.m. on July 22nd, in which on five separate occasions he called for health reform legislation featuring the establishment of “an independent board of doctors and health care experts” to make the life-and-death decisions of what care to provide, and what not, based on cost-effectiveness criteria – exactly the infamous “T-4” policy imposed by Adolf Hitler in 1939, for which the Nazi regime was tried and condemned at Nuremberg.

Lyndon LaRouche commented, within minutes of Obama’s remarks:

“President Obama is now impeachable, because he has, in effect, proposed legislation which is an exact copy of the legislation for which the Hitler regime was condemned in the post-war trials. This is an impeachable offense: to propose such a thing in this time, is an impeachable offense. The time has come that the President of the United States deserves impeachment. With this statement from him, the President now deserves impeachment.”

On how many levels is this ridiculous? The independent board of doctors and health care experts would replace MedPAC – a board that currently provides guidance to Congress in setting Medicare rates. Instead of advising, Obama’s new board – the IMAC – would make recommendations as to levels of pay that would be sent to the president and, if then endorsed by him, would be subject to the approval of Congress. They would also do studies of the comparative effectiveness of different types of treatments. Does this sound like a euthanasia program to you?

4. There is also an email is circulating that makes all sorts of outrageous claims about the bills under consideration on health care reform – including many of the above claims – and pretends to cite the pages and lines of the bill that mandate what it describes. Like many of these viral email lists of lies, it relies on the laziness and gullibility of the American people – trusting that people will pass it on rather than check the truthfulness of the claims themselves. The email was pretty thoroughly debunked by Linda Bergthold, a health care policy consultant and researcher who has been working in the field for 25 years, and Politifact, an arm of the St. Petersburg Times that analyzes the truth of political statements.

A lot of this stuff is hard to believe – but as Bill Maher pointed out last week – if you let even stupidest arguments stand unchallenged, they will take root and destroy even one’s best efforts. Which is why I’m going to try to make a point of calling bullshit on these outrageous lies as they come by…and you should too…

[Image by criswell; used without permission, but hopefully he’ll respond and give it to me soon.]

Categories
Barack Obama Criticism Politics The Opinionsphere

Obama and the Technocrats

[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.]

Categories
Barack Obama Humor Politics Videos

Bill Maher Takes On The Birthers

[digg-reddit-me]I haven’t commented much at all on the “birther” movement. It just seems too stupid to discuss. And yet, a recent poll shows that 42% of Republicans believe that Obama was born in America. But Bill Maher made a good point tonight – which I think is worth sharing:

An appropriately somber message delivered with humor: ignoring stupidity doesn’t make it go away.

Categories
Barack Obama Health care Political Philosophy Politics The Opinionsphere

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

[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.