Peter Boyer at The New Yorker reacted to last night's presidential speech with a short essay that upbraided Republicans for turning the term "public option" into "the most effective weapon against reform." This response, hysterical on the part of the zealots and cynical on the part of the vested interests, is completely at odds with the option's humble aspirations and limited potential, since it "was conceived as a means of accommodating moderates, bringing market forces to bear on the problem of cost by creating a new entity to compete with private insurers."
Who, exactly, conceived the public option in these humble terms? Not Jacob Hacker, the prominent health policy expert at UC Berkeley, and not Roger Hickey of the Campaign for America's Future. According to Mark Schmitt of The American Prospect, Hacker and Hickey were the driving force behind the successful effort to sell the public option to liberal activists and the leading Democratic candidates in 2007 as a way to surmount the political impediment posed by the "hard reality" that large numbers of Americans are not willing "to be put into one big health plan run by the government." The point was to assure the Democrats' single-payer advocates that the public option was "a kind of stealth single-payer," one that "would someday magically turn into single-payer." The new public option was designed, not merely to compete with private insurers, but to win that competition in a rout and "become the dominant player" in the health insurance market.
Neither is Jonathan Cohn of The New Republic playing small ball. He recently urged liberals not to let the best be the enemy of the good on health care policy. Even if only part of the whole wish list can be enacted now, those parts will make possible the enactment of the rest down the road, he advised: "It's not as if it will be impossible to scale up these reforms later on. If Congress passes and the president signs a bill putting in place the key institutional elements of reform now, they can always revisit, and strengthen, the measure later. During the 1980s, Henry Waxman almost single-handedly expanded Medicaid to its current levels by gradually making more people eligible and securing the funding to pay for them. All he needed was the institutional structure--the program, the rules, and the basic funding stream--on which to build the new coverage. The fact that Waxman is a chief architect for this year's program ought to give liberals confidence that, once again, these reforms needn't represent the upper limit of what might be achieved over the next few years. They are a start, and a very good start, but not a finish."
Pres. Obama's characteristically self-effacing pronouncement - he "will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it" - has nothing to say to legislators or citizens who believe it is better governance to abandon a plan that is flawed in ways so fundamental that no improvements could possibly mitigate the damage it will do. There is precedent. Democrats four years ago did not exert themselves to find ways to improve George Bush's Social Security plans. Instead, they decided that it was good politics and good enough governance to kill it, rather than haggle over details about private retirement accounts or formulas for curtailing the growth of benefits to more prosperous Social Security recipients. Indeed, seven years after Pres. Bill Clinton had made the urgent need to "save Social Security first" the focus of a State of the Union address, the Democratic consensus became that there was nothing to save Social Security from, that the program's finances were in splendid shape for as many decades into the future as any sane person could care about.
Republicans today are similarly averse to entering negotiations that require them to jettison, as a condition for a place at the table, their fundamental belief about American health policy: The bigger cause for the shortcomings of the American health care system is not the good things government should be doing but isn't, but rather the many things it is already doing - some badly, and others that it ought not to be undertaking at all. Before discussing the next increment of government regulation and spending, say Republicans, let's optimize the government's current massive and maladroit intervention into the financing of medical care.
As it happens, Rich Lowry of National Review provides several recommendations along these lines today:
- Modify tax policy to eliminate the disincentives for individual purchase of health insurance and health care.
- Eliminate regulatory barriers that prevent small businesses from cooperatively pooling and self-insuring their health risks by liberalizing the rules that govern voluntary health care purchasing cooperatives.
- Eliminate laws that prevent interstate purchase of health insurance by individuals and businesses.
- Eliminate rules that prevent individuals and group purchasers from tailoring health insurance plans to their needs, including federal and state benefit mandates and community rating requirements.
- Eliminate artificial restrictions on the supply of health care services and products, such as the overregulation of drugs and medical devices, as well as state and federal restrictions on who may provide medical services and how they must be delivered.
- Improve the availability of provider and procedure-specific cost and quality data for use by individual health consumers.
- Reform the jackpot malpractice liability system that delivers windfall punitive damage awards to small numbers of injured patients while it raises malpractice insurance costs for doctors and incentivizes the practice of defensive medicine.
So, Mr. President, should Republicans waste time with those who have made the calculation that it's better politics to kill these proposals than improve them?
To his credit, Milbank notes, among other Democrat "provocations," the chamber of medical horrors showcased by the visitors in the First Lady's box. "Obama wasn't subtle in his effort to make his foes look cruel."
But Milbank distorts the misbehavior by some Republicans by omitting Obama's charge that unnamed "prominent politicians" are spreading "a lie, plain and simple" about the vaunted death panels. Can anyone provide another instance of a President addressing Congress and calling his opponents liars? See political theorist Tim Burns, via Powerline.
Moreover, Milbank errs in referring to last night's occasion as "a sacred ritual of American democracy"--this was not a constitutionally mandated State of the Union address but rather a rare partisan occasion (try naming a couple others) for a President to push pet legislation. Such a political appropriation of the elected branches of government merits a political response.
"In my life, I had sought out other parts of the world--Patagonia, Assam, the Yangtze; I had not realized that the dramatic desert I had imagined Patagonia to be was visible on my way from Sedona to Santa Fe, that the rolling hills of West Virginia were reminiscent of Assam and that my sight of the Mississippi recalled other great rivers. I'm glad I saw the rest of the world before I drove across America. I have traveled so often in other countries and am so accustomed to other landscapes, I sometimes felt on my trip that I was seeing America, coast to coast, with the eyes of a foreigner, feeling overwhelmed, humbled and grateful.
"A trip abroad, any trip, ends like a movie--the curtain drops and then you're home, shut off. But this was different from any trip I'd ever taken. In the 3,380 miles I'd driven, in all that wonder, there wasn't a moment when I felt I didn't belong; not a day when I didn't rejoice in the knowledge that I was part of this beauty; not a moment of alienation or danger, no roadblocks, no sign of officialdom, never a second of feeling I was somewhere distant--but always the reassurance that I was home, where I belonged, in the most beautiful country I'd ever seen."
William M. Chace writes a thoughtful article on the decline of English as a college major and, more generally, as a coherent discipline. First the numbers. In one generation (1970-2003), the number of students majoring in English dropped almost in half, from 7.6% to 3.9%, reflecting a general decline in the number of humanities majors (business is apparently now the most popular major). Chace offers several reasons for this, but the main one is this:
the failure of departments of English across the country to champion, with passion, the books they teach and to make a strong case to undergraduates that the knowledge of those books and the tradition in which they exist is a human good in and of itself. What departments have done instead is dismember the curriculum, drift away from the notion that historical chronology is important, and substitute for the books themselves a scattered array of secondary considerations (identity studies, abstruse theory, sexuality, film and popular culture). In so doing, they have distanced themselves from the young people interested in good books.
I would add, they have distanced themselves from the young people who might be interested in using books to think about life and its questions. Among many other interesting arguments and observations, Chace reports that Harvard University recently replaced its survey of English literature for undergraduates with four new "affinity groups" - "Arrivals," "Poets," "Diffusions," and "Shakespeares." Sounds inspiring. And clear. (Incidentally, I had heard that Shakespeare didn't exist, but not that there were several of him.) The idea is that the content of the old survey will "trickle down" to students, but if no one takes thought that it happen, how likely is that? To his credit, Chace cautiously defends the idea of a tradition of English literature, and even intimates that those in the field ought to have a "sense of duty" towards the works of English or American literature. "Without such traditions," he concludes, "civil societies have no moral compass to guide them." It will be interesting to see how (or whether) the profession responds.
Congratulations to this month's winners of a No Left Turns mug! The winners are as follows:
Thanks to all who entered. An email has been sent to the winners. If you are listed as a winner and did not receive an email, contact Ben Kunkel. If you didn't win this month, enter September's drawing.
At the end of her denunciation Democratic party arrogance, Obama admirer Camille Paglia observes:
[A]ffluent middle-class Democrats now seem to be complacently servile toward authority and automatically believe everything party leaders tell them. Why? Is it because the new professional class is a glossy product of generically institutionalized learning? Independent thought and logical analysis of argument are no longer taught. Elite education in the U.S. has become a frenetic assembly line of competitive college application to schools where ideological brainwashing is so pandemic that it's invisible. The top schools, from the Ivy League on down, promote "critical thinking," which sounds good but is in fact just a style of rote regurgitation of hackneyed approved terms ("racism, sexism, homophobia") when confronted with any social issue. The Democratic brain has been marinating so long in those clichés that it's positively pickled.
Paglia's earlier reference to Bob Dylan as one true freedom-lover reminds us of his autobiography, Chronicles. Among Dylan's shrewd observations (about Thucydides as well as his contemporaries) is his criticism of Machiavelli's maxim that it is better to be feared than to be loved: No, the person who is the most loved can also be the most feared. Dylan also declares that his favorite politician from the sixties was Barry Goldwater.
A far greater poet of freedom with a funny voice was Winston Churchill. Those in the San Francisco area should make it to the Churchill Centre conference this weekend, featuring, among others, Justice Clarence Thomas and Hillsdale College President and Churchill scholar Larry Arnn.
A few days ago, the NY Times ran a story about the latest bright idea from Wall Street:
The bankers plan to buy "life settlements," life insurance policies that ill and elderly people sell for cash -- $400,000 for a $1 million policy, say, depending on the life expectancy of the insured person. Then they plan to "securitize" these policies, in Wall Street jargon, by packaging hundreds or thousands together into bonds. They will then resell those bonds to investors, like big pension funds, who will receive the payouts when people with the insurance die.
Basically, it's the same thing that Wall Street applied to risky mortgages, and that worked out so well. This time, however, the key variable is not the likelihood of people repaying their mortgages, but rather their lifespan: "The earlier the policyholder dies, the bigger the return -- though if people live longer than expected, investors could get poor returns or even lose money."
Is it unreasonable to worry that death panels will have new fans if these bonds become as popular as the mortgage backed securities were? And will Wall Street cease to invest in advances in medicine that prolong life. Or perhaps the backers of these bonds are already banking that those very things will be the inevitable result of moves currently being made in Washington.
"After a summer of healthcare battles and sliding approval ratings for President Obama, the White House is facing a troubling new trend: The voters losing faith in the president are the ones he had worked hardest to attract.
New surveys show steep declines in Obama's approval ratings among whites -- including Democrats and independents -- who were crucial elements of the diverse coalition that helped elect the country's first black president.
Among white Democrats, Obama's job approval rating has dropped 11 points since his 100-days mark in April, according to surveys by the Pew Research Center for the People and the Press. It has dropped by 9 points among white independents and whites over 50, and by 12 points among white women -- all groups that will be targeted by both parties in next year's midterm elections."
"More than half of whites older than 50 approved of Obama's job performance in April. But now, after weeks of Republican accusations that the Democrats would seek to cut Medicare benefits, that number is 43%. Among white Democrats, Obama's approval rating dropped to 78%, from 89%."
It goes almost without saying that he can regain much of this lost support after he is able to pass some sort of health care reform (but without the government option). Yet, after seeing his performance in Cincinnati, I am beginning to doubt that he can regain his standing.
"Since 'The Age of Reagan' will probably find more readers among conservatives than liberals, this is the message they ought to take to heart -- that being like Reagan can mean more than simply checking off a list of ideological boxes, or delivering a really impressive speech. It can mean marrying principle to practicality, tolerating fractiousness within one's own coalition and dealing with the political landscape as it actually exists, rather than as you would prefer it to be. (And in Hayward's account of the flailing Reagan-era Democratic Party, conservatives can find an object lesson in what happens if you don't.)There is also a message here for all partisans and all seasons -- for contemporary liberals as well as Reagan nostalgists, and for anyone who's invested himself in the redemptive power of politics. Reconsidering his hero inspires Hayward to meditate on leadership, on greatness and on the possibility of world-historical change. Channeling William F. Buckley, he ponders 'the limitations of politics,' the fact that "the most powerful man in the world is not powerful enough to do everything that needs to be done." From his lips, one hopes, to Barack Obama's ear."