Inane Heath Care Debates

Posted on August 24th, 2009

Paul Krugman says that

The debate over the public option has, as I said, been depressing in its inanity.

and over at the New Majority, David Frum asked his contributors

Tens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal?

Our survey says

No

The twenty-something responses to Frum’s question had a few common  threads. The most common was that universal healthcare would conflict with American values.

To insist upon guaranteed universal healthcare for every living person in America is to insist that healthcare is a universal right, which it is certainly not. If it were, then all Americans (especially conservatives) would be moved by the Declaration of Independence—which reminds us that government was instituted to “secure these rights”—to demand nothing less than socialized medicine. But, once again, it’s not.

and

Finally, it is not who we are as a nation.  We are not a welfare state.

Another theme is that,

The U.S. has a system of universal coverage now - it’s called “show up at the emergency room” - and while it is far from perfect, the overwhelming majority actually seem pretty content with it - at least any time we get down to the specifics of some other form of “universal coverage.”

The last is that the proposed health care reforms are a trojan horse for a complete government takeover of healthcare.

This is the equivalent of “dumping” by undercutting competitors’ prices, even at a loss, to take market share — but without the hit to earnings that some companies are willing to take.  The Democrats see this as an option to “keep insurance companies honest.”  I see it as a first step to what Obama et. al. have repeatedly clamored for over the years (new rhetoric notwithstanding).  A first step towards an ultimate take-over of the entire healthcare system by the “single payer” entity… Uncle Sam.

And these are from the non-crazy conservatives (you should hear what they say at The Corner).

The only great post comes from an enemy plant. It starts well.

The answer:  Mexico, Turkey, and the United States.  Ok, what is the question?

What are the only three OECD-countries — the 30 largest free market democracies, broadly defined — in which sizable numbers of citizens lack health insurance?

Not company our nation usually keeps.  Nor should it.  The idea that we can’t afford universal health insurance, as many NM contributors say, is just, well…let’s just say, it’s a bit more plausible coming from Mexico and Turkey, countries which are famous for sending legions of their people to wealthier countries like the U.S. and Germany. That enormous sum of money that Republicans keep warning us about–oh my goodness, over $1 trillion spread over ten years, the money it would take to insure about 97% of our population (to do it well, it would probably take about $1.4 trillion) — is less than 1% of our country’s estimated GDP over that same ten year period. [snip]  We can afford a defense budget larger than that of the next 20 countries combined.  We can afford an unfunded war in Iraq now in its sixth year.  We could afford to pay for the prescription drug bill and gratuitously launder about $200 billion of the taxpayers’ money to the insurance industry.  Yes, the United States can afford this.

He also takes on the story about how Stephen Hawking would have been left to die if he had been British and had to rely on the NHS.

But did it make any of you wonder:  What would happen to an American who suffered from what Hawking suffers from — or cancer, or severe heart disease — who lacks health insurance? Say, even the least sympathetic case, one of those arrogant 25-year olds, who think they are going to live forever, and wake up with a deadness in their legs, and are diagnosed with MS — I know someone like that, perhaps you do, too.  What happens to those people in America when they don’t have insurance?  What happens after they “show up at the emergency room”, in Bradley Smith’s inelegant phrase?  This is what a number of you seem to think is fully the equal of having quality health insurance (of the kind you yourselves have, about which more later).  So you’re diagnosed with MS or ALS, or you found some blood in your stool time and again, and you go to the ER, and you’re diagnosed with colon cancer.  So:  you followed Mr. Smith’s advice, and you showed up!!  Now what?

My favourite line:

People who couldn’t afford care would just be left to die on the street — after all, if they can’t afford healthcare, tough luck.  Just as if they can’t afford to buy that car, or a house, or sofa, or a lamp.  We don’t say, “Just show up at Crate and Barrel — you’ll get an emergency sofa, if you’re just ‘dying’ to have one.”

I have been very frustrated by the health care debate because it is so completely lost in wonkery. I can’t help think that if Obama stood up and painted the big picture of what this is really about…

Nor is it, ironically enough, like the sustained care that Stephen Hawking received from the socialists at the NHS.  And isn’t it odd, too, that we act as if people in these other countries we know well — entirely civilized, advanced countries like Canada, Denmark, the Netherlands, Germany, France, even the UK — are dropping dead on the streets of the cities and town as if from the Black Plague every day.  Oddly enough, many of us have been to these places, and this isn’t true — people receive excellent medical care at less cost than our system provides.

…if he turned Eugene Debs’ excellent essay…

American conservatives write often about patriotism and love of nation.  I wonder:  Do they ever feel even a tiny bit of shame, maybe at least the blush of embarrassment, when reading that our country lacks the minimum level of social decency promulgated by every one of its peer nations — and that we stand at the bottom in this category with the likes of Mexico (a nation Americans frequently mock) and Turkey?  That even a dictatorship like Singapore provides universal care?  That our great free market ally, Taiwan, does so, too?  That this is just something that nations across the world, and conservatives, liberals and social democrats simply agree is a benchmark of modernity and civilization, no more controversial, but every bit as essential as the traffic light.

….into the kind of towering rhetoric we heard from him last year, the whole debate would be over by now.

Politically Correct

Posted on March 20th, 2009

I’ve lost track… are conservatives for or against political correctness?

How many parties do you need for bipartisanship?

Posted on March 14th, 2009

I agree with Buffet’s criticism of Obama (via Slate):

BUFFETT: I think–I think a lot of things should be–job one is to win the war, job–the economic war, job two is to win the economic war, and job three. And you can’t expect people to unite behind you if you’re trying to jam a whole bunch of things down their throat. So I would–I would absolutely say for the–for the interim, till we get this one solved, I would not be pushing a lot of things that are–you know are contentious, and I also–I also would do no finger-pointing whatsoever.

I want Obama to live up to his promise of bipartisanship even as the other side decides to roam out on the distant plains of the political spectrum. I want Obama to make it easy for Spector and Graham and McCain to support him.

Earmarks are only 2% of budget so we shouldn’t worry about them, says Jon Stewart. That’s a better argument for getting rid of them than keeping them. Think of all the bipartisan goodwill you could buy with that 2%.

I haven’t filled in my N-400 yet.

The future of the Republican Party

Posted on March 1st, 2009

I finally watched both Obama’s speech and Jindal’s rebuttal. Obama was magnificent - it has been a while since I said that - but what was more striking was how stupendously bad Jindal was.

I have been reading the commentary about Jindal’s speech on the conservative blogs all week and everyone agrees how bad it was - but so many of them focussed on his delivery and noted that he has 3 years to work on that before the 1012 election.

But it wasn’t the delivery that was bad - though God knows that was awful - it was the content. The content was just dismal. It was a curious mixture of non-sequiturs (Jon Stewart noted the incongruity of following a complaint about the crap government response to Katrina with a complaint about money to understand volcanos) and outright dishonest sleight of hand. And WTF was that about with the sheriff and the boats?

The Dems astounded me for 7 years with their crapness. I think the Pubbies are on course to outdo them.

Even David Brooks thinks so:

America can be better than it has been

Posted on November 6th, 2008

I have read lots of commentary about the significance of Obama’s election but none have resonated the way this did.

Obama’s idea, put simply, was that America can be better than it has been. It can reach beyond post-9/11 anger and fear to embody once more what the world still craves from the American idea: hope.

America can mean what it says. It can respect its friends and probe its enemies before it tries to shock and awe them. It can listen. It can rediscover the commonwealth beyond the frenzied individualism that took down Wall Street.

I know, these are mere words. They will not right the deficit or disarm an enemy. But words count. That has been a lesson of the Bush years.

You can’t proclaim freedom as you torture. You can’t promote democracy as you disappear people. You can’t stand for the rule of law and strip prisoners of basic rights. You can’t dispense with the transparency and regulation essential to modern capital markets and hope still to be the beacon of free enterprise.

Or rather, you can do all these things, but then you find yourself alone.

Obama will reinvest words with meaning. That is the basis of everything. And an American leader able to improvise a grammatical, even a moving, English sentence is no bad thing. Americans, in the inevitable recession ahead, will have a leader who can summon their better natures rather than speak, as Bush has, to their spite.

Maybe it is because the writer is also an expat Englishman. Roger Cohen cast his first vote as an American citizen for Barack Obama, as I will cast my first vote for his *re-election.

* Assuming he doesn’t suck (2 down, 1 to go)

Inspire us

Posted on October 23rd, 2008

Obama made his name by giving great, set piece speeches like the magnificent Walls of Jericho speech at the Ebineezer Church but, since the primary election has been over, he seems to have very consciously toned it down a little. His recent speeches have been more traditional campaign speeches as though he was wounded by the superstar digs. Even his DNC speech was pretty conventional by Obama standards.

I have been hoping for one last big speech on a topic less mundane than Winning Elections.  I think it’d be well received and do him a lot of good - especially among the people that are only now starting to pay attention to what he has to say.

But I have to say - even his speeches on Winning Elections are pretty good.

Especially when you compare them to this.

Would the real Obama please step forward?

Posted on September 27th, 2008

I have been checking the reactions to the debates on all the partisan blogs and it really is astounding how one-sided the commentary is on both sides. I saw a poll - which I can’t find again :-( - saying  95ish% of democrats and republicans claimed that ‘my candidate won the debate’.

I wonder if the problem is group think? You are in a crowd watching your guy when someone shouts ‘Hell yeah!’ and you are like ‘hell yeah!’ and ‘that’s bullshit!’ and then you watch the remainder of the debate through partisan-tinted glasses.

Over at The Corner, they seemed to be watching an American Super Hero take on a North Korean Fifth Grader in a wrestling match. They certainly weren’t watching the same debate as me. Except one guy…

I have been hanging out at the corner for a few weeks now and they really are an odious bunch. They are allegedly the cream of the conservative intellectual movement but - with two shining exceptions - you’d never guess it to read them. The worst of the whole bunch is Jay Nordlinger who is from the why do liberals hate america school of conservative thinking.

So I was mightily surprised to read his debate summary which had gems like these

35. If I were an ordinary American — who didn’t know anything — I’d say, “Hmm, Obama sounds okay — a moderate fellow. And don’t we need a change?” Bodes ill . . .

39. Amazing to have Obama, a left-wing Democrat, denounce “tremendous spending” and “an orgy of spending.” He’s a very good campaigner, sadly.

43. Obama said, “General Petraeus has done a brilliant job” — will that sit well with the “General Betray Us” people? But I imagine they’ll sit still for anything in a general election, just to get Obama in.

and his conclusion…

70. I think many people will take away the following impression: “They would both make a good president. They’re both solid, centrist, centered, informed, capable. But if I want a change — and Lord knows this country needs a change — I should vote for the Democrat.”

More here. Go read them. They are actually pretty good.

It was almost as if he had convinced himself that the conservative talking points about liberals were true and - for the first time ever - he was hearing a real liberal speak. What? They don’t hate the troops? I thought that liberals were all tax and spend !! Why does he want to kill Bin Laden when everyone knows the democrats love terrorists!

I wonder if this…

As is my custom, I’m writing my comments without hearing any other commentary — I am unaffected by other opinions.

…made any difference?

Apparently many of his readers were shocked too.

Many, many readers have written that my quick points on the debate depressed them — why did they have to be taken down, after being so up after McCain’s impressive performance? No one need be depressed: McCain did very well. He held up our end, as I said at the bottom of my notes. Of course, he has the advantage of the better positions.

But Obama’s more like a pro — more like a professional debater than a politician who happens to do all right in such settings. Not that that is necessarily the most effective thing, politically: There is such a thing as being too smooth.

And his rationale - when he is finally exposed to liberal policies instead of conservative talking points about liberal policies?

Obama is pretending!

What’s depressing, to a person like me, is that Obama has mastered the trick of coming off as perfectly moderate…

Wait until he finds out that we really DO love the terrorists and we want to tax the middle class and give the money to crack whores and we really DO want the government controlling your doctors! Mwuhahaha!

Who cares what a bunch of scientists think?

Posted on September 26th, 2008

During the administration of George W. Bush, vital parts of our country’s scientific enterprise have been damaged by stagnant or declining federal support. The government’s scientific advisory process has been distorted by political considerations. As a result, our once dominant position in the scientific world has been shaken and our prosperity has been placed at risk. We have lost time critical for the development of new ways to provide energy, treat disease, reverse climate change, strengthen our security, and improve our economy.

We have watched Senator Obama’s approach to these issues with admiration. We especially applaud his emphasis during the campaign on the power of science and technology to enhance our nation’s competitiveness. In particular, we support the measures he plans to take – through new initiatives in education and training, expanded research funding, an unbiased process for obtaining scientific advice, and an appropriate balance of basic and applied research – to meet the nation’s and the world’s most urgent needs.

A Bunch of Scientists

Economists for Obama

Posted on September 22nd, 2008

Interesting idea from Iglesias

Most notable, to me, is that the economists rate “wars and homeland security” as one of Obama’s strongest issues, whereas the conventional wisdom and the bulk of the public sees this as McCain’s strong suit. It’s part of a larger trend I’ve noticed of economists, who appreciate the positive-sum nature of international relations, having generally sounder views on foreign policy than do “foreign policy experts,” who seem to me to tend in the direction of being captured by the military-industrial complex over time.

Interesting also that they ding Obama on trade.

Obamanomics

Posted on August 23rd, 2008

The NY Times Magazine has an 8 page article on Obama’s economic policy. It’s required reading for anyone who claims that Obama is long on rhetoric and short on specifics.

Some highlights for people who don’t like to read detailed policy specifics or don’t like registering to read free articles:

For the first time on record, an economic expansion seems to have ended without family income having risen substantially. Most families are still making less, after accounting for inflation, than they were in 2000.

As anyone who has spent time with Obama knows, he likes experts, and his choice of advisers stems in part from his interest in empirical research. (James Heckman, a Nobel laureate who critiqued the campaign’s education plan at Goolsbee’s request, said, “I’ve never worked with a campaign that was more interested in what the research shows.”) By surrounding himself with economists, however, Obama was also making a decision with ideological consequences. Far more than many other policy advisers, economists believe in the power of markets.

“The market is the best mechanism ever invented for efficiently allocating resources to maximize production,” Obama told me. “And I also think that there is a connection between the freedom of the marketplace and freedom more generally.” But, he continued, “there are certain things the market doesn’t automatically do.”

When Reagan was elected, in 1980, tax rates on top incomes were so high that even liberal economists now say the economy was suffering. There simply wasn’t enough of an incentive for rich people to start new companies or expand existing ones, because so much of their profits would have gone to the federal government. Someone making the equivalent of $5 million in 1980 — in inflation-adjusted terms — would have paid a combined federal tax rate of almost 60 percent, according to research by Emmanuel Saez and Thomas Piketty, two academic economists. (These calculations cover not only income taxes but also payroll taxes, capital-gains taxes and others.) Reagan, by the end of his second term, had cut this rate to about 35 percent. Clinton raised it above 40 percent, but the current President Bush has reduced it to 34 percent. So over the same period that the rich have been getting much richer before taxes, their tax rates have also been falling far faster than the rates of any other income group.

The Tax Policy Center, a research group run by the Brookings Institution and the Urban Institute, has done the most detailed analysis of the Obama and McCain tax plans, and it has published a series of fascinating tables. For the bottom 80 percent of the population — those households making $118,000 or less — McCain’s various tax cuts would mean a net savings of about $200 a year on average. Obama’s proposals would bring $900 a year in savings. So for most people, Obama is the tax cutter in this campaign.

If there is a theme to the Obama tax philosophy, it’s that the tax code is not quite as progressive as you think it is. Most of the public discussion about taxes tends to focus on the income tax, which taxes the affluent at a considerably higher rate than anyone else. But the income tax doesn’t take the biggest bite out of most families’ annual tax bill. The payroll tax does.

McCain, by continuing the basic thrust of Bush’s tax policies and adding a few new wrinkles, would cut taxes for the top 0.1 percent of earners — those making an average of $9.1 million — by another $190,000 a year, on top of the Bush reductions. Obama would raise taxes on this top 0.1 percent by an average of $800,000 a year…[snip]…The bulk of Obama’s tax increases on the wealthy — about $500,000 of that $800,000 — would simply take away Bush’s tax cuts. The remaining $300,000 wouldn’t nearly reverse their pretax income gains in recent years. Since the mid-1990s, their inflation-adjusted pretax income has roughly doubled…[snip]…As ambitious as Obama’s proposals might be, they would still leave the gap between the rich and everyone else far wider than it was 15 or 30 years ago. It just wouldn’t be quite as wide as it is now.

The second criticism is that Obama’s tax increases would send an already-weak economy into a tailspin. The problem with this argument is that it’s been made before, fairly recently, and it proved to be spectacularly wrong. When Bill Clinton raised taxes on upper-income families in 1993, his supply-side critics insisted that he would ruin the economy. As we now know, Clinton presided over the longest economic expansion on record, the fastest income growth most workers had experienced in a generation and the disappearance of the federal-budget deficit. His successor, Bush, then did exactly what the supply-siders wanted, cutting upper-income tax rates, and the results were much worse.

Since the dawn of the Age of Reagan, the idea that government spending can be a good thing for the economy has been out of favor, even among Democrats. But it’s now making something of a comeback, particularly within Obama’s camp. His agenda calls for about $50 billion in new annual spending on various investments, including infrastructure, alternative energy and scientific research.

So I asked Obama whether he thought he had been able to tell an effective story about the economy during this campaign. Specifically, I wondered, did he think he had a message that compared with Reagan’s simple call for less government and lower taxes.

He paused for a few seconds and then said this:

“I think I can tell a pretty simple story. Ronald Reagan ushered in an era that reasserted the marketplace and freedom. He made people aware of the cost involved of government regulation or at least a command-and-control-style regulation regime. Bill Clinton to some extent continued that pattern, although he may have smoothed out the edges of it. And George Bush took Ronald Reagan’s insight and ran it over a cliff. And so I think the simple way of telling the story is that when Bill Clinton said the era of big government is over, he wasn’t arguing for an era of no government. So what we need to bring about is the end of the era of unresponsive and inefficient government and short-term thinking in government, so that the government is laying the groundwork, the framework, the foundation for the market to operate effectively and for every single individual to be able to be connected with that market and to succeed in that market. And it’s now a global marketplace.

“Now, that’s the story. Now, telling it elegantly — ‘low taxes, smaller government’ — the way the Republicans have, I think is more of a challenge.”

I clearly cherry-picked the good bits and you’ll have to read the article yourself for the more critical bits. But, if you enjoyed the McCain piece that I linked to a couple of months ago, you’ll enjoy this one too.