Politblogo

A bad bill as political laxative for US health care

Ian Welsh kindly posted a link to my previous post on his blog as a separate post of his own, but rather than come here, most of his commentariat decided to respond over there.  Since I promised not to respond directly on this issue on his site, I am going to make a GREAT SACRIFICE and break my promise to forget this moribund joint and respond to some common threads in his comments here, in a new post.  (I responded to Paul Lukasiak who kindly commented in the previous thread, and I'll respond to Helena if this post doesn't manage to cover her objections.)

It appears at this point that the Senate bill is likely to pass.  For all that it is full of FAIL, I haven't made any secret of the idea that I'm mostly convinced that it is a good thing.  The underlying motivation of the table of outcomes in the last post is the sense that, on health care, the US political system is like a highly constipated patient.  We want it to poop out the golden brick of a Canadian-style single-payer system, but for many electoral cycles, now, it has been completely unable to poop out anything at all.  The reasons for this are the usual: money and media and money-in-media. 

Those are big problems, and they are the reason why the bill is so failtastic.  But until the surgical suite is ready to fix these problems---a long project---the patient still needs a laxative.  The Senate bill has the potential to be that laxative.

With that, here are some of the major classes of objections:

Objection #1: Failure to pass a bill would leave the door open for better bill

I responded to this one in the comments to the previous post.  Very briefly, regardless of what Obama wants, failing to pass a bill means that Congress is simply not going to try again any time soon.  The official narrative is already ready: no one has done it before, and it's too hard.  Clinton failed.  The official narrative is part and parcel of the political constipation problem.  So, no, failure to pass a bill would mean/have meant that the effort is dead for another electoral cycle or two.  There's no evidence to believe that single-payer is going to happen at that point either.

Objection #2: Bad bills never lead to better legislation later on

My first reaction to this idea was a certain amount of incredulity.  So I'll farm this one out to Cogitamus, first and foremost.

More importantly, though, American progressives seem not to have learned something that the American right has known for a long time: that apart from actual policy, rhetorical metavictories actually have real, long-term value.  For example: even when they can't actually destroy Social Security or other progressive programs and priorities, they can create an overall cultural milieu in which "entitlements" are perceived to eat the future earnings of our descendants.  

This bill has the potential to create the perception, once again, that health care reform is both possible and desirable as a matter of conventional wisdom.  It may not, but passing no bill doesn't even try.

Objection #3: The public will hate the individual mandate

I can hardly argue that a public-option-less mandate is a great idea for controlling consumer-end costs.  This is by far the strongest argument against the Senate bill.  But my response is roughly the same.  Alright, let's say that it is unpopular.  Than the worst-case scenario is that a Republican Congress and President repeals it, leaving the USA back where it was before, roughly.  One way or another, if the systemic breakdown of the existing health care arrangement is reaching catastrophic proportions, the only question is time; and this bill could either speed it up or slow it down by a small amount---at worst.

Objection #4: Adopting this bill is a failure to negotiate effectively

This is one of Ian's favorite themes, and it depends on some assumptions, including who the negotiating partner actually is.  The negotiating partner is the insurance industry, and what is being negotiated in any health care reform package that might actually be serious is the very existence of a large chunk of that industry if not all of it as we know it.  So, they have no incentive to negotiate.

If you doubt that the negotiating partner is the insurance industry, consider the very fact that a public-optionless Senate bill with mandates is likely to pass.  With 60 votes.  Even with Bernie Sanders (I-VT), regardless of how he really feels.

In conclusion

Progressives from Markos to Jane Hamsher to Ian Welsh have quite well articulated the reasons why the Senate bill is terrible and does not lead in itself to a signficantly improved health care system.  This is probably all true.  What it does is open a door.  The cost to not opening that door at all isn't pretty.  Opening that door may not be pretty either.  But at least there is a chance of movement.  A slim one, but a chance.

One thing I have not so far seen is an account of how and when a better health care system would be instituted for the USA on hypothetical failure of this bill---aside from Objection #1, which I've dealt with.  It's really easy to sit around running a creepy drive-by psychoanalysis of Jacob Hacker, and another to explain a political plan given current conditions for accomplishing something via the legislative system.  One of these is more fun, I guess.

Otherwise, the best thing to do is to let the bill pass and then claim a rhetorical metavictory---because the meta in all of this is actually important until you have a plan to get yourself to the clean, ideal politics in which good policy is honestly debated.

Freedom is slavery, health is insurance: the metabenefits of a bad bill

(To my "regular" "readers": I am writing this blog post in response to multiple brous-haha around the interwebs into which I may have dipped more than just my little tippy-toe on the matter of health care.  It was written at the suggestion of ex cob logger Ian Welsh as a substitute for taking my frustrations out on his impudent commentariat. Don't expect this blog to stop going Billmon after this any time soon, especially since the Noo Typepad now suXX0rz.  Next time you see me blog, it will be on Wordpress or something non-annoying that does not make my browser cry bitter Javascript tears.  But at least thunderpants will be happy that I've satisfied his demand.)

I thought I'd write a long song-and-dance about my opinion on the US health care reform effort, but then I realized that not only would it be highly susceptible to the worst sort of nitpickulation, it would also be better summarized as a table.  Well, at this point in time, there are two legislative options: no bill, or a bad bill.  Here's my assessment of the relative likelihood of good, bad, and ugly outcomes of both options:

	Long-term outcome likelihood
	Good	Bad	Ugly
No bill	Nonexistent	Reasonable	High
Bad bill	Very Low	Reasonable	High

So, as you can see, I've done the math and I think it's better to pass a bad bill rather than no bill. A bad bill has a chance of defeating at least one pernicious meme: that no Congress or administration can alter US health care delivery systems, which are wholly broken. 

I will not get into Nate Silverian attempts at defending anything about the bill as it stands.  It's a terrible bill.  It is completely bone-headed not to simply expropriate the "health" "insurance" "industry" wholesale and immediately institute a Canuckistani single-payer system.  Anything that doesn't lead to this outcome is a lie.  However, if I had a dollar for all the political lies and terrible ideas we have to tolerate, I'd be Warren Buffett.  Am I Warren Buffett?

Nevertheless, the bill should pass.  The only condition under which I would take this statement back is if there is any chance that there are legislators who are willing to scuttle this turkey who also have the wherewithal to bring about a better bill---one that eventually eliminates the desurance industry.  Since this has a hellball's chance in snow, it's better for all the other people who think that they'd rather have no bill to fix that problem---that they have no effective progressive representation in Congress, or that they have no leverage either way---than engage in perverse quests to leave the effort with nothing.

De-front-paged Corrente post: Compounding their error; or, I do indeed enjoy shooting fish in a barrel

The following is a post I wrote at Corrente which continues an ongoing bit of flamewar whose context may be a bit mysterious to my usual readership. Corrente's owner decided it was too flamewar-y for the front page his blog, but I meant to say what I meant to say, because it illustrated the point I wanted to make. I believe those with Corrente accounts can still read it, but I intended to put it on the open Internet and here it is. I mean, it has a high snark level, and I can understand why someone may not want to encourage that level on their site.

The overall context is that while I think that Obama was a somewhat bigger campaign risk than Hillary Clinton, I do believe she lost due to a small number of misapprehensions about why the Obama campaign took off the way it did. And that some of these misapprehensions are reflected in the PUMA movement---which I believe to be real, and reflecting a consequential reality---in a different way.

The specific context is a series of posts about the mortgage meltdown which reveals the kinds of poor ideological and political judgement that mars the PUMA movement. However, the owners of the Confluence blog decided to compound the error with a very interesting set of circumlocutions, which I proceed to take down.

Well! You may recall my recent scathing critique of a Confluence post on the mortgage meltdown that I thought was at best buying into tedious old right-wing saws about anti-discriminatory measures. I am flattered to report that, despite her disagreement with me over the admittedly trolly bit at the end, Anglachel has seen fit to cite my post approvingly in one of her own.

Well, this finally provoked the "Conflucian"* response. And it has appeared as a pair of posts by riverdaughter and by dakinikat (who wrote the post I originally objected to). Needless to say, these are awesome circumlocutions from start to finish. For example:

However, it is the case that sometimes reality is reality and people in the news of all races, class, status, color, gender, you name it, do things that make them look bad. This is an unavoidable fact of like. It is also the case that sometimes programs and federal funds that are created for very good purposes are exploited by people who happen to be of all races, class, color, gender, you name it, who *are*, after all, imperfect humans. Greed and bad behavior is not restricted to Republicans. We have seen that some Democrats are quite capable of it.

Amazing. So, astonishingly, all kinds of people are bad. This is what we have discovered. And thus we are invited to ignore the context of what dakinikat actually said in her post. Bad person is bad.

The comments, oh the comments. They could fill and entire blog's worth of deconstruction. Like the blog posts that precede them, they studiously avoid discussing how exactly we got here. For starters.

And as for dakinikat, it is so tempting to quote the "my black friend" she pulls near the end---it would be like shooting a tuna balanced on a wet thimble. Or the appeal to "peer-review" authority, as though peer reviewed journals do not continuously contradict each other even in real science**. But that's not the important bit. The important bit is right at the beginning, where she reasserts the very article that's at issue, the Liebowitz article that buries a very charged set of ideological claims under an ultimately quite irrelevant discussion and analysis of mortgage typology. And she does so not merely apparently oblivious to the objection, but also forgetting why the objection was raised: an claim about the Congressional Black Caucus.

So, as I recall, commenter Valhalla admonished me in the last post that I did not attempt to engage with them. While I felt I had good reason to critique them from Corrente rather than from their comments, I attempted to correct this by posting the following brief but substantive response to dakinikat:

*BOOP*

Dakinikat insists on repeating the Liebowitz business, which I made the very focus of my own post to which Anglachel links. Its entire purpose is to do one of three things, and probably all:

* Discredit the idea that mortgage approval discrimination exists against minorities (while ignoring subsequent evidence and argument to the contrary).

* Blame the foolishness of mortgage lenders on *gasp* an anti-racist policy, when it's been amply shown that this is not the case.

* Blame the allegedly impending economic collapse on mortgage qualification liberalisation, deflecting it from the actual cause, which was allowing these segments of the credit apparatus to be overleveraged.

These three things are interconnected by ideology, and they bear a number of ideological fruits. One of these begins with "r". Oh no!

Yes, it is sharp and critical, and yes, it is somewhat snarky. But, unlike nearly anything else on either Confluence response posts or their comments, it addresses the point being made directly. What Liebowitz is saying is basic and well-known glibertarian cant (which is sometimes popular with economist-types). But it is an ideological claim no matter which way his data actually falls out. Because economics doesn't really tell us half us much as it claims to do, about the facts, but it sometimes gives us a language to talk about ideology.

And I happen to believe that the predictable result of this type of glibertarianism is a racist result. I'm sorry if this hurts anyone's feelings.

However, I am known there as a "crazed Obama-loon", and my substantive response was quite predictably deleted, and quickly. And the moderator decided to respond with:

fuck off mandos.

Oh, woe is me. But: at least Valhalla should now know why I didn't try the first time.

So, the point is not that PUMAs are burning crosses on their front lawns, or aren't perfectly nice people who wouldn't go out of their way to give a brown guy a break, or don't have dark pigmentation themselves. It doesn't even mean they have no legitimate complaint, or that their complaints are entirely motivated by nefarious intent. Far from it. It is merely that the PUMA movement, at least as represented by quite a proportion of Confluence regulars, has allowed defensiveness and anger over Obama campaign strategy to severely blunt their political judgement, even so far as misunderstanding the actual tactic the Obama campaign used. And, for that reason, we should hope beyond hope that this poor judgement is not loudly echoed in the wider political sphere.

*They apparently have a web radio show called "Conflucians Say". Uhm. I really couldn't resist, sorry.

**Economics is dressed-up moral argument at best, well before it is science, and the Liebowitz paper at issue is no exception.

What follows is a comment thread that I think is also interesting in itself, but I'm still working out what/how to refer to things for which I've written a response comment.

Got inner turmoil?

skdadl at pogge reminds us that certain parties regularly get away with spinning their regular wrongitude into a larger, more noble narrative of rightness.  And that those who were right never get the credit for it.

Look: the point is that Iggy and company may have been wrong in the observable, normal universe---what you or I might call "reality"---but they were wrong in a noble, beautiful way.  The kind of wrongness to which they fell victim is the kind of wrongness that allows one to cover ones eyes with the back of one's hand, stretch out the other hand, and sigh, "Ah, me!" 

On the other hand, those who were right are, as Krugman points out, DFHs.  They may have been right in the observable universe, but they weren't right in an ennobling way.  They were right in a childish, "I told you so" way, which only highlights their fundamental unseriousness.  It was easy for them to be right.  When DFHs are right, they are right in a dirty $@#$ing way.

You see, the real distinction between being right and being wrong is not one of verifiability.  It is one of aesthetics.  Was it difficult for you to come to your conclusion?  Did you suffer for it?  Was it dramatic?  Did you sit leaning forward, chin on fist, in pensive repose like that cliché thinker sculpture, only with more clothes?  It's the inner turmoil, and the hard decisions about other people's lives (whether they will live or not) that makes you a Serious Person.

But if the answer was obvious to you, plain as day, well, that's a pretty ugly way to come to the right conclusion.  No drama, no suffering, no inner turmoil.  You didn't even have an interesting pose.  There was nothing tragic about it.  You may as well have been at the grocery store or driving home or doing whatever it is that unserious, unimportant people do.

If you come to conclusions based on evidence, and if you see what obviously is unfolding before your eyes, and you do not have a Deep, Difficult Choice to make to sacrifice the lives of thousands, you are unserious and Serious People should ignore you.  Actually, the choice to sacrifice thousands of lives would prove that you were a Serious Person, because you certainly felt inner turmoil as you did so.

And the inner turmoil is what matters.

The scientist as actor

My Canadian readers may be familiar with this common phenomenon: I have a few American readers of this blog, and even among them, it is not uncommon to hear frustrated expressions of desire to become Canadian when their politics adds another razor-wire loop to the loopiness that it is.  My Canadian readers will also be familiar with the both the feeling of flattery tinged with a small amount of guilt: justified guilt that it is not deserved.

Via ReWind.it at Bread'n'Roses, we find this charming bit of news in the Notional Pest:

Until now, Environment Canada has been one of most open and accessible departments in the federal government, which the executive committee says is a problem that needs to be remedied.

It says all media queries must now be routed through Ottawa where "media relations will work with individual staff to decide how to best handle the call; this could include: Asking the program expert to respond with approved lines; having media relations respond; referring the call to the minister's office; referring the call to another department," the presentation says.

Gregory Jack, acting director of Environment Canada's ministerial and executive services, says scientists and "subject matter experts" will still be made available to speak to the media "on complex and technical issues." He would not explain how "approved lines" are being written and who is approving them.

This sort of thing will be no surprise to anyone following the saga of the frankly excellent Linda Keen, the Canadian nuclear regulator who stood up to a Canadian government presently dominated by an unadulterated Bushian neocon.  (Her total smackdown testimony linked from here.) And by dint of that, these tactics should be highly familiar to American readers, as they were learned from You Know Where.

Next year's baked goods are going to suck anyway

The Cookie Fascists have struck again!  Instead of recognizing my greatness and giving me my rightful due (a full supply of cookies next December), they have seen fit to give the Cookie Crown to another, another who was willing to pander to their narrow-minded definitions of "cookie."  I mean OATMEAL COOKIES???  Anybody can do that.

So now I know how it goes: assuming I don't go on strike and boycott next year, I will endeavour to make the most boring, blandest dough-disks imaginable, perhaps even ready-made, rather than the startlingly awesome confections that I made this year.  And I shall no longer listen to blandishments and praise, because these promises of greatness-recognition did not bear fruit.  Fie!

The Cookie Sultanate will have to wait another day because of the infidels.  Infidels, I say.  Infidels who gave out at least five prizes out of NINE contestants, and the name of Námo Mandos not among the winners.  Even the cookies that (might have) had interesting effects on canine digestion won a prize (judging a second-string contest).

One last thing: a big shout-out to the folks and loyal fans at Bread'n'Roses, especially GDK for the brownie recipe.  Y'all get to be sore losers along with me.

Be grateful you aren't starving

For some reason, I decided today to punish myself by reading redstate.com.  RedState, for my Canadian readers, is a wannabe Daily Kos for the right-wing.  The people who run it are the sort of Republicans who give off a sort of normal, less freepish aroma, but do not be fooled: they are actually completely loopy neocons and the like with the thinnest veneer of erudition. 
The difference between them and the freepers is the recognition that you have to put on a suit to get the creamier fraction of wingnut welfare.

So anyway, token funny-name* dude Pejman Yousefzadeh approvingly quotes this stunning piece of Jonah Goldberg-ian sophistry from some nobody writer in the NYT.

 

All economists know that when American jobs are outsourced, Americans as a group are net winners. What we lose through lower wages is more than offset by what we gain through lower prices. In other words, the winners can more than afford to compensate the losers. Does that mean they ought to? Does it create a moral mandate for the taxpayer-subsidized retraining programs proposed by Mr. McCain and Mr. Romney?

Um, no. Even if you've just lost your job, there's something fundamentally churlish about blaming the very phenomenon that's elevated you above the subsistence level since the day you were born. If the world owes you compensation for enduring the downside of trade, what do you owe the world for enjoying the upside?

This is, in a nutshell, why capitalism---whatever its merits---exists in deep opposition to democracy. What is this guy really telling the victims of trade and, indeed, the rest of us?  What is the moral corollary of this logic, logic that the writer quite correctly identifies as emanating from capitalist ideology?

Be grateful that we allow you to survive.

I don't normally go after right-wing ideologues directly myself, happily preferring, as I do, what others call the circular firing squad; I have generally preferred to go after intellectually dishonest people who profess to be, in some way or another, on my side.  And I can't help but feel that this sort of logic also underlies those people as well, especially the well-meaning economists and the like. 

But when someone tells me, "Congrats!  We are not going to kick you onto the street today," I may indeed count my blessings for myself.  But I am not obliged to express any gratitude for it.   If I believe that I owe gratitude for survival to something, then I believe that it is my master.

*I can say this because in real life, I have a funny name like his.

The second day of Oilmas

Yesterday was Oilmas! $100 NYMEX, baby!

Public service announcement

Sadly, No! has a post on the congressional Democrats' complicity in torture, just in case you might have once thought, like Bradrocket, that the Dems were better on that issue.  The credibility of the report is disputed in comments, but there's an overall discussion on the crediblity of the Dems in general.

Why do I even bother voting for Democrats again? I mean, WTF. It would be nice, really really nice, to have at least one goddamn party in this doomed nation that stands fully against torture. Jesus H., you horrible assholes. Don’t you have any damn principles? Don’t you have any ethics? Have you ever, at any point in your miserable lives, taken a principled stand on any issue?

Again, I feel sick.  Favoring torture is now a bipartisan issue.  David Broder must be very pleased.

This Kos diary by Jerome à Paris contains a link to a fascinating Financial Times report.

Minimum wages are new in Germany, where pay is traditionally negotiated by business federations and trade unions. Yet they are hugely popular – a survey this week showed 78 per cent in favour. Yet Mr Westerwelle said the CDU’s decision to bow to popular pressure merely underscored the weakness of its leadership.

The horror!  Leaders bowing to popular pressure?  Next thing you know, they'll want democracy.

The FT editorial on this issue is a hoot too.

None of this will be new to most of you.  I don't know why I posted it---which is the general problem with blogging for me, it's so hard to post anything original, and there's nothing more banal than hatred for democracy.  But then you get those public service ads on TV from the Shriners about not cooking your kids, so I'm thinking of this post in that vein.