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.

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.

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.

Woe unto the Men of Númenor

I felt obliged to post now in order to counter the litany of slander and lies against me and my fellow competitors in a certain bake-off in which I am participating with some US bloggers. 

But this contest is completely over.  Yes indeedy, the Doom of Mandos has decended.  Fear my wrath.

My goodies, of course, arrived first, first of all the goodies in the bake-off.  Were it not for the Númenorean stubborness and rejection of inevitability by the competition, that should have been that.  I would not only be the Vala of Doom, I would also be Cookie King for a year. 

Let us examine!  Emerging great and terrible from a smithy I borrowed from Aulë is but the merest beginning of the total pwnage.  Behold!  The brownies of the Noldor, in their natural splendor:

And then, made from the remaining sap of Telperion, is the secret family egg dish of the Valar.  Here is its humble but amazing batter beginning:

It prepares to enter the furnace of Aulë:

And here it emerges, to be placed among the stars (and served to the judges)!

Last, there is the sacred spicy nut brittle of the Vanyar, eaten only every 157 years, at the special feast of the Movement of the Foot of the Lark.  It is cooling.

Arrogant mortals will always regret going up against the forces of the Valar.

And looks like it is ready to ship to the cookie judges, including the great Cookie Queen and her co-judges themselves via the Eagles of Manwë.

And we have some beautiful music to accompany it!

(Thanks to some nameless Canadian Maiar who will remain unlinked, alas, until the contest deadline has passed.  But this was a team effort.)

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.

Dashing my haber

Yes, yes, a nothing post and then a post about haberdashery.

So, every six months or less, I must buy a new pair of shoes.  Walking is my main mode of transport, so my shoes wear out very quickly.  Buying shoes is a difficult task for me, because I have big feet, and worse, one foot is a bit larger (wider) than the other.

In my own weird way, I also have stylistic concerns.  You'd think that for someone who walks a lot, I'd buy a lot of comfortable runners.  Not so; I have my own peculiar image to maintain, not to mention the fact that I simply am too mentally lazy to juggle which shoes to wear for what.  What I want is nice black shoes that are comfortable for miles of walking with good grips and high durability that don't hurt my peculiar feet.

Yes, that is a tall order.  And it takes a correspondingly long time to fill it.  Grrr.  Why do so many shoes have no grip?  Who wants to slip and slide across, say, tile floors?  Well, I found something.  But it is not perfect.

In the same vein, I am also looking for a new wallet.  I bought my old wallet in Karachi, Pakistan last winter.  At a big gift shop warehouse festooned with reassuring anti-child-labour posters, a sure sign that children had indeed been harmed in the making of my wallet.  (As they probably have with yours, which I do not say in my defence...)  I need to carry a large number of cards around with my at once.  I imagine that nowadays, most people do.  I've got change, receipts, and on rare occasions, even cash.  It's a big bulgy wallet that I keep in my trouser pocket.

But why is it next to impossible to find a wallet that can store any reasonable fraction of that now?  What's this with ridiculously thin wallets?  What, so people are afraid of a little pocket bulge?  Seriously.  I can't find a decent wallet anywhere.  Not a one of them even has a change pouch.

Finally, while at the mall, I noticed a major department store's "Big and Tall" men's clothing collection catalogue.  Lots of tall, but no big.

I CAN HAS BATHTUB?

The Grover, he is winning.

So, I love to get snippy with DKos.  But with things looking up for the Dems, it looks like the stifling conformism is relaxing a little bit. And, truth be told, some of the "diarists" at that site have been consistently informative for years.

One longstanding diarist, bonddad, has commented on finance for some time now.  And he writes that the next US president, probably a Democrat, is probably going to be hobbled economically.

Democrats have high hopes for the 2008 election.  And they should. Bush’s policies have done an incredible amount of damage to the Republicans.  It’s doubtful they will recover anytime soon. But should a Democrat win, the fiscal mess left by Bush has already predetermined the next president’s primary policy goal: to clean-up the mess Bush is leaving behind.

He then quotes some very scary debt figures.

Canadians will know to be very wary of debt scaremongering.  If there's one thing this country learned during the previous Liberal government(s), it's that it's surprisingly easy to dig oneself out of rather deep holes.  Canadian writers such as Linda McQuaig have built careers out of pointing out the artificial nature of debt and deficit numbers and their propaganda value in media-popular victim-blaming schemes, whereby the weakest are accused of soaking up and squandering our valuable resources and left to fend for themselves.

Certainly, any drawdown in US forces in Iraq will have a noticeable effect, for instance.  Reversing some of the tax cuts, another.  And so on.

But even this long in hock has had an effect, and the patient---the prospect of a decent social welfare schemes in the USA---is still partly drowned in Grover Norquist's bathtub.  Perhaps not quite the way that dear old horrid Grover intended it; he entertained, at least publicly, the fatuous thought that it might be brought about by spending cuts on the meagre redistribution schemes for the poor, or something like that.  But by the only way it could: coercive wealth transfer to the powerful.

As usual, the Onion delivers

In The Know: Are America's Rich Falling Behind The Super-Rich?

Via the comments at Sadly, No!

I have shaken the hand that annoyed Tucker Carlson

I went on a trip to DC, and today a new era in world history has begun.  I have met Chuckles in person!  This momentous event sent a cataclysmic  of mystical energies through the ether, the magnitude and significance of which you may never comprehend---but they will affect you!  And it did involve eating delicious Ethiopian food.  Awaze tibbs, mmm mmm.

(My Canadian readers wouldn't know who I'm talking about or his significance to human history, so they might want to read the Coles Notes version here.)