politics

James Fallows’ cover story in The Atlantic, How America Can Rise Again, is worth a read. He talks about the current round of historical declinism, and notes that in many measures the culture of the U.S. is still a strong asset:

The simplest measure of whether a culture is dominant is whether outsiders want to be part of it. At the height of the British Empire, colonial subjects from the Raj to Malaya to the Caribbean modeled themselves in part on Englishmen: Nehru and Lee Kuan Yew went to Cambridge, Gandhi, to University College, London. Ho Chi Minh wrote in French for magazines in Paris. These days the world is full of businesspeople, bureaucrats, and scientists who have trained in the United States.

Today’s China attracts outsiders too, but in a particular way. Many go for business opportunities; or because of cultural fascination; or, as my wife and I did, to be on the scene where something truly exciting was under way. The Haidian area of Beijing, seat of its universities, is dotted with the faces of foreigners who have come to master the language and learn the system. But true immigrants? People who want their children and grandchildren to grow up within this system? Although I met many foreigners who hope to stay in China indefinitely, in three years I encountered only two people who aspired to citizenship in the People’s Republic. From the physical rigors of a badly polluted and still-developing country, to the constraints on free expression and dissent, to the likely ongoing mediocrity of a university system that emphasizes volume of output over independence or excellence of research, the realities of China heavily limit the appeal of becoming Chinese. Because of its scale and internal diversity, China (like India) is a more racially open society than, say, Japan or Korea. But China has come nowhere near the feats of absorption and opportunity that make up much of America’s story, and it is very difficult to imagine that it could do so—well, ever.

But Fallows is far less sanguine about the state of the federal government, noting that “one thing I’ve never heard in my time overseas is ‘I wish we had a Senate like yours.’” The government’s stability and continuity, he argues, as ironically part of why it is so subpar today:

The most charitable statement of the problem is that the American government is a victim of its own success. It has survived in more or less recognizable form over more than two centuries—long enough to become mismatched to the real circumstances of the nation…

Every system strives toward durability, but as with human aging, longevity has a cost. The late economist Mancur Olson laid out the consequences of institutional aging in his 1982 book, The Rise and Decline of Nations. Year by year, he said, special-interest groups inevitably take bite after tiny bite out of the total national wealth. They do so through tax breaks, special appropriations, what we now call legislative “earmarks,” and other favors that are all easier to initiate than to cut off. No single nibble is that dramatic or burdensome, but over the decades they threaten to convert any stable democracy into a big, inefficient, favor-ridden state. In 1994, Jonathan Rauch updated Olson’s analysis and called this enfeebling pattern “demosclerosis,” in a book of that name. He defined the problem as “government’s progressive loss of the ability to adapt,” a process “like hardening of the arteries, which builds up stealthily over many years.”

Fallows cites specific problems, not that novel to people who care about such things: The fact that Senate votes are absurdly nonproportional to population, the overuse of the filibuster, the stasis of gerrymandering on state and federal levels. I would add to that a massive top-down complexity. Democracy is not well-served when the country’s highest governing bodies routinely pass laws that are too long for any one person to read.

What I find disappointing in all this is that some of these problems routinely disadvantage the left, but the left by and large doesn’t have much to say about them. If Senate representation actually gave enough votes to people living in large cities, we would’ve passed health care reform by now. But the left also generally loves centralized government solutions, so I suppose that makes it hard to argue that the centralized government we have now is deeply flawed.

As for how to fix these massive structural problems: Fallows doesn’t seem to believe it can be fixed, just that we’ll muddle through. And maybe that’s realistic, but it’s also pretty depressing to contemplate. Personally, I’d be happy if people in the more populous states continued a modified version of Grover Norquist’s work, shrinking the federal government and working to supplant as many services as possible at the state and inter-state level. The goal would not be to drown the federal government in Grover’s bathtub, but simply to participate less in a federal government that takes a lot of their taxes and gives them way less votes than Wyoming. That could conceivably lead to some Constitutional amendments that might rejigger the Senate somehow. It’s a pipe dream, obviously. But given enough time, the rot in U.S. government could destroy what’s special about U.S. society, so it’s probably not a bad time for a little brainstorming.

“The Central Bank of Iran has tried to take these banknotes out of circulation, but there are just too many of them, and gave up. For the activists’ people it’s a way of saying ‘We are here, and the green movement is going on.’”

Andrew Sullivan’s post, which was written before Obama’s speech, seems about right to me:

... everything I hear sounds like conventional drift to me – Bush’s policy with a much more interesting and intelligent discussion beforehand. So instead of staying in neo-colonial occupation against an insurgency that now feeds off US intervention with no real strategy, we will stay in neo-colonial occupation against an insurgency that now feeds off US intervention with lots of super-smart defenses of the indefensible. Great.

I guess my general feeling is that I’ve heard nothing that makes Afghanistan deserve such a special place in our foreign policy planning. Sure, it’s a war-torn place rife with religious extremism, but unfortunately, that doesn’t make it unique in this world. The next September 11th could come out of Somalia, say, or any of a dozen other hotspots on the planet. Are we really saying it’s our job to occupy and economically develop every last one of these places for the next few decades? Empires decline when they overreach.

I can’t say I’m super-disappointed in Obama, though. He’s not King; he’s President, and he reports to an entire country of people, many of whom can’t stomach anything that looks like surrender. Personally I think there’s no shame in acknowledging past mistakes and changing direction, but then nobody would be fool enough to vote for me as President.

Buzzfeed: The 20 Best Signs At The National Equality March (more than 20, if you count posted images in the comments)

Writing over on Andrew Sullivan’s blog, Jim Manzi discusses two differing, though not mutually exclusive, strains of libertarianism, which he calls “liberty-as-goal” libertarianism and “liberty-as-means” libertarianism:

In somewhat cartoon terms, one strand takes liberty to be a (or in extreme cases, the) fundamental human good in and of itself; the other takes liberty to be a means to the end of discovery of methods of social organization that create other benefits. ...

Liberty-as-means libertarianism sees the world in an evolutionary framework: societies evolve rules, norms, laws and so forth in order to adapt and survive in a complex and changing external environment. At a high level of abstraction, internal freedoms are necessary so that the society can learn (which requires trial-and-error learning because the external reality is believed to be too complex to be fully comprehended by any existing theory) and adapt (which is important because the external reality is changing). We need liberty, therefore, because we are so ignorant of what works in practical, material terms.

Manzi probably knows the libertarian movement far better than I do, but from an outsider’s perspective I can’t help but feel like there are a lot of movement libertarians who are “liberty-as-goal” libertarians. And it’s this strain that makes it really unlikely that I’d ever identify myself as a libertarian, even though I often find myself in agreement with the specifics of a libertarian policy argument.

I’ve had plenty of discussions with libertarians, online and offline, who act as true believers who are only interested in the messy details of real life as long as they can be bent to conform to a certain ideological predisposition. Obviously you can be this way with many ideologies: For similar reasons I don’t consider myself a Marxist or a Friedmanite, and I’ve been finding the recent aggro atheism pretty off-putting as well. I just don’t see life that way. The world is complicated, and if your political philosophy can be summed up in one paragraph, it’s probably a crap philosophy.

But as a side note: I’ve actually noticed over the years, as the word “libertarianism” seems to be getting broader currency, that the percentage of self-identified libertarians who are also raging assholes seems to be going down over time. Not sure what that means, though I suppose it probably bodes well for that movement.

Via Buzzfeed.

A lot of the health care discussion focuses a lot on wonky technical jargon. I could happily wonk out all day, but perhaps there are genuine differences in the underlying values that are worth teasing out. And as should be expected with something as massive and complex as the U.S. health care system, much of the discussed reform addresses more than one belief at a time in a intermingled, potentially confusing way.

So here’s an experiment, now that I know that some people actually comment on this blog. Please respond to the following statements, saying whether you agree or disagree with them, and maybe even why:

1. It’s fair to ask people who are younger or healthier to pay more (through taxes, premiums, etc) to help provide health care for people who are older or sicker.
2. It’s fair to ask people who are wealthier to pay more to help provide health care for people who are poorer.
3. The right kind of governmental involvement can help bring down the cost of health care treatment.
4. The level of health care that Americans expect from doctors, clinics, insurance companies, and pharmaceutical companies is reasonable.

So, I don’t know why I keep blogging on this issue; it’s not like I’m some huge expert or that my personal health care situation is really bad. But here I go again:

Conor Friedersdorf argues that the health care reform package is vulnerable to stirring up irrational fears because it’s big and complicated and people are naturally risk-averse to large complex changes.

My grandmother, my mother, and countless other Americans may be misinformed about the particulars of health-care reform, and express certain misbegotten fears, but health care proponents would do well to understand the anxiety’s source: Theirs is ultimately a fear of rapid, sweeping policy shifts, especially those brought about by lengthy, amorphous legislative proposals that leave unclear exactly what might change the month after next.

I think this is a legitimate concern in general, just because of my own personal experience in work, and side projects, in life in general: Getting anything done in the world is about a hundred times more complicated than you think it should be. Sweeping national legislation in a country of hundreds of millions of people always has the potential for tons of unintended consequences, so sometimes it’s not irrational to want to stick with the devil you know. A lot of the thinkers I respect the most are the ones who are most humbled by the unknowability of the world, and I think a lot of well-intended reformers could do well to learn from that just a bit.

That being said, the current system’s pretty horrible, so at some point you have to take risks and change things. And it’s not like the world’s standing still even if you don’t change government policies. Conor argues for a number of small reforms, that individually can be passed and can incrementally improve the situation, instead of one giant reform, as more realistic and ultimately more likely to help more people.

In response to Conor, however, Matt Steinglass is arguing that incremental reforms can become impossible if the status quo is too complex.

Substantively: the reason one often can’t pass individual planks of the reform in isolation is that taken individually, each plank generates perverse consequences that will lead to strong opposition from a particular constituency. Universal community rating, for instance, will make health insurance for the young and healthy more expensive. That creates adverse selection, as the young and healthy will drop out. And adverse selection threatens private insurers’ revenues: they lose their best customers. So to kill such a bill, private insurers will trade on young people’s fear that they’ll lose their health insurance. And they’ll be correct!

I might argue that Matt’s trying to cut along the wrong axis. Maybe it would be useful to imagine keeping most of the planks, but making the individual planks less sweeping. For example, instead of saying everybody is required to buy health insurance, start with saying that everybody age 40 and up is required to buy health insurance, with subsidies to help those who are of age but poor. That doesn’t get you to 100% coverage overnight obviously, but neither does a omnibus package that never passes.

In Massachusetts, they chose universal coverage as a goal before cost-controls, and Ezra Klein thinks that’s the best way to do it.

In 2006, Massachusetts passed a big health-care reform bill. The structure of it was actually pretty similar to what we’re seeing nationally. And, like what we’re seeing nationally, it didn’t have much in the way of cost controls. But nor did it promise to. The short-term priority, officials said, was getting coverage to everyone. The long-term priority was cost control. And the two would work together.

After all, without cost controls, subsidizing health-care coverage would become unaffordable, and Massachusetts would have to abandon the reforms it had worked so hard to pass. Without cost control, there could be no universal health-care system. That would focus the mind, they predicted. That would help them make the hard decisions.

I find it sort of hard to get excited by this being replicated on the federal level. For one thing, those cost controls which are now being considered in Massachusetts have yet to be implemented, so we don’t know how successful they’ll be. This stuff is complicated, and it’s not impossible that the cost controls will be designed poorly and result in reduced quality of care. Also, shouldn’t representative democracies avoid these sorts of “let’s make the situation worse so we can make it better” strategies?

FWIW, it seems to me that one easy win would be to remove the health care tax exemption from companies and put it onto individuals, which would improve health care portability and make it easier to start your own company. It’s not a huge sea-change, but I think it’d be easy to put through, not least because there aren’t a lot of people arguing for it, except for I suppose your shitty Fortune 500 employer who wants you to stay at your job even if you hate it.

I’m also interested in any sort of cost-control measures alluded to in Atul Gawande’s fascinating New Yorker article last month, but those things are complex and hard to get right. And what I don’t particularly understand is why, if those cost controls could be implemented by private health insurance companies, why they haven’t done so to gain a price advantage over their competitors. It could be because, unlike, say, hard drives or t-shirts, health care is a good whose value is very hard for the average person to assess, especially because the product’s good plays out over years and involves unlikely, high-cost events like a cancer diagnosis that are hard for people to reason about. Would it be useful for a government agency to rate aggregate quality of outcomes for different private health insurance plans? Of course, trusting the agency’s ratings is an issue then.

I also believe that increasing taxes slightly on the wealthy to improve health care for the poor is a good thing, though I’m not sure if that improvement should realistically be through government programs, or health care vouchers, or whatever. But I’m not really a huge fan of the government-administered option, primarily because I haven’t read anything that’s convinced me that it’s the profit motive that’s the problem in the American health care system. And what about non-profit health plans?

I am not convinced we should be forcing young healthy people to buy health insurance, and as Massachusetts’ example has shown that doesn’t seem to do much for cost control. Also, going without health care to save some money seems like an option you should be allowed to have, and I know a lot of people who do it here in NYC. Though there is the externality of emergency care that needs to be accounted for somehow.

Anyway, I think it’s a shame these things aren’t being discussed more heavily. It’s not enough to say “something needs to be done”: You have to figure out what that something should be, especially because the wrong something could actually be harmful.

It would be helpful if we had a sane center-right opposition that could force a principled discussion of different aspects of health care, instead of simply trying to set themselves up for taking back Congressional seats in 2010. Marc Ambinder argues that the politics will probably play out in the Democrats’ favor:

Remember: the Democrats are still much more trusted as a party to fix health care (in the generic sense) that Republicans are. The public buys in to the urgency of the problem, even as they’re not officially sold on any solution. What’s now known in liberal circles as the “DeMint/Kristol” strategy is an instinctual Republican strategy derived from the gut; it misreads the public’s ambivalence about Obama and the health care debate as a sign that the public has soured on health care reform in general (nope) or Democratic principles in particular (not really). It may well have the perverse effect of generating sympathy among independents for Obama. Independents want to get health care done; they respect Obama for trying, even as they’ve begun to sour on his leadership skills.

That sounds about right, politically speaking. Not sure where health care itself will be when we’re done with this round.

This can’t possibly keep up, can it?

These are from a recent Gallup poll which show that, yes, you are reading it right, since George W. Bush took office the GOP has not gained ground with any demographic. Not with people over 65 or with people who describe themselves as conservative. Even people who go to church weekly only held steady at 0. Maybe the margin of error gets a few of those groups into positive territory but this a really terrible record.

Not surprising, really: My dad was a lifelong Republican but became a frothing-at-the-mouth Democrat when the Bush administration was done with him, and I’m sure he’s not the only one. A bit disappointing, I will say, though, because it’s probably better for the country to have healthy opposition. Don’t get me wrong, I’m not hoping the current, horrifying GOP gets any more traction in this country. I’m just saying that I hope that the GOP has whatever internal civil war it needs to have for the non-insane conservatives to take over soon, and with a minimum of fuss. Or that the GOP just explodes in flames so some other party can take its place in the American duopoly. Then we can talk about the Republicans the way we can talk about Whigs or Know-Nothings, and maybe national politics can be a little less of a circus.