Although this here blog has been silent for a while as I am knee deep in my crash-course on health policy and other distractions I will hopefully write about later, I thought that this succinct description of the Republican, courtesy of Rep. Alan Grayson (D-FL), was worth passing along (h/t TPM):
I am positive that I am not that knowledgeable about the details of the health care debate. This is a little troubling on a personal level since, tomorrow (i.e., eight hours from now), I am going to a class focusing on health policy. Yes, I too thought that I was done with classes years ago, but it is part of my program that I take this class. Although I study health, I study neither health care nor health policy, though part of the program that I am in is designed to have participants think more about health policy. Can't say that there is much better of a time to have a tutorial than now and I am really looking forward to it.
Let me start my thoughts by saying that I think that Obama's speech was great. Given my cursory knowledge of the subject, I think that his plans sounded reasonable. Of course I would like a full-fledged universal insurance program, but I don't think that it is possible or, frankly, at this point that important. If insurance is made affordable enough to make good health care attainable to all Americans, I think that reform will have succeeded. While fully universal coverage would be a better option, having the organizational structure in place to show the American public that it is possible will succeed in making it impossible to get rid of it. The perfect demonstration of this point is the number of people out protesting last month against government-sponsored health care who didn't want Medicare touched. Beyond the cognitive dissonance that makes it difficult to believe that these people make it through a regular day, the fact that Medicare and Social Security are untouchable demonstrate my point.
At the same time, it is also true (again, to my limited knowledge) that both Social Security and Medicare have remained largely the same since their creation. The fact that neither has changed significantly doesn't bode well for incremental-style changes that some in the center and the right (including Newt Gingrich) are advocating. Simply doing something isn't going to cut it in terms of creating good policy; therefore, if anything like what Obama proposed tonight is passed through Congress, then he and Kathleen Sebelius need to develop a strong agency that is relatively impervious to meddling in the future and that aggressively pursues its mandate at its inception. If the agency that is developed is strong enough to assert itself and to regulate the insurance industry to accomplish the goals laid out by Obama, then I think that a bill resembling Obama's outline tonight — with all of its significant shortcomings — can actually improve the state of health care in this country.
[1] TPM has also noted that this might lead to a censure of Rep. Wilson by the House for violating the rules of decorum. Following these rules, the Minorty Whip, Rep. Eric Cantor (R-VA) was also caught violating the rule to "Refrain from eating, smoking, or using electronic equipment, including cellular phones or lap top computers, on the floor." Video here.
It has been a couple of exciting weeks for us. I ended my previous job, we spent a week relaxing in gorgeous Ocean City, NJ, moved to Philadelphia, and I started my new job while E. started in her new office. Blogging has been short on the list of priorities as we still have boxes that need unpacking and stacks of used boxes need to be put somewhere; but, hopefully we will be back up and posting more regularly soon.
The “debate” surrounding health care reform has caught almost everyone's attention. The vocal opponents of health care have been variously described as a “mob”, “un-American,” and even “brownshirts.” This isn't just anyone saying this, but it is (in order), arguably the leading progressive columnist (Krugman), the #1 and #2 Democratic leaders in the House, and a U.S. Congressperson. The hostility and animosity expressed during these demonstratiosn including firearms being brought to events or Sarah Palin saying that a “death panel” would euthanize her son because he has Down's Syndrome (before, gallantly calling for civility) is becoming downright scary, including the actual death threats against sitting members of Congress. But, to have the kind of people calling out opponents of health care as un-American or comparing them to fascists is downright wrong.
Although I disagree with the tactics used by those who oppose health care reform, Andrew got me thinking about what it means to denounce them. Very thoughtfully, he reminded me that the sort of “deliberative debate” that I would prefer
imply a particular kind of deliberative democratic subject:
- One who is calm, considered, rational, and deliberative. This worries me because it implies that emotion is an illegitimate way of engaging in politics. That, in turn, privileges particular kinds of people, and kinds of discourses, as a matter of form.
He is right to point out that many people, often those who I care about greatly and support, use these tactics. I have been to labor protests where the rules of civility were thrown out the window because civility favored management. Disruption hit the financial bottom line and forced the managers, who were hiding behind this cloak of civility, to take notice. There is, I suppose, nothing wrong with these protests as a tactic and, certainly nothing un-American or fascist about them (leaving any violence—real or implied—aside). Americans have a right to redress their grievances to their government; nothing ever said that the government had to like the way that citizens chose to carry out this redress.
This reminded me of a really influential passage in the book Urban Fortunes by John Logan and Harvey Molotch. The book describes the process of urban land development, providing an interesting synthesis between traditional neo-classical and human ecological models of urban growth and Marxian models of economic growth. One of their main points throughout the book is that:
The traditional academic literature on the topic tends to equate “community organization” with progressive social forces generally and to see all such groups as analytically equivalent because they are from the “grass roots” and help “empower” local people.
They go on to point out that many local organizations (their interest is in understanding the forces guiding urban development) are indeed not progressive. One can look back in history to local community forces that were, indeed, not so progressive such as the northern white block clubs that tried to maintain the starkly segregated residential color line.
I have seen the argument that there is a difference because these protests are “astroturffed”, insta-activism bought by the insurance lobby. Although it seems to be funded by the insurance lobby, I also have a hard time believing that all of these activists are bought off. I also don't think, as Paul Krugman suggests, that “the driving force behind the town hall mobs is probably the same cultural and racial anxiety that’s behind the ‘birther’ movement, which denies Mr. Obama’s citizenship.” Granted, many of the birthers are probably among the crowds, but to say that this is all about Obama's race or that the tactics are somehow un-American denies the reality that there is a substantial opposition to health care reform. I don't think that it is the result of deep-seated hatred (though, for some, this is undoubtedly the case), but is likely a fear and mistrust of the government that has a real basis in reality.
The answer to this is not to disparage and insult those who are protesting, to question their patriotism (remember the “Dissent is Patriotic” bumper stickers). It is to organize an opposition, including some who might simply be confused or nervous about changes and have real concerns about government-run programs. I'm not tilting at windmills; I don't believe that one will ever convince most of the people shouting at town halls and I think that it would be futile to do so. But there are lots of people, I would guess, who are hearing some of their concerns echoed by the vocal protesters and who see that people—fellow citizens—really care about opposing this bill. Without effective organizing to counter-act this movement and inoculation against the opposition's talking points health reform is unlikely to succeed. Reformers have the advantage is that there are many in the reform movement, including the President himself, who have learned how to build an effective organizing base from which to enact reform. If this truly is an astroturf campaign, then real organizing (with time) should be able to overcome it. I just hope that he remembers that is how he got to have the meteoric rise from a state senator to President in less than a decade and that he calls some of those advisors up to help rather than those he keeps finding from inside the Beltway.
E. and I were driving home from a family function last week and caught the end of the This American Life episode on "fine print." Among the stories was a heart-wrenching tale about the problem of rescission, which is basically where insurance companies take premiums for years and, right when you need an expensive procedure, drop your insurance because you "lied" on your application. This really affects people who get their insurance on the private market. During the episode (described in more detail by James Kwak at Baseline Scenario), the health insurance companies being grilled during congressional testimony argued that rescission affects about 0.5% of their clients.
But, in a truly amazing post, Taunter explains how conditional probability can explain why this 0.5% can sound so small but amount to an unconscionable fraud on the part of insurance agencies. Using the Monty Hall Problem (and, implicitly, Bayesian reasoning), he explains why the insurance executives essentially bank on rescinding one in two claimants for those in need of service! He points out that you have a three times better chance to survive a game of Russian Roulette. It is an amazing lesson in conditional probability and Bayes Theorem that could be an incredible teaching moment.
Until the patients needs an expensive procedure, patients are paying their premiums into the coffers of the insurance company and the pockets of their executives. The expensive procedures, of course, are why people need insurance. The insurance companies, though, get to keep all those years of premiums for all of those years even though they don't follow through on their commitment to pay out, getting rich off those years and years of premiums. The procedure goes something like this: take money from a group of people and promise them a return in the future, use the money to pay off claims of others (minus a heavy for the service), and when it comes time to pay out, renege. Taunter points out that this seems vaguely Madoffian.
The justification of this procedure is that, without it, insurance prices would rise for everyone in the system and that people should be punished for fraud. Of course, many of these people did not commit any sort of fraud and instead got confused by the leagalese and convoluted medical language which were intentionally designed to get people to slip up. It is probably true that insurance premiums would probably go up, but it doesn't really matter if people aren't getting a service that they pay for (in other contexts, that's called stealing). But, it is also an argument for why the "free market" does not always know best and why health care reform is so important. I hope that in the coming days and weeks, the Obama administration and Congress get their footing and actually start to stand up for reform.
I have a hard time imagining anything that could be better for the Pragmatic Idealist household. E.'s favorite band jamming about statistics! No, I'm not kidding. Really, I'm not. Check it out (h/t Mark Blumenthal):
I have to admit, I have become very weary of hearing about the Gates incident in Cambridge. I hate the vitriol that this discussion causes and makes people instantly react and assume that those involved acted in bad faith and were out to "get" the other one. I don't like it because it so often turns into an argument about the veracity of claims or the impugning of character that draws on entire histories of caricatures of peoples positions on certain groups. "Cops are all racists" and "There 'they' go again, playing the race card." Yet, in placing these caricatures on both the sergeant, it is a convenient way to avoid talking about the underlying historical role that these forces play. Instantly, we (the public) assume a narrative that we believe to be the case and impose it on the situation.
How is it that an officer that had taught a class on racial profiling ends up being caught in a media firestorm over a racially-charged arrest? On the one hand, some say that it is "proof" that there was nothing racial about this incident whatsoever. Or, that a black officer supporting the sergeant's arrest must be evidence that race has no role whatsoever in this. On the other hand, there are those who argue that really, the cop could still harbor subconscious racism and "had Gates been white, this wouldn't have happened."
What I think we need is a greater understanding of each other and knowing that we all make mistakes, but also the vast majority of act in good faith. I find this debate tiring. Not because I don't believe that race is important in shaping the experiences of all people, particularly in the United States. Nor do I believe that we should just say that everyone made mistakes and this was troubling, and then move on. In some way, the mistakes were perfectly predictable. The fact that racial profiling happens a far greater proportion of the time than it should provides the basis for mistrust. The fact that the officer teaches classes on it doesn't mean that the situation might have been handled differently had Gates been white. At the same time, it doesn't take away the fact that police officers face dangerous situations and, on a regular basis, have people lie to them. That it seems like Crowley escalated the argument rather than trying to diffuse it was a mistake, but it was an understandable human reaction to the situation. The fact that Gates was, by all accounts, heated didn't help the situation but, again, it was an understandable human reaction to the situation. I have little patience for people who say, "I would have done this or that in the same situation." One, it is impossible to tell—I have been surprised by the way I have reacted in many situations; and two, just because I would react in a certain way does not mean that every person acts differently in a situation does so in a way that is unreasonable or not understandable.
That is why, in all of this, I find this surprise press conference by the President refreshing. First, he admits that he didn't help the situation—he admits that he did something wrong. Let me tell you how much of a relief that is after President George W. "I make no mistakes" Bush. There can be no understanding and dialogue if people are not willing to admit that they would, if they had the opportunity, to do or say things differently. But second, and I think more importantly, Obama doesn't give in solely for political expediency. He could have apologized and said that everything was blown out of proportion; instead, he said:
...where all of us, instead of pumping up the volume, spend a little more time listening to each other, and try to focus on how we can generally improve relations between police officers and minority communities, and that instead of flinging accusations we can all be a little more reflective in terms of what we can do to contribute to more unity.
In other words, I did something that I wish I hadn't done and didn't help the situation. At the same time, let's not pretend that there is not a situation of minority profiling/discrimination that requires dealing with because I did something I wish that I hadn't done. It should also mentioned that the consequences of this racial discrimination and profiling can be truly tragic for the police as well. Obama's final statement:
There are some who say as president I shouldn't have stepped into this at all, (which) I disagree with. The fact that this has become such big issue is indicative of fact that race is still a troubling aspect of our society.
speaks to this.
Ultimately, I am not arguing that Crowley or Gates should have necessarily acted differently. It is in fact my very point—I know nothing about the situation other than how it fits into a larger narrative that requires assuming bad faith on one or both sides of the incident. By playing into that narrative and personalizing a structural situation into these two individuals leads to nothing but mistrust and hot air that ultimately gets us nowhere. I truly hope, if Sgt. Crowley and Dr. Gates are both interested in moving race relations forward—as much evidence seems to indicate—that they can then work together over beer, with the President, to actually make this a more constructive dialogue.
