After watching the debacle that is the United States Senate over the last few months and hearing the pundits deplore or defend the use of the filibuster and anonymous holds, I am fairly receptive to alternative structures to accomplish the task of legislating. The minority party has a strong incentive to grind the gears of government to a halt, regardless of the urgent business of the country. The minority party can then go to their base and claim, with evidence, they stopped the other side from enacting their evil agenda and go to the public at large and claim, again with evidence, that the majority party did not accomplish anything in these perilous times. The base is energized so it will show up to vote next time around and the public is disillusioned with the government and stays home (at worst) or believes in the incompetence of the majority and votes the minority into power (at best).
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Mr. Coates, one of the best writers you aren’t currently reading, describes here some of the challenges he’s facing in deciding how best to educate his young son in Harlem. In brief, Mr. Coates finds that many, if not most, of the public schools near his home are more accurately described as test-prep schools designed to prepare students to achieve on the standardized tests that higher education uses as a proxy for determining likelihood of success in college. The post touches on a couple different subjects, but there are two I’d like to explore more fully.
1) The strong impression the reader gets is that public schools in poorer, urban areas serve a different purpose than the education provided by private schools or suburban public schools, namely to increase the prospects of college attendence. This stands in contrast to what I’d view as the historical model of public education serving the same general purpose for all students in the country – to provide a baseline set of facts that society views as necessary to function and the tools to learn new facts and identify the relative merits of new theories.
Presumably most of the students in Mr. Coates area are coming from families in which they would be the first to attend college. If you believe that college attendence is a positive, as I do, and view the correlation between college attendence and income levels as legitimate, this model offers some value. And I’m completely sympathetic to the position that giving a kid that opportunity may outweigh any greater societal costs. And, theoretically, a college education can fill any gap in more traditional learning that is sacrificed. My fear is that given this country’s distaste for education in general and life-long learning in particular, every opportunity we have for sparking a flame for learning and thinking is a precious moment. How many success stories do you hear today that sing the praises of a particular high school or middle school teacher that set a student’s feet on the path that led to their acheivement? Can we sacrifice even one opportunity?
2) At the same time, I worry about the dissolution of the education structure into multiple levels of service. One of the strengths of the universal system serving everyone more or less in the same manner is that society has buy-in. If you didn’t attend public school, chances are fairly good that you know someone who did. Having a relationship with the public schooling system helps all of us want to see it succeed. Alternatively, if urban public schools are the product sold to the poor as a tool to get the next generation into college, suburban schools the product for the middle-class to provide an avenue to (most likely) one of the nearby state universities, and the rich retreat to private schooling, all I see is increased societal stratification. (I understand these are gross oversimplifications and hope you can get beyond them to understand the point). Conservatives seem to believe that the public education model is a flawed, or worse failed, experiment. How much easier will it be to chip away further at the institution, at one or multiple levels, if it is a product only used by a group to which the majority of the country doesn’t belong?
This isn’t a subject I have much in the way of answers. Unusual, I know. That said, for all of the platitudes that every leader in our society lays at the feet of education, I’m increasingly uncomfortable about its future prospects.
Amongst the Reasonable Right™ there has been some pushback on the condemnation of Mr. Sorba’s presentation at CPAC. For background, Mr. Sorba is a virulent defender of opposite sex marriage and seems to believe that homosexuality is an acquired trait, if one were to read his The Born Gay Hoax (I wouldn’t recommend it). Mr. Sorba was invited to give a talk at the annual Conservative Woodstock defending his beliefs. During his speech, the crowd started booing and the moderator had to remind the crowd that they respected “freedom of opinion.” A number of bloggers saw this as further evidence of the homophobia and ridiculousness of what passes for conservatism today. Mr. Sorba didn’t exactly help his case when, after being confronted by Someone Claiming To Be Gay (couldn’t actually BE homosexual, according to Mr. Sorba), this inspiring young homophobe decided their differences might best be resolved in a round of fisticuffs.
So in summary – Mr. Sorba gives anti-gay speech, receives some booing, threatens dissenter with physical violence. A number of the Reasonable Right™ respond that the real newsworthy event here is the booing. OK, I’ll play along. Yes, I’m glad that some participants in CPAC condemned the bigoted views of a troglodyte. But from the several video shots I saw, it seemed those objecting to Mr. Sorba were a small a dedicated group, perhaps a member of this GOPride organization itself. The vast majority of the crowd seems content to day dream about the dangers of escalators or their coworkers, or the dangers of Rascals. I’m fine with being open to inviting a plethora of voices to your little rally, if only so things don’t get stale (I’ll leave it to you, gentle reader, to come up with your best old-person-stale joke). If nothing else it gives you an opportunity to precede and follow said crazy person with articulate voices speaking in opposition and demonstrating to attendees and the press that while you respect everyone’s right to an opinion, and you are even willing to provide a forum for them to defend their opinion, your organization disagrees with those views.
So again, is it great that a group of young people voiced their objection to Mr. Sorba’s position (not to mention a group of young people was able to stand the old person stench long enough to participate)? Yes. You have my admiration and respect. I’ll even throw a few kudos to the Reasonable Right™ for emphasizing those voices of dissent. But I’ll reserve most of my congratulations for when those voices manage to convince the rest of the conservative movement (or let’s settle for a majority) that gay people don’t have cooties instead of simply waiting for 75% of the conservative coalition to just go away already so that the movement can join the rest of us in the current century.
While driving home tonight, I heard one of the political radio shock jocks (one of those substitute hosts, you know the type – not equipped with the level of intelligence the scientists refer to as “mild retardation” that is necessary to have a full-time gig regurgitating talking points from Hot Air or The Corner, but a guy who cleans off the spittle from the microphone after the full-time moron leaves for the day, but today the moron had to call in sick because his drug dealer was late and he couldn’t face the world without being in a haze that allows him to make the logical conclusions necessary to educate his dedicated audience – but I digress) speak about a good cause (helping wounded vets) but stating that a charitable group doing the work was doing God’s Work while similar efforts by the government were leading to the Collapse Of Our Society. Now in fairness, one shouldn’t hold a guy like that responsible for his words. He’s simply suffering from an illness. But it does raise an interesting point that I’ve never fully understood.
Why is it that the central objection to welfare programs by conservatives are based on the moral hazard argument? It seems to me we can debate about the relative efficacy of any particular effort and of allocating resources amongst the multitude of worthy causes. We can venture beyond the practical and look at the moral/religious/ethical components (if you can get beyond the hyperbole, this argument is interesting). And while those arguments do get made, the go to response is that you encourage people not to work. And that, put quite simply, is hard to reconcile with the full-throated support for charity. Can anyone clarify this for me? Headhunter? Kotter?
As temperatures cool, I want everyone to take another look at the plan we’ve proposed. There’s a reason why many doctors, nurses, and health care experts who know our system best consider this approach a vast improvement over the status quo. But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. Here’s what I ask of Congress, though: Do not walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people.
“Let me know”? Seriously? What have we been doing the last twelve months? We’re going back to the drawing board?
Pass the damn bill.
In light of Ms. Coakley’s defeat at the hand of Sen-Elect Brown, I’m forced to reflect on what all has been accomplished over the course of the last 12 months on healthcare. The “debate” has been characterized by a lot of heat without much light. It appears we have a bill that prohibits preexisting condition exclusions (Sec. 2705 of the Public Health Service Act), provides preventative care for free (no co-pays) (Sec. 2708 of PHSA), ensures certain minimum standards (Sec. 2707 of PHSA), and cover kids up to age 26 (Sec. 2709 of PHSA). And these are the things it will directly accomplish for “middle America.” Structurally, it will set up a more transparent market that will allow consumers to more easily weigh the costs and benefits of different plans, while covering costs by disincentivizing the current absurd insurance delivery system through employers. And all that while covering roughly all but 5% of legal residents and subsidizing those most in need. It’s far from a perfect bill and it undercuts President Obama’s rhetorical flourish that while not the first President to take up the healthcare cause, he is determined to be the last. But it does advance the ball.
Now I’m guessing most readers skimmed through that paragraph quickly. My impression is that most people who follow politics are not interested in the substance of arguments. Politics is a game like any other. The fundamentals aren’t important. What is important is which side wins. And that’s reflected in the ignorance of the elected officials. (Look here, here, here, here and here for the highlights. And yes, Sen. Lieberman appears twice not because of a lack of other examples, but because he is just that awful.) I can’t recall one example of a member of Congress being swayed on a policy argument during this whole process. Members that were convinced to vote a certain way had their ideas incorporated into the bill or taken out of the bill, but no member came to the table with one opinion and left it with a different opinion.
This leaves two options. The first is that each Representative and Senator was fully informed about healthcare before setting foot in Washington. Under this scenario all of the policy discussions and studies done by experts are superfluous in the legislative effort. Our representatives don’t need more information, much less time to debate. All that is required that a bill include enough of the issues they care about (be it money for their constituents or the opportunity for revenge on a constituency that wronged them). The second option is that our representatives, by and large, don’t care about the substance of a bill except as it may enhance or detract from their electability next time around or, if they are retiring, the likelihood a “friend of the party” will set them up with a job that pays a lot and requires no actual work. I’ll have to agree with the vast majority on this one.
And the troubling thing about this is that I don’t see many participants acting to change the incentive structure. We’ll continue to devolve into my-side vs. your-side, with experts increasingly marginalized in favor of articulate think tanks with an ideology that will churn out talking points like pig farms churn out excrement. Those with a real interest in policy will seek other avenues and government will be deprived of talent. Or at least the talent that matters.
When the initial Move Your Money campaign began, I thought it would collapse under the weight of its own inanity. But now that its spokesperson has transitioned from an animated she bear to someone with the economic chops of Felix Salmon, I had to rethink my quickly formed conclusions about the program.
Two fundamental points here. The first is the motivation. A goal of “choosing to move their money out of bigger banks and into smaller, community-oriented financial institutions that generally avoided the reckless investments and schemes that helped cause the financial crisis” sounds catchy, I know. Not as catchy as this. As intellectually coherent, maybe. But definitely not as catchy. See we’ve collectively identified certain banks as Too Big To Fail. When it looked like they would do just that, the best and the brightest on both sides of the aisle (no, not this guy) agreed to bail them out, that not to do so would so harm the global financial infrastructure as to push the world over the economic ledge. Now Ms. Huffington’s campaign seeks to punish these banks for their dastardly deeds by … causing a run on their funding source and pushing them back to the precipice. While the villagers have picked up their pitchforks, my money is on the Fed and the rest of the adults throwing all the money they’ve got left in TARP back at those banks if they start to face financial difficulty again. And we get a whole new reason to unite the populist right and the populist left.
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In light of this new Underwear Bomber (Aside: Seriously? Coca-Cola can scrape the residue off the rats in their factories, repackage it as Coke Zero, have marketing teams use absurd gimicks , and sell it (at discount, no less) for more than $1.25 a can? And we can’t come up with a better name than the Underwear Bomber? Can’t someone find a way to -gate this name?), I’ve been reconsidering my outlook on what we can do to prevent domestic terrorism on airlines.
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I’ll point out at the outset that I have yet to find a person of any age stay as abreast of the healthcare reform process as Mr. Ezra Klein. Anyone seeking to understand the minutia of the problem can find no better guide that Mr. Klein’s frequent and user-friendly summaries. A recent post, however, raises an interesting point which I haven’t seen adequately addressed by anyone. In summary, the post discusses the vilification of the health insurance industry primarily as a function of the incentives in place for market participants – i.e., insurance companies seeking to maximize profits attempt to insure as many (low-cost) healthy customers as possible while avoiding the (high-cost) chronically ill. Compare this to the providers (hospitals, doctors, clinics, etc.) who seek to treat as many people as possible due to the incentives of healing people and getting paid on a fee for service basis. Providers have little (relative) incentive to contain costs and contributes to the inflation in healthcare prices at rates above other industries. The current paradigm emphasizes coverage at the provider level and cost concerns at the insurance level. Reform proposals attempt to expand coverage at the provider level and are less specific about cost controls.
Mr. Klein suggests the facially non-controversial change of making providers accountable for their results – rewarding positive results and punishing negative results. This begs the question, if we start compensating providers on results will they start to adjust their service along risk lines? Will doctors begin to refuse to treat patients whose condition undermines their long-term viability? Anedoctal evidence (with the usual caveats) states that surgeons refuse to conduct surgery on high-risk patients for fear it will hurt their success rate [On this point, if anyone has actual evidence supporting or disputing that conclusion I would be very interested in seeing it]. How do reformers address this issue?

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