Republican Campaign: Pander v. Pander

Since I'm obsessed with being painfully honest, I think I have to give Romney a bit of a plug. He really wants to give his constituents, whomever he perceives them to be, what they want. So when he runs for senator or governor in the liberal state like Mass (my home), he gives convincing assurances about reproductive choice. His Republican constituency in 2011 is more conservative than those of 2008, so he's had to get more conservative. If he gets to the general election or White House, I expect more changes to please the wider audience.

The important point, though, is that he wants to make the wider populace happy, not just a narrow slice. He's a likeable, wonky-but-not-too-technocratic, Mr. Fixit with a soft-conservative foundation.

This puts him miles ahead of Gingrich, who wants to burnish his own legacy and power above all else... then the power of his cohort... then somewhere down the list is the general good of the country, conservative principles, or whatever.

I think I know which panderer would be less worse for the country. Hands down, it's Romney.

 ...but ... What are the other choices again?

"I could do better than this clown"

Most of the Republican candidates state that Obama's done a horrible job with the economy. A few of them will admit that the economy wasn't in good shape when he came into office. (Maybe that's the Republican form of compromise: we'll compromise on what the situation was, but not on the solution.)

Overall, though, the Rep candidates make it sound like Obama was a brainless fool in his handling of the  economy. It could've been easily fixed using good old conservatives principles.

I'll be surprised if this argument flies with most of the electorate. The economy was a mess in 2008-2009. Unemployment was soaring faster than any recession since WWII. People were rightly scared. They were angry about the bailouts, but that doesn't mean people thought they were unnecessary. Similarly with the stimulus.

These Republican arguments, if they don't jive with reality, are going to fall apart like tissue paper with a quick reminder of what those times were like. That's no guarantee the Democrats will do better however. They can spin a tissue of lies and unlikely scenarios too, and then the electorate will have to choose who is less bad. If you look over the last 30 years, the voters have mostly gone for the Republicans, so the Democrats better have good, believable plans, or we could have a change of government. Or I should say a change of clowns.

(In case you don't recognize him, that's Rick Perry. He was the best looking clown, but not the most likely to be nominated. I decided on eye-candy.)

Solving the Healthcare Cost Puzzle

Republican solution: Block-grant Medicaid (limits federal costs), voucherize Medicare (again, Feds get to set limits on their contribution).

Democrat solution: um, decrease reimbursement to doctors, a bunch of other nips and tucks.

The Republicans have the solution that is simpler to understand, that's for sure. Of course that's not the best way to judge a policy proposal, but when it's put up against a complicated, incoherent plan, it does pretty well.

 Truth squad

But in many ways, the whole political debate about providing healthcare is incoherent because there are many competing interests, and not all of them are openly declared. Here is a sampling of some of the objectives in the debate:

• Provide healthcare to as many people as possible.
• Provide healthcare to as many Americans as possible, but not to immigrants.
• Provide healthcare to productive members of society (and retired productive members of society).
• Eliminate the problem that some people don't have health insurance.
• Provide enough healthcare to the uninsured so that it's not embarrassing or unchristian, but also minimize taxpayer expense.
• Allow patients and doctors to make healthcare choices without interference from bureaucrats.
• Protect individuals from the high cost of healthcare by spreading the cost to larger groups.
• Slow down the growth of healthcare costs dramatically.
• Demonstrate that life is the most important consideration no matter what.
• Cast doubt on the motives of your opponents regarding healthcare availability, cost, and who shoulders the bill.

I probably missed some goals, but it does paint the picture. There are goals for healthcare coverage, goals for handling healthcare expenses, and goals for winning elections.

• Too much of the political debate is centered on electoral goals where it's important to cast doubt on your opponent and insulate your side. Clarity, not surprisingly, is sacrificed. 
• When it comes to individuals deciding how to vote or what to advocate for, often the issue is fear of losing access to needed healthcare, plus the desire to shift costs. Cost prevention or cost containment may not register.

 A goal we can agree on?

In the all debate, fear, and sniping, something that is often lost is whether we should try to make our medical spending more efficient and how. Efficient really means not doing the low value or no value procedures. If we don't want to cut the number of procedures, we have to squeeze what we pay for them. That means not passing the Doc Fix every year, and hoping the people doing the work won't resent performing the same job for a lot less money.

Rather than simply squeezing the providers, I'd prefer to cut the number of procedures. But no one  seems to want to talk about making do with less medical care. I can easily do it as a personal choice (sure-I'll wait five years for my next colonoscopy!), but how can we get large numbers of people to sign on? And make the right decisions about what to trim?

 Doctor's advice

Really, the doctors should start this revolution. We have more trust in them than in having our insurance companies or government panels make the recommendations. Doctors could save the entire country a lot of money by cutting back on the testing they recommend. I saw an article (now irretrievably lost in the web) that Americans spend 40% more on outpatient testing than other advanced countries, so this is one area we can definitely trim back.

Unfortunately, doctors often have a business interest in recommending testing, since GE has sold them a bunch of expensive medical equipment, and the docs need to make those payments. There is also malpractice fear. I think someone is going to have to persuade and guide our medical professionals, but that brings us back to the hated insurance companies or government bureaucrats. Oh what a mess. Still, I hope it would be possible for some of our larger medical groups, like Kaiser Permanente and the Mayo Clinic, to study what treatments and testing are effective and cost-efficient. If we can save enough money by stripping out inefficient medical spending, we may not have to touch that third rail: rationing of medical care.

I'll break the taboo, just a bit, and talk about rationing. But to some people, any management of healthcare choices is rationing. In one way I agree, but I see it as good rationing. (Similarly, there is good discrimination, which is what you use if you date only sane, responsible people.) In the future, we may need to ration medical care on a variety of criteria including: odds of survival, odds of recovery to productive status, cost of care, citizenship, etc. This is where the arguments really heat up, and I don't want to go there yet. Let's remove inefficient spending from our system, and see how much breathing space that gives us.

Maybe we can pay with play money...

Extra: Explore some detailed data on healthcare spending with this nifty/easy tool.

History for Amnesiacs: 2009 Bipartisanship FAIL

Obama came into office saying that he wanted to change the atmosphere of partisanship and bring people together. I wanted to look back with see how this vision failed and to apportion blame.

 The Republicans

The campaign was plenty nasty, especially among the activists. It's not surprising that rhetoric like "socialist," "hates America" and such couldn't be turned off in the weeks between the election and when Congress started its new term.

The conservative blogs, or more accurately, the talk-radio online blogs, were saying things like:

So much for a "Centrist" Obama Administration - Punk Emanuel Selected for Obama Chief of Staff -- Macsmind blog 11/4/08

I do not want the government in charge of all of these things. I don't want this to work.... I would be honored if the Drive-By Media headlined me all day long: "Limbaugh: I Hope Obama Fails." Somebody's gotta say it.--Rush Limbaugh 1/16/09

The respectable conservatives and Republicans were taking a wait-and-see posture. But that evaporated pretty quickly. For some, all it took was two words "I won" spoken at a meeting with Republican leaders in the run-up to the stimulus bill (see below). Others waited until the unveiling of the stimulus bill, which the Wall Street Journal called the "40-year Wish List." That was comparatively polite (see below). [Update 4/11/14. Maybe the respectable Republicans weren't waiting. An author specializing on Republicans reported that on Inauguration Day, Kevin McCarthy said "We've gotta challenge them on every single bill and challenge them on every single campaign." This was at a strategy dinner attended by a dozen congressional leaders and GOP strategists, including Frank Luntz. Update 2/1/15. I don't know how I missed this. The plan was conceived and enforced by GOP leadership, and it was absolute--no cooperation at all. ]

Republican amendments to the bill were voted down. But you should also note that some objectionable provisions were removed by the Democrats before the bill was made public. A third of the stimulus was in the form of tax cuts and rebates. However, no Republican in the House voted for the bill. Any semblance of bipartisanship in the House was over.

A few Republican senators, including Snowe and Grassley, continued to work with Democrats on the Senate version of the stimulus. In the end, only three Republicans votes for the stimulus: Snowe, Collins, and Arlen Specter, soon to be a Democratic, then soon to lose his seat. The stimulus was signed on 2/17/2009. (An overview of the bill and a critique here.)

A tiny bit of bipartisanship lingered on in the Senate during the summer, when Olympia Snowe worked with Democrats on the health reform bill, but it was over by sometime in the fall of 2009. Of course in the meantime, the Tea Party movement started in February 2009. Its founders had already organized in anticipation of some Democratic offense, and they readily felt offended by the stimulus.

The Democrats

On the Democratic side, the major mistake was cramming too much stuff into the stimulus and not being more fair-handed in deciding what to cram in. There were a few other mistakes--the biggest being Obama's invitation to Judd Gregg to be Secretary of Commerce, only minus the responsibility for the 2010 census.
Among the activists, or those who announce what is just below the surface, there was a lot of self-congratulations and at least a few threats to follow a non-centrist agenda (see below).

Division of the Blame

In an earlier post, I asked:

• Did conservatives ever give Obama and Congress a chance to be bipartisan? Did the Democrats have a chance but blew it? Or were the compromises never going to be enough, and these conservative networks were poised to attack from the very beginning?

Chances were heavily stacked against this president. Maybe it was impossible for a new president, coming into office during a financial crisis, to get every choice correct. But I have to say no, it wasn't absolutely inevitable. But small and medium-sized mistakes are all too likely to happen. With the other actors on the scene, there wasn't much margin for error. We elected a president who wasn't wise and experienced, and who didn't have a canny team who knew how high the stakes were. So Obama and his team deserve a small share of the blame.

Nancy Pelosi, with her handling of the stimulus bill, deserves somewhat more blame. I can't back this up with more evidence than what I've given (which isn't much), but she was the Speaker, and she was heavily involved. Her hand in the creation process of the stimulus and reviled health reform bills costs the Democratics a great deal of support. She should step down. I think her egotism keeps her from stepping aside and giving the leadership to someone who could help Democrats rather than further blacken them.

The largest portion of blame belongs to the Republicans and conservatives who were so ready to throw aside bipartisanship and become the hyperpartisans they are now. There were only a few in the Senate who demonstrated any commitment to bipartisanship. For the rest, it was just a pantomime.

(Edited 11/24/11)

Extras

Balanced article on this topic by a journalist with more resources than I have. Loads of details.

12/9/08. Before civility fell apart. WSJ article and tame comments:

"The general sense among economists being canvassed by the Obama team is that "every day there's a new bad number," one of the people familiar with the matter said. "And people's sense of what the appropriate stimulus is rises" with the news."

1/18/09: Opposition getting stronger:

"I think we're going to be treated to.hagiography for weeks if not months," Erickson complained. "The first time Obama uses the bathroom, Newsweek will do a five-page spread."

I hope he fails

1/21/09. Incidentally, Rush's pronouncement was inspired by a request from the Wall Street Journal for a piece for Obama's inauguration. Newt Gingrich received the same request, and provided this:

President Barack Obama is one of the smartest leaders ever to occupy the White House. His transition has been centrist and responsible in tone. His appointments have been establishmentarian far more than radical left. His outreach to conservative intellectuals and to Republicans in the Congress has been positive and has had serious impact.

On the other hand, ... Mr. Obama's trillion dollars on top of Mr. Bush's trillion dollars represents the largest orgy of government control and government expenditure since the New Deal...

Conservative Vitriol Nearly Full Force

1/23/09. Here were conservative some reactions to reports that Obama said "I won." It's incredible that the talking points that have become so familiar were already honed back at the beginning of 2009. But that's to be expected from a well-functioning political lie machine:

Bob wrote: BO is of course correct, the D’s won, but that still does not make the concept that 50% of the American public will not be paying Fed Income taxes / some will get a check for breathing, correct.

AP wrote: The Manchurian Candidate certainly does not build confidence in the GOP with his comment. He has clearly set the table for stark debate between the two factions once again. Let’s all remember that he is nothing but a dirty politian anyways.

Richard Ingold wrote: Now as to what the GOP should do…FIGHT LIKE HELL AS CONSERVATIVES, NOT LAY ON THEIR BACKS W THEIR FEET IN THE AIR LIKE DEAD BUGS! RESIST NEVER SUBMITT…..DID THE DEMS STOP RESISTING IN 2001 OR 2005 …CERTAINLY NOT!

Huh? wrote:  after the Dems forced the banks to make those bad loans, what did you think the Dems intended for them to do with them? ‘Spread’ the risk around the rest of the economy or sit on them and go bankrupt? C’mon.

The Winners Speak

1/23/09. Liberals were quick to remind Republicans of certain facts:

toadnet wrote: You Rebublicans do remember getting your asses kicked in the last 2 elections – losers need to step aside and let the new team clean up W’s mess.

Big Duke wrote: Dear Republicans and you shills at the WSJ. We tried it your way for 8 long years. With the exception of the select few of you who just got the biggest government handout in the history of history, we are pretty much all worse off for it.

Limbaugh as Co-President

1/29/09. Limbaugh:

Let’s say the vote was 54% to 46%. As a way to bring the country together and at the same time determine the most effective way to deal with recessions, under the Obama-Limbaugh Stimulus Plan of 2009: 54% of the $900 billion — $486 billion — will be spent on infrastructure and pork as defined by Mr. Obama and the Democrats; 46% — $414 billion — will be directed toward tax cuts, as determined by me.

I remember my reaction to this proposal by Limbaugh. I thought he was quite the egotist: that he was on par with the duly elected president; that he spoke for the "loyal opposition" and could bargain on their behalf; that he should have control over some of the proceeds from national legislation.

Full-Force Opposition

2/6/09. Three weeks after the inauguration:

Poor little rich kid handed everything he wants on a silver platter. Gets the presidency with a lock on Congress and gets upset he doesn't get 100% compliance. Stop looking for cover ZERObama. Pass your Porkulous and garner or suffer the fallout depending on its merits.

BHO is just showing his socialist agenda; America should not be surprised.  He should drop the facade of trying to look to be anything but a socialist.

Harry Reid Prays for PORK and PAYOFF money!

[Alternate view] So come on G.reedy O.bstructionist P.oliticians. You did not obstruct your war criminal President Bush. You gave 700 billion, calling it " bail out money "to your corporate ceo friends for a luxurious lifestyle. Now give some help to hard working Americans, health care and schools and give President Obama a chance.

(Edited 11/24/11 for chronological order, length, and adding titles. Edited 1/5/12 to add short quotes.)

Tax Cut Delusion Syndrome

The dogmatic belief that tax cuts are the solution to most macroeconomic problems in the US (doesn't necessarily apply to other countries), including, but not restricted to:

• Stagnant economy
• High unemployment
• Recession
• Banking crisis
• Deficit reduction
• Surplus reduction

This condition persists even after mathematical intervention.
Treatments: Unknown
Cause: <free feel to speculate>

The Dilemma of Political Parties

Ezra Klein had great column a few weeks ago. I don't name-drop on columnists because I'm not impressed by names, and I certainly don't want to become one of the hundreds of bloggers who constantly comment on what other bloggers say.

But this column--it was a wonderful explanation of how political parties are ruining governance at this sorry time in our history. I'll quote what he says because it's completely clear and readable:

Parties no longer compete to win elections by giving voters the policies voters want. Rather, as coalitions of intense policy demanders, they have their own agendas and aim to get voters to go along. [quoting a paper]

...So the basic work of political parties is figuring out precisely how much of their agenda they need to sacrifice on the altar of electability.

...Parties must still... respond to voter wishes, but they wish to cede as little policy to voter preferences as possible [quoting again]

Klein shows how this applies to the current crop of Republican candidates, or leftovers as I've called them:

[The Republican party] members sense that this election might end with Republicans controlling the House, the Senate and the presidency. In that event, Republicans could get away with quite a lot. So they don’t want to blow it. What a shame it would be to have wasted this opportunity on a centrist candidate who will just end up compromising with Senate Democrats and looking to burnish his image with independents. On the other hand, it would be even worse to blow the opportunity on an extremist candidate who will scare voters into reelecting President Obama.

Definitely read the column. But the follow-up to this thesis is the practical question--how do we make our political parties answerable to more of us, not just to the "intense policy demanders?" If I ever read about that, I'll let you know.

Update 1/5/12. I heard a piece on NPR that is a corollary to Ezra's post. If politicians, when in office, are responding to their most intense supporters, we get a pendulum effect of throwing one set of partisans out, and electing the other set, and then having to throw them out. My post on the topic here.

Funny Moments in America Bonds

I love the fascinating bits of lore you come across on the internet, so I'm sharing this one.

Faced with the dilemma of financing WWII President Franklin D. Roosevelt received adamant advice to raise taxes and introduce a forced savings program. Instead, FDR wisely followed the advice of Secretary of the Treasury Henry Morgentthau, JR., who working with Peter Odegard, a political scientist specialized in motivating masses (read propaganda) created the War Advertising Council.

The result was a whopping $187.5 Billion ($2.5+ Trillion dollars adjusted for inflation into 2009 dollars) to fund the war effort. Just as important as the money, the War Bonds became a rallying cry for the public to express its patriotism, follow its iconic leaders' calls for action, and allowed for 85 million Americans to actively participate in the War effort.

The threat to our country in 2009 is greater than in early 1940. Not only is our economic survival threatened, but, our survival as a species on this planet teeters on a dangerous fulcrum. ...

A current day version of FDR's War Bonds, the FundAmerica plan as proposed by the Prosperity Mandate provides a new source of $2.5 Trillion and:

• Is Budget Neutral
• Does NOT Raise Taxes
• Requires No More Debt
• Is Sustainable and Renewable...

When you're done laughing, answer this question: Would you take whatever money you had and buy the equivalent of a war bond? I might...

...if FDR was president and the US didn't have a $15 trillion debt.