Showing posts with label Health Care. Show all posts
Showing posts with label Health Care. Show all posts

Tuesday, June 28, 2022

Too Big to Concur?

Kavanaugh Burns Down His Home Just To Get It Over With
 —Headline on the satirical newspaper web site The Babylon Bee, June 24

Is the United States simply too big to hold together?

Americans, like most everyone else in the world, tend to take the size of their country for granted, but when you live for a while in a smaller country, you begin to notice things. For one thing, a national consensus seems easier to achieve.

For example, let’s take the abortion issue. Historically, Ireland was predominately Catholic, socially conservative country. Yet when social mores evolved, people went to the polls and voted to legalize the procedure through a change to the country’s constitution.

Is there any possibility something like this could happen in the U.S.? It’s hard to imagine, despite the fact that in the U.S. abortion could be legalized (or banned) nationally simply by an act of Congress. The cumbersome constitutional amendment process would not even be necessary.

One of the arguments for overturning the Roe v. Wade precedent was that abortion is mentioned nowhere in the U.S. Constitution. By contrast, the issue actually was addressed in the Irish constitution. That document’s 1983 Eighth Amendment said, “The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.”

Four years ago Irish voters repealed that amendment, making it possible for their elected representatives to legislate on the issue. That was seen as a huge victory for women’s abortion rights. Ironically, thanks to the U.S. Supreme Court’s recent ruling, America is now in the same situation as Ireland (abortion being a legislative matter), but because of the different context, it is seen as a setback for women’s abortion rights.

Upon the Eighth’s repeal, Ireland’s government promptly legalized abortion during the first 12 weeks of pregnancy. That’s pretty standard in Europe. The UK and the Netherlands permit the procedure during the first 24 weeks, and Sweden 18 weeks. Other countries range between 10 and 14, except Malta, where abortion is outlawed altogether, and Poland, where it’s allowed only in the case of rape, incest or saving the mother’s life.

Ireland’s law actually matches fairly closely the general U.S. opinion. Polls have consistently shown Americans favor legal abortion during the first trimester but not in the second or third ones. So why doesn’t Congress or state legislators simply put that into law? Why does the public debate always seem to be conducted between those who either want abortion banned entirely and those who want it guaranteed until the day before a baby’s birth?

Simply put, it’s hard to compromise when your position is tied to your core beliefs about humanity. If you truly believe a zygote has a human soul, then you’re going to consider its elimination murder. That makes it a public matter. If you believe that a woman’s physical autonomy is paramount, then you’ll conclude the fate of a zygote, embryo or fetus is a concern only for the woman carrying it. That makes it a private matter.

How do you reconcile public policy when society is divided between those two world views? Obviously, it happens because we can see that democratic countries, like those in Europe, arrive at legislative solutions—and as it happens, ones not so far off from the polling in the U.S. I mentioned.

Here’s the rub. The overall national opinion in America is not uniform in every geographical sector. Some states already have very liberal abortion laws on the books, while others have laws (old and new) that ban the procedure. (Some of the so-called trigger laws may possibly be revised since Roe’s revocation is now a reality and not merely theoretical.) So, is that the solution? A patchwork of abortion policies decided (ultimately) by the voters in each state? That may satisfy people who look at the issue with a certain legal detachment, but it does not make people happy who have strong beliefs in the human values mentioned above. Living in a state with an abortion policy you agree with is small consolation when people just across the state line have the opposite situation.

To a certain extent, the same is true about how people feel when talking about national borders—but there may be more detachment in that case. I don’t think, for example, Germans fret about the lack of abortion rights in Poland in quite the same way that Washingtonians think about the situation in Idaho. Washington and Idaho, after all, are part of the same country.

Or are they? I mean, in a cohesive, social sense? That brings me back to my original question. Is the U.S. too big to contain its diversity of world views and human values? It all comes down to how strongly people are tied to certain beliefs and how motivated they are to defend them—or impose them on others.

Wednesday, June 16, 2021

Bot and Sold

This is a cross-posting with my movie blog.

A funny thing happened on my film blog last month. No, it wasn’t something I wrote—or at least that’s not what I’m talking about anyway.

I have a page where each month I present a few statistics from the previous month. Mostly it’s to get an idea of who is looking at my blog but also to amuse myself. The page features a pie chart showing the various countries from where I am getting hits. Historically, about half the hits are from the United States with the next larger slices from places like the UK, Ireland and Canada. After that the slices get pretty fragmented into a few dozen other countries all over the world. I also list the ten weekly commentaries in my archive that have gotten the most hits. And then just for fun I list five of the most entertaining web searches that have found my site.

When I went to gather the numbers for May, I encountered something that hadn’t happened before. Ninety-seven percent of the hits were from one country, and that country was Indonesia. The U.S. came in second with two percent. Twenty-six other countries were tallied with percentages rounded off to insignificance.

Why did internet users in Indonesia suddenly take an interest in my movie reviews? The answer is that they almost certainly didn’t. Something else was going on. I think the term we’re looking for here is web bots.

While such a massive number of hits from one country is unprecedented for my humble site, this weird kind of bot activity is not. Only very belated did I realize that my site was prowled by Russian bots coming up to the 2016 election. During September, October and November of that year, 11.9 percent of my hits came from Russia (after Ireland at 34.13 percent and the U.S. at 20.45 pecent). That had never happened before. Historically, my hits from Russia had always been nil or negligible. Cluelessly, I just shrugged and thought it must have had something to do with a few movies I had reviewed that were made by an Azerbaijani filmmaker. He had contacted me through a Russian email address (Azerbaijan being a former republic in the USSR), and I figured that he must have just had a lot of friends and relatives checking out my reviews of his films.

It was an embarrassingly long time afterward that it dawned on me that it might have had something to do with the 2016 presidential election. In my defense, I was kind of oblivious to the Russian trolling thing because none of those political bot messages everyone talked about seemed to show up in my Facebook feed. Did you know that hidden in your Facebook settings is a profile page where Facebook displays all the information it think it’s found out about you—things like religion, political preference, etc.? From this I know that Facebook has never been able to figure out what political party I support, and maybe that’s why I somehow avoided all the bot propaganda that I kept hearing about in the wake of President Trump’s election.

When the 2020 election rolled around, I was more savvy, so I kept an eye out for any more bot funny business. Sure enough, the numbers went screwy again. In the period from September to November 2020, the second and third most hits (after the U.S. at 36.09 percent) were from Hong Kong (20.26 percent) and China (7.56 percent), respectively. Nothing like that had ever happened before. Does that mean Chinese bots were working mischief during the election? People who had screamed bloody hell about Russian interference four years earlier did not seem concerned about it anyway. After all, the right candidate had won.

What does it all mean? Beats me. I don’t mind all the extra hits, but it would be nice if, while the bots are at it, they’d click on some of ads and maybe buy something.

We’re definitely in a strange time when it comes to the internet. A few times lately our broadband service has been disrupted by denial-of-service attacks by malicious cyber actors. Also, the entire Irish healthcare system has been forced to go retro because of a ransomware attack (traced by the authorities to Russia) that put its online systems out of commission. That points up the risks in having systems that are overly centralized. There may be other lessons as well. More than one acquaintance who happens to be a nurse has said that they love having the system down. It means a lot less time filling out online forms and more time actually working with patients. It also means fewer statistics on Covid ‑19 cases and death and on progress with vaccinations on the nightly news—something the government may not be all that unhappy about.

Okay, I can understand all the Russian bot activity in 2016 and all the Chinese bot activity in 2020, but what the heck is the deal with Indonesia in May of 2021? That one has me completely confounded. I can only hope the bots are aimed directly at me because one of the characters in my most recent novel Searching for Cunégonde happened to have an Indonesian father.

Wednesday, October 28, 2020

Expert Advice

“Sorry, Only Seeing This Now…” Government Finally Text NPHET Back After Recommending Level 5 Restrictions 2 Weeks Ago
 —Headline on the Irish satirical newspaper web site Waterford Whispers, October 19
If you watched the original Star Trek series when you were a kid, as I did, then you may have wondered, as I did, why Mr. Spock was not the ship’s captain instead of James T. Kirk.

Spock was invariably cool, calm and in total control of his emotions. He was a brilliant scientist—in fact he was the Enterprise’s science officer—and a rigorous practitioner of logic. While Kirk was frequently distracted by some bit of intergalactic skirt or otherwise being led by his emotions, Spock was completely dedicated to his work and mission. Whenever Kirk had to absent himself and would tell Spock to “take the com,” things always seemed to run much more efficiently, and the leadership decisions were more consistent and clear.

There is an obvious reason why Kirk was the captain and not Spock. It made for better stories. Efficiently run organizations are not inherently watchable from an entertainment point of view. The show’s writers did actually come up with a justification for the Enterprise’s command structure. In the sixteenth episode of the first season (“The Galileo Seven”), Mr. Spock is in a position of command on an away mission. After an emergency landing on the planet Taurus II, Spock’s manner annoys and frustrates his subordinates no end. A desperate attempt is made to escape the planet, but the shuttle cannot escape the planet’s gravity. In an apparent act of desperation, Spock dumps the craft’s precious remaining fuel and ignites it. This seems pointless and foolhardy, but the flare is spotted by the Enterprise crew, which is then able to save the shuttle passengers by transporter beam in the few remaining seconds.

Kirk—and perhaps the writers—think Spock has learned a lesson in leadership because he acted emotionally rather than logically, but wasn’t Spock’s desperate act actually logical? After all, it succeeded. In a last-ditch situation, trying anything, even with near-zero probability of success, is surely more logical than doing nothing. Still, Kirk’s larger point stands. Leadership is more than just technical expertise.

In times when people get frustrated with their political leaders, you often hear voices arguing that governmental decisions should be made by technocrats or “experts” rather than individuals whose strongest ability is climbing to the top of the political ladder. You particularly hear this nowadays as countries struggle with a long-term emergency medical situation. President Trump has been roundly criticized for being dismissive of Anthony Fauci, a lead member of the White House Coronavirus Task Force, and other medical advisers. Joe Biden, who looks likely to replace Trump in January, says repeatedly that, as president, he would “follow medical experts’ advice.”

For months Irish politicians smugly compared themselves to Trump and congratulated themselves on following the experts. The self-congratulation stopped abruptly four Sundays ago when the press learned that the country’s chief medical officer, on behalf of the National Public Health Emergency Team (NPHET), had written the government advising that the Republic of Ireland move to Level 5, i.e. the most restrictive set of measures currently available. The following evening, in a television interview, Tánaiste (deputy prime minister) Leo Varadkar defended the government’s decision to go to a lower-than-recommended level of restrictions, saying the medical advice had come “out of the blue” and was “not thought through.” Sixteen days later, under continuing media criticism and deteriorating case numbers, the government went to Level 5.

In his original defense of the government’s hesitation to tighten restrictions, Varadkar pointed out that the government must take into account all manner of economic and social repercussions, while the medical experts’ brief is limited to the spread of the virus. They have the luxury, if you want to call it that, to strive for minimal risk in their recommendations. The government faces serious risk no matter what it decides. The government’s defenders declared that, while NPHET should be heeded, it is not the government.

One of the strongest arguments I have read for not turning experts into autocrats comes not from some right-wing sheet but from an article two years ago in the left-of-center Guardian. In the piece David Runciman of Cambridge University argued against “epistocracy: the rule of the knowers.” It is a detailed and thoughtful article and well worth reading. Here is the nub of his argument:
Epistocracy is flawed because of the second part of the word rather than the first—this is about power (kratos) as much as it is about knowledge (episteme). Fixing power to knowledge risks creating a monster that can’t be deflected from its course, even when it goes wrong—which it will, since no one and nothing is infallible. Not knowing the right answer is a great defence against people who believe that their knowledge makes them superior.
The nature of science is exemplified by experimentation, debate, revision and skepticism. Ironically, many people, usually not scientists themselves, invoke Science as some immutable ultimate authority, not unlike the way religious fundamentalists would try to shut down arguments by invoking the Old Testament.

Such people would have you believe that there is near-unanimity among scientists on a range of critical issues. Worse, they seem at times to believe the anointed experts are infallible. Certainly, following the prevailing scientific opinion in a crisis is the smart thing to do, but it should never be treated uncritically as received truth. Unanimity of opinion is the virtual antithesis of science. You only have to read the October 4 Great Barrington Declaration by professors from Stanford, Harvard and Oxford or a recent letter to the Irish government signed by fifteen doctors, including those on the frontlines, to realize that there is a healthy debate going on about the best way to deal with pandemic.

By all means, you want Mr. Spock on the ship’s deck for his technical expertise and his advice. The captain, though, will want to hear from him and other crew members and then draw upon his or her own judgment before heading out into the great unknown.

Wednesday, October 21, 2020

Centuries

“I feel great. I feel, like, perfect. I think this was a blessing from God, that I caught it. This was a blessing in disguise.”
 —President Trump on his having contracted Covid‑19, October 7

“I just think is God’s gift to the left.”
 —Actor/activist Jane Fonda, during a Working Families Party online event, October 2
Sometimes it is worthwhile to look back and recall what was happening a hundred years ago.

As it happens, in 1920 the world was enduring the fourth wave of a pandemic. The first wave of the so-called Spanish Flu had occurred in 1918. Also, in 1920 Russia was midway through a bloody civil war. The two things may or may not be unrelated.

At the beginning of the current year, a lot of political analysts opined that President Trump was sailing toward an easy reelection on the strength of the U.S.’s strong financial numbers. These days, however, because of the Covid‑19 pandemic and its effect on the economy, the smart betting is that he will lose to Joe Biden. Did something similar happen with the 1918-1920 pandemic?

Cause and effect are always tricky to prove, but some historians suggest that the flu’s scourge did have a political effect. Europe was already reeling from a devastating four-year war when the pandemic began. In her 2017 book Pale Rider: The Spanish Flu of 1918 and How It Changed the World, author/journalist Laura Spinney suggests the flu “fanned the flames that had been smoldering since before the Russian revolutions of 1917 … illuminating the injustice of colonialism and sometimes of capitalism too.”

No doubt it was one more factor in the deteriorating post-war situation in Germany, which would eventually lead to a second world war. On the more constructive side, the ravages of the disease prompted citizens of democracies to press for better healthcare systems, a struggle that continues to this day.

Did the Spanish flu really fan the flames of activism, progressivism and radicalism in the 1920s and 1930s? More to the point, is the current pandemic having that effect in our own time? It is arguable whether the prospective election of Biden would necessarily signal a major leftward shift in the American electorate. After all, Democratic primary voters—and more importantly Dem party leaders—seem to have settled on him precisely because, compared to younger Democratic politicians, he looks downright moderate and not scary to most voters. If he wins, it will clearly be a rejection of the incumbent rather than a ringing endorsement of anything voters heard in the primary debates.

Still it cannot be ignored that the Democratic Party, which is by all measures (except perhaps the Electoral College) is the largest of all U.S. political parties, has moved decidedly leftward in the 21st century. A Democratic President and Congress will certainly come under pressure from progressive factions in terms of the economy, social issues and climate change. Republicans would have you believe that the country will go full-blown socialist if Biden is elected and particularly if Democrats also take the Senate.

Experience suggests that is unlikely. The Democratic leadership can use all the right woke buzzwords, but once the party is in control of government they can act pretty darn moderate, usually contorting themselves in blaming the Republican opposition for a lack of results. Remember the 111th Congress (2009-2011) when Democrats controlled the White House and both houses of Congress? They got through Obamacare—not even the single-payer system progressives had long fought for—and what else? Climate change? President Obama signed a treaty in Paris but then never submitted it for approval to the Democratic-controlled Senate because it was certain to fail. The party’s reward for its one accomplishment, healthcare reform, was a rout in the 2010 midterm elections.

But maybe things are different now? There’s a new generation of voters. There’s better education. People are more politically active. Young people are finally really engaged. The problem is that these are all things we’ve heard during every election since 1968. We’ll find out after November 3 whether things have really changed that much.

More worrying is how activist progressives will react if their political victory falls short of their ideals. Republicans know how that turns out. Four years ago the party saw many of its usual voters give up on the old establishment types and go for a populist firebrand. Will progressives do something similar if they also decide the system is rigged against them?

Here’s something to chew on. The Times of London reported the other day that a survey of nearly five million people found that those born between 1981 and 1996 had less faith in democratic institutions than previous generations. “The collapse of confidence,” said the paper, “is particularly pronounced in the ‘Anglo-Saxon democracies’ of Britain, the United States and Australia. However, similar trends are seen in Latin America, sub-Saharan Africa and southern Europe.”

The study was conducted by the Centre for the Future of Democracy at Cambridge University. Roberto Foa, its lead author, said, “This is the first generation in living memory to have a global majority who are dissatisfied with the way democracy works while in their twenties and thirties.”

“In western democracies,” reported The Times, “41 per cent of millennials agree that you can ‘tell if a person is good or bad if you know their politics,’ compared with 30 per cent of voters over the age of 35.”

Added Dr. Foa, “The prevalence of polarizing attitudes among millennials may mean advanced democracies remain fertile ground for populist politics.”

One-hundred years ago next month, the Chairman of the Council of People’s Commissars of the Russian Soviet Federative Socialist Republic, Vladimir Lenin, addressed the Conference of Political Education Workers. He declared, “Each man must choose between joining our side or the other side. Any attempt to avoid taking sides must end in fiasco.”

A century later his words echo strong and clear.

Tuesday, April 21, 2020

Life in Lockdown

“As well-armed as the Parliamentary forces were, their deadliest weapon may have been the one they brought inadvertently. People in the town were now dying of a plague that had traveled with the English. Memories were all too fresh of the 1649 plague that had killed well over 3,000.”
   —Excerpt from the 2019 novel The Curse of Septimus Bridge
The above quote is a handy reminder that 1) plagues, endemics and pandemics have always been with us and 2) I actually wrote a novel called The Curse of Septimus Bridge. (For more information on that, as well as an update on my upcoming novel, see my book blog.)

History tells us that armies, explorers, conquistadores, holidaymakers and business travelers have, at various points in time, have helped spread virulent diseases from one territory to another. What is amazing is that, in this age of globalism and cheap-and-easy international travel, such outbreaks do not happen more often. Instead we appear to be going through a once-in-a-century phenomenon with the current crisis evoking mostly recollections of the 1918-1920 so-called Spanish flu pandemic.

That flu is estimated to have infected a third of the world’s population and killed, in the most liberal guesses, as many as 100 million. Then the world was much more defenseless than now. The ventilator would not be invented until several years later, and flu vaccines were decades away.

As the experts remind us, Covid-18 is not an influenza strain and so does not behave like one. That is what makes it scary. We are only learning as time goes on exactly how it behaves and just how dangerous it truly is.

There are signs of optimism if you want to look for them. For those of us in the majority who (as far as we know anyway) have not experienced it, the danger is more theoretical than real. For those who have had a mild or even asymptomatic case, the main concern is for others rather than for oneself. Perhaps the most optimistic sign is that many people’s nerves have relaxed enough that they have already moved past the old-wartime-style-let’s-all-pull-together mentality right to using the crisis as one more political football. I don’t spend much time listening to the White House daily briefings, but based on what I have heard they seem to contain a lot of useful and/or interesting information from government and health officials. When it comes to cable news, the president and his twitter account, though, he and the press corps seem more than content to just carry on the same noisy and distracting game in which they have engaged since the 2016 election.

Here in Ireland the we’re-all-in-this-together spirit still mostly prevails. A lot of that has to do with the fact that news coverage here is led by a dominant state broadcaster that has little space for unsanctioned views or contrarian attitudes at a time like this. There is much collective self-back-patting at the Irish response, frequently drawing meaningless, self-flattering comparisons to other (much larger) countries, particular the UK and the US.

Having said that, there is a growing criticism, or at least collective regret, that the authorities were blindsided by the number of fatalities in nursing homes. With the benefit of hindsight it now seems clear that, while citizens in general were told to hunker down in their homes, not enough attention was given to the vulnerable elder population residing in clusters. This is probably because the planners were watching what was going on hotspots like China and Italy where living and family arrangements are more traditional than here. Ireland has become more like America in that the old folks are more likely to be sent off to a home.

For the average news consumer it is difficult to gauge exactly how bad things are in general. On one hand we see disturbing images of pine coffins stacked on top of each other in a trench on New York’s Hart Island as well as similar photos from Spain and Italy. On the other hand, there is the article in today’s Wall Street Journal about results of hundreds of blood tests taken in Los Angeles. Echoing similar stories from Europe, the emerging picture is that a lot more people than expected have antibodies for Covid-19, suggesting the rate of serious illness and fatalities among those exposed is actually quite a bit lower than previously thought.

I guess that’s a perverse kind of optimism. Another example is the fact that some people are emboldened to go out—against health expert advice—and protest restrictions imposed by authorities. People have marched or found other ways of protesting in such far-flung places as Michigan, Washington, Texas, France, Germany, India and Chile. Others have more cautiously done their protesting online. These are clearly signs of pent-up frustration at the personal and economic restrictions as well as local-issue-fueled discontent. The protestors are willing to test the assertion they risk spreading the disease more widely. In the process, they have become a political litmus test in the debate between those who want everyone to heed government/expert advice/diktats and those who subscribe to the spirit, which was big in the 1960s, of “question authority.”

The other night, protesting fishermen in Dingle, County Kerry, prevented the docking of Spanish-owned trawler for fear of introducing more virus cases. Were they perhaps thinking back a whole century to the Spanish flu?

Tuesday, February 4, 2020

Election Season

“Why, why why, could they not have had this reporting problem in 2004? Asking for a friend.”
—Late Monday night tweet about the Iowa caucuses from Joe Trippi, veteran Democratic strategist who was Howard Dean’s campaign manager in 2004
Remember that old Chinese curse about living in interesting times? I wonder if whoever came up with that was thinking about something like the coronavirus. Or maybe early 21st-century election campaigns?

For the next few days I am in the interesting position of observing fascinating campaigns in both of my countries. The American one will go on quite a bit longer, but the Irish one will end on Saturday—closing an election period with the very civilized lifespan of a mere 25 days.

Usually, the only questions in an Irish election are as follows: will it be Fianna Fáil or Fine Gael that will form a government and will they have to find a coalition partner? If the polling is to be believed, however, things could be different this time. A major opinion poll released yesterday has Sinn Féin in first place with 25 percent, followed by Fianna Fáil at 23 percent and Fine Gael (the current government party) at 20 percent. The margin of error is plus or minus 2.8 percent.

Typical Irish election
social media humor
Opinion polls, of course, are not destiny, as people who dislike Brexit and Donald Trump know all too well. For whatever reason, Sinn Féin has historically underperformed its opinion polling, but of course that will continue to be true only until it isn’t. If Sinn Féin does indeed come in first, it will be huge. It will mean that Irish voters will have taken a major step away from the legacy factions of the 1922-23 Civil War toward a party that is a strange mixture of nationalist and socialist ideas and of which the primary raison d’être is the reunification of the island’s 32 counties. My own personal political intelligence (I follow a few college-age Irish people on Twitter) tells me that many young, as well as some not-so-young, voters are enthused about the prospect of a left-wing coalition that could comprise the Green Party, Sinn Féin, and a collection of other smaller parties and independents.

What about older—and generally more reliable—voters? The country is actually in pretty good shape in terms of employment and the economy, but there is a lot of unease over hospital waiting times and a persistent homeless crisis. Moreover, a string of spectacularly violent incidents involving feuding criminal gangs has created an impression of things spinning out of control. The polling might indicate that people are looking for change even if they little to complain about their own current personal circumstances.

Meanwhile, how about things in the U.S.? I have to confess that I got a frisson of déjà vu this morning when a radio bulletin informed me there was hiccup with the results of the Iowa caucuses. This follows the rather shocking discarding of the Des Moines Register poll, which is traditionally the final pre-caucus tea-leaves reading. If one is prone to conspiracy theories, one might be tempted to fear a cover-up or an attempt at massaging results. Other details that feed this paranoia: earlier polls were suggesting that Bernie Sanders would win and the fact that, in certain banana republics, delayed election results are a warning sign of mischief.

Worryingly, this is more likely to be something worse than vote tampering. It could be sheer incompetence. Think about it. The very same party that has been harping for more than three years about Russian hacking into social media and U.S. elections is not only the same one whose last presidential candidate was found to have been conducting all her government business on an unsecured email server in a closet in her home but which is now the same party that has attempted to collate its first 2020 voting results with a new app that did not work.

I’ll be honest. I’m getting very worried about the Democratic Party. Not only did it clearly fix its presidential nomination process four years ago for a pre-determined candidate, but this time around it seems determined to sabotage itself by frittering away its two-year term in control of the House of Representatives by doing nothing but relitigating the last election and offering no clear-cut vision for the next election. That is not to say that there are not new and interesting ideas out there in the Democratic Party, but the people who run the party seem determined to tap the energy of those ideas without seriously entertaining the ideas themselves.

For more than three years now Democrats have lectured us that President Trump is a threat to democracy because of his authoritarian tendencies. They impeached him for seeking an investigation of a political opponent. The problem is that half the country looks at the Democratic Party and sees it doing exactly what it accuses the president of doing: using its political office to launch endless investigations of a political enemy. What else does the Democratic congressional majority have to show for the past year?

If voters have concerns about the integrity of American elections, will they really be inclined to turn to the people in charge of this year’s Iowa Democratic caucuses? And which happens to be the same party that was so concerned about democracy that it engaged in a completely quixotic attempt to bar the other party’s president from being able to run for re-election?

Friday, June 29, 2018

Nanny Super-State Blues

“We extricated ourselves from the British Empire only to accept unthinkingly the rule of the Roman Catholic Church and after that the EU.”
Irish Sunday Independent columnist Ruth Dudley Edwards, October 9, 2016
The other day my wife asked me to check whether a particular procedure was covered by our medical insurance. Finding the written policy overly complex and not very user-friendly, I decided to try the little chat window that always pops up on the insurance company’s web site. After waiting in a queue for several minutes, I was eventually informed that my wife would have to contact them directly. They could not converse with me about her coverage—even though we are married and it is all one policy—under Europe’s new General Data Protection Regulation (GDPR).

Unlike most policies/directives/edicts handed down by the crowd in Brussels, the GDPR is actually having a noticeable effect on my life. And I don’t just mean that my wife now has to get her own insurance-related questions answered. For instance, when I visit the web sites of many U.S. newspapers—including the one in Bakersfield which was the local daily paper I read growing up—all I get is a screen informing me that I cannot access the content because my IP address is in the European Union. Even more aggravatingly, one of the apps I use on multiple devices to save and read online articles (Instapaper) has stopped working for me. The web site explains that, in order to avoid any potential violation of European law, European users are being blocked until further notice while they study the law to see what they need to do in order to be in compliance. I suppose I could blame Instapaper. After all, anyone who was paying attention knew this was coming two years ago. On the other hand, I can understand why operators of a U.S.-based web site might put a low priority on something that, in theory, only affects users in other countries.

I mused on the possible effects of GDPR just as it was about to go into effect last month. To recap, this is a regulation handed down by the European Union which has the force of law in all EU countries even though no national parliament actually enacted it. It establishes very strict legal requirements for the storage and retention of individual citizens’ personal data as well as establishing sweeping legal rights for citizens to exert control over such data. In practice, as far as I have observed anyhow, the main practical effect is that for those of us in the EU there are many more legal agreements to review and agree to before we can do anything online. Of course, such agreements were common before GDPR, but now they are even longer and more complex and virtually ubiquitous. Past surveys have suggested that most people click on the “agree” button without bothering to read the agreement, and I have little reason to think it is any different now. As I understand it, I do now have the legal entitlement to contact any web site I have used and direct them to delete any or all of my data which they hold and/or to let me see it. Personally, I do not envision doing this, but who knows? Maybe a situation will arise in which I will be glad for this protection. In other words, I am not sure the benefit for me personally outweighs the inconvenience it has caused.

One U.S. publication that has not shut me out of its web site is The Wall Street Journal—probably because of the money I pay them. The paper’s tech columnist Joanna Stern notes that GDPR requires privacy policies to be “concise, easily accessible and easy to understand” and also written in “clear and plain language.” She adds, a bit mischievously, “Ironically, that’s found on page 11 of the 88-page official document.” As an example of the regulation’s effect, Twitter’s privacy policy has expanded from about 3,800 words to around 8,890.

According to two cybersecurity and privacy attorneys (Brian E. Finch and Steven P. Farmer of Washington and London, respectively) writing in The Journal last month, the main beneficiary of GDPR could well be cybercriminals. After all, the whole point of the regulation is to severely restrict sharing of individuals’ information. Apparently, this extends even to law enforcement.

“No government has ever before sought to impose such a sweeping privacy control,” observe Finch and Farmer, “perhaps because of the obviously deleterious effects on law enforcement.” Cybersecurity journalist Brian Krebs has written that European-based security companies have become “reluctant to share” internet-address information that could help identify cybercriminals.

Maybe you think it’s a good trade-off to make things easier for terrorists and criminals to communicate over the internet as long as it means that people won’t have Russian bots micro-targeting them to try to stir them up over populist issues. Me, I’m not only not sure it’s a good trade-off, I’m not sure that such internet mischief will be seriously curtailed.

Maybe I will be proved wrong, though, and I will see it differently over time. For now, however, this looks increasingly like what happens when you hand a problem to an army of bureaucrats who are not accountable to—indeed not even in the same country with most of—the vast swathes of people who will have to comply with their handiwork. To top it off, it may well actually make worse the problem they were supposed to solve.

Still, I will keep an open mind. In the meantime, if you come across any really interesting news from Bakersfield, please pass it on to me.

Monday, January 11, 2016

Market Forces

Anderson Cooper: “What can you say to somebody tonight to convince them that you don’t want to take away everybody’s guns? That you’re not coming for their guns?”
President Obama: “Well, first of all, Anderson, I think it’s useful to keep in mind, I’ve been, now, president for over seven years, and gun sales don’t seem to have suffered during that time.”
Cooper: “If anything, actually, you’ve helped.”
Obama: “They’ve—they’ve—gone up. I’ve—been very good for gun manufacturers.”
 —Exchange at CNN’s Guns in America town hall on January 7
What to make of that back-and-forth between the CNN anchor and the president?

I don’t want to put words in the president’s mouth, but I think it is fairly safe to say that he would prefer for gun sales to be going down rather than up. And, if we accept that premise, then the president’s defense against charges that he wants to undermine the Second Amendment basically amounts to this: Gun rights advocates do not have anything to worry about because I am so ineffective at achieving my policy goals—at least when it comes to guns.

The irony that gun sales have surged under this president—the very one who has been most vocal in our memory about the problem of guns in society—highlights an interesting point. Barack Obama’s actions as president suggest a very interesting understanding (or lack thereof) of how economies work. The BBC World Service’s overnight business program last week underscored, however unintentionally, that fact. One of their segments reported on how gun sales how had surged in response to his raising the gun issue. This is a pattern we have seen again and again. By injecting even the merest theoretical uncertainty into the future market availabilty of firearms, the marketplace responded by driving up demand for those firearms.

A similar thing has happened when it comes to business investment and, consequently, employment. During Obama’s first term, prolonged talk of tax increases and uncertainty over the healthcare law, which was rolled out in slow motion, caused businesses to hold back investment because they could not forecast their expenses. That, in turn, caused the recovery to be anemic. Yes, the latest job figures (seven years after the financial crisis) look good on paper, but the workforce participation number is the lowest in generations and wage levels have fallen.

The other segment on the BBC program was about the rise of healthcare costs in America. As reported by the BBC’s partner, the Marketplace program on American Public Media, a consequence of the Affordable Care Act is that it has encouraged hospitals to consolidate, resulting in higher costs from a lack of competition. To add insult to injury, Gallup reported the other day that, despite the ACA, the percentage of uninsured Americans ticked up to 11.9 percent last year from a low of 11.4 percent. (That compares to 14.6 at the beginning of 2008).

The president’s response to this sort of bad news is usually to blame participants in the economy for not conforming to his reality. He does not acknowledge the market demand he himself created for more firearms purchases. Instead, he blames the National Rifle Association for its lobbying activities. It does not seem to occur to him that the NRA’s successes are actually due to a widespread demand for guns rather than the cause of it. If people are rushing to buy more guns, it is not because of laws that are or are not passed by Congress or because of the activities of some lobbying group. If they are buying more guns, it is because they do not feel safe. You can argue whether those fears are rational or not, but it is certainly clear that this is what is behind the demand for guns.

If the president wants to see fewer guns being purchased, he needs to do what he can to make people feel safer because, so far at least, his response to terror attacks in France and California do not seem to have done the trick. Not only have weapons sales surged but so has Donald Trump’s political support. Even if that support does not amount to a majority of Americans—or even of Republicans—it is still an indictment on his ability to reassure the country.

Maybe more people would be less jittery if they perceived the government as having at least realized that the attack in San Bernardino was not strictly result of inadequate gun legislation. Or that the American marketplace consists of more than just the Democratic base.

Wednesday, April 22, 2015

Disrepair

“Politics is religion for atheists.”
—Comedian Dennis Miller
When we visited Washington D.C. a couple of weeks ago, the tourist destinations on and around the mall were not exactly at their best. Yes, we did get to see the famous cherry blossoms, but the reflecting pool was drained and some of the other sites were similarly undergoing various bits of repair or renovation.

Most notably, the Capitol dome was obscured by covering and scaffolding that made it look like a trauma patient headed for intensive care. By contrast, the White House looked okay but was not that easy to get a good look at because of lush green spring foliage—not to mention serious security that keeps ordinary people at a greater distance than it used to. People in the know told us not to bother with the White House since, after going through the hassle for a tour, you don’t get to see that much anyway.

U.S. Capitol
The U.S. Capitol, earlier this month

It’s tempting to regard the physical appearances of the Capitol and the White House as being symbolic of the institutions they house. On one hand, the executive branch has become rather obscure. The long-term trend toward less transparency has continued unabated during the Obama administration—despite the president’s promises to the contrary when he was a candidate. As for the legislative branch, it is clearly in serious need of repair—not only as a building but also as a functional part of the government.

The congressional dysfunction continues, but it seems to be lessening a bit, with progress actually being made on a few bills—including a “fast track” trade bill—and, not insignificantly, a real budget rather than the spending auto-pilot resolutions that were the order of the day during the reign of former Senate majority leader Harry Reid. There are still fringe factions on the left and right in both houses ready to stall legislation, but the departure of Reid is the single best thing that could have happened in terms of Congress functioning as it was meant to under the Constitution.

We had gone home by the time an off-duty postal worker caused a fuss—and raised anew serious concerns about security—by landing his flying lawn mower on the Capitol grounds. He was carrying letters for members of Congress, urging them to pass campaign finance reform. Whatever his methods, the man was certainly correct that there is way too much money in politics. Unfortunately, his solution just echoes what a few well-intentioned people—and quite a few hypocrites—have been pushing for years. If campaign finance “reform” ever had a chance, it was in 2008 when John McCain, an actual co-author of campaign finance legislation chose to accept public funding and Barack Obama, a self-proclaimed proponent of the reform, did not.

One would reasonably think that that would have been the end of the issue. Yet now we have Hillary Clinton, who stands to break all kinds of records in raising money for her presidential campaign, giving lip service to “reforms” that, given recent Supreme Court decisions, would effectively mean amending the Bill of Rights. Leave it to politicians to solve a problem they created by giving the government more control over how private individuals can raise and spend money in seeking elective office.

Why are there ever increasing amounts of money in politics? The answer is painfully obvious. The federal government is collecting and spending more money than it ever has before. And the federal government is regulating more areas than it ever did before. Under the current president, health care came under the federal umbrella, just as control of the internet is coming under federal jurisdiction. Money that was previously spent by large corporations in the private sector marketplace must now be spent on lobbying and on campaign contributions to seek favor—or avoid disadvantage—from the powers that can tip the scales in the marketplace.

You can pass all the “reform” you want, but rest assured that the money will still find its way to Washington one way or another. That’s because Washington is where, increasingly, the decisions that affect the economy and everything are being made. And, in the process, ordinary citizens, who do not have the resources of a Hillary Clinton, will find compliance with the ever-increasing rules for elective office prohibitive.

Tuesday, November 18, 2014

Faltering Vital Signs

“John Kerry said no, no we’re not going to tax your heath insurance, we’re going to tax those evil insurance companies. We’re going to impose a tax that if they sell health insurance that’s too expensive, we’re going to tax them. And conveniently the tax rate will happen to be the marginal tax rate on the income tax code. So basically it’s the same thing: we just tax insurance companies, they pass on higher prices that offsets the tax break we get into being the same thing. It’s a very clever basic exploitation of the lack of economic understanding of the American voter.”
—Jonathan Gruber, MIT economics professor and White House consultant for the 2010 Patient Protection and Affordable Care Act, in a speech on November 5, 2012


“Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”
—Gruber, on October 17, 2013


“My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration.”
—Memorandum signed by President Obama, on whitehouse.gov


The above comments from Professor Gruber, preserved forever in internet videos, have embarrassed Obamacare supporters. For Obamacare critics, they are the most improbable of welcome gifts. From the critics’ point of view, it’s a bit like that classic scene in Woody Allen’s Annie Hall, where Allen gets fed up listening to some blowhard in a cinema queue bloviating about the ideas of Marshall McLuhan and then, from somewhere outside of the frame, pulls in McLuhan himself to tell the obnoxious know-it-all that he doesn’t have a clue. That’s what Professor Gruber has inadvertently done to Obamacare defenders.

But neither of the quotes cited above is likely to turn out to be the most damaging one to come out of the professor’s mouth. That distinction will almost certainly belong to another comment, also caught on video and made during a January 2012 presentation on the Affordable Care Act: “I think what’s important to remember politically about this, is if you’re a state and you don’t set up an Exchange, that means your citizens don’t get their tax credits.”

In other words, Gruber effectively negates the Obama administration argument before the Supreme Court that the clause in the healthcare law, which provides federal subsidies only for state exchanges (and not for the federal one), was merely some clerical oversight. In other words, when the IRS decided arbitrarily to extend subsidies to consumers on the federal exchange, it ignored both the letter and the spirit of the law.

Of course, if the Supreme Court so rules next year, in a case called King v. Burwell, it will cause a huge mess. Subsidies have already been paid. Insurance companies have extended coverage to lots of people based on subsidies through the federal exchange. And the numbers involved are not trivial, since most states did not set up exchanges.

How does this get resolved? Can the court simply ignore the clearly stated content of the law? On the other hand, though, can the court put all those healthcare consumers in the position of suddenly owing a bunch of back payments to their insurance companies?

Before tackling that question, let’s take a moment to be properly angry at the way this law was drafted and passed. Unlike all previous major entitlement legislation, it was written and passed entirely by a single political party. A technical trick was used to avoid the usual 60-vote threshhold to get it through the Senate. It was pushed through even though it was immediately preceded by Massachusetts (yes, Massachusetts) filling Ted Kennedy’s Senate seat with a Republican who had campaigned against Obamacare.

The usual refrain in answer to these facts is that, well, the Republicans were crazy and unreasonable and they only wanted to keep Obama from getting a victory. You just couldn’t deal with them. Democrats had no choice but to go it alone. But the lie is given to that argument by the fact that Democrats would not even negotiate with the most collegial and bi-partisan of Republican members of the Senate at the time, Susan Collins and Olympia Snowe. Consequently, one of the two major political parties has absolutely no buy-in or interest in allowing to law to work or survive.

And the law, as drafted, is a shoddy piece of work. Exhibit A is the clause that is now the subject of yet another Supreme Court case.

The irony is that, despite Professor Gruber’s delight in how clever the Obama administration was in obfuscating the political argument, it didn’t really work. The law has never had the support of the majority of the American public. Depending on how the poll questions are asked, the law has consistently registered no more than 50 percent approval—and usually less. And public support is dropping. In a Gallup poll released on Monday, as reported by Politico, the law now had just 37 percent approval versus 56 percent disapproval. Combine that with the results of the recent midterm elections—not to mention the 2010 midterms, held soon after the law passed—and it seems pretty clear how the law has gone over.

What is not clear is whether the dropping approval of Obamacare is due to people’s actual experience with it or simply because of the news coverage. After all, most people have yet to feel its effects. Employer-provided coverage has yet to be affected, since that part of the law keeps getting deferred. Defenders of the law enthusiastically point out how many more people now have coverage who did not before. What they conveniently leave out, though, is that so far this has mostly been accomplished by expanding Medicare—something that the government could have done without bothering to enact Obamacare. Something else that does not get mentioned is the fact that more and more practitioners are refusing to take on Medicare patients for economic reasons.

So what will the Supreme Court do? In the last major challenge to the law, Chief Justice Roberts did a very interesting thing. He found that the law was not strictly constitutional because it required people to buy a private product, i.e. health insurance. But instead of sending it back to Congress to be fixed (which would have killed the bill since, by that point, the voters had put Republicans firmly in control of the House of Representatives), he said, very creatively, that the penalty for not buying insurance was essentially the same as a tax—even though Obama had personally sworn up and down that the penalty was not a tax—so everything was okay because Congress does have the power to impose taxes.

It will take even more creativity to somehow find a way to say that “an Exchange established by the State” actually means “an Exchange established by the State or by the federal government or, like, whatever.” But after going through such contortions not to overturn the law the last time, will the court really want to put a stake through its heart next year when the consequences will be even more far-reaching?

In any event, one thing we can certainly look forward to up until then is an unprecedented campaign of intimidation of the Supreme Court by the White House and Democrats warning it not to overturn the law. Expect the tide of history to be invoked frequently and passionately.

The mystery is why Democrats continue to fight so hard for this misbegotten law—with a sense of mission that was certainly missing in the law’s drafting. After all, in the beginning the bill’s most ardent supporters never claimed to want what Obamacare turned out to be—the imposition of a new layer of federal bureaucracy on top of the existing private health insurance system.

What those people said they actually wanted was a single-payer system. Some apparently thought that Obamacare would be a stepping stone to single-payer. But the irony is that, by giving so much strong and unconditional support to Obamacare, single-payer has now become something that is not very likely to be seen in our lifetime.

Tuesday, May 27, 2014

A Real Scandal

“I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system’s success provides a helpful corrective to anti-government ideology. For the government doesn’t just pay the bills in this system—it runs the hospitals and clinics. No, I’m not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate.”
—Nobel Prize-winning economist Paul Krugman, January 2006


The word scandal gets thrown around pretty easily by some. The party in opposition tends to attach the word to every occurrence that it thinks might make the public lose confidence in the government of the day. Republicans in particular have been determined to put the scandal label on everything from the administration’s handling and subsequent misdirection of the Benghazi terrorist attack to the IRS’s different treatment of conservative groups for tax-exempt status. In fact, the list of outrages cited by Republicans grew so long that at one point that the president dismissed them all together as “phony scandals.”

The situation that has come to light at the Veterans Health Administration is, however, different. Most or all of the outrage at previous “scandals” was necessarily limited to Republicans or, at best, non-Democrats. The IRS misconduct directly affected only politically engaged conservatives. Benghazi happened and then it was over. There is not much more to learn about it, although the prying loose of a memo directly contradicting the line that no misdirection had come from the White House has certainly given Republicans encouragement to have more hearings and, not incidentally, undermine Hillary Clinton’s legacy at the State Department.

Unlike those scandals, the VA mess is still going on and will continue to go on until it gets fixed. And it is not something that affects members of only one political party. Upset at the way veterans have been treated transcends political allegiances. So it is disheartening that the president’s response is not markedly different from his responses to the other scandals. He went weeks without addressing it and then, when he finally did, he unsheathed his standard scandal responses. On one hand, he made a point of emphasizing that the VA situation predates his administration. In other words, well into the sixth year of his presidency, he is still complaining about the mess he inherited from George W. Bush. On the other hand, he used the fact that there are ongoing investigations to justify a lack of action. Maybe people need to be fired. Maybe some need to go to jail. And he would certainly want all the facts before taking that kind of action. But there is no reason at all for him not to take immediate action to start reforming a system that is clearly not working. Republicans are not off the hook either, since Congress has role in this.

While the outrage is bipartisan, it is not at all surprising that Republicans have much more enthusiasm for expressing their indignation. The VA failures are politically awkward for Dems not only because they are the party in power but also because, as the above Paul Krugman quote illustrates, they have long touted the VA as evidence that the government can be an efficient provider of health care—something that also undermines the president’s stance that this is an inherited problem. The required tweak to the Democratic line could be subsequently heard last week from Nancy Pelosi and reliable talking point carriers like E.J. Dionne. According to them, the VA has generally done a good job but now it has been overwhelmed by the casualties of George W. Bush’s wars. So don’t blame the current administration if former soldiers are put on fake wait lists and denied health care. It’s really the fault of the warmongering neocons.

There is a valid point here. Advances in medicine have saved many warriors who would have died in an earlier era, and the flip side of that is a higher toll of grievous injuries. Also, mental and emotional disorders are now recognized that previously weren’t. But people who have crunched the numbers tell us that what is really overwhelming the VA is the same thing that stands to overwhelm public services generally. There is a massive demographic bulge (the baby boomers) among veterans—as among the population in general—hitting the age where it simply needs more healthcare services. Still, Pelosi’s attempt to shift the blame for mismanagement and fraud in government facilities resulting in avoidable deaths is certainly innovative.

Republicans are pointing to the VA fiasco as evidence that the government should stay out of the healthcare business. It is not exactly fair to compare a government-run hospital system with a government-run exchange system that matches up patients with private insurers. Obamacare and the VA are not equivalent. Still, the VA situation is not irrelevant either. By dictating to consumers what sorts of policies they must buy and by dictating to insurers what coverage they must provide and by expanding the portion of the population that gets healthcare subsidies, the government is undermining the market forces that would normally keep costs down and assure that supply be able to keep up with demand.

When supply cannot keep up with demand, it leads inevitably to de facto rationing, which in the current situation takes the form of secret open-ended wait lists that put patients in limbo.

Wednesday, March 12, 2014

News Hole

“Here we go. Okay, let’s get this out of the way. What did you come here to plug?”
—Zach Galifianakis, on FunnyOrDie.com

“Well, first of all, I think it’s fair to say I wouldn’t be with you here today if I didn’t have something to plug.”
—Barack Obama, on FunnyOrDie.com


When I studied abroad decades ago, there was a real sense of isolation in being so far from home. American news sources were not that easy to come by and, when available, were pricy for a student budget. No more. Nowadays everyone from the age of adolescence on—and oftentimes younger—has access to every news source in the world literally in the palm of his or her hand.

Thanks to the internet and satellite TV, there are times—as long as I don’t go outside of my house anyway—that I feel that I haven’t left America at all. If anything, I suspect that I pay more attention to news coming out of the U.S. than I would if I hadn’t moved abroad. Furthermore, my tablet and its apps, which efficiently find the news I’m interested in and organize it into very perusable formats, ensure that I consume more news than ever.

Is that true of everyone? Specifically, is it true of young people? I wonder because I have just watched—and laughed quite a bit at—the latest installment of Between Two Ferns, the mock talk show hosted by Zach Galifianakis on the Funny or Die website. It trades in the hip, post-modern, ironic kind of humor that is pervasive these days, and Galifianakis’s high-profile guests (his penultimate one was Justin Bieber, fresh off his recent tabloid headlines) go along with the joke that the host is a lazy, clueless dolt by playing into their own public personas. His latest guest, as you no doubt know, was none other than President Obama, who gamely played along with the gags—all the while pretending not to be amused.

Sample exchange: Obama: “Have you heard of the Affordable Care Act?” Galifianakis: “Oh yeah, I heard about that. It’s the thing that doesn’t work. Why would you get the guy who created the Zune to make your website?” I know it’s all supposed to be for laughs but, frankly, that is really unfair. It just so happens that I bought the very first Zune model when it came out and am still happy with it to this day.

So why did the president take time out of his busy schedule to do this? Because it was intended as a way (some have said a desperate way) to reach and encourage healthy young people to sign up for Obamacare so that insurance companies don’t go broke complying with the new healthcare law. Apparently, the traditional media have not yet convinced enough members of that age bracket to enroll.

It has always been true that teenagers and young adults do not follow the news as reliably as their elders, but something new is going on. In his blog a few months ago, TV critic David Zurawik noted that, during the previous eight years, viewership of the main evening newscasts on ABC, NBC and CBS had each declined 16, 17 and 22 percent, respectively. More stunning, though, is the drop in viewership of PBS’s NewsHour over the same period: a whopping 48 percent. (Zurawik got PBS’s numbers second-hand since PBS’s ratings, ironically for an organization whose first name is literally “Public,” are not made public.)

So hardly anyone is watching TV news then? Well, the Pew Research Center reports that 71 percent of Americans get their news from local stations, 65 percent from the networks and 38 percent from cable. Among cable news viewers, Fox News Channel is far and away the leader in viewership, with CNN and MSNBC tussling over a distant second place.

If I were an optimist, I might speculate that the large chunks of the population that aren’t getting their news from TV are getting it from newspapers and magazines. But we know from print circulation numbers that this isn’t the case. The internet then? Only the National Security Agency knows for sure. Let’s hope that young people are doing what I do and are using Feedly, Instapaper, Pocket and IFTTT to gather news and information from an array of media sources all over the globe—or at least reading the websites of some reliable newspapers.

I think I can understand why evening network TV news broadcasts are in decline. If you are serious about news, not only is their 22-minute “news hole” (the half-hour time slot less advertising) very brief, but half of it is typically taken up with soft features rather than hard news. As for cable, you can certainly find useful news programs, but if you do not choose carefully, you can wind up hearing a lot of the same information over and over—or else watching opinion programs that can entertain but not necessarily deliver a lot of real information.

The dramatic decline in PBS’s NewsHour viewership is particularly interesting because that program was supposedly designed to counteract the wasteland that is TV news. It certainly provides a much bigger news hole than the commercial broadcast networks. But its smaller budget has always meant that its “coverage” has largely consisted of talking-head interviews as opposed to field reporting. And its mindset has always been definitely inside-the-beltway and clearly identifying with the government establishment.

Personally, one NewsHour segment that I rarely miss is the Friday debate between commentators Mark Shields and David Brooks. They ostensibly provide left and right political perspective on the week’s news, and their discussion is useful for catching up with the latest talking points. Well, sort of. Shields is certainly a reliable—and, in fact, articulate and passionate—carrier of current Democratic talking points. How much is he in the tank? Well, on Friday I heard him actually defend the administration’s foreign policy by saying that the infamous “reset” with Russia somehow led to the election of the supposedly moderate Hassan Rouhani in Iran. I still haven’t gotten my jaw off the floor since that one.

On the other hand, Brooks—who is what passes for a token conservative at The New York Times, NPR and PBS—is a clearly interesting, intelligent and thoughtful man who speaks for a group that is, frankly, not much larger than just himself. To the extent that he represents thinking on the right, the best that can be said about him is that he is a good spokesman for a wing of the Republican Party that pretty much disappeared with Nelson Rockefeller.

In fairness, there was a show where you could see a weekly no-holds-barred debate between real honest-to-God modern liberals (such as Shields and NPR’s legal correspondent Nina Totenberg) and at least one true dyed-in-the-wool conservative (columnist Charles Krauthammer, a mainstay on Fox News). Produced by ABC affiliate WJLA and distributed to PBS stations, it was called Inside Washington and was hosted by Gordon Peterson. It began airing back in 1988 and was the successor to Agronsky & Co., which in 1969 pioneered the point-counterpoint format that would become a staple of television news.

It’s not clear exactly why Peterson pulled the plug on the granddaddy of talking-head political shows in December. Maybe he noticed that its potential future audience were all too busy streaming videos on FunnyOrDie.com.

Monday, November 18, 2013

Beta Tester Revolt

“[W]hat we’re also discovering is that insurance is complicated to buy.”
President Barack Obama, 14 November 2013


I happened to hear last week another in the seemingly endless stream of news reports on Obamacare. It was on National Public Radio and was about a White House promotion that stated that half of people under the age of 35 could get health care for $50 a month or less. As NPR reported, the government’s own numbers say that the number of people who could get insurance that cheap is actually 32 percent.

The most interesting part of the NPR piece was the reporter Chris Arnold’s somewhat blasé summation of the government’s misleading message: “So in other words, it’s like any other marketing campaign. All the pitches aren’t exactly entirely true but they get your attention.”

In a roundabout way, this highlights a fundamental problem that conservatives and libertarians have with the Affordable Care Act. If a major corporation ran high-profile advertisements that were as patently false as the above promotion or the infamous “If you like your insurance, you can keep it” assurances, it would face penalties for fraud. But who protects consumers from fraud when it’s the government committing the fraud?

Normally, that role would fall to the press, but the most pervasive media outlets seem to be acting as surprised as anyone that it has turned out that millions of people cannot keep their insurance policies.

I’ll confess to being taken aback by the furor over the canceled policies. I never considered President Obama’s repeated “If you like your insurance, you can keep it” assertion a lie because it was always so obviously untrue that I assumed no one actually took it seriously. It’s one of those falsehoods where the fault should lie with anyone clueless enough to believe it rather than with the person actually saying it. People have never had any guarantee they could keep their insurance, and nothing in the new healthcare law did anything to change that. In fact, the whole point of the law was to change the system. As NPR’s Mara Liasson cogently describes the law, it was specifically designed to be a disruptor.

But that “If you like your insurance, you can keep it” line apparently served its purpose. The vast majority of Americans, who had insurance and were reasonably happy with it, tuned out, assuming that the new law had absolutely nothing to do with them. They thought it was only about providing health care to those who did not already have it.

One of the questions we kept hearing when the healthcare.gov website bombed so badly was, why on earth didn’t they test it before rolling it out? The obvious answer is that it is being tested—now. A general principle that I remember from my days in the software business was that responsible companies do not use their paying customers as beta testers. But the fact is that insurance consumers in the individual market are now beta testers—not just for the website but for the new healthcare system in general.

Remember, originally the new system was meant to roll out for the entire insurance market on October 1. But, in a move that some argue was illegal since it changed the healthcare law without congressional action, the administration decided to delay the implementation of the new system for people who get their insurance through their employer. If not for that, we would be talking about complaints from across the entire insurance market—not just those in the relatively small individual market.

As I’ve said before, the anecdotal reports of people having their policies canceled or having to pay higher rates are not even the real problem. The real problem is that the new system is virtually designed to raise the costs of medical care and will inevitably be a drain on the government budget—on top of Medicare and Social Security, which are already on trajectories toward insolvency.

The trouble with anecdotes is that they can distort things and do not necessarily reflect the larger truth. But we pay attention to anecdotes because we can relate to people’s individual stories more easily than to reams of statistics.

The individual case that has made the biggest impression on me is that of Daily Beast columnist Kirsten Powers. Her comments may be discounted by Obama’s true believers because one of her jobs is as one of Fox News’s token liberal pundits. But she is a Democrat, a consistent Obama supporter and a veteran of the Clinton Administration, and she has gamely defended Obamacare all along, while conceding that she would have preferred a single-payer system. So it was a bit of a stunner when she went off on a rant about losing her own insurance policy canceled.

“If I want to keep the same health insurance, it’s going to cost twice as much,” she said. “There’s nothing substandard about my plan… All of the things they say that are not in my plan are in my plan, all of the things they have listed. There’s no explanation for the doubling of my premiums other than the fact that it’s subsidizing other people.”

But that was always clear—at least to me. That was always the idea of Obamacare: require everyone to buy insurance, subsidize those in the lower income brackets, and highly regulate the industry to spread out the costs.

Why is everyone acting so surprised?

Friday, November 8, 2013

Your Parrot Is Dead

There is a small silver lining to the problems that have plagued the rollout of America’s new healthcare exchanges. It has made me feel somewhat better about the Irish healthcare system.

Granted this silver lining is pretty limited and doesn’t apply to the vast majority of Americans, but it’s something.

As someone who wanted to see the U.S. healthcare system reformed to be more affordable and universal but who saw Obamacare as making the problems worse, I could probably be expected to be saying, I told you so. But I can’t. My problem with the Affordable Care Act was that it nearly seemed deliberately designed to make health care more expensive without necessarily expanding it to that many additional people. It never seriously occurred to me that the federal government, with well over half a billion dollars at its disposal, would be incapable of building a viable web portal.

The whole rollout of healthcare.gov seems like a classically wicked Monty Python sketch. The chronic political kibitzing, the vendors with no incentive to be efficient because they bill by the hour and the reflexive CYA among various levels of management all bring back vivid memories of my days in the software industry. This kind of mess is endemic in all kinds of large enterprises without clear and strong management—not just the government. But nowhere is it more pervasive than in the federal government, where no one ever seems to be responsible for anything when things go pear-shaped—the pending resignation of the CIO of CMS notwithstanding.

That doesn’t mean that government cannot do anything competently. I have been annoyed at various people comparing the healthcare exchanges to “the DMV.” Personally, I have no complaints about my acquisitions and renewals of driver’s licenses over many years in the states of California and Washington or even in Ireland. And I have done business for years with all kinds of government websites that have worked perfectly well.

In a strange way, the brouhaha over the website—and even the stories about people having policies canceled—may actually be good news for the Affordable Care Act. As long as people are talking about those things, nobody is talking about the real problems with the law, which will become apparent much more gradually than a botched website launch or anecdotes about policyholders being dropped. Those problems can, and probably will be, fixed. What will be more entrenched is the fact that the new healthcare system will have a lot of inefficiencies and waste built in.

The Affordable Health Care Act is perversely named because, as currently devised, it cannot help but raise the cost of health care. This will probably show up over time in higher premiums for everyone and, the more the government tries to combat this with subsidies and Medicaid coverage, the more the costs will be converted into long queues for care and, ultimately, rationing. Maybe fewer people will show up at emergency rooms because of not having coverage, but more are likely to show up because they don’t want to deal with the hassle of getting in to see a GP or scheduling time in a hospital.

There are some ironies in the way things have played out so far. One is hearing Democrats defend the law by noting that the exchanges in least some of the states are working much better than the federal one. Doesn’t that vindicate failed presidential candidate Mitt Romney, who said that this kind of system should be run by states and not by the federal government?

Another irony is that Democrats up for reelection next year are reportedly pressuring the administration to agree to delay the individual mandate for a year. Isn’t that the very same offer Republicans made to Democrats to avoid the government shutdown—after their initial demand to defund Obamacare went nowhere? If the individual mandate does get delayed, it will mean in hindsight that Democrats could have avoided the shutdown by admitting to Obamacare’s problems just a bit earlier. Now, for Democrats to get the delay they may well have to deal with Republican demands for other concessions to go along with it.

Things could still turn around on this issue for the Democrats, at least in the short to medium term. If the administration can get its website working reasonably well, the media narrative could go from debacle to turn-around. Stories about low-income people getting subsidies could eclipse those of middle-class people getting saddled with higher premiums—at least for a while.

Barring that, the president’s party will have little choice but to double down on its fallback strategy, i.e. heap as much blame as possible on the insurance companies and on “sabotage” by Republicans who, voters will surely remember, opposed the law unanimously and consistently from the very beginning.

Monday, October 21, 2013

Weak Tea?

I must live in a different universe than most other people.

Maybe that universe is Ireland, but I don’t think so. I seem to live in a different universe than most Irish people as well as most American people.

For example, I have been listening for many days to pundits, commentators and regular journalists proclaiming that the recently ended U.S. government shutdown was a huge victory for Democrats and an unmitigated disaster for Republicans—or at least that Republicans were hurt a lot more than Democrats. Democratic operatives I have heard on my various podcasts are wishing that the midterm congressional elections could be held this year instead of next year because of the anticipated wave for the president’s party.

Maybe Republicans will pay a price for what went on, but that’s not what happened after the last government shutdown—even though the Republicans back then, as now, were declared the overwhelming bearers of blame.

If the government giving itself authority to borrow enough additional money to keep running for a few more weeks is a huge victory for the president and his party, so be it.

But this is how I see things. If you judge the so-called Tea Party by how well it did at achieving its stated goals over the past few weeks, it failed miserably. But if you judge it against what probably would have happened if it had simply stayed quiet and gone along with business as usual, it actually did pretty well at its objectives.

Journalists all over the major networks, CNN and NPR have been saying that the Republicans made a major miscalculation because if the government had not shut down, those news organizations insist, they would have been giving full-bore coverage of the botched healthcare.gov rollout.

Really?

The fact is that Democrats are pretty darn good at driving the media narrative and, absent the shutdown, it’s certain they would have been spinning their own issues leading up to and after the passage of the continuing resolution. They would have been everywhere talking about how much pain the sequester is inflicting. The Democrats would have focused all their energy on building momentum for removing the sequester, and the media coverage would likely have reflected that. But that story never materialized because, frankly, the Dems were licking their chops at the prospect of a government shutdown because they knew it would reflect badly on Republicans.

In fact, the Democrats nearly overplayed their hand. When polls inevitably showed that, as expected, Republicans were getting blamed more for the shutdown, at that point the Democrats did try to press their advantage and propose rolling back the sequester, but by then it was too late. They were then in the position of running the risk that it would look like they were now the ones keeping the government shut down. And Republicans were ready with a quick rejoinder to the last-minute assault on the sequester. “It’s the law of the land!” they chided.

Maybe I’m wrong. Maybe if the government hadn’t shut down, everyone would have been talking for the past three weeks about what a disaster Obamacare is and how smart the Republicans were to oppose it. But I don’t think so. Even if I am wrong, it probably won’t matter in the long run anyway.

After all, if the new healthcare system works out its kinks and turns into a smashing success, people won’t remember or care that it got off to a rocky start. On the other hand, if Obamacare turns out to be the albatross around Democrats’ necks that Republicans expect it to be a year from now, the fact that poll responders didn’t much like Republican methods a year earlier will not matter very much. They’ll just remember which party was against the discredited system all along.

Tuesday, October 1, 2013

What Goes Around

Well, it’s the 1990s again.

How do I know it’s the 1990s again? Well, for one thing, the U.S. government has shut down. The last time that happened was during the Clinton Administration.

President Obama has been warning us how bad this will be for the economy. After all, after the last government shutdown, which began in December 1995, there was long-term devastation for the American economy. Remember? Oh, wait. Actually Bill Clinton’s second term saw what were arguably the best economic conditions in living memory. Of course, that wasn’t because of the shutdown. It was because of a number of government reforms that Clinton negotiated and implemented with Republicans after he was reelected.

Yeah, but Republicans will get the blame for this shutdown and be punished in next year’s midterm elections, right? Maybe. After all, Clinton did win reelection handily less than a year after the last shutdown. On the other hand, it’s hard to imagine that amiable, unexciting, middle-of-the-road Bob Dole would have done much better in that election even if the shutdown hadn’t happened.

In any event, the presidency isn’t on the ballot in the next election, which usually gives the opposition an advantage. And, if we look at the 1996 congressional election, we see that Republicans—although they did lose a few seats in the House of Representatives—controlled both houses before and after that post-shutdown election.

So basically everything the experts in the media keep telling us about what the shutdown means is wrong—at least historically. Even the bit about how federal employees will never get paid for the days of work they will miss. The fact is that, after every previous shutdown, Congress has voted to reimburse out-of-pocket employees for their time off.

Still, this makes the Republicans look really bad, right? Yes, at least in terms of mainstream press coverage. But this whole fight does help energize their base, just as it also energizes the Democrats’ base. But in one key way, this whole train wreck represents something of a triumph for the GOP. All anyone is talking about is Obamacare and whether it will be funded or delayed or how long the Washington Monument will be closed. What seems to be missed in the coverage is that the House continuing resolution (real actual budgets went the way of the passenger pigeon since Obama was first elected) keeps the sequester on spending in place. That actually seems to be the endgame for any final resolution.

How else are these days like the 1990s? Well, the U.S. government is dealing with weapons of mass destruction in the Middle East. Unlike Barack Obama, President Clinton seemed to have no reluctance in using military force in that part of the world. Among other incursions, he launched missiles into Iraq in 1993 (in retaliation for the attempted assassination of former President George H.W. Bush) and in 1996 (after Saddam Hussein attacked Iraqi Kurdistan). Two years later he signed the Iraq Liberation Act of 1998 establishing regime change as the official policy of the United States.

During this period U.N. weapons inspectors were in and out of Iraq, generally with inconclusive results. U.N. sanctions imposed economic hardship on the country and, to alleviate this, an Oil-for-Food Program was established to allow Iraq to buy food and medicine. This turned out to be rife with corruption, bribery and payoffs, and in the end was of little benefit to the ordinary Iraqi.

To those of us who see modern history unspooling in repeated cycles, it looks as though we are getting back to those days. In what are being portrayed as diplomatic breakthroughs, chemical weapons inspectors have moved into Syria and the Obama Administration is exploring the possibility of talks with Iran about its nuclear program.

Does President Obama understand that negotiations and inspections are sometimes a way of delaying, or maybe even avoiding, action?

I think he most certainly does. After all, I just heard him say that he would be more than happy to negotiate with House Republicans—after they have passed the continuing resolution that he wants.

Monday, July 2, 2012

Courting Disaster

Speaking of distractions...

During the seemingly endless months leading up to the Supreme Court ruling on Obamacare, the focus was primarily on the individual mandate. Now that we finally have the ruling, the focus continues to be on the mandate, I mean, the tax.

Now, I am as amused as anybody about the way the pundits’ predictions on the outcome were totally wrong for months and how politicians on both sides have shown their hypocrisy by reversing their supposed principles on what the Supreme Court should and shouldn’t do. Conservatives, who usually rail against courts that overturn duly passed laws, were fiercely disappointed that the court didn’t overturn this law. Liberals, who can frequently be heard bemoaning 5-4 decisions as proving the justices’ partisan motives, were this time praising the court’s integrity. And the president, who swore up and down that the mandate did not constitute a tax on the middle class and who ridiculed George Stephanopoulos for looking up the word “tax” in a dictionary, gratefully accepted (without acknowledging) the court’s definition of what a tax is.

But to my mind, this has all been and continues to be a distraction from what is really important. The question of whether Congress can order citizens to buy a product is certainly a very interesting one, as is the way it all finally got interpreted by the court. But personally, I have never particularly agreed with those who see the individual mandate as some sort of enslavement. Our personal liberty is limited in all kinds of ways by the government. What makes it okay is that the government has to answer to the voters, so these limits on our liberty are enacted indirectly by ourselves. If we don’t like what the government is doing, we can vote it out of office. That is what elections are for. No, the problem with the ironically named Affordable Care Act was never the mandate. It was the fact that, as it finally emerged from Congress, it pretty much guarantees that health care will continue to get even more expensive and out of reach for more, rather than fewer, people.

It attempts to “help” people get healthcare coverage. And it does it in the same sort of way that Fannie Mae and Freddie Mac were meant to “help” people to buy houses and government-subsidized student loan programs were meant to “help” people get a higher education. And the result of all that help has been to contribute to a vicious circle of those things becoming ever more expensive and people needing ever more “help” from the government. Think about it this way. Creating a healthcare mandate (of, if you prefer, tax penalty) to get more people to have health care is sort of like trying to end poverty by passing a law to require people to have money.

Yes, I understand that the idea is for those who can afford health insurance (including the young and the healthy who otherwise might not buy it) to pay into the system to provide more and better care for those who do need the health insurance and for those who cannot afford it. Requiring people to have insurance is not unreasonable, but it will only work if marketplace forces are allowed to keep costs down so that people can actually afford it. And the law, in all its volumes of text, never dealt with the factors that actually drive up health care costs. As a study cited in Time back in March (for example) notes, Obamacare makes no difference to the projection that health care costs will eventually exceed a typical family’s income. And with Obamacare in place, it will only be rational behavior for more and more people to give up and let the government subsidize their care rather than to keep working.

The president’s chief of staff, Jack Lew, made the Sunday talk show rounds in the wake of the court’s ruling, and I never saw anyone more anxious to change the subject from what was ostensibly a victory for his side. It just reminds people of all the laughable claims that were made about the Affordable Care Act while it was being fought over: that it was a “jobs bill,” that it would reduce the deficit, that it would bring costs down. Other Democrats in various panels (Donna Brazile on ABC’s This Week was one), when pressed about the illogic of how the whole thing was supposed to work, ultimately conceded that their preference was never really Obamacare but single-payer.

And that seems to be the president’s plan. If he can just get through the election, then when the healthcare situation worsens, he can put it forward that single-payer is the only solution. He’d be right insofar as it would be better than what is in place now. But it’s hard to see how, even if he is reelected, he would have enough support in Congress to put that through.

Unless the public collectively takes a firm stand, one way or the other, on the healthcare issue by giving the White House and a sizeable majority in Congress to one party or the other, we are liable to see two or four or more years of things getting worse and the two parties doing their best to attach the blame to each other, since there won’t be anything else they can do.