tag:blogger.com,1999:blog-6926413038778731189.post5896392649603301417..comments2023-10-16T07:13:12.123-05:00Comments on A plain blog about politics: "Selling" the Ryan Budget?Jonathan Bernsteinhttp://www.blogger.com/profile/15931039630306253241noreply@blogger.comBlogger16125tag:blogger.com,1999:blog-6926413038778731189.post-65526036574490651232012-03-26T03:47:05.829-05:002012-03-26T03:47:05.829-05:00This is probably more than a blog post, but i'...This is probably more than a blog post, but i'd be fascinated to read any broad treatment on the popularity of PPACA before, during the process of, and after its passage whenever you think the time is right to do one. (Realizing this may not be for ten years.)Michaelhttps://www.blogger.com/profile/10559337725063627254noreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-32353361616426419752012-03-24T21:28:51.740-05:002012-03-24T21:28:51.740-05:00Busted again. Its not a book about education stan...Busted again. Its not a book about education standards per se, but rather about why certain folks achieve greatness. Ours is a disappointingly idolatrous culture, believing that greatness inherently exists in certain people; read Colvin's book and you'll never believe that again.<br /><br />In the context of education, our idolatrous culture attributes too much specialness to superstars, educators or otherwise. For example, Jaime Escalante (from Stand and Deliver fame) was an exceptional teacher, but he was certainly not the magician we typically imagine; Colvin's book makes the frustrating case that anyone could be Escalante or his students.<br /><br />But that's for another thread.CSHnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-72306351979937298432012-03-24T20:15:50.884-05:002012-03-24T20:15:50.884-05:00OK. Don't know that book. From the review on A...OK. Don't know that book. From the review on Amazon, it doesn't look like a book on education (as I understand the term), but I'll look forward to hearing why that's wrong.Jeffnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-32200515756299217532012-03-24T18:38:43.872-05:002012-03-24T18:38:43.872-05:00Education standards? I can't wait! There'...Education standards? I can't wait! There've only been a few opportunities here to shill <a href="http://www.amazon.com/Talent-Overrated-World-Class-Performers-EverybodyElse/dp/1591842247" rel="nofollow">the book that influenced my thinking the most</a>. Let's have a raging education standards debate, and I'll find a way to work it in a half-dozen times a thread :).CSHnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-53368347302139327882012-03-24T16:15:29.089-05:002012-03-24T16:15:29.089-05:00CSH, it's not ALL smoke and mirrors. Having th...CSH, it's not ALL smoke and mirrors. Having the government manage health care and/or health insurance lowers administrative costs (all those people in cubicles reviewing every application and every procedure to figure out how coverage can be denied). But that aside, if I'm following it correctly, I agree with your analysis and would support your New New Deal.<br /><br />(Also, FYI, I too have a conservative homunculus inside my bleeding-heart liberal self. But what starts it squeaking are other issues, like education standards. More on this in other threads.)Jeffnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-74662724908608743812012-03-24T14:47:04.426-05:002012-03-24T14:47:04.426-05:00You're right. To rely on this kind of framing ...You're right. To rely on this kind of framing would be a risky scheme.*<br />_____________<br />*Copyright Al Gore, 2000.Robhttps://www.blogger.com/profile/11386165669907559416noreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-55919943946694392182012-03-24T10:47:01.917-05:002012-03-24T10:47:01.917-05:00That little liberal homunculus inside my callous c...That little liberal homunculus inside my callous conservative self, the one that screams about the perils of the world my small children will inherit, is constantly railing about how the left should argue for a New New Deal - not so much universal health insurance, which is just another band-aid on a burgeoning problem, but stripping the profit motive from health care altogether.<br /><br />In this New New Deal the left would appeal to our self-preservation by pushing for a collective effort to reduce the cost of the myriad, miraculous ways that we can keep our chronically ill selves alive indefinitely via advancing health care technology. In the New New Deal the role of organizations like the NIH would be expanded dramatically, perhaps largely replacing the for-profit entities in the health care system, with the twin objectives of finding:<br /><br />a) New and better miraculous ways to sustain and save lives, and<br /><br />b) New and cheaper versions of the same.<br /><br />Anything else, including ACA, single-payer, etc, is essentially just smoke and mirrors, in my not-particularly-humble opinion.CSHnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-70335663217357158302012-03-24T10:40:02.246-05:002012-03-24T10:40:02.246-05:00I think Jeff is correct, @3:26, when he argues tha...I think Jeff is correct, @3:26, when he argues that market forces make health care more expensive. I consider it somewhat unfortunate, however, that the left believes that a single-payer reimbursement system 'solves' this problem. More accurately, it hides it, at least for a while.<br /><br />Reason: market forces make HC more expensive in the constant quest for new and more costly technologies to keep the chronically - and former terminally - ill alive with reasonably good quality of life. The stress this system puts on any polity is covering the cost in a reasonable way; single payer systems haven't at all solved this problem, though they have arguably addressed it in a more egalitarian way, by relying on concepts like waiting lists to triage whose long-term care will be covered - arguably more fair than 'luck of birth' that decides such matters in the US.<br /><br />It is questionable how long these single payer systems can sustain themselves; two developments in Canada are alarming in this regard. The first is the explosion of private, supplemental insurance - I recently saw a stat that the average family of four in Ontario is paying $3,000/year for insurance supplemental to OHIP; insurance pretty obviously designed to buy one's way out of the queue. <br /><br />Even more daunting is the rise in medical tourism. Suppose OHIP makes you wait 3 months for your quadruple bypass, knowing there's a 25% chance you won't make it, and OHIP will thus avoid the lengthy, long-term cost of maintaining you after the surgery. Fine, you say, I'll spend $10 K to have the surgery next week in India. You would do so, wouldn't you? Clearly OHIP is not forcing you to wait cause they're worried about the cost of the surgery; its the three decades of high-cost care after. Which you're going to come home from India and impose on the polity anyway (more...)CSHnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-64131742606701356232012-03-23T17:27:14.688-05:002012-03-23T17:27:14.688-05:00Sheesh. Glad I'm NOT on their side! (Note to s...Sheesh. Glad I'm NOT on their side! (Note to self: The "Preview" button is there for a reason.)Jeffnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-56257817823405998962012-03-23T17:26:01.986-05:002012-03-23T17:26:01.986-05:00What Scott says is all true. However, just about a...What Scott says is all true. However, just about all historical experience suggests that controlling medical costs requires expanding the role of government. The countries that have lower costs and better outcomes have either nationalized systems or something like Medicare for all. That's because health care is an unusual product, one that market forces tend to make more expensive rather than cheaper. To counteract this, you need to give consumers and patients monopoly power vis-a-vis providers. That's the government's role, and it's one that most modern governments have embraced or at least accepted (even the U.S., so far, in the case of senior citizens and veterans).<br /><br />As Chait writes today, the difference between the parties is that Republicans don't want the government to play that role and, therefore, are in effect arguing that health care is not a right but an earned privilege. He calls that position "barbaric," although I think it's more accurately described as feudal: it harks back to a pre-democratic morality in which people are not assumed to be all of equal value. What's described above -- the Luntzian poll-testing and so on -- is modern marketing technology harnessed to the project of reviving this premodern vision, of getting a modern public to believe its expectations are being met when they really aren't.<br /><br />Meanwhile, a Republican primary campaign is underway in which one candidate, Rick Santorum, represnts the more honest, purer version of that effort: just try to scale back modernity altogether, urging on the polity various elements of the premodern value system (institutionalized in the modern West in conservative Christianity), such as biblical literalism and a rollback of women's equality. On the whole, though, even the GOP isn't willing to go that far. Another alternative currently on offer is Gingrichism, which suggests that if we just think outside the box, there's some techno-utopian solution that also involves dismantling the present welfare state but can still be imagined as providing its benefits -- HMOs in earth orbit, or something. But the party is also rejecting that option. So it's left with Luntz and poll-testing and propoganda techniques, plus a candidate like Romney who had hoped to run as the hard-headed consultant who can cleverly find the mixed public-private solution, as he did in MA, but who had that rug pulled out from under him and now has to run on the self-contradictory message that he's really as deeply committed to feudalism as Santorum but, unlike Santorum, won't actually deliver it, so swing voters don't need to worry. It's a conceptual mess and a political loser, certainly longer term and probably even short term. I'm glad on their side.Jeffnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-50163956368900224122012-03-23T16:44:10.332-05:002012-03-23T16:44:10.332-05:00I like the image of a bunch of old guys gathered i...I like the image of a bunch of old guys gathered in a "smoky" room to bring down Medicare, of all things. Monty Python, call your office.Jeffnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-37605764874403136442012-03-23T16:03:32.883-05:002012-03-23T16:03:32.883-05:00You're never going to resolve the problem by c...You're never going to resolve the problem by conceptualizing it as "Medicare costs." Medicare is expensive because it pays for skyrocketing health-care costs. Cutting the Medicare budget and dumping the health-care costs back on the people who couldn't afford them 45 years ago may improve the government's balance sheet but it doesn't resolve society's problem. (Ironically, when you think about it, the Republican approach amounts to making society suffer to help solve government's problems.) No, we need to address the medical costs themselves. Then, Medicare's problems will resolve themselves.Scott Monjehttp://foreignpolicyblogs.com/author/scottmonjenoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-59098876528570739672012-03-23T15:45:26.684-05:002012-03-23T15:45:26.684-05:00Here is the question. How do you deliver bad news ...Here is the question. How do you deliver bad news when your opponent is likely to demagogue the issue? Neither party has figured out how to <a href="http://moderatepoli.blogspot.com/2011/11/solving-healthcare-cost-puzzle.html" rel="nofollow">contain Medicare costs</a> without pain at the ballot box. All it takes is a weasly opponent who won't put his cards on the table, but will lambast your more specific plan. <br /><br />By the way, the weasel can be from any party: "death panels," "ending Medicare as we know it," "taking half a trillion from Medicare and giving it to Obamacare," etc. We've all heard it and we know it's going to happen.ModeratePolihttps://www.blogger.com/profile/01721945380057992971noreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-25945233857036798572012-03-23T15:07:20.522-05:002012-03-23T15:07:20.522-05:00Oops. Scratch "47." Put in "46.&quo...Oops. Scratch "47." Put in "46." The rest remains.Anastasiosnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-51183661962404326062012-03-23T14:43:04.618-05:002012-03-23T14:43:04.618-05:00Andrew,
I think the thing that might put a wrinkl...Andrew,<br /><br />I think the thing that might put a wrinkle in this is that, as Mr. Bernstein points out, the GOP only gets 47 percent approval when they are putting the plan forward in the best possible way in a milieu in which they control the information flow. That will not be the case on the campaign trail, where information will be flowing from multiple sources and multiple outlets, most of them not under GOP control. They may be thinking, "we already have 47 percent and we haven't even started explaining yet," when the truth, as I think Mr. Bernstein would see it anyway, is more like "we only have 47 percent and the Democrats haven't even started campaigning yet."<br /><br />Now, if the plan were polling at, say 63 percent in GOP internals, then I think the scenario you outline might be strategically plausible. Then they might think, "we'll take a hit but we'll ride it out and it'll be worth it." That is, by one way of thinking, what the Democrats did with ACA, the outline of which was initially quite popular before the fight really started.<br /><br />But 47 percent? That's a low place to start given the near certainty that fierce opposition will drive that number down, not up.Anastasiosnoreply@blogger.comtag:blogger.com,1999:blog-6926413038778731189.post-67924634086104227912012-03-23T14:30:34.212-05:002012-03-23T14:30:34.212-05:00If I were a Republican, I wouldn't be too worr...If I were a Republican, I wouldn't be too worried about this. The Ryan plan, as you and countless others have observed, is a campaign document, not a realistic blueprint for legislation. No one really thinks the massive benefit cuts entailed in the Ryan plan will ever come to be law - even if the GOP sweeps in November.<br /><br />The only point of the Ryan plan is to earn votes, and whether or not it earns votes depends on people's perception of the plan, not its theoretical results. And the perception, unlike the reality, is susceptible to be changed by using "magic words."<br /><br />If you understand that this is a campaign document, and you understand that politicians may sometimes intentionally take unpopular positions in order to advance what they believe is the best policy... then it shouldn't be hard to understand why the GOP would want to fool voters into thinking this is a plan to "save Medicare", even though it's not. By the time the voters realize they've been duped, Medicare as we know it will already be kaput. For the GOP, that's mission accomplished.Andrewhttps://www.blogger.com/profile/15913245096162048743noreply@blogger.com