Showing posts with label Obama. Show all posts
Showing posts with label Obama. Show all posts

Monday, November 9, 2009

Never bet against Barry Obama: how we’ve gotten to where we are on health care reform

Everyone knows that pitchers purposely throw balls to set up “out” pitches later in the count. But do hitters ever purposely swing and miss at hittable pitches? If anyone does it, you know it’s gotta be Manny Ramirez. It’s rumored that Manny purposely misses easy pitches in April to throw off scouting reports—so pitchers won’t be afraid to throw the same, crushable pitch in September and October when it really matters. Baseball guru Bill James swears that Manny purposely gets into full counts with a runner on first, so the runner can take off with the pitch and score on a well-hit ball. Manny’s so good, he can purposely dig himself into a hole just so his opponents are more surprised when he blasts out of it. No matter how bad it looks, you never bet against Manny.

And you never bet against Barry—Barry Obama, that is. Despite a summer of cynicism, replete with media obituaries of his administration not ten months into its first term, health care reform passed the House Saturday night.

To be sure, there’s still a long way to go in the Senate, but I’m going to go ahead and predict exactly that: the Senate will pass health care reform and the President will sign it into law. (True, Joe Lieberman’s filibuster threat would seem to pose an insurmountable obstacle, but I’m gonna call his bluff—this seems like a childish ploy for attention, not a serious threat.)

Why am I so confident in my prediction? It’s not based on media reports, although the Economist does report:
Harry Reid, the majority leader of the Senate, said that he may have the 60 votes necessary to pass a version of the health-reform bill that includes some form of public plan. A public plan may, therefore, now be politically viable again.

It’s not based on insider knowledge, although sources do tell me:
Senator Reid’s decision to include a public option in the Senate bill will likely give him enough support within the Democratic Conference to bring a bill to the floor. He then will determine which public option compromise (trigger or state opt-in) can get the 60 votes required to end a filibuster… While the next few weeks will be difficult once the bills reach the floor, it will be hard for Republicans to stop the President’s top domestic priority and the top domestic goal of the Democratic party for six decades. [Notice that it’s not “whether” a public option can get 60 votes, but “which” version of the public option will be included.]

It has nothing to do with electoral math, Nate Silver-esque modeling, or statements from Senators—although Sen. Baucus does state there’s a “sense of inevitability.”

The reason I’m predicting passage of health care reform is simple: I’ve learned never to bet against Obama, because he wins. Some people just have an innate ability to come through in the clutch, to not lose no matter what. Michael Jordan had it. LeBron has it (and it’s gonna take him to a title in the next couple seasons). And Barack Obama has it. All through the election, whenever the media counted him out (down 30 points in the polls to Hillary, “Bittergate,” Jeremiah Wright, Sarah Palin’s Convention speech), he stuck to his plan and pulled out the W. Now that it’s actually time to get things done, I feel the same mojo about him. He’s like the Mike Jordan of reforming, the Papi of the Potomac (2004-07 version), the Tiger Woods of Washington. Like Tom Brady (pre-David Tyree), you know that no matter what’s happened for the first 58 minutes, he’s coming through in the last two.
Think about where we were just weeks ago. For months, the President endured a cacophonous chorus of conservative contempt, clamoring breathlessly over death panels and socialism. Meanwhile, pessimistic progressives pleaded for the President to abandon bipartisanship and rely on the Democrats’ 60-vote majority to ram reform through the Senate. They criticized his arms-length strategy of outlining broad principles and leaving the details to Congress, and couldn’t understand why, with 60 Democratic Senators, he was pursuing bipartisanship with an opposition whose guiding principle was “Whatever it is, I’m against it.” The media all too happily promoted the negativity, pronouncing health care reform dead on arrival—and the Obama administration with it.

But, recognizing the pessimism as the product of a 24-hour news cycle obsessed with short-term events, the President pressed on. A month ago, progressives fretted and conservatives thought they smelled blood in the water—and yet here we are, closer to health care reform than at any point since Teddy Roosevelt came up with the idea 97 years ago. Even before passage by the House, last Monday’s New York Times reported:
President Obama’s arms-length strategy on health care appears to be paying dividends… Democratic leaders and senior White House officials are sounding increasingly confident that Mr. Obama will sign legislation overhauling the nation’s health care system — a goal that has eluded American presidents for decades.

So how did we get here, and how did the pessimists get it so wrong? Pretty easily: the President played them all like Manny Ramirez—putting himself in a bad position early on, only to lull his opponents into making a mistake when it counted. Like in baseball, it’s fall, not summer, that counts.

Obama’s strategy seems to have been to give in to Republican demands until, tempted into overconfidence by the concessions they’d already won, they rejected one compromise too many, exposing the true nature of their obstructionism. That moment seems to have been in August when Sen. Chuck Grassley, a “moderate” seen then as the best hope for compromise, endorsed Sarah Palin’s death panel myth, and subsequently sent out a fundraising letter detailing his opposition to “Obamacare.” From that point on, Obama could credibly point out, “look, we’ve given in to everything the Republicans have demanded, and they still say no.”

In other words, knowing full well from the beginning that the GOP would never give in to ANY concession, Obama was able to offer extremely generous concessions that he never intended to implement, anticipating that when the GOP rejected even those, he could move on unilaterally while credibly claiming to have pursued bipartisanship.

In short, if you’re a progressive who’s nervous that Obama is swinging and missing at a fat pitch over the plate, don’t be—he’s been just what he was on the campaign trail: calm, determined, and relentless. I’m not sure who said it, Jay-Z or Nas, but I do know this about Barack Obama: he… will… not… lose. Just look at this face:


Sunday, October 4, 2009

If Obama supports the Olympics, they must be bad: cutting off your nose to spite your face

Despite the shouting and name-calling, our politicians and pundits earnestly want what’s best for the country; they merely have different ideas about how to achieve it. When President Obama’s fiercest opponents endlessly criticize him and obstruct his agenda, they’re doing it because they genuinely believe that his policies will make the country worse off, not out of petty desire for short-term political gain (or to protect powerful interests). If he had ideas they agreed with, they would support him. Right?

Let’s test that assumption by looking at an issue that’s not ideological at all: the Olympics. Unlike health care, where you can make a legitimate case that there are better and worse ways of improving the nation’s health (and whether that is even a legitimate outcome for government to pursue), the Olympics are unambiguous in terms of the desirability of the outcome and the means of achieving it. That is, we all agree that bringing the Olympics to Chicago would be a good thing for the country, and there is no debate over the means for doing that – you either bring them here or you don’t.

So how did Republican activists react to the news that our country had lost its bid to host the 2016 Olympics? See for yourself (the clip is from the conservative Americans for Prosperity’s Defending the American Dream Summit):




I mean, wow. A room full of Americans absolutely giddy that America lost its bid for the Olympics – or rather, giddy that the Olympic Committee delivered a loss to President Obama. And that's after Glenn Beck insinuated that the Olympics would lose Chicago $1 billion, and Republican Congressmen criticized the President for pitching the United States to the Olympic Committee. Seriously people, you don't have to stop liking the Olympics just because Obama likes them too.

We’ve thus come full circle since Rush Limbaugh’s infamous quip that he “hopes Obama fails”:




This isn’t the first time conservatives have called for their followers to inflict damage on the country out of spite for President Obama. Conservative radio hosts have, for instance, advocated a boycott of General Motors to ensure the company fails, knowing that a successful emergence from bankruptcy would be a victory for Obama (and more importantly, vindication of a greater role for government in the economy). Glenn Beck says that because Obama supports AmeriCorps, it must be a secret Nazi army. Michele Bachmann warns that the Census has been infiltrated by ACORN.

The smug giddiness over losing the Olympics only confirms the larger trend, showing just how fanatical opposition to Obama has become; for the most conservative of Republicans, it’s no longer principled opposition to specific policies – it’s a hope that the country itself will fail in order to vindicate conservative ideology. What scares die-hards the most isn’t that progressive policies will fail – it’s that they will succeed. Because that would prove liberalism correct after all.

Hence campaigns to destroy General Motors, to keep affordable health care out of the hands of millions of Americans, and even to oppose bringing the Olympics to the US. If the country must burn to prove an ideology – even if the flames are deliberately set by the ideology’s defenders – then so be it. The ability to never change your mind comes at a high price.

And congratulations to Rio for becoming the first South American country to host the Olympics. I’m not going to cheer my own country’s defeat, but I’m happy for another part of the world having its chance to shine.

*Note* Does anyone have video editing skills? It’d be great to create a mash-up of the Rush Limbaugh clip and the one of the people cheering over the Olympic decision. Leave a comment with contact info if you know how to do that.

UPDATE: Paul Krugman totally steals my argument

RELATED POSTS:

A different perspective on "you lie!"

Has right-wing hysteria claimed its first life?

AmeriCorps: the most dangerous army in America

Wednesday, September 30, 2009

The catch-22 for opponents of health care reform: more health insurance economics

The public option is looking more in trouble by the day – just yesterday, it was rejected by the Senate Finance Committee – which means I need to hurry up and get in the rest of what I wanted to say about health care. In particular, I wanted to finish eviscerating the quagmire of absurd arguments against the public option before it’s all over and everyone stops caring.


We’ve all heard the fuss over a “government takeover of healthcare,” which, as I’ve explained before, makes no sense. The public option is just that: an option. The government adding itself to the list of insurance providers can only provide more choice, not less.


The Senators must have been reading my blog, because I haven’t heard much of the “public option equals government takeover” argument of late. Now, the argument is more subtle. The public option would not be a government takeover today, but rather would lead to a takeover down the road by running private insurers out of business – in the words of Sen. Orin Hatch, the public option is “a Trojan horse for a single-payer system.”


Of course, this raises a serious question – or rather two. First, would it really lead to a single-payer system (government option is the only choice)? And second, even if it did, why would that necessarily be a bad thing?


Coming from a capitalist, the first argument makes little sense. If the market always produces the best solution, and the government is always inefficient and corrupt, how could a government run health insurance scheme run the supposedly superior firms out of business? The “magic of the market” is that the better option always wins.


Opponents of reform counter that the government would compete unfairly, allowing the government program to undercut private insurers on price. Of all the premiums private insurers collect, 15-25% go to sales and marketing and administrative costs – after all, they have to pay actuaries to estimate customers’ health risks so they can figure out how much to charge and who to exclude. These costs would be unnecessary for the government program. And of course, private insurers also need room for profits. In other words, government competition would be unfair because it can provide better service at a lower cost.


The obvious question at this point is, why is that a bad thing?


In fact, health care economics suggests that a single-payer government program should be the only option. Insurance works by pooling risk – there’s no money selling insurance to sick people, but if you pool enough people together paying premiums, most of whom are NOT sick, the healthy people essentially fund the sick. The more people you have in a risk pool, the lower the chance that a catastrophe to any one person will threaten the solvency of the overall pool, and the lower premiums you can charge.


Now, you may counter that all industries benefit from scale. Wouldn’t this argument justify the government taking over all industries? That WOULD be socialist!


Well, no. Unlike industries that transform raw materials into finished goods, profitability in the insurance industry is not technology-driven. Insurance companies are in the business of math – estimating and betting on risk. Whereas a factory can invent technologies that allow it to produce more stuff at lower cost, there’s no technology that enables you to squeeze another unit of math out of a dollar of cost.


If the goal is to provide as many people as possible with access to health care, there are only two ways to increase the amount of coverage you can provide for a given premium: reduce overhead costs or increase the size of the risk pool.


A single-payer system wins on both counts. A government program whose goal was to cover everyone would not have to hire actuaries to figure out who was too risky to cover, nor would a single-payer system need sales and marketing. A single-payer system would also create the largest possible risk pool, achieving the highest economic efficiencies. Sure, you’d be paying for it in taxes, but because of these efficiencies, the amount of the tax would be less than what you (and your company) currently pay in insurance premiums; your take home pay would therefore increase by more than your taxes.


Reform opponents are caught in a catch-22. If they’re right about the absolute efficacy of markets, then private insurers will easily be able to reform themselves and out-compete any lumbering and inefficient government-provided option. But if opponents’ fears are founded, and the public option would inevitably run the private companies out of business, that begs the question – if private health insurance can’t provide the same or better service than the government at a given price, why should health insurance be a private industry in the first place? If the government option turned out to be better, well then there’s no reason to bemoan the demise of private insurance. And there’s even a safety value: if insurance companies were all driven out of business, and the government option grew inefficient and corrupt over time, some clever entrepreneur should inevitably emerge to take on the government and steal its customers, making a tidy profit. What this proves is that a government insurance program can never leave you worse off.


So why do “free market” conservatives oppose expanding people’s choice so vehemently? My thinking is that conservatives aren’t so much in favor of free markets as they are opposed to anything that would make existing businesses have to work harder to earn their keep. If you increase business’s costs or competition, that might actually force them to innovate, and that would be, well, CHANGE.


Related posts:


WSJ inadvertently supports case for health care reform: do you want to trust your health to profit and loss?


There's no money in selling insurance to sick people: more reasons free markets don't work in health care


The Takeover: What opponents of health care reform don't get


Are Sarah Palin and Martin Feldstein closet universal health care supporters?

Monday, August 31, 2009

The Takeover: What opponents of health care reform don't get


U-S-A, we runnin’ this health shit

Obama, we runnin’ this health shit

Death panels, we runnin’ this health shit

Get zipped up in plastic—when it happens, that’s it.


It’s the takeover, the break’s over. They’re coming for you, so take cover.


The President and his panel of experts think they know better than you and your doctor how to treat what ails you. The government takeover of health care will put a bureaucrat in charge of deciding what health care you get—decisions which are best left between you and your doctor!


More insidiously, the experts think they can pick out which individuals are most valuable to society, and therefore most deserving health care. Fail to make the productivity cut, and that’s it—you get zipped up in plastic, no matter how badly YOU think you deserve to get that expensive lifesaving treatment.


That’s what health insurance companies Republicans want you to believe, and that’s what countless misguided people at town halls across the country are shouting.


The obvious flaw in this line of thinking is that no one is talking about having government decide which treatments would be allowed, but rather which treatments would be paid for by the government under a public option. That’s not a “takeover” of health care. Doctors would not be employed by the government. Private insurance companies would still exist, and you could still buy insurance from them—and if you didn’t like your coverage or couldn’t afford it, you’d now have the option of buying insurance through the government.


Even if the government insurance option did drive private insurers out of business (I’ll post later on this), you’d still have the option of paying out of pocket for treatments the government opted not to cover. Only if you were BANNED outright from buying health care beyond what the government covered could reform be considered a “government takeover.”


And in fact, when people understand that the public option is government insurance, not government health care, they overwhelmingly support the President’s plan. As Nate Silver points out, most people don’t understand what a “public option” is, but when you explain it clearly as this poll does, asking “Do you support or oppose giving people the option of being covered by a government health insurance plan that would compete with private plans,” 62% support the plan, versus 32% opposed. Defeating health care reform thus DEPENDS on people believing LIES.


That’s strike one.


The other absurdity in the “bureaucrats making health care decisions” argument is that, well, that’s what happens in private insurance too. Your insurance company already makes decisions about what treatments it will and won’t pay for, which is why doctors have to spend up to a third of their time filing paperwork, battling to convince the company bureaucracies to cover your treatments. In fact, the insurance company bureaucracies unnecessarily waste $286 billion PER YEAR.


So extreme are insurance company efforts to ration treatment that they’ll even revoke your coverage after you’ve paid years of premiums, a practice called “rescission.” Reposting from an earlier entry:


This has happened 20,000 times over the past 5 years (at least one company evaluates its employees on savings from rescinded policies). Here’s how it works. When you get a diagnosis that will require expensive treatment, it triggers a processso-called “denial engine” software, to see if you forgot to report any illness on your initial health status questionnaire; if there’s been even one mistake, no matter how small, they revoke coverage from you and your entire family (of course, without refunding all those premiums you paid). You can have your coverage rescinded for something as simple as shortness of breath or hay fever. Health care rationing indeed. by which your insurance company scours your medical records, using


Unsurprising considering the insurance company bureaucrat has a profit motive to provide as little care as possible. Rationing care is how insurance companies make money!


Simply put, the idea that health care decisions are solely between you and your doctor assumes that there are no constraints on your ability to pay. Otherwise it’s not a choice made freely by you and your doctor, but one limited to the treatment options you can afford—you’re consulting your doctor, your own preferences… and your budget.


Arguing against universal coverage on the grounds that it leads to “rationing” is like arguing against food for the homeless because they aren't deciding what food or how much of it the charity gives them. Creating a public option can only give people MORE choices, not fewer.


So my question for reform opponents is: why is it worse for a government bureaucrat to make these calls than an insurance company bureaucrat?


RELATED POSTS:


There's no money in selling insurance to sick people: more reasons free markets don't work in health care


The catch-22 for opponents of health care reform


WSJ inadvertently supports case for health care reform: do you want to trust your health to profit and loss?


Are Sarah Palin and Martin Feldstein closet universal health care supporters?