Matt Yglesias thinks it would be more “environmentally conscious” to surround the Pentagon with “office buildings featuring underground parking garages.”
Is it really necessary, 16 years after the first World Trade Center bombing, to explain why underground parking garages at the Pentagon might be a bad idea?
Month: August 2009
Respect For The Dead
Despite my best efforts to find something positive to say about Ted Kennedy, CBS tabs me as an example of speaking ill of the dead. Well, at least I was concise. Well, the worst sort of disrespect one can imagine is finding humor in the death of someone you killed.
Caleb Howe has some related thoughts, which as usual are extensively documented.
No Bill
Prime Time
Thanks to TNL’s relationship with the CBS News site, my health care costs piece ran here.
Big Hole
Heritage’s Brian Riedl crunches some of the still-staggering numbers on the Democrats’ spending spree, including the fact that the projected 2009 budget deficit is larger than the Bush budget deficits for FY 2002-2007 (the six years when Bush had a Republican Congress to work with) combined. A worthwhile fact to recall when dealing with liberals who cannot comprehend how one could be more concerned about Obama’s deficits than Bush’s (of course, as always my concern is with spending, not deficits – deficits are just a symptom of overspending – but even then, Reidl’s point that 43 cents of every federal dollar spent at present is deficit spending is pushing into worrisome territory, especially with important sources of funding drying up). He also walks through the usual budget gimmickry, like how 75% of Obama’s projected budget “savings” are from not having another surge in Iraq each year, which was never anybody’s plan (note that these are budget numbers that don’t include the cost of the health care plan, either).
This year, President Obama will spend a peacetime-record 26 percent of GDP….The 22 percent spending increase projected for 2009 represents the largest government expansion since the 1952 height of the Korean War (adjusted for inflation).
Digest this, as you consider how many of Obama’s massive spending plans haven’t even been passed yet:
Federal spending per household (adjusted for inflation) remained constant at $21,000 throughout the 1980s and 1990s, before President Bush hiked it to $25,000. In 2009, Washington will spend $30,958 per household — the highest level in American history — and under President Obama’s budget, the figure will rise above $33,000 by 2019.
Read the whole thing. H/T Mark Tapscott.
Remember: Obama was the man who twice looked the nation in the eye in the October debates and pledged a net reduction in federal spending.
Ted Kennedy, Workhorse Lawmaker
It is traditional, upon the passing of an important and famous person – however controversial – to find some good words to say. This is not an easy task in the case of Ted Kennedy, a man whose personal life ranged from alcoholism to debauchery to sexual harrassment to (sadly, uncharged) second-degree murder, and whose public career entailed the embrace of nearly every foolish, ruinous and cruel political idea of the past five decades and whose most enduring legacy is installing the bitterly polarized modern Supreme Court confirmation process.
But a few words are nonetheless in order to recognize the man’s work. Ted Kennedy arrived in the Senate in 1962, as soon as he was Constitutionally old enough to serve; aside from a Korean War-era non-combat tour in the Army, it was his first real job. Kennedy was a young man with fame, glamor and a fair amount of his family’s natural charm, but had done nothing of distinction with his life to that point; he’d inherited the seat as effectively a family heirloom, and a review of his life to that point – such as being suspended from college for cheating and a reckless driving arrest for leading cops on a 90 mph chase while in law school – would hardly have suggested a man likely to take seriously the work of a United States Senator.
Kennedy at that point could have taken a number of different turns. He could have become a Senate showhorse, making the rounds giving speeches and national TV appearances and doing little real work. He could have become one of Capitol Hill’s time-markers, coasting to re-elections while using his office as just a prop for the exhausing, booze-and-flooze nightlife he pursued for so many years. He could have decided that fame and glamor meant he deserved to run for President at the first available opportunity, and stayed far away from any of the real and often controversial work of making laws.
To Kennedy’s credit, he did none of those things. He hired the most aggressive, competent staffs on the Hill and immersed himself in the daily business of making laws. Boring bill markups, blathering conferences, wicked hangovers; Kennedy took them all and kept working, working even to the end. He learned how the sausage was made and the deals done, and made quite a lot of it himself. He waited 18 years to run for President, and did so only after compiling an extensive record of actual accomplishment in the Senate.
Kennedy’s influence waned after his unsuccessful 1980 run; that year ushered in an era in which Republicans controlled the White House for 20 of the next 28 years, and more or less controlled the Senate (to the extent the Senate is “controlled” by the majority party) for the better part of 17 of those 28 years. But with key committee seats and an energetic staff, he remained a player in important legislative business to the end, whether forging successful bipartisan compromises (as with No Child Left Behind in 2001) or fighting for unsuccessful ones (the McCain-Kennedy immigration bill, which failed even with the backing of President Bush). The harshness of Kennedy’s partisan rhetoric never left him unable to figure out how Beltway Republicans ticked and how to get them to the bargaining table; Republicans who worked with him testify unanimously to his Irish charm and personal grace.
Kennedy’s career could have been a cautionary tale for our current president, who might not have found himself in quite the fix he is in at the moment if he’d followed Ted’s example, bided his years, spent more time in the trenches doing the unglamorous work of legislating and taking the hard punches that must be taken to sell the product to the public, learning how the system works, why it works and who makes it work. Most of the changes Ted Kennedy made in this nation over his career were change for the worst – but he did, over time, make real change because he worked at it instead of just saying the word “change” and hoping it would be so.
There’s No Such Thing As A Death Panel. There’s No Such Thing As A Death Panel. There’s No Such Thing As A Death Panel.
From last year:
H/T
Brian Faughnan has more on the Oregon case; Nat Hentoff has more on the current debate.
First Among Equals
Ahem:
In a morning conference call with about 1000 rabbis from across the nation, Obama asked for aid: “I am going to need your help in accomplishing necessary reform,” the President told the group, according to Rabbi Jack Moline, who tweeted his way through the phoner.
“We are God’s partners in matters of life and death,” Obama went on to say, according to Moline’s real-time stream.
Partners. Not servants. Partners.
And if you disagree with the domestic legislative agenda being pushed by God and Obama, not necessarily in that order?
Treason.
Field of Nightmares
Back from Citi Field tonight: it’s my third trip this year, counting the preseason exhibition, and I have yet to see the Mets enter the third inning with a chance to win the game.
Where Are The Cost Cuts Going To Come From?
One of the central selling points used by President Obama to push the Democrats’ health care plan is the notion that a comprehensive overhaul of the health care system will reduce costs. But costs to who, and how? Let’s step back a minute and try to figure out how Obama’s cost-cutting argument could possibly be so.
Prologue: Tax That Man Behind The Tree
First, a quick reminder of two reasons why cost-cutting is such an important selling point.
Number one, the core of what the Democratic base, in particular, wants from health care “reform” is universal coverage. You often hear statistics thrown around about there being 30 or 35 or, last I heard, 47 million people without health insurance, and the implication that these people are receiving zero or negligible healthcare. Debunking those statistics and assumptions is itself a cottage industry, but let’s leave that aside for the moment, because the fact of the matter is that in a country of 300 million people, when you strip out the people who (1) already have health insurance and expect to continue having it, (2) don’t especially want to buy health insurance, (3) are only briefly without health insurance and not worried about it, or (4) don’t or can’t vote, what you end up with is a very small slice of the electorate that would benefit from getting health insurance they currently lack or fear lacking. Now, voters don’t only vote their own self-interests on any issue – but the fewer people who benefit directly from legislation, the harder it is to drum up public support for a bill that may threaten the self-interest of others. So, it becomes politically necessary, if the bill is to be as sweeping and ambitious as most of the versions circulated have been, to sell it to the public on the basis of some argument above and beyond insuring the uninsured. That’s doubly so because if your goal was solely to insure the uninsured, much of what is in the various bills would be unnecessary.
Second, specific to the issue of saving money for the federal government, the Obama Administration and the Democrats have already severely tried the electorate’s appetite for massive expansions of federal spending, especially deficit spending. The explosion of new spending, most notably the pork-laden “stimulus” bill, makes prior complaints about spending under Bush look like complaints about the deck chairs on the Titanic and flatly contradicts Obama’s read-my-lips pledge during two of last October’s debates that his proposals would result in a net reduction of federal spending. The voters have noticed that they’re not getting anything resembling what they were promised. Thus, Obama has repeatedly pledged, with the same assurance as his campaign pledge on spending, that the health care bill would be “deficit neutral.” The Congressional Budget Office, typically a liberal redoubt, has repeatedly thrown cold water on the claim that any of the proposals on the table would be deficit-neutral. Clearly, to get there, cost savings would need to be found somewhere to completely offset outlays.
How’s that gonna work?
Let’s review the options. The Democrats’ main argument is that restructuring the entire health care sector will reduce the nation’s total (public and private) outlay for health care. When you boil it down, though, there are only three variables you can cut: reduce the amount of medical care provided; reduce what providers of medical care earn for their products and services; and reduce intermediary costs. All are problematic.
I. Less Medical Care
The most obvious way to cut spending on medical care is to buy less of it. That’s at the crux of the public’s worry about “death panels” cutting off care, about rationing; it’s why so many of the people showing up agitated at town halls are senior citizens worried about getting less medical care.
The “death panel” phrase was shorthand, of course, but it neatly captured the core of the problem: government already rations care, albeit not very efficienctly, in programs like Medicare and Medicaid (see, e.g., here – then again, the failure to do more rationing explains those programs’ exploding, budget-busting costs) and the end-of-life consulting procedures criticized by Palin and subsequently dropped by chastened Democrats are not the only way in which government incentives could or would be brought to bear on physicians to push patients from consuming health care to preparing for death or assisted suicide. More here, among many other places. But you don’t have to be looking at the end-stage to see that any plan premised upon cost-cutting by reducing the amount of care provided would, well, reduce the amount of care provided. And if the costs being cut are taxpayer costs, the power to do so would end up being vested in some sort of governmental entity, likely a panel of government-appointed “experts,” as Mickey Kaus notes was alluded to by President Obama himself back in April:
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
LEONHARDT: So how do you – how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance.
One argument advanced by proponents of the various plans is that costs would be reduced by providing more care, because preventative care would prevent more expensive care from being needed. Even leaving aside the grim fact of human mortality (i.e., preventing heart disease at one age can just leave you to die slowly of cancer or suffer prolonged dementia later), Charles Krauthammer notes that studies in reputable medical journals have concluded that the need to offer preventative care to so many people to make sure you catch health problems early means that more widespread preventative care is more, not less expensive:
Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care.
That’s a hypothetical case. What’s the real-life actuality? In Obamaworld, as explained by the president in his Tuesday town hall, if we pour money into primary care for diabetics instead of giving surgeons “$30,000, $40,000, $50,000” for a later amputation — a whopper that misrepresents the surgeon’s fee by a factor of at least 30 — “that will save us money.” Back on Earth, a rigorous study in the journal Circulation found that for cardiovascular diseases and diabetes, “if all the recommended prevention activities were applied with 100 percent success,” the prevention would cost almost 10 times as much as the savings, increasing the country’s total medical bill by 162 percent. That’s because prevention applied to large populations is very expensive, as shown by another report Elmendorf cites, a definitive review in the New England Journal of Medicine of hundreds of studies that found that more than 80 percent of preventive measures added to medical costs.
Whatever else can be said for more preventative care, it is likely to offer no great cost savings.
Moreover, reducing the total amount of care provided contradicts one of the central premises of the entire project, which is that it will result in providing more care to tens of millions of people not presently receiving it. As Bob Hahn notes, if this is the case, it won’t just drive up costs but will create shortages:
If we added 47 million more people to the health care system, there would be lines. We wouldn’t even know how to send 47 million more people to McDonald’s without causing lines.
I’m unfamiliar with the details, but apparently there is some provision in Obama’s plan that expands the number of doctors, nurses, hospital beds, etc., to instantly accommodate 47 million more people. It usually takes eight to ten years to school a new doctor, so whatever the Democrats are doing here is a major advance.
The Democrats can’t have it both ways. One way or another, they either need to sell the public on the idea of sharply curtailing the amount of medical care provided, or stop claiming cost savings that can only come from less care.
II. Medical Care For Less Cost
The issue of shortages brings us to the problem with the second option: rather than reducing the amount of care provided, reduce the amount paid to the people who provide it: doctors, nurses, and pharmaceutical and medical device companies. Certainly on the Left there is a fair amount of sentiment for making it less profitable to provide care. But there is really no getting around the basics of supply and demand: if we make it less profitable to become a doctor, we will end up with fewer doctors. If we skimp on salaries for nurses, home health aides, and less-skilled care providers (e.g., people who work in nursing homes), we will exacerbate the existing shortage of nurses and other providers, which is likely to become more acute in years to come as the population ages. And if labor responds to financial incentives, capital is even more sensitive: slash the profit margins of drug companies and medical device manufacturers, and inevitably there will be less investor capital for those companies and less coming out of the pipeline in terms of drugs and devices that save or improve lives. The net effect will be the same as rationing care directly: cost savings will come only by reducing the quantity and quality of medical care.
III. Cutting Out The Middleman
With open advocacy of government rationing of care largely politically infeasible and reducing the profitability of health care providers economically impractical, the debate logically falls upon the middlemen, mainly insurance companies. Pretty much everybody hates insurance companies, whose business model by nature involves collecting more money than they lay out. And there’s empirical data to support the idea that we’re spending proportionally more of our health care dollars on insurance, rather than care, than we used to spend. To shift the discussion away from rationing care, Democrats are desperately trying to paint the insurers as somehow siphoning off more money to enrich themselves than they “should,” an effort that’s now leading to an especially vindictive crackdown by panicked Congressional liberals:
House Democrats are probing the nation’s 52 largest insurance companies for lavish spending, demanding reams of compensation data and schedules of retreats and conferences.
Setting a deadline of Sept. 14, the letters demand extensive documents for an examination of “executive compensation and other business practices in the health insurance industry.”
The main idea here, other than simply intimidating the insurers, is to try to sell the Democrats’ plan on the theory that the insurers are artificially inflating their overhead. The fact that they have to subpoena 52 companies suggests that this will not be as easy a case to make as in the case of a monopoly industry…and of course, a monopoly is the preferred solution of Democratic policymakers, elected officials and even Democratic base voters who essentially see the long-term goal as using a “public option” to plant the seeds for replacing this patchwork of private companies with a single-payer system of government monopoly insurance.
But let’s unpack here a little further the elements of the expense of a middleman. First of all, there’s the question of why have insurance at all. Most of us pay for other life essentials – food, clothing, shelter, transportation – directly, rather than buying, say, grocery insurance to make sure that an insurance company or government agency will give us groceries every week on terms acceptable to the insurer plus a premium. Now, unless you are seriously wealthy, insurance against truly catastrophic health care costs makes economic sense, so that the pool of the insured absorbs the individual occurrences of massive spikes in one person’s health care costs. But pretty much all the proposals on the table go far beyond purely catastrophic coverage.
The entire rationale of the Democrats’ proposal is to get more people to buy insurance or have it bought for them than is currently the case, thus increasing the proportion of our health care that is paid for through intermediaries rather than directly. That’s true of people who currently buy no insurance and get little or no care, or pay for it out of pocket; it’s true as well of people who currently get their care from emergency rooms. That’s exactly the opposite direction of where you want to be moving if cutting intermediary costs is your goal.
And in the existing health care market, Democrats (with the help of big-government Republicans) have been driving up costs for the past two decades by piling on mandates and “patients’ bill of rights” legislation that ever increases the number of procedures that the insurers have to be involved in. The Medicare prescription drug plan likewise expanded the scope of health care products and services paid for through a public intermediary rather than directly by consumers. And of course, subsidizing preventative care that may be presently paid for out of pocket does the same. So, not only are the Democrats proposing to have more people use health care intermediaries (public or private), but their proposals will inevitably continue the trend towards having more types of health care paid for through intermediaries.
Well, say Democrats, we will use more intermediaries, but we’ll be much more efficient in doing so, because the public plans won’t have a profit motive and expensive executives. Which is true. But it’s also true that government programs, even ones that start out fairly simple, tend only to grow and expand over time and grow less efficient as their competition is eliminated and the political power of those who draw salaries and contracts from them grows. Will unionized government workforces necessarily be less expensive than non-unionized private insurer workforces? History doesn’t suggest so. As one National Review reader posed the question:
If we can cut a half-trillion dollars from Medicare and Medicaid to pay for health insurance reform but if, as looks to be the case, healthcare reform won’t pass, why not just cut a half-trillion dollars from Medicare and Medicaid anyway?
The fact that it hasn’t happened and won’t happen should remind us that replacing a competitive private marketplace with a colossal, Washington-run bureaucracy is a bad bet to produce savings. The conservative answer in this situation is not to throw out the entire existing system on the hope that things will work out better than they ever have before.
The elephant in the waiting room is the other big cost driver of intermediaries besides the scope of coverage and the cost of having shareholders and executives: lawsuits. Precise figures are again a subject of intense dispute, but a goodly chunk of what drives the amount of ‘unnecessary’ care provided, the cost of providing services and the cost of intermediaries is the need to protect against and pay for the cost of medical malpractice and denial of coverage litigation. None of the Democratic proposals, however, seek to make any practical inroads against this source of costs. Replacing a private system with a public one could arguably do so if the trial bar is effectively precluded from bringing against the government many of the kinds of lawsuits now used against private insurers – but aren’t liberals in favor of keeping those kinds of suits viable? And how likely is it that in the long run they won’t provide other mechanisms to keep one of their vital constituencies in business?
We have pretty much exhausted the options for cost-cutting: less care (at a steep political price, at the cost of giving frightening power to the government, and at odds with the goal of providing care where none is now given); less money to caregivers, which would amount to the same thing; less use of intermediaries (which is likewise contrary to the whole thrust of the project); or less cost in using intermediaries (which is impractical and unlikely to pan out).
There will be no cost savings. There’s no sense in pretending otherwise.
Legitimacy
We are not trying to create some kind of Jeffersonian idyll in the rugged heart of Central Asia, after all, but an Afghan government that is recognized as legitimate by the majority of Afghans — a government that can therefore prevent the country from turning back into a haven for terrorist training camps. If there were someone acceptable to all factions, we might presumably consider helping the Afghans restore the monarchy. For that matter, if the Afghans were willing to accept an appointed American puppet, we might, I suspect, consider that, too, at this point. But there isn’t, and they won’t. Which means that democratic elections — which the majority of Afghans support — are the only means of establishing any Afghan government’s legitimacy. It isn’t that we are setting the bar “too high” by holding elections in Afghanistan; it’s that we don’t have anything better to offer.
And that is why the Taliban is trying to scare Afghanistan’s voters. It won’t be able to stop the elections altogether, and it won’t be able to shut down all the polling stations. But that isn’t the Taliban’s intent: Its goal is to make the elections appear illegitimate, so that doubts about the president’s right to rule will haunt the winner throughout his term of office. If it can lower the turnout dramatically in the southern part of the country; if it can intimidate women and prevent them from voting; if it can cast a shadow over the fairness of the counting; above all, if it can convince Afghans that the election was inconclusive, it will have achieved a great deal.
Read the whole thing.
Taking A Dive
Regular reader/commenter Jim Anderson has an excellent Part I of II piece in the Hardball Times on hitters having spectacular second-half collapses.
Carney Lansford’s appearance on the list is no surprise; George Brett’s is more surprising given his usual pattern as a hot-weather hitter, but 1983 was an unusual year for him. Several of these are memorable collapses or dropoffs from memorable first halves.
This Is What Else Can Go Wrong
Note to self: stop asking “what else can possibly happen to the Mets this year?”
I don’t necessarily agree with Filip Bondy’s suggestion that the Mets shut David Wright down for the entire season after last night’s concussion-inducing beaning – you don’t want to ice him too long and make him gunshy – but I’d at a minimum keep him shut down for a full week before even considering playing him again. The season is lost, Wright’s the Mets most valuable asset, and the team’s incompetent medical staff proved clearly last season with Ryan Church that they cannot be trusted to evaluate head injuries.
UPDATE: Mets have put Wright on the 15-day DL. It’s the right call.
Kinda Funny Sir To Me
Here’s an argument-starter for the hard-core Springsteen fan: a 1-200 ranking of his songs, with an effort to justify each slot.
A lot of these just seem very wrong to me, and reflect the biases of the guy doing the list. Near the bottom, “Mary’s Place” was one of the high points of The Rising, and doesn’t deserve being rated so low. Near the top, “Thunder Road” is rated way too low at #18. And the writer goes way overboard on Bruce’s wordier pre-Born to Run tunes and mopey Nebraska tunes, at the expense of some of his masterpieces: “Incident on 57th Street,” though a good song, is way too high at #3 and “Lost in the Flood” at #7 (personally, I never, ever listen to the studio version of either, preferring the live version of “Incident on 57th Street” that I picked up from a Japanese release of extra songs off the 1975-85 Live album, and “Lost in the Flood” off the 1999 Live in New York album). Yet, inexplicably, the same guy puts “It’s Hard to Be a Saint in the City” way down at #155. And seriously, “Highway Patrolman” at #13, ahead of “Thunder Road” and “Badlands” (“Badlands” is always the high point of any Bruce concert)? “Meeting Across the River” at #17? “Stolen Car” at #19? “Your Own Worst Enemy” at #23?
I did appreciate the love for “Loose Ends” at #24, though, one of the classics that was held off too long until the Tracks compilation.
The Power of Protest.
When Bush was at 70%+, his prosecution of the war was first branded “divisive” because something like 500,000 anti-war activists were marching on CNN. And it was a short hop from branding the war “divisive” to branding it a disaster.
Much the same is now happening with health care. The public option is, at the very minimum, now perceived as divisive. As controversial. As anything but the sweetness and light upon which Obama uniquely depended on to govern.
In the long run, the side that most insistently believes in its own arguments usually wins. This neatly sums up the outcome of the 2008 election, and the current state of the health care debate. I don’t think every swing voter would categorically embrace everything that’s happened at the town hall meetings (on either side), but the fervor of one side over the other sends important signals to unaffiliated voters that the doubts outweigh the reassurances on Obamacare, and to armchair quarterbacks everywhere, that the President is on the defensive and dogged by opposition.
He also notes the impact on swing Congresspersons…one thing about Members of Congress is, they may swear up and down in public that the town hall protestors are some sort of paid shills, but the reality is that people who show up motivated at an August town hall in an odd-numbered year – or lay out money and organization to get others to do so – are surely going to do the same the next November. That lesson is never lost on vulnerable Members of the House or Senate.
That Hitler Mustache
Yes, of course, the TV networks and lefty blogs have been trying to discredit conservative opponents of Obamacare with…signs and rhetoric from Lyndon LaRouche supporters who think Obama’s plan isn’t far enough to the left:
H/T Caleb Howe – go to Caleb’s post if you can’t get the video to load here. I don’t even know at this point whether to attribute this to deliberate dishonesty or just plain stupidity, but it hardly matters.
(Of course, you could cure anemia with the irony of left-wing blogs discovering, on January 20, 2009, that it’s not nice to compare the president to Hitler – or even Democratic politicians saying so after years of things like this and this and this and this. Worse yet is the Democratic tendency to accuse conservatives of “carrying Nazi symbols” when they mean “calling Democrats Nazis,” as if to say that the protestors on the Right are in favor of National Socialism).
Par for the course.
Obamacare and the Ghost of Terri Schiavo
NPR’s headline on yesterday’s town hall on health care by President Obama:
Obama Says His Health Plan Won’t ‘Pull The Plug On Grandma’
The NY Daily News had a similar headline using that quote in this morning’s print edition, as does this Reuters item; the NY Post less delicately shortens the headline to ‘WE WON’T PULL PLUG ON GRANNY’.
This is not the place the White House wanted to be in right now. Even George W. Bush, as many things as his opponents threw at him and as low as his approval ratings went at times, never felt compelled to … well, as Jake Tapper put it,
[I]f the president finds himself at a town hall meeting telling the American people that he does not want to set up a panel to kill their grandparents … perhaps, at some point, the president has lost control of the message.
I’ve previously covered one of the primary reasons why Obama is in this pickle: he doesn’t have a clearly defined, easily and consistently explained plan. There are still multiple bills, none of which has the unambiguous support of either the White House or a working majority in both Houses of Congress; the bills are massively long and complicated, yet for the most part they leave huge numbers of unanswered questions by deferring important decisions to vaguely-constructed and questionably supervised bureaucracies. Many of the worst things in the bills are not what they say they will do, but what by silence they would permit to happen. The absence of a ban on using federally-provided insurance funds for abortions is one example, as noted by the US Conference of Catholic Bishops in explaining why the USCCB (long a supporter of more government funding for universal health care coverage) can’t support the House bill:
Some seemed surprised at [a previous objection by the Bishops], since abortion was not specifically mentioned in draft health care bills until recently. Those with longer memories may recall that the Medicaid statute doesn’t mention abortion either, but it was funding 300,000 abortions a year in the 1970s until we put a stop to that with the Hyde amendment. In any case, numerous amendments to keep abortion out of health care reform have been defeated in committee, and it is now apparent that some leaders have every intention of threatening the health care reform process by forcing Americans to accept abortion mandates and/or fund unlimited abortion in their health coverage.
Camille Paglia, also a supporter in general of health care ‘reform’ but a critic of Obama’s approach, connects the same dynamic to the debate over whether Obamacare would create “death panels” empowered to cut off treatment for those deemed not worthy of continued life, as we have seen happen in European systems:
I simply do not understand the drift of my party toward a soulless collectivism. This is in fact what Sarah Palin hit on in her shocking image of a “death panel” under Obamacare that would make irrevocable decisions about the disabled and elderly. When I first saw that phrase, headlined on the Drudge Report, I burst out laughing. It seemed so over the top! But on reflection, I realized that Palin’s shrewdly timed metaphor spoke directly to the electorate’s unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished.
Surely, the basic rule in comprehensive legislation should be: First, do no harm. The present proposals are full of noble aims, but the biggest danger always comes from unforeseen and unintended consequences.
Even beyond the particulars of the present bills, what Obama and his Congressional allies are confronting is the legacy of their own party’s deliberately constructed image. And a part of that image that they may least have expected to haunt them is the ghost of Terri Schiavo.
Political parties are not born anew each election cycle. The average voter, having limited time to devote to politics, very prudently comes to rely upon the general reputation of a party to form an impression of what its individual members stand for. A reasonably informed voter will try to learn at least a few things about particular candidates, but even political junkies rarely know A to Z on where all their elected representatives stand on every issue of public consequence (quick: what does your State Senator think about immigration? capital gains taxes? the minimum wage? gun control?). Thus, a party’s image is important and carries the baggage, for good and for ill, of the high-profile debates in which it takes a prominent position. Moreover, a party’s image is built not only by its leaders but its supporters inside and out of public office. People can usually filter out the crazies on the margins, but the battery of media commentators and activists involved in any given controversy add to that overall image.
Indelible images are hard to shake. During the last election, Obama ran ads criticizing John McCain for opposing federal funding for stem cell research and being an anti-immigrant hardliner. These were blatant lies, of course – the polar opposites of McCain’s actual positions, laughably in the case of the immigration ads given that McCain had risked his political career over his support for the comprehensive immigration bill – but Obama obviously assumed that the ads would be effective because the audience would identify McCain with his party’s reputation on those issues and would be unaware of his actual record.
Which brings us to Terri Schiavo. Now, I have previously discussed the immediate political cost to the Bush Administration’s agenda of the Schiavo brouhaha in March of 2005. Commentators have debated for some years now how much political damage the GOP suffered with moderates from its identification with the movement (headed largely by committed pro-lifers, many of them religious) to prevent the State of Florida from, essentially, starving the brain-damaged Schiavo to death. That controversy was an unsettling one: the issue was what to do about a woman who had no medically realistic prospects for recovery, was consuming expensive healthcare dollars, and had left no reliable instructions on what her wishes would be in that situation, and a lot of people were very uncomfortable with either option, continuing to pay for her care or depriving her of nourishment. Public opinion at the time was hardly unanimous on what should be done (indeed, even some high-profile left-wingers sided with those who opposed removing Schiavo’s feeding tube). The conventional wisdom in the pundit class was that the damage done was all to one side – that the flap revealed the GOP to be in the thrall of religious extremists. I don’t doubt that some such damage was indeed done. But little attention was paid to the fact that the Right vs Left narrative of the Schiavo episode – one willingly stoked by Democrats eager to capitalize on precisely the “Religious Right overreach” angle – painted the Left as the advocates of ‘pulling the plug’ on Terri Schiavo. Another anecdote had been added to the public’s collective memory of what the two sides stand for – an anecdote, I should add, that is consistent with other pieces of the puzzle, as the Left has clashed with the same pro-lifers again and again on abortion, assisted suicide, and the destruction of embryos for stem cell research. Sarah Palin’s invocation of her Down’s Syndrome son Trig is another flashpoint: it is the Left that insists that it is appropriate to abort a child when prenatal testing reveals such a condition, and it was from the Left that we heard cruder jibes suggesting that Palin should have done just that. A coherent pattern emerges, forms itself and takes root in the public’s mind.
In 2006 and 2008, nothing happened – at least, nothing visible that would interfere with the Democrats’ march to power, as other issues were at the fore and nobody on either side much wanted to discuss euthanasia. But now, with health care legislation at stake and the end-of-life issues it poses front and center, and with “cutting costs” a core part of his mantra for “reform,” Barack Obama is running into the legacy of Terri Schiavo and those other pieces of the pattern. Schiavo’s name isn’t heard much, but it doesn’t have to be, because it’s part of the public’s memory. The American people know that the same people who wanted to pull the tube from Terri Schiavo want to be trusted not to pull the plug on grandma. Which is why they are appropriately skeptical of any hint that Obamacare would leave any power in federal hands to make those decisions.
Four years ago, the Left was proud of its stance on withdrawing not just medical care but food itself from Terri Schiavo. That was their choice. If the price to be paid is a public in need of assurance that President Obama and his plan don’t share those values and won’t encourage the same thing, well, choices have consequences, and the voiceless dead can still haunt us in ways we had never foreseen.
Gunk
UPDATE: Consensus in the comments seems to be that my recollection is wrong and Jason is no relation to Ross Grimsley.
Jason Grimsley is apparently talking to the feds about Roger Clemens and steroids. Grimsley is something of a Zelig of baseball cheating: his father Ross was a notorious spitballer, and Grimsley has previously confessed to stealing a corked bat that had been confiscated by the umpires from then-teammate Albert Belle.
BASKETBALL: Rick Pitino, Scumbag
I’ve been a fan of Rick Pitino since his Knicks days, but this story sucks and it stinks and it sucks:
University of Louisville men’s basketball coach Rick Pitino told police that he had consensual sex with Karen Cunagin Sypher at a Louisville restaurant where he’d been drinking on Aug. 1, 2003.
He also told police that he later gave Sypher $3,000 to have an abortion, according to Louisville Metro Police reports The Courier-Journal obtained under the Kentucky Open Records Act.
Ugh. Read the whole thing, it doesn’t get prettier.
The Lobbyist Lobby
Michael Kinsley’s singularly ungracious column in the Washington Post yesterday took the occasion of the death of longtime Democratic Beltway lobbyist Anne Wexler to denounce that favorite scapegoat of liberals, the influence of lobbyists in Washington. But Kinsley is not serious about the influence of lobbyists, because unaddressed in his diatribe is the source of their power in the first place.
Kinsley notes Wexler’s background as a principled liberal, and bemoans how her work as a lobbyist strayed from that:
Wexler was a pioneer of bipartisan lobbying — the ultimate in cutting-edge moral neutrality — in which one firm supplies both well-connected Democrats and well-connected Republicans.
Kinsley then moves in to denounce the entire process of representing paying clients in advocating their interests before the political branches of government:
And what is wrong with this? After all, the Constitution guarantees each of us the right to petition our government for the redress of our grievances. Plenty is wrong. First, there is nothing in this list of services about determining which side of a legislative dispute happens to be correct before jumping in on the side that has hired you. Second, if the lobbyists’ claims about being able to affect the outcome of political disputes are even close to being true, this tilts democracy in favor of those who can afford to hire them. And third, what a waste of a lot of smart people’s time! What might Anne Wexler have accomplished for causes that she really believed in if she hadn’t spent the last three decades of her life taking on any cause that walked in the door with a checkbook in hand?
Kinsley is right that making a living this way is a departure from principled political advocacy – but so is most of what private-sector enterprises do. In the legal profession, for example, there are a variety of limits (some personal, some institutional, some legal-ethical) on what clients and causes a lawyer will represent, but fundamentally, the lawyer’s job, or the lobbyist’s, is to speak for the interests of the client before the power of the State. That may be neither as pure a cause as political activism nor as socially productive as private enterprise that caters to the public, but it is a necessary function and there is nothing dishonorable about it. In 2008, amidst a campaign season with even more than the usual huffing and puffing about the evil of lobbyists, both parties nominated presidential candidates who had themselves worked as lobbyists – Barack Obama as a “community organizer,” John McCain as a Capitol Hill “Congressional Liaison” for the Navy. Neither job involved representing private institutional interests, but both were basically lobbying roles: that is, special pleading before the elected branches of government on behalf of their clients, in Obama’s case the community interests chosen by his organization, in McCain’s case the branch of the armed services in which he served. People like Kinsley would no doubt argue that these are more virtuous interests to lobby for than private companies, but in many cases that depends on the merits of the issue – the very thing Kinsley bemoans as being disregarded when lobbyists put their clients’ interests first.
In any event, if Kinsley was serious about limiting the role of lobbyists, he would have to recognize that the explosive growth of lobbying as an industry unto itself in recent decades is a symptom, not the disease itself. The disease is the pervasive intrusion of the federal government into picking winners and losers in the economy, and that intrusion plays precisely the same role in the lobbying industry that the growth of litigation does in the legal profession. From the perspective of a corporate client, spending money on lobbyists only makes sense if lobbyists can deliver for their clients either (1) government favor, (2) protection from government hostility, or (3) the opposite results for their competitors. Prior to the New Deal, there were precious few lobbyists in Washington because the federal government’s role in doing any of those things to particular private businesses was much more limited. The growth of the regulatory state, the increasing complexity of the tax code, and the growth and specificity of the federal budget have all created vast opportunities for the federal government to make decisions that redirect profits and losses among private businesses with the stroke of a pen.
The Obama era in Washington is nothing if not an effort to vastly expand the role of the federal government in determining the favor or punishment doled out to companies and industries, greatly exceeding what is already an overgrown favor factory. The legislation pushed by this White House and Congress – and cheered by media liberals like Kinsley – presents an endless parade of new opportunities for the shaping of rules and the doling out of appropriations: who gets stimulus money, and on what conditions? Who gets a bailout, and will it be structured to benefit some interests (the cash for clunkers program essentially funnels taxpayer money to the automakers to institutionalize a bailout designed to insulate the UAW from the consequences of the industry’s labor costs and practices) and harm disfavored ones (used car dealers). How will the health care bill help or harm insurers, hospitals, companies that provide health insurance, unions, malpractice lawyers, etc.? (There was a report that Wal-Mart was supporting Obamacare because it expected the bill to put more costs on Target – even if that’s not accurate, it’s illustrative of how corporations will evaluate the bill and how their support can be negotiated). What conditions will attach to cap-and-trade provisions as they apply to varied industries? No serious adult should be so naive as to be surprised when the end product benefits powerful moneyed interests who know how to work the system. With government decisions reaching further into more industries, and the details of those incursions buried in thousand-page bills nobody reads, it can’t possibly be a better time to be a lobbyist.
Oh, of course, restrictions – many of them cosmetic – can be placed upon the how and the where of lobbying, but none will change the fundamental dynamic that as long as private businesses see government power as a determinant of their success, they will use every means at their disposal to influence the course of that power, and the nature of people in political power will always be to be susceptible to being influenced.
If you want money out of politics, get politics out of money. If you want to stop influence peddling, go after the influence, not the peddling. If Michael Kinsley was serious about thinking the growth of lobbying a bad thing, he would not be denouncing the symptom while cheering for the disease.
Paid For By…
I know I link to a lot of RedState posts these days, but really, Caleb Howe has done it again with an extensively documented post examining efforts to pay for support for Obamacare, as well as rounding up more from other blogs on the same subject.
Debra Saunders also has more on the media coverage I referenced the other day:
When Boxer grilled Secretary of State Condoleezza Rice about what personal price the childless Rice paid for the Iraq war, Boxer later boasted that she was “speaking truth to power.” But when angry voters try to do the same with elected officials, whether they’re heckling them or just showing up, Boxer wants the media to investigate.
It’s laughable: Democrats discrediting protests because – ooooooh – they’re organized. Last year, weren’t these same folks guffawing about Jesus being a community organizer?
+++
When anti-Bush protesters behaved badly, when Code Pinkers shouted and anti-war protesters brandished signs with swastikas, they did not rate nearly as much press scrutiny as the ObamaCare protesters. There seems to be the impression in my profession that comparisons of Bush with Hitler were to be expected, but not of Obama with Hitler. That’s below the belt.
Anthem
Shaddup And Take Yer Medicine
Peggy Noonan, who has so rarely been worth reading the past few years, nonetheless nails the dynamics of the health care debate. FreeRepublic.com veteran Bob Hahn, who is always worth reading but far less frequently around to read, offers his own experience organizing conservative demonstrations and zeroes in on the specific double standard by which the Left and the media treat anger at Republicans as a sign of genuine, authentic popular discontent (think of the deification of the unhinged Cindy Sheehan once upon an August) while anger at Democrats about domestic politics is treated as a sign of dangerous extremism. Jim Geraghty asks what kind of dissent from Obama’s policies would be regarded as legitimate. David Boaz (via Instapundit) looks at knee-jerk Democratic accusations that opposition to nationalizing health care equal racism.
It seems to me that the Democrats are still, even at this late date, engaged more in assertion than argument:
If I came up with a health care plan that provided all Americans with universal coverage, protected the 45 million people without health insurance, did so without rationing treatment, prevented insurance companies from denying coverage, didn’t cut Medicaid and Medicare benefits for seniors, AND provided significant cost savings over the current system I’d be proud of it.
I would be out there everyday talking exclusively about my health plan, ignoring all other distractions. I’d sit down with every major network primetime news cast. I’d have my staff write columns and do interviews with every major print publication.
In an effort to explain my plan to as many Americans as possible, I’d go on daytime talk shows like Oprah and The View, I’d go on late night comedy shows like the Daily show and Redeye, and I’d sit down with political commentators like …Anderson [Cooper] and Bill [O’Reilly].
I’d have national hotlines, web casts, hosted chats and discussions. I’d push every Senator and Congressman to host open town halls, allowing the American people to voice their concerns, ask questions and get answers. I’d fill those town halls not with members of unions, political action committees, or cronies that support everything I do, but with ordinary people. Regular folks that might be confused or even worried about my plan. I’d have representatives stay, hours on end to ensure each question is addressed and answered.
But this isn’t what’s happening…
One of my RedState colleagues puts the matter starkly: if Democrats are so certain, in the face of noisy opposition and fretful poll numbers, that the public is overwhelmingly behind them and that all opposition is illegitimate, extremist, manufactured, and worthy of being reported to the authorities, why not just draw clear lines, vote and wait for the GOP to be punished at the polls? Which side in this debate is acting as if it is confident of public support?