New Year's Party

Krugman v. Obama

2008-04-25T09:57:00.000-07:00

OK, so here's my theory on why Paul Krugman, who is of the general type to be drawn to an Obama-type figure (i.e., an academic who can imagine/idealize a politics that raises the level of debate and tries to get past ideology to get to real solutions), is so exercized about his candidacy and is engaged in a one-man show to undermine support for him among Times readers. (Here's the latest offering.) Actually, I can come up with two reasons. In increasing order of importance in his motivation:

1. Krugman has some legitimate gripes with Obama's policy positions, most notably his health care plan. Once his favored candidate (Edwards) went down, he saw it as his job to shake up the Dem race by continuing the fight to put true universal coverage on the table. The same can be said of trade deals, tax policy and others. He wants to keep up his role as a "thought leader" on the left and opposition is simply the best way to be perceived as a leader. This will be especially true if (when?) Obama becomes president. Krugman serves no role if he is always agreeing with the president, thus, he needs to set the stage for an oppositional arrangement now.

2. More than any other columnist or pundit, Krugman loves playing the role of an "I told you so" prognosticator. Consider: Other columnists, like Harold Meyerson and even the more conservative Andrew Sullivan, have taken the plunge in their support for Obama, knowing full well that he could very well flame out when he gets into office. I'm pretty sure they know that his soaring rhetoric and his grand vision may wind up as withered fruit in the face of GOP dirtiness and the cynicism that is our modern life. At the same time, precisely because our politics today has been so sullied and de-legitimized, they are willing to take a chance, they are willing to live on hope for a little while. Krugman, on the other hand, knowing the same thing sees an opportunity to be able to say "See, I knew that Obama was all hot air. He never fooled me." In fact, pending an Obama election, I foresee a Krugman column just about a year from now when he declares exactly so. (And then, I get to say "I told you so.")

Morning after thoughts

2008-03-05T04:01:00.001-08:00

Tough night for Obama. Hard to say whether it was a good night or not for the Democrats, but I'm inclined to think not.

If I'm a superdelegate, I am feeling no rush to move anywhere at this point. There will be another intense 6 weeks of campaigning to do what it should -- help the American people sort through these two candidates. I feel that, as of right now, Hillary actually has the tactical advantage, and she will solidify that advantage with a win in PA. This race will be determined by the superdelegates, among whom she has deeper and stronger connections. He has a good case to make with regard to a pledged delegate lead that I don't think that Hillary can overcome, but she has a good case to make with regard to her having won almost all of the big states, them having split the purple states, her momentum in finishin stronger, and her maybe being tied in the popular vote. (Obama is only ahead 12.6 mil to 12.1 mil now.) The FL/MI issue could be both her salvation in terms of the numbers or a calamity in terms of how a credentials fight like that could tear the party apart and alienate the superdelegates. I have a feeling she is going to take a softer tone on that going forward without conceding the point.

Hard to know if this is good for the party or not. It's good that Obama is getting a close look. However, I'm not sure if his loss of inevitability will ultimately help him, by testing him against the type of attacks McCain will run at him, or will weaken him, by planting seeds of doubt in people's minds that McCain will later exploit. If I had to say, I think it's the latter. Hillary made some tough charges start to stick against Obama, or at least introduced enough doubt, and these next 6 weeks are going to be at least as hard-fought and nasty as what we've seen before. He's going to be much more nicked up before this is done, and he is going to have to take some of the existential questions about himself (like does he have the experience, who is he really, is there a "there there") head-on now. His answers so far haven't been good enough and/or have been drowned out in the metastory of Obama the rock star.

It will be interesting to watch if McCain keeps going after just Obama or goes after Clinton as well. That will give a read on which is the candidate they'd prefer to face. Dave I know is much more optimistic about the megatrends impacting November than I am. Obama and Clinton are both strong, but flawed candidates. I still think that Obama has enough substance to assuage people's concerns about him in the general and to be a more likely victor against McCain. Clinton certainly stacks up better against McCain on national security, but I still can't get past the fact that so many Americans have visceral dislike for her, which would push GOP turnout and tilt independents away from her. If Clinton does emerge and win in Nov, she will have Obama to thank. The coronation script that her campaign had written was much less effective than the fighter/comeback story she could tell if she gets past Obama.

We Could Write for the NYT, Too

2008-02-08T09:42:00.000-08:00

Here is what David Brooks had to say. Mirrors much of what we both said about why more educated folk can feel safe to attach themselves to Obama. And we don't even have to get all corny with some fake interview shtick.

Yes. He. Can.

2008-02-07T10:34:00.000-08:00

Interesting video. I had read about it but hadn't watched it. Thanks for passing it along.

I hear both of your responses. I think there has been a long-unquenched desire on the left for "the next Kennedy", an inspirational leader who speaks about something bigger than ourselves, takes the high ground and still can win elections. And I think, particularly after 2004, there is a huge swath of this country that just feels completely shut out of the power of decision-making and is ready for that to end. Obama definitely faces the "where's the beef" test vs. both Hillary and McCain. I think he would play up the policy differences more so in the general election, but will have a big hurdle to get over on national security. (BTW, Wes Clark could be a strong Veep contender for either candidate.) But I don't see that translating into a broad suspicions of him as some kind of cult-like leader. We are far too much of a youth-obsessed society for that meme to catch up.

Personally, I'm not getting caught up in the whole Obamania thing. I support him because I think the country's political atmosphere has become too corrosive in ways that are preventing us from finding common sense solutions to pressing problems and also in ways that are detrimental to our democracy and our civic life. Also, I don't know that I'm a believer in the power of any politician to "make us a better people". I think there will always be better and worse angels of our natures, and politicians should be focusing on setting up structures to let the better angels of our natures ultimately prevail, and avoiding appeals to fear and prejudice. I think that Kennedy was more a creature of his times rather than the major shaper of what the 1960's became. (Demographics, economics and the Vietnam War did that.)

BTW, apropos of your concerns, I have a new theory about the split in supporters for Hillary vs. Obama. I'd call it trust. Blacks, young people and higher ed junkies feel like we know Obama because he is one of us. We know where he is coming from and see him as a member of 'our tribe'. To others (Hispanics, Asians, older people, white under $50K earners), he is an unknown newcomer, but they trust Hillary because they have known her for 15 years and have seen what she and Bill have stood for and done.

And if you don't like that theory, here's another one, based on Maslow's hierarchy of needs. If your basic needs have been taken care of, then you can look for someone to provide less material benefits like uplift and you can afford to take more of a chance. If you're worried about your basic needs, you're not looking to take any chances and want someone who can promise to protect you.

Obamania

2008-02-07T09:24:00.000-08:00

Don't know if you've seen this video, but I had two opposite reactions to it, one immediately following the other. My first reaction was largely positive. I felt like this video encapsulates exactly how Obama really has captured the spirit of this time -- an amalgam of media and pop culture and politics and public sentiment that is more about mood and aspiration than about politics. This is why he got my vote -- not because I think he will be better, but because he has the potential to make us better. Hokey, I know, but I figured that after the worse administration in American history, perhaps this wasn't a bad risk to take.

My second reaction to the video, however, was much less favorable. Indeed, I suddenly had an urge of suspicion and fear that I hadn't felt before. Suddenly, Obama felt too cultish, too hucksterish. My thoughts even skipped to the Manchurian Candidate. I think the media are beginning to feel this way, too, and, if the drumbeat grows louder, it could definitely take the shine off. We shall see which perspective flowers over the next few days and weeks, but, for the first time, I'm thinking that my second reaction might just be the dominant one.

Start flexing those toes

2008-02-06T12:22:00.000-08:00

I love the news about how motivated the Dem base is compared to the GOP, but I think that recent history has shown that Presidential elections are much more about personalities than parties. McCain will have broad appeal across independents, and I don't know how much concerns about his conservative cred will suppress GOP turnout, especially if the alternative is Hillary. The vote will be about the future, and we're not running against Bush this time.

Re: the class splits in the Dems, that's very interesting. I think that Obama is running more of an "intellectual" appeal. Plus, there has been some commentary that lower-middle class voters have a greater identification with the Clintons and their struggles and attacks they have sustained. Plus, racism can play a part in the primaries as well as in the general.

Tanned, rested and ready

2008-02-06T12:19:00.000-08:00

Thx for providing the impetus for reviving the blog!

I hope you're right. Hillary/Obama would clearly be the dream ticket. Hard to say how it would go down. I'd have to think that Obama would prefer not to be asked. I think he would chafe under Clinton for 8 years, and while it may be the dream ticket for an election, I don't see them working well together. But, if Hillary asks, I think he has to say yes. Interesting to ponder whether she would ask. It reminds me of 2000 and Gore, in that Hillary will have to decide whether it's more important to win or to do what she wants.

But I'm more concerned about nastiness precluding this and tarnishing them both. I don't see big policy differences between them, and if it's not quite about character, it's about tarnishing each other with the brushes of 'too inexperienced' vs. 'more of the same'. I don't see future debates being that illuminating, and we'll have to deal with moderators continually baiting them.

I will take a look at those exit polls and get back with my thoughts. One comment (re: IA, actually) that I thought was right on is that Obama is doing well in places with almost no blacks or with blacks making up a majority of Dems, but not with the in between states. This would track with the belief that white-black tensions are higher when the races are actually in contact with each other. It's a lot easier to not be prejudiced in theory than in practice.

And Another Thing...

2008-02-06T07:37:00.001-08:00

This is why I continue to remain pretty upbeat about the Dems prospects in the fall. Even if there is a lot of dirt thrown during the general, the GOP is suffering voter fatigue, the Dems are enjoying a resurgence. The dirt will hurt both candidates and might suppress turnout, but the Dems are starting so far ahead of the GOP that they have some room to lose voters and still come out ahead. Even if McCain is able to peel away some independent votes, I think the Dem base is sufficiently strong -- and, frankly, McCain's sufficiently weak -- that I am not terribly worried. I know in politics anything can happen and this is why I continue to keep my fingers crossed. But, as I've noted before, I don't see the need, as I have in the last two elections, to cross my toes, as well.

One More Observation

2008-02-06T07:05:00.000-08:00

A quick scan of some exit polls on the Dem side reveals that Obama consistently pulls in a majority of college graduates and Hillary a majority of non-college graduates. My own little theory on this gap -- which, coming from someone with a postgraduate degree, might come across as patronizing and for that I apologize -- is that those who feel more comfortable with the nuances of policy (read: more educated class) are more willing to accept someone who speaks in less specific, but posits a larger theme to tie together his views. Those who are less comfortable with the details of policy are more eager to put their trust in someone who has a very deep knowledge of the ins and outs of the policy maze. Thoughts?

Interesting Times, Indeed

2008-02-06T06:20:00.000-08:00

Last night I heard the faint cries of our lonely blog page, "Why do you ignore me so? Why does no one take me seriously?" Oh, wait. I think that was Mike Huckabee.

In any event, I thought that this discussion deserved to be preserved in a format other than e-mail. So, here is what Eric wrote: "This is rapidly becoming an illustration of the putative Chinese curse "May you live in interesting times." This is going to drag on for a while. (While you can make a case that keeping the Dems in the spotlight longer is a plus for us, I see more downside to upside of stretching our conflict out. Not every debate is going to be the lovefest that the last one was, and the media loves conflict.)One reflection and one request. The reflection is how odd it seems that the margins of victory in different states were so wide on both sides. Besides CT and MO, every other state seemed to have a 10+ pt gap. Any theories? (Besides the racial one which does seem to explain the deep Southern results.) Was there an explicit strategy on Clinton's side to go after the big states and by Obama to go after the smaller ones? Didn't see any coverage of this beforehand.The request is to send along any consolidated exit polling that you find. I'll be very curious to see the racial/gender/age vote splits, either national or state-by-state."

And here is my response:
I think the drawn out campaign is good for the Dems. They have both gotten sharper and smarter by riffing off each other. I also think that there is still overwhelmingly positive feelings about both and the more that the media show them, the more voters realize that there is a better way. Another consequence, I believe, is that a drawn out contest will likely push Hillary -- if she is the ultimate winner -- to pull in Obama as the VP, which I think would be a very positive development. Typically, you don't want your VP candidate to outshine you, but I do think it could work in this case. In a sense, Obama would help to offset Bill's looming shadow by demonstrating that a Hillary administration is something totally new from her husband's.

As for the large margins of victory, I simply cannot explain the phenomenon. (The GOP experienced a similar thing, even with a three-man race!) Perhaps this is a question for Malcolm Gladwell. After all, it does seem to be a case of reaching a "tipping point" that just pushed an overwhelming majority to vote with a certain candidate. For me, the strangest contrast is that Hillary won TN by 30 points, but lost MN by 30. I think this Super Tuesday and this whole primary season has bestowed political scientists with a huge gift. I could imagine whole careers being built on this one election. The exit polls (which are available here: http://www.msnbc.msn.com/id/21660890/) give a good place to start the analysis.

So, what next? Does the Dem campaign get nastier? Signs are there that it will. (See the fight over health care.) At the same time, perhaps this is my Panglossian view, but I do think that even if it turns nasty, both candidates will be able to maintain a general perception that they are fighting over policy, not character -- unlike the GOP -- and this will ultimately serve the party well. We shall see.

A Partial Answer

2007-09-19T12:25:00.000-07:00

I realize I have been wholly delinquent in getting you an adequate response to your counter-challenge to me: how exactly are you going to sell universal, government-run health care? Mostly, I have not responded because I've been terribly busy and just haven't found the time to give a well-reasoned (or, at least, semi-coherent) response. (Indeed, this post is written at the expense of doing mywork and, so, I'm afraid, will be shorter than it should be.)

In part, though, the delay in response is because I've been stumped. I mean I still firmly believe that a single-payer system represents the best policy from a practical and fiscal point of view. It contains the greatest potential to curb price rises and to expand access and, in turn, to increase the health of our nation. Yet, rational solutions to complex problems, sadly, aren't all they're cracked up to be in this country (or really anywhere, I suppose, but right now I'm picking on us). Too many conflicting interests mean that policy becomes one giant compromise, rather than one coherent, Pareto-optimal strategy. (I know my use of the term "Pareto-optimal" is somewhat imprecise here, but...)

If compromise is the MO of the nexus between politics and policy, then, how is a radical solution like single-payer supposed to come to fruition? Well, as I struggled with this question, a funny thing happened. Some lady named Hillary (or something like that) showed one way of how to make 75% of the ideal sound like a reasonable compromise to all interests. Her plan of mandated coverage operating within the private insurance system -- which is based largely on the Massachusetts model -- gets us entirely to one of the goals (universal coverage) and, at least puts us on the path towards the second (curbing rising costs). Not that she would ever admit this, but I do think that her plan also prepares the groundwork for moving toward single-payer because it includes a public-private competitive component. If consumers have the option of choosing either a private or government plan that are placed on equal footing, my guess is that, over time, the government plan is going to become increasingly attractive, while the private plans -- with much larger overhead -- are going to wither on the vine.

Anyhow, the bottom line is that at this stage, I'm willing to accept the HRC health care policy -- or something very close to it -- as what is feasible at this stage in the political life of our nation and, then, as time wears on and private insurance seems increasingly flawed relative to a public system, we'll begin to see an opening for single-payer coverage. (By the way, the other two major Dem candidates propose plans with similar elements, but, IMO, Clinton's is the most complete and the only one to consider seriously the matter of the second goal of curbing costs.)

I realize that there is a lot to unpack in this statement and I regret I don't have time to do it now, but suffice it to say that in this election cycle I'm content to go for a 75% solution to begin to shift the policy debate and seek a more complete change in the future.

Does 300 million count as a crowd?

2007-09-10T10:57:00.000-07:00

This poll from the NY Times shows that the American people, as a whole, are frequently wiser than the pundits on TV, or the politicians with their gamesmanship. While I love vocal democracy and the passion of MoveOn.org and their ilk, the mainstream Democratic candidates and Congressional leadership are doing well to avoid being overly influenced by those on the left.

BTW, while we mull over health care with all deliberate speed, what do you think about Patraeus' testimony?

Ping. Pong.

2007-08-29T19:22:00.000-07:00

This is fun, in addition to being tough. I think that right now, health care is one if those areas where "only Nixon can go to China". I like your pro-business rationale for single payer, but I just think it is a bridge too far for the American people right now. 1993 really poisoned the well for single payer. Socialized medicine, another big government program, and truly massive tax increases -- the talking points for the right wing echo chamber are very well rehearsed and have a ready audience. There is no way to get this through on a bipartisan basis, it's way too easy for the Republicans to parody, and it is a giant risk for the Dems to take in an area that isn't a crisis in people's lives. It is probably the best solution, if designed correctly, and it could be a political winner for the GOP in 2008 or for the Dems in 2016, but I don't think it is for the Dems now. Politics (and this exercise) is the art of the possible, and I can't see the Dems being able to pass this.

But let me give you a chance. Tell me the legislative/political steps by which you think single payer could pass in the next 4 years. Convince me that it's possible. :)

BTW, I really like the MA plan. If the goal is 100% coverage, that is probably the most effective way to get it done that is broadly acceptable. BTW, I am very concerned about the law of unintended consequences. It's a practical reason to be very cautious about a wholesale reinvention of 15% of our economy. Those MA pols are pretty clever? Who was the gov. who did that?

Luddites unite (right after the anarchists)

2007-08-29T10:41:00.000-07:00

The site totally messed up the format of my last post. I e-mailed it directly to Dave. If any one of our multitude of readers wants to see it, s/he can e-mail me directly. We'll continue the rest of the discussion on the blog.

Data Dump

2007-08-29T08:51:00.000-07:00

Thanks for the compliment, and I'll take a longer read through your post for us to discuss. But to react to your first two paragraphs, reading poll results is as much art as science, so each of us can find different facts out there to support our reasoning. Below are some I just found. (One of them is quite old, but I believe that a more recent poll would should similar results.) Looking at the polls further, I still read this situation as similar to how I think people see education -- country in crisis, but I'm doing OK, thanks; and I think the country's ambivalence towards NCLB and federal involvement in local education would be reflected in a wellspring of opposition to any specific plan that would involve lack of personal choice due to more federal involvement in health care.

But I was very surprised in the last three polls below by the extent to which people expressed support in general for more radical health care solutions. (In the 2nd to last poll in particular, I'd be interested to hear the results if the question was phrased in terms of "increased taxes" instead of "increased spending".)

More to follow, but these provide some interesting food for thought.

Now I am going to read you some things two candidates have said in their (2008) campaign for President. After I read these descriptions, please tell me which one you agree with more. Candidate A is a Democrat who says that we need to fundamentally change our health care system. We need to make sure everyone has health insurance by requiring employers to pay for health care for their employees or pay into a fund to provide health care for those who cannot afford it. We need to make health care more affordable by creating a national insurance program anybody can buy into that is big enough to force insurance and drug companies to lower their rates. Candidate B is a Republican who says that, of course, we need some major changes in our health care system. We need to cut bureaucracy and reduce the number of frivolous lawsuits. We must help states make affordable private health insurance available to their citizens and give tax incentives to every individual purchasing health insurance. But we should make sure Americans can still make their own health care choice and not be forced into accepting lower quality health care plans. Democrat/Republican, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form A half sample * = less than .5%.

28% Support Democrat strongly
11 Support Democrat, not so strongly
14 Support Republican, not so strongly
43 Support Republican strongly
2 Neither (Vol.)
* Both (Vol.)
2 Don't know/Refused

[Question ID: USGREEN.07DCJUL.R073]

Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

Now I am going to read you some things two candidates have said in their (2008) campaign for President. After I read these descriptions, please tell me which one you agree with more. Candidate A is a Democrat who says that we need to fundamentally change our health care system to cut costs and create a framework to provide coverage to all Americans. We need a national prevention initiative to reduce diseases such as cancer, introduce a paperless health care technology system to cut cuts and reduce error and create an independent 'Best Practices' institute to empower consumers, providers and health plans to make the right choices and put in place common-sense malpractice reforms. Candidate B is a Republican who says that, of course, we need some major changes in our health care system. We need to cut bureaucracy and reduce the number of frivolous lawsuits. We must help states make affordable private health insurance available to their citizens and give tax incentives to every individual purchasing health insurance. But we should make sure Americans can still make their own health care choice and not be forced into accepting lower quality health care plans. Democrat/Republican, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form A half sample * = less than .5%.

24% Support Democrat strongly
13 Support Democrat, not so strongly
17 Support Republican, not so strongly
43 Support Republican strongly
2 Neither (Vol.)
* Both (Vol.)
1 Don't know/Refused

[Question ID: USGREEN.07DCJUL.R074]

Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

Thinking about the country as a whole, would you say you are satisfied or dissatisfied with the quality of health care in this country? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form C half sample  


19%  Very satisfied
30   Somewhat satisfied
21   Somewhat dissatisfied
28   Very dissatisfied
2    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R048]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Thinking about your own situation and your own family, would you say you are satisfied or dissatisfied with the quality of health care you receive? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form C half sample  


48%  Very satisfied
33   Somewhat satisfied
9    Somewhat dissatisfied
9    Very dissatisfied
1    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R049]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

"Overall, how confident are you that your health insurance for next year will meet the healthcare needs of you and your family?"

Base: Will have employer-sponsored health insurance next year

	Total
Very/Somewhat Confident (Net)	89%
Very confident	55
Somewhat confident	35
Not Very/At All Confident (Net)	9
Not very confident	7
Not at all confident	3
Not sure	1

Note: Percentages may not add up exactly to 100% due to rounding.

Next, thinking about the campaign for the presidential election in 2008, which one of the following health care issues would you most like to hear the presidential candidates talk about and focus on in any health reform plan they may develop?...Expanding health insurance coverage for the uninsured, reducing health care costs, improving the Medicare prescription drug benefit for seniors, improving the quality of care and reducing medical errors, reducing spending on government health programs like Medicare and Medicaid

Subpopulation/Note: Asked of Form 1 half sample

32% Expanding health insurance coverage for the uninsured 31 Reducing health care costs 13 Improving the Medicare prescription drug benefit for seniors 11 Improving the quality of care and reducing medical errors 7 Reducing spending on government health programs like Medicare and Medicaid 2 None of these (Vol.) 1 Other issue (Vol.) 3 Don't know/Refused

Survey by Henry J. Kaiser Family Foundation. Methodology: Conducted by Princeton Survey Research Associates International, May 31-June 5, 2007 and based on telephone interviews with a national adult sample of 1,203. [USPSRA.062007HTP.R03]

Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

(Now I'm going to read you some pairs of statements about health care reform for the country.  After I read each pair, please tell me whether the first statement or the second statement comes closer to your own view, even if neither is exactly right.)...First statement:  The best way to lower health care costs is through government intervention.  Second statement:  The best way to lower health care costs is through more choices and competition....(If First/Second statement, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form A half sample  


27%  First statement strongly
9    First statement not so strongly
13   Second statement not so strongly
45   Second statement strongly
1    Both (Vol.)
1    Neither (Vol.)
3    Don't know/Refused

(Now I'm going to read you some pairs of statements about health care reform for the country.  After I read each pair, please tell me whether the first statement or the second statement comes closer to your own view, even if neither is exactly right.)...First statement:  Now is the time to establish a Canadian-style national health care system that provides affordable health care for all Americans.  Second statement:  We can improve our health care system through incremental steps without taking radical measures that will result in a government takeover....(If First/Second statement, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form A half sample  


40%  First statement strongly
13   First statement not so strongly
14   Second statement not so strongly
29   Second statement strongly
1    Neither (Vol.)
3    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R066]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

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from this Survey

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Democracy Corps Poll [May, 2007]

Survey by Democracy Corps. Methodology: Conducted by Greenberg Quinlan Rosner Research, May 29-May 31, 2007 and based on telephone interviews with a national likely voters sample of 1,000. Likely voters are registered voters who voted in the 2004 election/weren't registered/ineligible/too young to vote and said they are probably or almost certain to vote in the 2008 election.






 (Now, I'd like to rate your feelings toward some people and organizations, with one hundred meaning a very warm, favorable feeling, zero meaning a very cold, unfavorable feeling, and fifty meaning not particularly warm or cold.  You can use any number from zero to one hundred, the higher the number the more favorable your feelings are toward that person or organization.  If you have no opinion or never heard of that person or organization, please say so.)...Single-payer health care system...Give...single-payer health care system a rating, with 100 meaning a very warm, favorable feeling, zero meaning a very cold, unfavorable feeling, and 50 meaning not particularly warm or cold. (If Don't know, ask;) Would you say you are unable to give an opinion of...single-payer health care system, or have you never heard of...single-payer health care system?

Subpopulation/Note: Asked of Form A half sample Mean = 45.1 


16%  Warm 51-100
24   Cool 0-49
25   Not particularly warm or cold 50
35   Never heard of/Don't know/Refused

[Question ID: USGREEN.07DCJUL.R030]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 (Now, I'd like to rate your feelings toward some people and organizations, with one hundred meaning a very warm, favorable feeling, zero meaning a very cold, unfavorable feeling and fifty meaning not particularly warm or cold.  You can use any number from zero to one hundred, the higher the number the more favorable your feelings are toward that person or organization.  If you have no opinion or never heard of that person or organization, please say so.)...Canadian-style health care system...Give...Canadian-style health care system a rating, with 100 meaning a very warm, favorable feeling, zero meaning a very cold, unfavorable feeling, and 50 meaning not particularly warm or cold. (If Don't know, ask;) Would you say you are unable to give an opinion of...Canadian-style health care system, or have you never heard of...Canadian-style health care system?

Subpopulation/Note: Asked of Form B half sample Mean = 48.9 


34%  Warm 51-100
32   Cool 0-49
14   Not particularly warm or cold 50
20   Never heard of/Don't know/Refused

[Question ID: USGREEN.07DCJUL.R031]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.




 Thinking about the country as a whole, would you say you are satisfied or dissatisfied with the quality of health care in this country? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form C half sample  


19%  Very satisfied
30   Somewhat satisfied
21   Somewhat dissatisfied
28   Very dissatisfied
2    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R048]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Thinking about your own situation and your own family, would you say you are satisfied or dissatisfied with the quality of health care you receive? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form C half sample  


48%  Very satisfied
33   Somewhat satisfied
9    Somewhat dissatisfied
9    Very dissatisfied
1    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R049]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Thinking about the country as a whole, would you say you are satisfied or dissatisfied with the cost of health care in this country? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form D half sample  


5%   Very satisfied
18   Somewhat satisfied
32   Somewhat dissatisfied
42   Very dissatisfied
3    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R050]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Thinking about your own situation and your own family, would you say you are satisfied or dissatisfied with the cost of health care? (If Satisfied/Dissatisfied, ask:) (Is that very or somewhat?)

Subpopulation/Note: Asked of Form D half sample  


18%  Very satisfied
25   Somewhat satisfied
24   Somewhat dissatisfied
32   Very dissatisfied
1    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R051]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Which of the following do you agree with most?...One:  On the whole, the health care system in America works pretty well but some changes are necessary.  Two:  There are good things about the health system in America, but some major changes are needed.  Three:  America's health care system is so inadequate and has so many problems that we need to completely rebuild it.

Subpopulation/Note:  * = less than .5%. 


20%  One:  On the whole, the health care system
in America works pretty well but some changes
are necessary
55   Two:  There are good things about the health
system in America, but some major changes are
needed
24   Three:  American's health care system is so
inadequate and has so many problems that we
need to completely rebuild it
*    Other (Vol.)
1    None (Vol.)
*    Don't know

[Question ID: USGREEN.07DCJUL.R052]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Now I'm going to read you some pairs of statements about your own health care priorities.  After I read each pair, please tell me whether the first statement or the second statement comes closer to your own view, even if neither is exactly right....First statement:  Lowering health care costs is the more important thing to me.  Second statement:  Improving quality is the more important thing to me....(If First/Second statement, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form C half sample  


32%  First statement strongly
9    First statement not so strongly
14   Second statement not so strongly
38   Second statement strongly
4    Both (Vol.)
1    Neither (Vol.)
1    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R054]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.


2
 (Now I'm going to read you some pairs of statements about health care reform for the country.  After I read each pair, please tell me whether the first statement or the second statement comes closer to your own view, even if neither is exactly right.)...First statement:  Now is the time to establish a Canadian-style national health care system that provides affordable health care for all Americans.  Second statement:  We can improve our health care system through incremental steps without taking radical measures that will result in a government takeover....(If First/Second statement, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form A half sample  


40%  First statement strongly
13   First statement not so strongly
14   Second statement not so strongly
29   Second statement strongly
1    Neither (Vol.)
3    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R066]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 (Now I'm going to read you some pairs of statements about health care reform for the country.  After I read each pair, please tell me whether the first statement or the second statement comes closer to your own view, even if neither is exactly right.)...First statement:  Now is the time for single payer health insurance that is funded and administered by the US (United States government.  This Canadian-style system would guarantee affordable health care coverage for all Americans and reduce costs by streamlining the administration of health care.  Second statement:  We need to make changes to our health care system, but we cannot put it in the hands of the government.  While health care accounts for 15 percent of our economy, a government takeover is a radical move that will reduce quality of care and eliminate a patient's choice of doctor....(If First/Second statement, ask:) Do you feel that way strongly or not so strongly?

Subpopulation/Note: Asked of Form B half sample  


29%  First statement strongly
17   First statement not so strongly
14   Second statement not so strongly
35   Second statement strongly
2    Neither (Vol.)
3    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R067]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.



 Would you favor or oppose a proposal that provided every American with health insurance, even if it meant your taxes or health care premiums would increase as a result? (If Favor/Oppose, ask:) Do you feel that way strongly or only somewhat?

Subpopulation/Note: Asked of Form A half sample  


27%  Strongly favor
27   Somewhat favor
16   Somewhat oppose
27   Strongly oppose
4    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R068]


Data provided b

 Let me tell you about a proposal to reform the health care system in this country.  This plan would use what some people call a single-payer health care plan.  Under this plan, you still would be able to see your own doctor, just like under Medicare, but the federal government would pay the health care costs for all Americans.  This would require a significant tax increase, but all of your current health care costs and insurance premiums would be covered by the government.  Having heard this, do you favor or oppose this proposal? (If Favor/Oppose, ask:) Do you feel that way strongly or only somewhat?

Subpopulation/Note: Asked of Form D half sample  


25%  Strongly favor
29   Somewhat favor
12   Somewhat oppose
29   Strongly oppose
5    Don't know/Refused

[Question ID: USGREEN.07DCJUL.R072]


Data provided by The Roper Center for Public Opinion Research, University of Connecticut.

Health Care: A Much Different Answer

2007-08-29T06:43:00.000-07:00

I am beginning to realize just why this little project I have gotten us into is, in fact, deeply challenging. You and I, two reasonably intelligent adults who share many common beliefs about the proper role of government and of what constitute our major problems of the day, still adopt fundamentally different approaches to one of those major problems. Usually, I tend to disguise my conclusions of an argument until the end so that I can build to it, but let me make an exception in this case and start at the end and then walk through the logic of my thinking-- to use the term liberally -- all while trying to address the points you raise in your post. So, here's the bottom line: I think the only adequate solution to the health care challenge is to move to a single-payer system. Now, let me explain why.

I'll start by challenging your starting point. You claim that most people are satisfied with their own health coverage, but complain that the system itself is broken. I actually think that most people believe the system is broken AND that their own coverage is both unsatisfactory (or at least frustrating) and -- to one degree or another -- at risk. (By the way, the one group for which the complaints about health care system are lowest is among the elderly who benefit from a single-payer system.) If one starts with this premise, it is a lot easier to argue that radical change (though I wouldn't use that term to sell the plan, of course) is needed. I totally agree that single-payer is easily parodied and has lots of interests arrayed against it, but I also think that the reasons why it is not so far fetched to consider is that (a) a majority of the public is already accepting of single-payer of one form or another and (b) the largest interest of all -- buisness -- is quickly coming to the conclusion that the current system where buisnesses are largely responsible for paying health care costs is unsustainable.

Taking these points in order, consider this poll from CBS, where two thirds say that they believe that there should be universally guaranteed health care and that only 8% want the whole system to stay the same and fully 36% want a total overhaul. I know that these type of polls are not totally reliable because they are conducted in a political vaccuum where people only imagine a best-case scenario without considering all the potential downsides, but still, it seems to me that the public is primed for a total re-thinking of the ways in which health care coverage is delivered in this country.

The second point, in my mind, is more important. You argue in your post that we need to avoid making this about covering the uninsured because -- by and large -- the uninsured don't vote. On this I agree, but rather than aiming to satisfy/appeal to the middle class, I think instead that the whole issue needs to be framed as one that supports business growth. This is an argument that has even broader appeal and, actually, is even more accurate. Until we figure out a way to enable buisnesses to get out from under the burden of rapidly rising health care premiums, economic growth is threatened. When compainies like GM, IBM and GE are paying billions every year in health benefits for their employees, they are looking to stop the bleeding. The best way to stop it is not to stem the rise of health care premiums, but to throw off the burden all together. I suppose these large companies could simply refuse to pay premiums any more and risk losing vast numbers of employees, but a much more reasonable solution is to get some other big entity to pay. Enter the U.S. government.

This argument, by the way, to me represents the true $800 screwdriver. When GM is about to enter contract negotiations with the UAW and the main issue on the table is how to cover the rising health premiums -- not wages, not work conditions, not retirement benefits -- then it seems that the general public will begin to appreciate the scope of the problem.

Now, as to how to implement. This, I grant you, is a bit tricky not so much because the idea is flawed, but because you can't very well propose a plan that -- as attractive as it might be to many -- wipes out an entire industry (HMOs). I was going to propose that we need an interim phase where coverage is universal and that the cost burdens are shifted from business to the government, but that preserves the role of HMOs to manage individual plans. I suppose this is the route that Massachusetts has taken. (Details here.) We'll have to see how this plays out. It will certainly help with one of the main issues -- coverage -- but I find it hard to believe that it is going to make much of a difference on business growth matter and, so, does not represent a long-term solution.

Instead, I think we need a plan that simply sets the goal of universal health care coverage by the U.S. government as a goal and builds in a phasing in period where essentially Medicare extends its coverage to ever-greater age range. Coverage should begin first with 0 - 18 and then, for example, could add people within five-year age range increments each year over the next several years. This phase-in period would then give time to (a) HMOs to adjust their services to supplemental coverage -- much as they do for the over-65 set now; (b) the government to build up the systems needed to vastly expand and, as you rightly suggest, streamline the coverage and delivery of health care in several ways (electronic record-keeping, standard-setting, etc.); and (c) buisness to adjust salary structures to accommodate the sloughing off of paying health care benefits. On this last point, I would suggest that any good plan also has to have some regulation built in for how businesses shift monies from paying health care premiums to increased salaries that is fair to both employer and employee.

As for the issue of choice, I've never understood this problem. If every doctor accepts the same payer, then presumably patients would have more -- not less -- choice than they do when some doctors now accept patients from some plans and not others. There would be less choice for doctors, I suppose, but I think it is possible to build in some safeguards to insure that payments are fair and that there is limited abuse. As for rationing of certain procedures, this may be a real problem, but think it will be relatively limited and, if we are able to spread health care dollars more equitably, then it will actually make other problems like better technology driving up costs less dramatic. We could also build in some incentives for getting more primary care doctors into practice to build in more gate keepers into the system

A final detail point about how we pay for all this. Coverage is paid for by an increase of taxes to both employers and employees/taxpayers, but these increases, I am assuming, will be lower overall than current taxes + health care premiums. Even if the total tax/health care burden is reduced by 10% overall, it seems a no brainer. My guess, though, is that there will be even more savings than that, however. I am not sure, but I would think that covering the uninsured will do much to drive down costs. After all, if the uninsured currently use expensive ERs as their primary form of care and do not take preventive health seriously then it just makes sense that they will spend less as individuals with access to regular health care and, so, costs for the whole system will fall, as well. I know that Massachusetts is counting on this phenomenon to kick in. Also, eliminating HMO bureaucracy from the mix is bound to reduce overall costs.

To wrap up, I am both optimistic and pessimistic. On the latter point first, considering you claim that a single-payer system is a non-starter in your view, I'm not sure you and I are going to come up with some consensus plan that satisfies both our perspectives and if we can't do it, then I fear that no one can. If we cannot reach some national compromise, we'll be stuck with some variation of the same mess we are in now. At the same time, I have become increasingly persuaded that we are approaching a crisis moment. As many are fond of saying, the Chinese word for crisis is a combination of the words "risk" and "opportunity". I believe that as the crisis looms larger, the U.S. will simply have to take a more risky, but opportunity-filled step of completely overhauling the health care system. With all due respect, anything else just tinkers around the edges and leaves us in the same sorry state we're in now.

One final -- and tangential -- point that I was going to include in a separate post, but may as well throw it in here since it stems directly from yours. Your notion that there should be a set of industry-based standards of care is, in theory, good, and should defintely be explored within the context of a single-payer system, but I also think that you both overestimate and gloss over the capacity of medicine to adhere to standards. On the one hand, medicine is as much art as science. There may be certain standards of care, but as I see up close, there is also a fair amount of guess work and gray areas that simply cannot be regulated from afar. There may be room for standards, I suppose, but doctors also operate on a case-by-case basis and make decisions with individual patients and so such standards may not be possible to implement absolutely in practice. On the other hand, doctors also can fall into the habit of operating by rote and misdiagnosis or mistreat some condition because they are looking at the problem in a particular way or with a particular set of experiences. Standards may act only to exacerbate such tendencies and may, in fact, make things worse, not better.

I guess that, ultimately, our debate will continue. I only wish that the debate in the wider public sphere would continue with even a modicum of the respect and earnestness we are trying to exhibit here.

Equal Opportunity Reviewer Bashing

2007-08-27T16:52:00.000-07:00

I am similarly displeased by this review from the left of another "What's the matter with the Democrats" book, "The Argument" by Matt Bai. A few points:

1) Michiko reviews far, far too many contemporary political books. And her "reviews" are rarely more than summaries of the key points from the books with a few illustrative quotes, followed by some like-minded piling on against the Bush Administration.

2) I'm very tired (as has previously been documented, as my friend Ted knows) of the self-serving reviews within the Times of books by NY Times writers or which have previously appeared in a different form in the Times. These books should appear in a "Noted for your Information" column, as the Times has shown no ability to conduct reviews for these books which are either fair or useful for their readers.

3) I haven't read Bai's book, but I've read almost all of his NY Times Magazine pieces, and this book is so clearly a compilation of the past 4 years of this reportage. Maybe Bai is hoping that no one has noticed, but the political world has changed just a bit since 2003. How can any serious reviewer can not point out how dated the book is? This is yesterday's first draft of history, which isn't too different from what is lining today's litter box.

BTW, the Salon review of the book includes this great quote.

One of my favorite stories in "The Argument" features Democratic Congressional Campaign chairman Rahm Emanuel, another ambiguous figure -- Bai seems to like him, even though he's a message-agnostic, win-at-any-cost pol from Chicago -- blowing up after having to sit through a work session on crafting a coherent Democratic appeal. Told that it's not enough to simply attack the Republican Congress (which is the whole point of Bai's book), Emanuel snarls: "I have my knee on their vertebrae, and I'm not going to let up on the pressure until I hear the vertebrae snap."

I don't know the date of this quote, but it could be anytime from 2006 until now. Emanuel is right and wrong at the same time. We'll find out in Nov. 2008 if he was more right than wrong. (It's a little bit like the difference between Hillary and Obama. BTW, I would love to sit in on the uncensored conversations that he and Obama have. Same city, same generation, and seemingly such a different approach to politics. Would be fascinating.)

Attack of the smug

2007-08-24T18:30:00.000-07:00

Though I appreciate the diversity that David Brooks brings to the NY Times Op-Ed page, and he frequently makes some interesting points (which are just as frequently expanded way out of proportion to his supportive evidence), this "review" is Exhibit 28 in why he infuriates me. And the editors thought he would write a fair (and meaningful) review of this book, Why?

Go Team!

2007-08-23T13:29:00.000-07:00

I didn't mean to leave you speechless, Dave. Well, good thing we have 15 months to go before we give these ideas to the next Democratic President. :)

While it's a pretty safe assumption that Dems will be less aggressive and strategic in responding to spurious claims than the right, I think that Drum is off-base here. Dems still have a winning hand on the Iraq issue. It's was a war of choice, George Bush's choice, it's going badly, 70%+ of Americans want it to end and for us to bring our troops home. Bush and the GOP have been dead wrong on every aspect of the war, from choosing to fight it to how they fought it to telling the American people for 4 years that it was going great. Bush is desperately grasping at anything he can to rebuild some support for the war, but Vietnam is a distraction. We should keep focus directly on this war, which is a disaster for everyone and is Bush's fault. (And I like your line. That kind of dismissal of this attempted sideshow is perfect.)

The problem we all have is that Colin Powell was right, and, to some extent, Bush was right. We broke it, we bought it. Maybe 2-3 years ago it was accurate to say that much of the violence in Iraq was spurred by the American presence, and therefore our departure may have been an improvement for Iraq. But now, with a full fledged, low-level civil war underway, it seems hard to argue that the Americans are not a stabilizing force in the country and that, at least in the short term, you'd see an upswing in violence were we to leave.

This is a very tough one. There's a reason why the objective function of the Baker-Hamilton report seemed to be an outcome that would have broad bi-partisan support among the U.S. public and preserve some of our dignity rather than one which would be the best for the Iraqi people.

Worst. Foreign. Policy. Debacle. Ever.

We Interrupt This Discussion...

2007-08-23T11:26:00.001-07:00

I know I have lamely shirked my responsibility to respond to your thoughtful post on health care. I promise that I will, but wanted to get your thoughts on this idea that Kevin Drum proposes.

What is the proper reaction to the president's latest salvo at undermining all that is good and noble about simple truth? Do we ignore the inanity of the claim that Vietnam could have been won and we are in the same situation now in Iraq so that we prove its inanity by ignoring it or do we actually try to counter the fantasy by bombarding the public with a dose of reality? I'm actually inclined to take the middle ground between the choices. How about dismissing the claim not with an argument, so much as with a snarky comment like, "If the president really wishes to associate his war with the ten years of failed military and political policy of Vietnam, that is his choice."? If Kevin really wants us to fight back against the right, then we need to sound as arrogant and cavalier as they do.

What say you? Talk truth, ignore fantasy or talk trash?

Health Care - The Answer :!*)

2007-08-13T22:12:00.000-07:00

OK. I’ve been thinking about your health care challenge over the last week or so. I definitely view this as a work in process, to be improved by our mutual contributions. Let me lay out a framework for how I’m thinking about this, then work up to a policy solution and a way to package it.

The landscape on this issue is not as politicized as some. To the extent that it is, the groundwork is laid along the usual lines of the Dems as the mommy/big government party - wanting to make sure that everyone is covered and healthier and eager to see the government expand deeper into all of our lives to accomplish this - and the GOP is the daddy/small government party - wanting to see people take responsibility for their own health, trusting the free enterprise system to solve social problems, and wanting a relaxation of the government's role in the sector.

Currently, I'd say most Americans feel about health care similarly to how they feel about education. Everyone says it’s a crisis, so it must be, but my school (or coverage) seems to be pretty good. To the extent that there is a problem, people would describe it differently. Some point to 50 million uninsured, some point to the hassles of those with insurance and the evils of HMOs, some point to the toll that health care spending is putting on American companies, some point to the wasteful spending, with primary subproblems within that being too little spent on prevention, too much spent on insurance and unnecessary procedures, too much spent on paperwork and processing, too much spent on pharma, too much spent on the last 3 months of life.

One issue with taking the lead in trying to solve health care is that no one can agree on what the problem is. So, first you've got to convince the majority of the American people that what you say is a problem is really an important problem, then you've got to deal with everyone trying to tear down your solution.

There are a few traps for the Democrats to avoid. First, they have to avoid single payer. The entrenched interests against it are too many, it’s too easy to parody as socialist (or worse, French) and there is not enough of a sense of crisis for people to support a revolution in our health care delivery and payment system. Second, you have to avoid anything that would restrict or ration care at the top end, for the same reason. Third, you have to avoidance making 'universal coverage' your rallying cry. The middle class doesn't care, many uncovered people could afford coverage but choose not to buy it, and the working poor are outnumbered and under-registered.

So, what do you do? First, you focus on the issues of the middle class and the economy. Then you focus on cost and quality. We’re not getting what we pay for. Increasing technology is decreasing costs in computing, home electronics and telecommunications. Why is it increasing costs in health care? And why aren’t we healthier when we are paying so much?

To step back, why do people buy insurance? Typically, it's to avoid risk. Maybe there is only a 1/1000 chance of your house burning down this year, but that outcome is so catastrophic that it is worth paying 1/500th of the value of your house each year for fire insurance. So, it's worth paying $5000/year for health insurance to avoid the 1% chance of having to pay $250,000 in health costs which would be bankrupting. For health insurance, there is another, somewhat paradoxical reason to buy it. Humans are notoriously poor at making trade-offs between the present and the future. Even while we know that eating fatty foods will clog our arteries in the future, we often don't pass up the KFC for the big salad. In terms of health, that means that people will put off that check-up at their doctor and stay home to watch Big Brother instead. So, it makes sense to have pre-paid insurance so the check-up is free and more people would go than if they paid the actual price. The downside of insurance is what's called moral hazard. If I know that I have collision insurance in my rental car, I may drive a bit more recklessly than if I knew I was liable for any scratches. (The health care world is filled with enough other economic inefficiencies to fill about a dozen PhD theses.)

So, here are some attractive principles to start with that make sense and would appeal to the American public. I’ll build my policy and packaging suggestions from these:

1) People need catastrophic insurance. They want it and need the security of knowing that they are not one illness away from bankruptcy
2) People need choices. You only can go to this one doctor and have to pay huge to go out of network is a non-starter
3) Squeezing cost out of the system is good, if it doesn't hurt quality or personal choice.
4) Americans like technology and they like progress. Any system has got to encourage technological advances
5) Health care should be affordable for the average American
6) Single payer is a non-starter
7) The focus of reform efforts should be on things that make life better for the middle class
8) There is lots of room for quality improvement in American health care
9) You shouldn’t have to pay a lot to get high quality. People get it with Toyota and Target.

So here are some components of a solution that should be sellable. I'll think about the packaging of this a little later.

1) Implement voluntary, industry based standards organizations with incentives to join. Government imposed standards are easy to attack. Industry driven standards work very well in the technology/telecommunications fields and are harder to criticize from the right. There should be standards of care for say the 10-20 most common/expensive complaints/procedures/ conditions. The AMA and hospital associations, etc. should get together to agree on these standards of care, convened by the government. Health care providers should be judged based on how well they meet these, and there should be a financial incentive (but no requirement) to do so.

2) Tort reform. This is an issue to take away from the GOP and it reinforces the message of controlling costs (even though it’s probably not a big component of that.) A couple of things I’d suggest. First, all MDs or HMOs should be exempt from liability when they follow the standard of care guidelines above. Second, there should be a declining, sliding scale for legal fees. Third, punitive damages above a certain amount go to a central fund not to the plaintive.

3) There should be differential Medicare reimbursement rates based on efficacy. Providers meeting the standards of care above should be reimbursed at a higher rate. New drug reimbursement rates should be keyed to how much of an improvement the drug is over the previous therapies. Perhaps MD’s or hospitals should receive some kind of incentive based on how often they prescribe generics when they are available.

4) Tax advantages should be available for companies and individuals that follow these “more effective” plans. This should help lift the burden on companies facing foreign competition and make it easier for uninsured Americans to buy plans.

5) There should be an industry based standard for electronic medical records. Not a standard software, but a standard dataset and flows. This is a huge savings opportunity and a great way to use standards to help a whole community. (It's like defining a standard rail track gauge in the olden days.)

6) Cover all kids. This is just a no brainer. (I'm not up on the details of the current proposals for this.)

7) Create attractive national policies for individuals not covered from work to buy into. These should be offered by private companies, and giving people a choice of different tiers. The baseline ones should be low cost, cover preventative care for free, give $ back for healthy behaviors, have high deductible but good catastrophic coverage.

In terms of messaging, I think these are the kind of messages we should use:

Health care is becoming unaffordable for the average American
We need to make sure health care is affordable for everyone
We can get higher quality at lower cost
We will use market based solutions to fix market failures
American ingenuity will help us make sure that all Americans have the best health care in the world

Also, to drive the cost point home, we need to find our $800 screwdriver -- the sticky example of just how broken the system is. And we should make the point that these changes will be revenue neutral at all levels of government. The federal government will spend more on tax breaks for these “approved” plans, but it will reap savings in Medicare and Medicaid spending, and the state and local governments will save a lot in these two areas.

To wrap up this mega-post and return to its political possibilities, the left wouldn’t like this plan because it doesn’t provide universal coverage. The right wouldn’t like it because it will increase federal spending and also injects these standards organizations into the marketplace. The pharmas won’t like it because they will have to show greater efficacy for their drugs to get maximum reimbursement. I’m not sure how the AMA and hospital groups would react. Getting them inside the tent on the standards of care setting is key. (But that process will be hellacious.) Individual doctors may object, saying that the government is telling them how to practice medicine. (In reality, the government is just setting different reimbursement rates based on the scientific recommendations for standards of care.) Insurance companies should like the electronic medical records and the additional tax incentives, but may have issues with selected standards of care.

For middle class consumers, I think this issue is winnable in this presentation. They would be told that their own health care costs will start to decline and that the government is reining in costs overall. Not exactly the most powerful rallying cry, but I think it is still a compelling message for how they benefit and how the country benefits, which is what was missing in the compromise immigration bill.

Your thoughts?

See you in a week

2007-08-03T10:39:00.000-07:00

Good choice. Health care is a bit easier than some, because it's less ideological than many of the other issues (though the GOP tried to change that in 1993). But it's harder than others because it's not nearly as clear what the "right policy answer" is. (I consider defining the goal as "universal coverage" to be part of the Dems problem, but I'll get back to that in my next, longer post.)

BTW, I'm realizing that you really are much more cynical than I am. I'd say that on an issue-by-issue basis, 50% of success in gathering public support is having a good solution to an issue that matters to people, and 50% is how it is framed and presented (by both sides). So, I see a big part of our exercise to be coming up with smart, workable solutions. The rest (which may indeed be harder) will be informed by these interesting insights and a little strategic thinking on our part. (That's where your cynicism will come in very handy.)

Have a great time this week on vacation, and I'll post something here over the next week for you (and others) to react to.

Leading Off...

2007-08-03T09:18:00.000-07:00

Well, it seems that there are a couple of ways to go here. We could start easy and then tackle more difficult issues -- not that any issue is really easy -- or we could try to tackle the bigger, more complicated ones first and then the "simpler" ones can flow from there. I'm inclined to adopt the former approach, so here goes.

Health care. This is shaping up to be perhaps the number one domestic issue of the campaign. It is also an issue that is prone to a lot of myths, in part because everyone has had personal experience with the health care system and, as human beings, we tend to extrapolate from personal experience to the whole, and in part because it is so easy to lampoon and propagandize. Just yesterday, for example, Guiliani came out with his health care "plan" and it is based entirely on the principle of not turning our healthcare system "French". All objective analyses, of course, point to the French system as essentially equal to ours in quality -- and superior in some areas -- that costs 40% less, but those inconvenient facts shouldn't stand in the way of good old American exceptionalism and a little French-bashing, to boot.

So, then, what is a good solution? For so many reasons, there is no way we can hope to replicate the French system -- French doctors earn a lot less, for example, and the AMA would never allow that to happen -- and we don't want the British system which actually is worse than the U.S. in many areas in delivering services. Yet the current American system of a patchwork of private insurers which only partially cover people and, often, only the healthiest people, is, to use one scholar's term, "sicko." How do we get to universal coverage -- which I do think must stand as the only really acceptable goal -- without making it seem like socialized medicine? Notice I use "seem" in the last sentence. Smart people know that the best-run health care system in the country is run by the govt. in the VA and that the group least likely to complain about health care coverage is the elderly who have Medicare. This then is all about marketing, not about facts. But that is the point of this whole exercise anyhow.

Good luck.

Oh, Great. Another Gauntlet :)

2007-08-01T11:21:00.000-07:00

What a bracing and stimulating idea, Dave. You're on. I don't think this work is easy by any means, but I think it is doable, within the constraints you laid out. Let's take one issue at a time. (As even doing one well would be a worthy accomplishment.) Select one to start with from the following (or add your own):

Fighting fundamentalist Islamic terrorism
Immigration
Globalization
Climate change
Entitlement insolvency
Education
Health care
Abortion
Moral issues/strengthening families
Farm policy
Government spending
Taxes
Estate tax
Economic growth
Regulation/tort reform

The Samuelson article was interesting. I don't know too much about his other writing, but this seemed reasonably on target. (Though I think there probably has been a lot of serious work on this issue by a various of groups, all bound and gathering dust on staffers' shelves somewhere.) It's always easier to make big changes after a crisis, so this topic remains the "third rail" of American politics until either people understand there is a coming crisis (do we need to watch "An Inconvenient Lockbox" before that happens?) or if a politician has the courage to upset the status quo to try to solve this proactively. Or until two verbose bloggers solve the country's problems with enough time left over to catch the ballgame tonight. :)

Addendum

2007-08-01T10:01:00.000-07:00

Usually I find Robert Samuelson to be maddeningly "even-handed" in his discussions of policy, refusing to acknowledge that Republican (or Democratic) ideas are just a sham, but this strikes me as a pretty good idea, in general, and not just on the big issue he suggests. Perhaps if our experiment fails, we could get something like this started.

Throwing Down the Gauntlet

2007-08-01T06:14:00.000-07:00

OK, big shot. So let's put this blogging thing to good use. If you think it is actually possible to message smart policy in easily digestible and attractive ways, let's get started. Over the next few days (or weeks, whatever), let's take on a series of issues and actually put language around some sound policies that might also have some life on the campaign trail. In other words, let's try to inch Democratic candidates closer to a real agenda, while, at the same time, making that agenda marketable to the broader public.

I still contend that when it actually comes down to engaging in this work of messaging, it is incredibly difficult and, frankly, is much easier when you actually don't care about policies that will really have a positive impact. That said, I am willing to give it a try, if you are. (There is no way I could do it alone, but I think a bit of back and forth has a better chance of producing something useful.)

Let me propose a couple of groundrules for this little exercise. First, you need to come up with a pithy slogan that accurately captures the essence of the policy AND that the general public can resonate to. (After all, if we are going to effectively counter the GOP, we need something that can counter something like "lower taxes and less government," etc.) Second, you need to lay out at least a few key principal policy points that (a) demonstrate a reasonable amount of depth and move beyond platitudes to real change proposals, (b) are feasible, both financially and politically, (c) are "simple" enough that they can be readily understood and (d) effectively point out where the opposition is wrong and why this policy approach is superior. Perhaps it is unfair to place such a high bar, but, IMO, unless you can satisfy all these criteria, we'll be in the same place we are now.

Since I proposed the groundrules -- which you can push back against, if you think they are too constraining or misguided -- you can pick the issue(s). Off we go...

Is it the message, stupid?

2007-07-31T08:00:00.000-07:00

I'm less pessimistic than you are on the messaging front, Dave. The New Deal and containment were two relatively complex programs that were able to be explained so they gained the support of the American people. The changes that Sarkozy is proposing to make in France are pretty complex, but he seems to have been able to get at least tentative support for them.

The Dems need to figure out what they stand for, then decide on a strategic context (maybe it's the story, stupid) for promoting it, then come up with some compelling messaging that appeals to the heart as well as the head. I don't see any issue in which we can't do this. I think that there are 3 key reasons why this hasn't happened so far: the permanent campaign mode, the weakness of the party and the relative strength of the GOP on messaging. Given how close Dems are to each other on most key issues, the primaries are really about character and personality, so there is no incentive to put out comprehensive policy proposals and messages, especially when they just provide ammunition for the other side. And there is no real center within the party building up a message for longer than the next election cycle. The DLC did this for a while, but its day has passed.

I think that something like "tough but smart" could be a core of good Hillary messaging on terrorism. Getting into an argument on whether we agree there is a "War on Terror" or not is fighting on the GOP's terrain. Except on Iraq (which plays differently in the UK), Hillary could learn a lot from Gordon Brown message on terror.

10 more years of All Star Game wins?

2007-07-31T05:53:00.000-07:00

It's interesting to see at the trade deadline this year that most of the significant talent is going from the AL to the NL. The young players coming back (and perhaps some of the traded players coming back when they hit free agency) should help do their part to maintain the AL's position as the stronger league.

It's odd that, while if you made a list of the top young players in MLB, most would be in the NL (Howard, Braun, Reyes, Wright, Utley), the AL's recent dominance seems to be holding. I wonder if there are any structural reasons for that. (Or, in a related question, if there are any structural reasons for the parity in the NL.) I'm inclined to believe that it is a quirk of history, plus the fact that more of the best managed franchises in baseball are in the AL (say A's, Red Sox, Yanks, Indians, Tigers vs. only Braves and Mets in the NL) while more of the worst are in the NL (Cubs, Rockies, Giants, Nats, Pirates vs. D'Rays and Orioles and maybe Rangers.)

Any predictions on Red Sox or Yankees deals before the deadline?

Messaging the Enemy

2007-07-30T06:28:00.001-07:00

I'm actually not so sure that it is possible to generate crisp statements of principle on something as complex and, frankly, poorly defined as terrorism. I'm writing this post before diving into Powers's article, so perhaps I'm speaking out of turn, but I think the first order of business is to educate the public that "war on terrorism" is a foolish, counterproductive approach. It paints a black and white world, when there are oh-so-many shades of gray. But how do leaders explain complexity using simple terms, I just don't know. When it comes to fear, shades of gray just do not compute. Life vs. death is a binary choice, so most expect our policy should be as clear-cut and this is why the Republican approach of us vs. them, kill or be killed holds sway. How do we move from that clearly understandable, even if wrongheaded, position to one that is smarter, but a lot more difficult to distill into pithy statements and one-way-or-the-other decisions?

In the Cold War days, policy nuance was actually possible because the Communist enemy was at least operating with the same strategy -- territorial control to gain political control. "Winning the hearts and minds" was a "simple" matter of getting more people in more countries on your side. Now with a diffuse enemy that is essentially nihilistic, such a calculus no longer applies. How do you fight back against an enemy that has no interest in self-preservation?

As you can see, I have no answers, which is what makes blogging so relaxing. I can spout off at the mouth (i.e., keyboard) and am accountable to no one. Unfortunately, way too many columnists who are paid to do what they do, have adopted the same attitude.

2008 Issue - Terrorism

2007-07-28T09:14:00.000-07:00

This review is a thoughtful overview of the much of the current state of the "War on Terror". I like Power a lot. She's smart, balanced, and appears to let facts rather than ideology primarily inform her observations and prescriptions. (Or maybe I'm just saying that because I agree with her.) :)

She is right on in pointing out that the Democrats have not put forward any clear and compelling message on how they would address the al Qaeda threat. "Work more with our allies" doesn't cut it. I don't think that having an intelligent and nuanced strategy means that you can't find a crisp, attractive way to communicate it.

Pop (Culture) Quiz, Hotshot

2007-07-27T14:30:00.000-07:00

I'm very, very excited about seeing The Simpsons movie tonight. There was an interesting discussion on the AV Club site about how influential The Simpsons has been, and whether a TV show can truly be influential.

My question to you is, what would you consider the most 5 influential (in terms of broadly influencing society) pieces of pop culture in our conscious lifetimes.

It's just a fantasy...

2007-07-25T18:06:00.000-07:00

You know how there is "fan fic", where people take off from say the "real" Harry Potter universe and write new stories involving the same characters. Well, I think you might have a future doing that with the Democrats. It takes about $150 million to run for President, and Nobel prize or not, I don't know who is going to give the Goreacle that kind of money. If he does win the prize (and they might do it just to stick it to W), it will be a 3 day story in the news, some fodder for columnists, and then it will be back to our regularly scheduled programming. I think Dem voters see Gore, like Kerry, as a loser whose time is passed, and nothing can change that. But it is interesting to think about. :)

Actually, if we want to think about a combination that would really be great for America in terms of moving us forward and getting things done, how about Bloomberg/Obama. Bloomberg could take the rational/results-oriented approach to hard problems that he has in NYC and Obama could give us all a collective hug and help provide a more inspiring meaning for the administration. And I do have the same fear that you (and our friend Neil) do, that Bush(4)-Clinton(8)-Bush(8)-Clinton? is an entirely disspirting sequence for most Americans to contemplate. More of the same, coming up.

In terms of the media's role, I really don't think I can say much about that with any confidence. I never watch the news on TV, get most of my news from the NYT, NPR and Jim Lehrer News Hour and most of my commentary from those sources plus The Economist, The New Yorker, Washington Post and a few blogs. Needless to say, a somewhat biased slice of the media universe. :) And since I don't have cable, I can't even learn about the MSM from their skewing on Colbert and The Daily Show.

With that as prologue, overall, I think the broadcast media (3 networks and CNN) tend to play it pretty safe, and probably have since the beginning of TV. They are a forum for the views of the 2 parties (so we can't blame them for not getting the Dems' message out when we don't have one), and try not to offend anyone so they can garner the largest audience possible. Before the Iraq War, both parties were for it along with 70% of the American people (IIRC), so the MSM's coverage was framed by that. The reason why we remember Murrow coming out against McCarthy and Cronkite against Vietnam is that those instances are so rare. (And even those two were hardly ahead of the curve.) But I'm willing to be convinced that I'm wrong. And we could have a robust future discussion on what a healthier media in a democracy would look like. There certainly are many other models around the world.

BTW, I see the immigration debacle differently that you. This was W's baby, and the Dems were happy to push it as it's good policy and very popular with one of our constituencies. But it's a hot button issue for a lot of noisy, core GOP voters, and GOP reps didn't see the benefit in carrying water for an unpopular lame duck President on an issue that their loudest constituents opposed. Amnesty for lawbreakers is bad. It's bad. Let's just hope than no one reminds us that Reagan dd exactly that. And, yes, that AG montage was depressing beyond words. He should just come out as gay so Bush would fire him already.

Reality and Fantasy

2007-07-25T10:49:00.000-07:00

I guess you are right about the Dems also playing politics to advance their political -- rather than a policy -- agenda. And you have it right on the way they have taken on Bush, re: Iraq. Still, I think that the GOP version of politics is just meaner and less concerned with results other than who is in power than the Dems' version. And your point about hitting singles and doubles confirms my perception, I think. The several instances where the Dems have actually tried to get good legislation -- relatively speaking -- passed, the GOP has simply blocked it for no other reason than that they could.

Immigration is the prime example, of course. Here was legislation that most thought was a reasonable compromise. It would have made some progress on the issue, even if it left some particular problems unsolved. A vast majority of Dems voted for it and a vast majority of GOP against it. The only gain the opponents could have been seeking was blocking good (again, relatively speaking) policy to stick it to the Dems. There is no way that there is going to be better legislation -- better, in their view -- passed in the forseeable future. The only gain they were seeking was the loss of the Dems; they didn't care about the issue itself. Then the GOP and its noise machine turn around and blame Dems for the inaction.

And, BTW, the press is largely complicit in this game, often reporting failed legislation as the fault of Dems, rather than the GOP minority which has a filibuster-proof majority, which it uses relentlessly. (There was a graphic I saw the other day which showed that if the current pace keeps up there will be about triple the number of filibusters -- or threatened filibusters -- as any time in modern history.) Unless the public starts to understand exactly why Congress has been so ineffectual, the Dems will continue to lose in the court of public opinion. The press, IMO, has a responsibility to make this point crystal clear, but they fail to, time and time again.

As to the debates, I honestly haven't watched them much. I agree with you that Clinton has come across as capable, smart and moderate -- all the qualities that I think are in high demand in this election cycle. Overall, though, I must say that I think, for me, it is Obama who consistently hits the right notes. I am concerned he lacks experience and that his ideas and personality are built more for campaigning than governing -- much as we are experiencing here in Mass. with Patrick -- but I do think that he has the right balance of candor (or at least what seems like candor), depth and, frankly, attractiveness to win over a lot of votes. I'm not convinced I'll be voting for him, but I do remain intrigued. That said, I remain highly skeptical that a black man can win the presidency and, espcially, a man whose middle name is "Hussein" and whose last name is one letter different from Enemy #1. The 5% of the public that actually makes the decision in presidential elections -- the least informed, most swayable portion of voters -- just will not be able to look past that totally irrelevant fact.

OK. So here's my fantasy -- a fantasy that will never happen, but, in the very, very, very, very unlikely chance it (or something akin to it) does, then I can at least say that I predicted it would. (Of course, I could also make the same argument about predicting the Blue Jays to win the World Series.) In October, Gore wins the Nobel Peace Prize. He decides then to put his hat into the ring, but first he makes a phone call. He calls Obama and offers him the vice presidency and promises to serve only one term. I don't know if a pres. and VP candidate can legally run together in the primary, but they do figure out some way for Obama to pledge all his $ and supporters to Gore in the primary. Obama cannot win on his own in the general, but Gore cannot win in a head-to-head-to-head against Clinton and Obama in the primary. It seems a win-win for both.

There are so many reasons why this will not happen, but the reason why I have devoted time to the fantasy is because these two politicians strike me as the best hope the country has for overcoming the very phenomenon you note: the public's disgust with placing politics ahead of sound policy and governing. Perhaps that very notion that leaders can have that much power to change culture is a fantasy in itself (not to mention the fact that these two men are the right ones to do it), but, certainly the way that our current "leader" has so poisoned politics, I'd like to think it can work in the opposite direction, as well.

And that, my friend, is how the mind of an idealist who has lost all hope operates.

BTW, if you have a chance, check out Josh Marshall's video of Gonzales's testimony yesterday (at www.talkingpointsmemo.com). If anyone has any doubt about the poisoning of our politics that this president has wrought, the literal -- not legal -- contempt of Congress the AG shows is one more piece of evidence.

More winning moves

2007-07-25T08:07:00.000-07:00

An addendum to my last post. I think that one of the smartest things that the Democrats did during the Clinton years was to neutralize 3 traditions strengths by putting forward, sensible, moderate proposals to solve real problems -- welfare reform, balanced budget and crime. There are lots of areas now we could do the same -- tort reform, abortion reduction, marriage promotion, AMT. It means putting something out there which could be criticized, including by some of our allies, but until we get a Democratic leader who can put forward a compelling vision of what our party stands for, at least we can address some of our perceived weaknesses and hopefully make some real progress.

Just Win, Baby

2007-07-25T06:55:00.000-07:00

Interesting. I've got a few thoughts on that. On your first question, I think that the Democrats do play that game, but just not as often and not as well as the Republicans. (For example, they are totally trying to have it both ways now with the war. They could have cut off funding for the right after the 2006 midterms, but they would rather complain about Bush rather than take the heat for the consequences of ending the war now.) There is that book which was just written saying that the GOP wins because they understand that people make political decisions for emotional reasons, not rational ones, and I think there is a lot of truth to that. The Democrats too often think that just having the "best idea" and explaining it again and again is enough to win. The GOP is much more willing to play in the field of images, values and emotions.

BTW, I like Drum a lot and agree with his general point, but those examples are pretty weak. I haven't heard the GOP saying that Katrina shows that we don't need the federal gov't to be involved with our lives, and, as much as I don't like privatization, neither party can be particularly proud of its role in letting the Social Security (and Medicare) problems balloon over the past 25 years. At least the GOP put a solution on the table. The Dems seem to still be much more comfortable playing defense than putting anything out there that could be criticized or would alienate one of their core constituencies.

On your 2nd point, I think that the American people are tired of this "you're lying, no you're lying" era. I think the 2006 election was a referendum first on the war, and second on getting something accomplished in Washington. Bush is willing to play chicken on the war funding, so the Dems aren't willing to end the war at any cost. I think that the winning move for the Dems is to pass a series of popular "singles" and publicize them, minimum wage, student loans, limiting earmarks, and send some doubles and triples that will be hard for the GOP Senators to vote against, even if they get vetoed, like children's health coverage. Then they have a positive record to run on in 2008 -- some things they have actually accomplished and more that would have gotten done with a Dem in the White House. Right now only something like 20%-30% of the US thinks that Congress is doing a good job. You can't argue with 80% of the population, but you can try to get some things done. People think of this Congress for immigration and not ending the war. The Dems in Congress need to spend their time on something positive to change those perspectives.

On a related topic, what are your thoughts on the results of the debates? I had a crazy idea pass through my mind, which I guess the Clinton campaign is hoping will prevail. If you had never heard of or saw Hillary before, you'd think, "Boy, she seems smart, decisive, reasonable, very well informed. I think she'd make a pretty good President." If you can see past the baggage, she's a good candidate. Hmm, maybe if enough people try to just look at her instead of being blinded by everything they already have heard about her, maybe she could get 51% of the vote.
Am I crazy? I had been in the camp of "you can't win if 40%+ of the country already doesn't like you". Is my optimism and sheer psychological need to believe we'll end this 8 years of mismanagement outweighing my rationality?

The GOP MO

2007-07-25T06:32:00.001-07:00

Here is a quote from one of my favorite bloggers, Kevin Drum of WashingtonMonthly, in reaction to news that the GOP will use the August recess to make the argument that Reid has failed to move forward on any major legislation this session: "You have to give Republicans points for consistency. They bring the Senate to a halt and then blame Democrats for not getting anything done. They destroy FEMA's ability to respond to natural disasters and then hold it up as an example of why you can't trust government to do anything right. They lose a war via unparalleled military incompetence and then claim that liberals are defeatists for pointing it out. They spend 20 years claiming that Social Security is going bankrupt and then use the resulting public insecurity about Social Security as an explanation for why the whole system needs to be privatized."

Two questions. First, do the Democrats engage in such blatant chicanery, but I am just too partisan to see it or are they really just fundamentally more honest about policy? Second, assuming that the American public actually is persuaded by the GOP's specious position(s), how do the Democrats convince the public that the GOP is, to put it bluntly, deliberately and maliciously lying?

Talking baseball

2007-07-23T15:04:00.000-07:00

I didn't follow the Sox results that closely over the weekend, but this is clearly a very talented team. I have a hard time seeing the Yanks catching them or the Sox not making the playoffs. I know they've been close to .500 the past 6 weeks or so, but this is a team that, barring additional injuries, should play better down the stretch, as the get Schilling (and hopefully Ortiz) back, add Lester and potentially Buchholtz (sp?), probably improve via trade, and keep getting the benefits from guys shaking off the first half rust (Manny, Crisp, Lugo). Solid SP, very strong pen, excellent offensive talent, a pretty big lead and no more curse. I'd say there's at least a 80%-90% chance the Sox make the playoffs. I'd put Yanks at no better than 40%, which is assuming an upcoming move bigger than adding the lesser Molina.

In terms of trades, I think that the Yanks will make a 1B/Util-type upgrade, like Wigginton, and probably a middle reliever too. Duncan's hot start makes them less likely to go after a big name 1B. Cashman's MO seems to be to not add any long-term contract commitments and to not give up any of their top 10 prospects. That plus Helton's seeming decline and the Coors Field effect I think makes a deal for him unlikely. And I hear that Texas is looking for a whole lot for Texiera after feeling that Daniels got burned big time in his last 2 big trades. (Soriano and Chris Young.) It seems harder to get a big trade done than in a past. I'm not sure if this is because past experience and the new CBA and leading to so many teams are following the same strategy (keep your young studs and buy out their pre-arb years and don't rent a star for only 2 months if he will become a FA at the end of the year) or if there is some other reason.

I don't know about the record for runs in a series or in 3 games, but I'd have to believe it was set in Colorado or in the run-happy early '30's. (Actually, 2 mins of quick 'net research turned up a 47 run series by the Dodgers in the '50's (where they only went 2-1!) and a 48 run series by KC (Athletics?) in the early '60's. Weird. I wonder if there was some strange weather involved, lots of minor league players just called up, or if it's just like flipping a coin a million times and seeing 20 heads at one point.)

On that topic, I believe I've noted over the years that I'm a bigger believer in "luck" in sports that you, my fellow co-blogger. While I acknowledge that the games are decided on the field by real live human beings, as susceptible to stress and bad days as the rest of us, and not by rolls of the dice ala Strat-o-matic, I do think that explanations such as "knowing how to win", "wanting it more than the other guys", and "great team chemistry" are much more often appealing labels placed on post facto results rather than truly explanatory (and predictive) elements. One baseball piece of evidence is that records in one-run games tend to be relatively random, within seasons or from year-to-year, with the exception of varying based on bullpen quality.

Short post

2007-07-23T15:03:00.000-07:00

Amen.

Three Games Each

2007-07-23T07:54:00.000-07:00

Could this weekend have been any better for our respective teams? I hadn't heard definitively, but did the Yankees break a record for runs scored across a span of three games? If not, I'd have to think it was pretty close to the record. C'mon, 45 runs in 3 games? That is freakin' ridiculous!

As for the Sox, Friday night's game, to my mind, was a pivotal moment. Robbed of two runs in the first inning because of a botched call, the team still came through and, especially, the three players who had been struggling most -- Crisp, Lugo and Drew -- carried the team on their backs. We hadn't seen that kind of balanced win since May and it felt good. It reminded us of what this team is capable of. And, actually, reminded me of the game in 2004 against the Yankees when Mueller hit the homerun to win the game. The mood in Boston then, as it was on Thurs., was one of desperation. "Please let us know that you have some life in you... that you actually care about winning," seemed to be the consensus. And then they showed that actually winning was possible and important. The next two games were icing on the cake.

It occurs to me that both our teams were facing the dregs of the MLB in our victories, but earlier in the year (and more recently in the Sox case) those dregs were beating us up, so these are the games those expecting to win a playoff spot absolutely have to win. And we did.

Should be an interesting run down the stretch. I still think the Yankees will close the gap a bit from the current 7 games, but won't catch the Sox. Yankees pitching overall -- especially the bullpen -- is just not as strong as the Sox.

Sox, meanwhile, I think are poising for a significant trade. Not much out there, I know, and not much buzz so far, but Gabbard is at his peak trade value right now and with Lester back in the rotation, Tavarez, who has value for some teams, is expendable (or so the Sox would like to beleive). I somehow think Theo will strike while the iron is hot. Perhaps some bullpen help, like that guy Marte from Pittsburgh. Personally, I'd like to see the Sox take a shot at Oswalt (HUGE long shot and don't think the Sox are quite willing to part with what it would take to get him) or Saltalamacchia (still a long shot because so many other teams are hungry for catchers). We'll see. IMO, Yanks are going to get Texiera or Helton. What do you think?

The best news for Boston fans is that even if the Sox fall down flat, we still have the Patriots. (And, yes, that was a dig at Jets' fans.)

Clean up, clean up...

2007-07-20T08:05:00.000-07:00

I confess to a mild exaggeration. I haven't seen the movie of The Lion King, but I did see the play. (And I have some passing familiarity with the source material too.) :)

Re: Bonds and the smell test, if he would be embarrassed to see it reported in the press, I'd say he knows that it's wrong. There is a reason beyond the illegality that no active players have admitted steroid use. In terms of competition, I think there's a baseline in sports of playing hard and trying to win, which include keeping in shape and doing what a "reasonable person" who wanted to win would do. Going above and beyond (like crashing into walls, running full steam on pop-outs, ala Pete Rose) isn't required, and I would put using illegal, harmful substances into that category.

Re: the business argument you suggested, that's why companies strongly prefer the "umpire" to set and enforce firm rules to establish a level playing ground. (Like environmental rules re: NAFTA, national health care re: UAW or Wal-Mart, anti-bribery regulations re: MNC's, and steroids rules re: MLB.) So, while the failure of the "umpires" to act should be a mitigating factor, I still contend that the "smell test" is an awfully good common sense indicator of when wrong is being done. I appreciate your thoughtful response in not jumping on an anti-steroids bandwagon, and there are shades of gray, but let me ask you a black and white question. If your kids were in Bonds' situation, would you have wanted them to do steroids?

Yeah, McCain is a huge head scratcher. I'm still shocked that he isn't the front runner. And you're right, it is ironic that McCain, who was W's biggest GOP enemy for so long, will take the biggest political hit for W's failings. But I actually lay the blame for this mostly on McCain and not the American people. Once you set yourself up as being "not a regular politician", you have to be purer than Caesar's wife. I think "the kiss" killed McCain's maverick image (and credibility) just as surely as "the tank" killed Dukakis. An indelible image that fixed a negative character trait in people's minds. If McCain hadn't run towards Bush before running away from him, he'd be having a much easier time now.

What I do fault the American people for is their reluctance to see shades of gray and their attraction to the flavor of the month. There should be space for politicians to fail and to run again. But it seems that a loser's mantle has become an unforgivable sin. I don't think that the Democratic field would be better with Gore or Kerry, but both were far more than their caricatures. We run from cognitive dissonance so quickly (how could Kerry have been a brave soldier and also against the Vietnam War?) that we degrade ourselves and the people who feel that they need to present a simplified image of themselves to pass through the media gauntlet and get elected. I think the "old news" and the hypocrite factors are hurting McCain more than his hawkish stance on the war now. (After all, are his positions really significantly to the right of Thompson, Romney or Guiliani?)

Tidying Up and Moving On

2007-07-20T07:30:00.001-07:00

Wait a second. Do you mean to tell me that you've never seen "The Lion King"? It's like I don't even know you anymore.

As to responding to your Bonds post. Let me start with the bottom line: I'm not convinced. I sort of buy your argument about passing the "smell test", but let me counter that with the facts. At the time Bonds was taking steroids, a huge portion of his teammates and, more importantly, his opponents were taking them -- at least according to some reports. Even if by normal human standards, steroids seems unethical, the frequency of their use certainly took away some of the stench. Building on that point, let me pose a question straight out of the bar course sponsored by the Devil's law school: what kind of competitor would Bonds have been if he refused to take steroids? I mean, if you were a director sitting on a board of a technology company that refused to use some software pirated from a Chinese company just because it didn't seem ethical, but all your competitors were using it, wouldn't you have an obligation to push them to use the software. I mean, how responsible would it be to shareholders if you knew that not using the pirated softward meant that your company would suffer, in a relative sense?

Believe me, it brings me no pleasure to defend Bonds, but I still think that his actions are not absolutely wrong and there is way too much gray in his case -- and in the case of so many other athletes -- that it is difficult to take an absolute stand against his actions. It is a knee-jerk reaction, it seems to me, to take a stand against steroid use. I am merely trying to resist that reaction.

By the way, as to your point about holding athletes to a higher standard, do you think we should send your thoughts to Michael Vick? Now, there is an absolute wrong that I can get behind.

On to a topic that has been bothering me. What the hell happened to John McCain? Here is a guy who is as principled as they come and he totally took the fall for being principled. As Gail Collins noted in her OpEd yesterday, it is a myth that Americans appreciate principled politicians. They only like principled politicians who agree with them. Still, I feel like this guy has suffered more than he should have and that perhaps of all the political victims George Bush has left in his wake, McCain is worst off. Don't get me wrong, I could never support a McCain presidency, but at least he has the gumption (most of the time) to live true to his political stands. His fall, IMO, speaks volumes about how broken our system is.

P-Day

2007-07-20T05:35:00.000-07:00

I enjoyed your rundown of your kids' actual and potential relationship with Harry Potter. I'll be curious how kids who haven't read the books yet will interact with them in the future? Is there a classic (and still very popular) piece of children's literature that kids encounter first as a movie? Or is there something about discovering that private world on the page which resists that public projection on screen? I can't remember if I read Willy Wonka (aka Charlie and the Chocolate Factory) before I saw the movie, but it was one of my favorites as a kid. On a serious note, I wonder if these fantasies of the ordinary, anonymous kid being thrust into a major role in a magical world (Oz, Wonka, Middle Earth, Hogwarts, Star Wars, etc.) are also the archetype of popular children's literature in non-Western cultures which are less focused on the individual. Any places you can think for us to look for evidence?

BTW, I remember that you were telling Emily an original, extended goodnight story at bedtime when she was younger. When did you start that? There's only so much more of "Pajama Time" I think I can take. :)

Re: the value of reading for its own sake, that is a very interesting question. We'll have to save the "deep dish" topic of the quality of art for another day (though I'm inclined to agree with you that today's popular fancy may be tomorrow's art). On the one hand, I agree with the received wisdom that reading is a good thing, encouraging imagination, reflection and a depth of experience that watching TV (for example) doesn't foster, and that those "skills" are both useful and just plain enriching for an adult life. But, I do think we should be on guard against the prejudice against the new. Perhaps in the future, the skills fostered by the Nintendo Wii (or Facebook) will be viewed as most essential for participants in a thriving democracy. :) Have you read any Montaigne? I did back at Brandeis, and have been thinking more about him recently. Perhaps that could be a future project for us, to pick an essay or two and see what that sparks.

Thanks for your G-rated movie reflections. (And thanks for giving away the ending to The Lion King! To return the favor, Rosebud was a sled. :) ) Any additional Bonds/roids thoughts? Two HR's away. I read one BB-blogger who reflected on the mixed emotions surrounding Maris' and Aaron's feats and thought that 30 years from now, people would look back on this chase fondly as well. I think not. Moving past nostalgia is one thing. But "condoning cheating" in achieving "the most famous record in sports" is something else.

Potter's Popularity -- So What?

2007-07-19T11:21:00.000-07:00

As I write, I can see the blocks falling before my eyes -- and they all fit so perfectly in place. Unfortunately, I'm not sure my thoughts will convey the same symmetry and sense of satisfaction.

To answer the easiest question first, my girls have not read and have no plans to read Harry Potter. Emily claims that she doesn't like "fantasy" books. Given what I have heard about the elegance and gripping-ness of Rowling's writing, I am disappointed that she has not given them a try. (In general, she is not much of a reader, which gnaws at my bibliophilic identity, but, as you will learn, you do have to let your kids be true to themselves and not your vision of what you want them to be.) Shira looks to be a bit more of a reader, but has not read the Potter books. Perhaps she will someday. Jonathan, to sound boastful, could probably read the Potter books now, though only in a technical sense. He wouldn't understand the words. We'll give him a couple of years.

By the way, as the last paragraph suggests, I have not dug into them yet either. I generally resist popular trends -- especailly with books, where I am incredibly priggish in my tastes -- but I will probably take them up someday. Perhaps I'll read them together with Jonathan.

Actually, the Potter books pose an interesting cultural question and one that pops up in the education world frequently: is reading instrinsically a positive activity or does the content matter? As kids storm book stores to get the latest Rowling offering, most would be inclined to answer that a positive attitude toward reading among youth is a good thing, no matter what, but what if, some cultural critics counter, they never progress from Potter to Shakeare and Dickens? And, more to the point, does it matter? Who is the cultural arbiter that says that Rowling's books aren't as intrinsically valuable as "David Copperfield"? (As another aside, I have taken up "Great Expectations" recently, as the last time I read it was in high school. Without disparaging Mr. Dickens too much, I can certainly see the point of those who argue that Victorian literature is not magically better than 21st century American literature.)

To your more philosophical question about exposing kids to pain and loss in literature, I'm not sure I have any deep or original answer. I tend to think you need to weigh each instance separately and make a judgment based on the details of the situation, the personality of your kid(s), and, frankly, what you want the outcome to be. I remember that when we first got "The Lion King" on video, we would, when Emily was watching it, religiously skip over the scene of Mufasa's death. Finally, when she was about 4 1/2, we let her watch the movie the whole way through, fearing the worst. Guess what? Not an eyelash was batted. Partly because kids don't really know what death is -- at least in our upper-middle class America -- they don't really have a sense that there should be an adverse reaction. Needless to say, Shira was a lot younger when exposed to that scene. Other than her irrational fear of wildebeasts, you can't even tell!

Seriously, I think the bottom line is that you shouldn't fret too much. Kids are remarkably resilient and so such exposure is not too taxing on their minds. Of course, I wouldn't go take Abby to "Friday the 13th" movies any time soon, but when exposure to pain and loss in art is limited and in ways that aren't psychologically jarring because of their graphic or intense nature, there is nothing to fear. Lesson of the day: G-rated movies are safe.

Issue of Tomorrow

2007-07-19T09:47:00.001-07:00

Here's a question for you, Dave. What do you think about the Harry Potter phenomenon? Are your girls into them? Are you? And, more broadly, what is your attitude, experience and feelings towards your children meeting experiences of loss and pain through art? As still a relatively new parent, I'm looking to learn from those who have trod the path before me.

Bench-pressing Issue of the Day

2007-07-19T08:04:00.001-07:00

That is a good, juicy issue to start off with, one which I have many thoughts about.

Let me start off with my overriding perspective of how I think about this. First, sports is a special realm in our society. We've talked about this before. It is completely illogical and irrational for anyone to care and/or think that it matters what a few grown men do throwing, hitting, kicking, catching or otherwise propelling little (or large) balls. Yet, in every "advanced" society that I know of, sports are a significant part of the culture, and of immense interest to much of the population. Why? My guess is that there are 2 main reasons.

First, sports provide much of the same function as myths. Humans crave meaning and life can often seem like a "tale told by an idiot, full of sound and fury, signifying nothing", to quote some British dude. Sports provides a clean through line, a simple field where success or failure is immediate and clear and determined by our own efforts, where opportunities for redemption are always arriving. Our own struggles and arenas are mirrored, smaller yet larger, in a way we can better understand, and even learn from.

Secondly, I think that sports provides a civilizing function. Instead of young men trying to kill each other or countries warring for blood and treasure, countries and cities and individual meet on the playing field and play out these conflicts in a less violent way. It's no accident that the fiercest sports rivalries are between locations with some real emnity between them.

So, all of this is to say that I think we should, and often rightly do, hold sports figures up to a higher standard. Sports for kids is a venue to learn how to play together, work together and compete together, how to win and how to lose, and how to learn right conduct, what used to be called "honor". Just "not breaking the law" isn't a sufficient standard for sports figures, particularly those who contend to be our biggest heroes.

The business world uses a bi-level ethical framework (all evidence to the contrary accepted). The first is the "legal" level. Does our conduct break the law. The 2nd level is the "Wall Street Journal" level, or the smell test. Does this seem wrong? Would I be embarrassed if this behavior was printed on the front page of the Wall Street Journal, even though it is legal. I guess I would call that societal mores.

To that I would add one more level --the "soft" categorical imperative level. "Would it be OK if everyone acted like this?" (The "hard" categorical imperative level -- "Would I actively wish everyone to act like this?" -- isn't needed in this realm.) I think all 3 of these levels should inform our moral judgments.

In baseball, as in life, there are "rules" and there are "rules". Take speeding 5 miles over the speed limit. It's against the law, but I think it passes society's "smell test", and it would be broadly OK (i.e., not harmful) if everyone did that. (As they do today.) Similarly, baseball has informally decided that some actions are OK, like stealing signs from the dugout, while others are not OK (like the batter peeking back to see where the catcher is set up), even if they are not prohibited in the rulebook.

So, let's look at possible performance enhancers -- exercise/nutrition, caffeine, "greenies", steroids, HGH. All were "legal" in baseball until recently. Maybe all passed the baseball "smell test" until recently too. In terms of exercise/nutrition and caffeine, they pass the "soft" categorical imperative test -- there is no harm to everyone doing them. Greenies and steroids are illegal, so fail that aspect of the broader societal smell test. And steroids in particular have very harmful effects on the body, so it fails the "soft" categorical imperative test. It clearly would not be OK for everyone to be doing steroids, both in terms of their own health and their impact on younger athletes. HGH is in a funny category. It is illegal, but its harmful effects have not yet been proven. I would say that it fails the soft categorical imperative test too. Would it be OK for everyone to be taking any untested, illegal, potentially harmful substances? Seems like the potential risk and harm from that is too high. The line between nutritional supplements and potentially harmful "drugs" is a fuzzy one, but governing (and legislative) bodies should help to define it, and these two "extra-legal" ethical tests can assist in that.

To bring this back to Mr. Bonds and the other users of banned or illegal substances, they exploited a loophole in baseball's rules and broke the law knowing that they were doing something wrong. They deserve a certain amount of approbation for that. At the same time, the powers that be in baseball (owners, commissioners, union) were quite aware of this behavior, and share culpability for allowing it to continue for so long. I don't think that any steroid user from prior to the ban in baseball deserves to be punished by MLB for their previous use.

The HOF is a different story. That is a place to honor the games greatest on-the-field heroes. (BTW, the HOF is completely separate from MLB. After the Pete Rose ban, the HOF voted to permanently exclude anyone on MLB's lifetime ban list, but they could lift that at their discretion.) If someone was a racist, a jerk, an alcoholic, didn't pay their taxes, but what they did on the field did not compromise the integrity of the game, they should be eligible for election. (Just like if there was an artist's Hall of Fame, there would be a lot of misogynists, alcohols, bad parents and racists in there too.) Their sportsmanship and behavior should be taken into account with respect to what happened on the field of play only.

If I were a voter, I would not elect anyone whose record without use of dangerous, illegal substances most likely would not deserve enshrinement. I also would not elect non-players who share significant complicity in enabling the continuing use of these substances. (Like Selig and Fehr.) I would elect players like Bonds whose statistical record prior to presumptive PED use would have ensured induction. I could see a strong case for keeping players like that out, but I hate to see only players punished for the abuses of an era.

Pressing Issue of the Day

2007-07-18T13:07:00.001-07:00

I know you said you were going to start this little project off, but I'm eager to get started, so I wanted to start on a distinctly non-political topic. I imagine that as we get rolling into this thing, politics will occupy much of our "ink" space, but I wanted to begin with the number one issue in baseball today:Bonds. (Full disclosure: I sent a modified form of this post to a baseball blogger. I haven't heard back from him yet, so I thought I'd expand the circle of my inquiry.)

I don't know where you fall on the pro-Bonds/anti-Bonds scale, but many people I respect (and many I don't, of course) believe that Barry Bonds has de-legitimized himself as a player because he took steroids, but my question is: why? There are really two issues that inform my question. First, what constitutes “cheating”? Why should steroids be considered cheating and not, say, weightlifting or caffeine? Are steroids worse than testosterone injections? What about human growth hormone – a substance natural enough that, as Selig mentioned, there is no test for it? In other words, where should the line be drawn? What enhancements to the body or body processes are acceptable and what are not?

The second issue arises from the first, but in a more legalistic context. As I understand it, at the time Bonds (and McGwire, Sosa and all the others) admitted to taking steroids, these substances had not been banned by MLB. If so, this means that the charge of “cheating” is purely an ethical one, because it is not possible to be a breaker of a rule, if there is no specific rule that is being broken. Am I correct? Is the “cheating” Bonds and others engaged “just” morally wrong or were they breaking the (baseball) law? If it is the former, then, by rights, he cannot be excluded from the HOF because he did not violate any rule of baseball in his play of the game – at least at the time he is accused of taking steroids.

It is difficult, I think, to separate out Bonds’s selfishness, disrespect for the game of baseball, inability to be contrite, and general misanthropism from the issue of whether or not he cheated at the game, but, in the interest of fairness, I do think that such a separation needs to made. When it comes to his eligibility for the HOF, I think this distinguishing between the person and his body of work is especially important.

I'm curious to get your opinion.

Come on in, Dave, the water's fine

2007-07-12T20:11:00.000-07:00

Now I'm off to discover how to invite you to join me in this brave new e-world.