On Tuesday the duly elected President of the United States will deliver a message to students across the land. The message? Stay in school. Fair enough. Reagan did it, so did Bush Sr. Bush Jr., I remember, went to read to children in a school back in September of 2001. Reagan and Bush Sr. delivered explicitly political messages (Reagan even talked about gun control). Here, for your viewing enjoyment, is the reaction of one particularly unscrupulous right wing talker. Key point: Obama's stay in school speech is "not entirely consistent with the idea of education."
Serious Breaches of Trust
David Broder argues today that while he supports accountability for illegal acts and serious breaches of trust, he does not support investigating illegal acts and serious breaches of trust. I have trouble putting these two claims together:
First, we should investigate and hold accountable the guilty:
My friend and fellow columnist Eugene Robinson has written a characteristically passionate and well-reasoned piece commending Attorney General Eric Holder's decision to name a special counsel to examine possible law-breaking by interrogators of terrorist subjects during the last administration.
But I think he is wrong.
First, let me stipulate that I agree on the importance of accountability for illegal acts and for serious breaches of trust by government officials — even at the highest levels. I had no problem with the impeachment proceedings against Richard Nixon, and I called for Bill Clinton to resign when he lied to his Cabinet colleagues and to the country during the Monica Lewinsky scandal.
I'm all for that as well. Now the second claim:
Cheney is not wrong when he asserts that it is a dangerous precedent when a change in power in Washington leads a successor government not just to change the policies of its predecessors but to invoke the criminal justice system against them.
Illegal acts. The policies of the previous administration may have involved–may have involved–illegal acts. Their being policies of an administration does not remove them from the realm of legal and illegal. At least I hope it does not. Broder continues.
I think it is that kind of prospect that led President Obama to state that he was opposed to invoking the criminal justice system, even as he gave Holder the authority to decide the question for himself. Obama's argument has been that he has made the decision to change policy and bring the practices clearly within constitutional bounds — and that should be sufficient.
Accountability for illegal acts. Now for some self-congratulation:
When President Ford pardoned Nixon in 1974, I wrote one of the few columns endorsing his decision, which was made on the basis that it was more important for America to focus on the task of changing the way it would be governed and addressing the current problems. It took a full generation for the decision to be recognized by the John F. Kennedy Library Foundation and others as the act of courage that it had been.
It's hard for me to understand the logic of this argument. If Broder took the position that Clinton should have been impeached for lying in a civil deposition (lying to the country and his cabinet colleagues was not the crime in question, I think) about the character of an adult consensual relationship with a former employee, then how does it not follow that much more serious crimes (such as torture, murder, conspiracy, etc.) deserve at least to be investigated by the criminal justice system?
If you like it so much
This episode has been repeated all over the place, but I'll repeat it here, just because it is so absolutely emblatic of the dismal state of our public discourse on health care. Maria Bartiromo, a CNBC financial reporter (no really), played the role of a health care pundit yesterday, asking New York Democratic Congressional Representative Michael Weiner, 44, why he wasn't on medicare if he liked it so much. Here is their conversation:
REP. WEINER: Listen, Carlos talks about Canada. You talk about Europe. Let's talk about the United States of America, Medicare —
MS. BARTIROMO: You have to look at where there are public plans.
REP. WEINER: No. No. The United States of America, 40 percent of all tax dollars go through a public plan. Ask your parent or grandparent, ask your neighbor whether they're satisfied with Medicare. Now, there's a funding problem, but the quality of care is terrific. You get complete choice and go anywhere you want. Don't look at —
MS. BARTIROMO: How come you don't use it? You don't have it. How come you don't have it?
REP. WEINER: Because I'm not 65. I would love it.
MS. BARTIROMO: Yeah, come on.
Now this is an obvious attempt, I stress "attempt" at ad hominem tu quoque. For those who are new to fallacy analysis, and ad hominem argument is one where you discount a person's view because of irrelevant (that's important) facts about that person. There are a few ways of doing that. One way is to call their character into question, assail them with insults, and so forth: "your view is wrong because you have a weight problem!" Another way–a very common one among small children–is to charge irrelevant hypocrisy. So if your doctor says smoking is bad, yet she smokes, challenging the truth of the view with the fact of her smoking is irrelevant. The doctor means that smoking is bad for anyone–including herself. Indeed, one of the reasons it is bad is because it's addictive.
Now in this circumstance, Bartiromo, who I am not kidding is a financial reporter for a major US business cable channel, alleges that Rep.Weiner is a hypocrite for not opting for a health plan (medicare) he is not eligible for. That means he can't even be a hypocrite. Now all of this is even more silly from the point of view of the public option–where the government would offer a low cost alternative to private insurance. It's a public option–not a public requirement.
When I hear this stuff–which is all of the time–and then I hear the likes of Michael Gerson, former speechwriter for George W. Bush (think, "axis of evil" and other belligerent pro-life Christian phrases) pronounce:
The incompetence of President Obama's health-care reform effort is undeniable, and unexpected.
No amount of competence could counter the massive lies, distortions, scare tactics, and sheer ignorance of what calls itself "opposition to health care reform." That is the premise of Obama's "defeat."
The ____r is now the ____d
Richard Cohen watches too many movies. For the basis of his op-ed on torture is the ticking time bomb scenario:
Call him Ishmael.
Call him a terrorist or a suicide bomber or anything else you want, but understand that he is willing — no, anxious — to give his life for his cause. Call him also a captive, and know that he works with others as part of a team, like the Sept. 11 hijackers, all of whom died, willingly. Ishmael is someone I invented, but he is not a far-fetched creation. You and I know he exists, has existed and will exist again. He is the enemy.
Now he is in American custody. What will happen? How do we get him to reveal his group's plans and the names of his colleagues? It will be hard. It will, in fact, be harder than it used to be. He can no longer be waterboarded. He knows this. He cannot be deprived of more than a set amount of sleep. He cannot be beaten or thrown up against even a soft wall. He cannot be threatened with shooting or even frightened by the prospect of an electric drill. Nothing really can be threatened against his relatives — that they will be killed or sexually abused.
He knows the new restrictions. He knows the new limits. He may even suggest to his interrogators that their jobs are on the line — that the Justice Department is looking over their shoulders. The tape is running. Everything is being recorded. He is willing to give up his life. Are his interrogators willing to give up their careers? He laughs.
This is really beginning to sound like a joke: the uber terrorist (played, believably, by Maori actor, Cliff Curtis), who knows our legal system and its "rights" so that his sneering makes Cohen's blood run cold. What about that guy, he wonders, what about that guy?
Well, I'll tell you what about that guy. He is the basis of Cohen's "hard case" moral lesson. A "hard case" should you wonder is a notion used by philosophers of law to think about the limits of general rules and such. But it also sounds like the title of a legal-themed adult movie, which is closer to Cohen's point anyway. Here's the moral lesson:
This business of what constitutes torture is a complicated matter. It is further complicated by questions about its efficacy: Does it sometimes work? Does it never work? Is it always immoral? What about torture that saves lives? What if it saves many lives? What if one of those lives is your child's?
Deep thinking. What if blowing up a planet deep in space with creatures uniquely able to suffer pain infinitely saved your child? Would you do it? Well, would you?
In case you weren't shocked by your own willingness to torture people to save "many lives" or "your baby," maybe you'll be impressed by a little bit of absurd moral equivalence:
Attorney General Eric Holder has named a special prosecutor to see whether any of the CIA's interrogators broke the law. Special prosecutors are often themselves like interrogators — they don't know when to stop. They go on and on because, well, they can go on and on. One of them managed to put Judith Miller of The New York Times in jail — a wee bit of torture right there. No CIA interrogator can feel safe. The interrogators are about to be interrogated.
No seriously, I didn't alter that at all. He really wrote that. We have reached new levels of badness here. Skipping to the end:
The questions of what constitutes torture and what to do with those who, maybe innocently, applied what we now define as torture have to be removed from the political sphere. They cannot be the subject of an ideological tug of war, both sides taking extreme and illogical positions — torture never works, torture always works, torture is always immoral, torture is moral if it saves lives. Torture always is ugly. So, though, is the hole in the ground where the World Trade Center once stood.
First you get a little bit of the "who's to say. . . in this complex modern world of ours" argument–call it the self-serving pseudo skeptical argument. Then Cohen converts it into a full-tilt "both sides" are wrong, there must be some middle ground. Top this off with an almost full tilt ever since 9/11 I've been enraged by Chappaquiddick.
The long argument
There seem to me to be a number of good arguments for a health care system not unlike one that works. Ours it not one that works at its primary job–delivering health care. It seems rather its primary job is restricting it and rationing it on the basis of employment, wealth, or oddly, extreme (and undesirable) poverty. That leaves people in a bind, of sorts. If they're extremely wealthy (against all misfortune), it doesn't matter; if they're extremely poor or above the age of 65, they're covered (partially); If they get a job that pays enough, they go off medicaid, and so become poor in a different way again; if they aren't rich and old, they will still live with severely restrictive costs; for everyone else, the wheel of fortune (employment) turns round and round: don't even think about starting your own business (you'll lose your benefits!), getting fired, working for an innovative start-up company with no benefits, living in an area with no access to quality health care (it's true folks), or, worst of all, don't even think of getting sick, for you may still go bankrupt anyway. So those are reasons–sufficient I think–to change our system. Every other industrialized nation in the world has (1) better health care outcomes; (2) pays not nearly what we already pay per person; (3) covers everyone. Those are fairly straightforward facts. The level of direct government involvement in each of these systems varies: a lot in the case of Britain; little in the case of Germany and Switzerland. It has been established by crushing, boring, Al Gore-style reality, that such systems exist, work, and few of the citizens in those countries would dream of switching them for what we have. What does this mean? It means that when folks like Tom Coburn, Senator of Oklahoma, say that it's false that government is the solution, it is right to wonder what the evidence for that view is. The government has been the solution for everyone else.
Normally here we don't make arguments. We criticism them. That of course opens us to the (immature) objection: if you're so smart, etc. This is not an answer to that criticism–which is too silly to be answered. Rather, in light of the enormous weight of the evidence in favor of a health care system not unlike one that works (and there many examples of them), we in America have to have a conversation about things like the following:
Obamacare Version 1.0 is dead. The 1,000-page monstrosity that emerged in various editions from Congress was done in by widespread national revulsion not just at its expense and intrusiveness but also at the mendacity with which it is being sold. You don't need a PhD to see that the promise to expand coverage and reduce costs is a crude deception, or that cutting $500 billion from Medicare without affecting care is a fiction.
Yes, a red herring. Back in 1993–I remember it well–a criticism of the Clinton plan was that it involved "very long" and "complicated" legislation. Here is James Fallows' comment (in 1995!) on this argument:
To say that the resulting package of proposals was "too complex" is like saying that an airplane's blueprint is too complicated. The Medicare system is complex. So is every competing health-care-reform plan. Most of the 1,342 pages of Clinton's Health Security Act (which I have read) are either pure legal boilerplate or amendments to existing law. Conventional wisdom now holds that the sheer bulk of the bill guaranteed its failure. The Nafta bill was just as long, and so was the crime bill that passed last summer. If the health bill had been shorter and had not passed, everyone would know that any proposal so sketchy and incomplete never had a chance.
So I did some number crunching. I threw all my old Technician newspaper columns into Word, removed all paragraph breaks and titles, 12pt. Times New Roman double-spaced and came out to be 342 words/page. I took some representative samples of reports with natural paragraph breaks and section titles, also 12pt. Times New Roman double-spaced, and got between 270 and 300 words/page. Online you’ll find that an average book has between 200 and 250 words/page. I even went and compiled some quick and dirty statistics on the Harry Potter books, which average 255 words/page [no, I didn't control for publishing format, just wanted some quick numbers].
For H.R. 3200, I went and found the number of words per page for 20 random pages throughout the bill. The numbers ranged from 104 word/page to 215 words/page, for an average of about 159 words/page for the 1,036 page health care bill.
If we take these figures for more commonly found page formatting (342, 300, 270, 255, 250 words/page) and translate that to the health care bill, we’d have a bill that is between 485 pages to 663 pages, for an average length of 592 pages.
The last five books in the Harry Potter series have page lengths of roughly 448, 752, 870, 652, and 784. Jared Diamond’s Guns, Germs, and Steel hardcover clocks in at 512 pages. War and Peace is over 1200. Atlas Shrugged is about 1200 pages too.
Take that Randians–Atlas Shrugged is longer than the health care bill! Who could possibly be expected to read it?
In the end, I think it would be nice to have a conversation about reality, but perhaps in the meantime, we can avoid debating about whether a bill is "complicated" (of course it is to some degree, but geez), or "long". Those are just silly red herrings.
Meretricious
Since George Will thought to write a eulogy for Kennedy which included the term "meretricious," we thought it might be entertaining to take a trip back in time. Here, via Hullabaloo via Somerby, is an excerpt from a 1995 James Fallows' article about Bill Clinton's 1993 attempt at health care reform:
Much of the problem for the plan seemed, at least in Washington, to come not even from mandatory alliances but from an article by Elizabeth McCaughey, then of the Manhattan Institute, published in The New Republic last February. The article's working premise was that McCaughey, with no ax to grind and no preconceptions about health care, sat down for a careful reading of the whole Clinton bill. Appalled at the hidden provisions she found, she felt it her duty to warn people about what the bill might mean. The title of her article was "No Exit," and the message was that Bill and Hillary Clinton had proposed a system that would lock people in to government-run care. "The law will prevent you from going outside the system to buy basic health coverage you think is better," McCaughey wrote in the first paragraph. "The doctor can be paid only by the plan, not by you."
George Will immediately picked up this warning, writing in Newsweek that "it would be illegal for doctors to accept money directly from patients, and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem 'necessary.'" The "doctors in jail" concept soon turned up on talk shows and was echoed for the rest of the year.
These claims, McCaughey's and Will's, were simply false. McCaughey's pose of impartiality was undermined by her campaign as the Republican nominee for lieutenant governor of New York soon after her article was published. I was less impressed with her scholarly precision after I compared her article with the text of the Clinton bill. Her shocked claim that coverage would be available only for "necessary" and "appropriate" treatment suggested that she had not looked at any of today's insurance policies. In claiming that the bill would make it impossible to go outside the health plan or pay doctors on one's own, she had apparently skipped past practically the first provision of the bill (Sec. 1003), which said,
"Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services."
It didn't matter. The White House issued a point-by-point rebuttal, which The New Republic did not run. Instead it published a long piece by McCaughey attacking the White House statement. The idea of health policemen stuck…
Through most of 1993 the Republicans believed that a health-reform bill was inevitable, and they wanted to be on the winning side. Bob Dole said he was eager to work with the Administration and appeared at events side by side with Hillary Clinton to endorse universal coverage. Twenty-three Republicans said that universal coverage was a given in a new bill.
In 1994 the Republicans became convinced that the President and his bill could be defeated. Their strategist, William Kristol, wrote a memo recommending a vote against any Administration health plan, "sight unseen." Three committees in the House and two in the Senate began considering the bill in earnest early in the year. Republicans on several committees had indicated that they would collaborate with Democrats on a bill; as the year wore on, Republicans dropped their support, one by one, for any health bill at all. Robert Packwood, who had supported employer mandates for twenty years, discovered that he opposed them in 1994. "[He] has assumed a prominent role in the campaign against a Democratic alternative that looks almost exactly like his own earlier policy prescriptions," the National Journal wrote. Early last summer conservative Democrats and moderate Republicans tried to put together a "mainstream coalition" supporting a plan without universal coverage, without employer mandates, and without other features that Republicans had opposed. In August, George Mitchell, the Democratic Party's Senate majority leader, announced a plan that was almost pure symbolism–no employer mandates, very little content except a long-term goal of universal coverage. Led by Bob Dole and Newt Gingrich, Republicans by September were opposing any plan. "Every time we moved toward them, they would move away," Hillary Clinton says.
Another demonstration of "the merely contingent connection between truth and rhetorical potency."
5 years
This blog has been in business for five years and a few days. I remembered at the beginning of the month that the anniversary was coming up, then it skipped my mind. Sorry, blog. I used to, by the way, hate to call it a blog.
The core idea of this blog has always remained a very simple one: apply the lessons of the most rudimentary skills (such as I have) in critical thinking to the big millionaire pundits and see what happens. I think in five years of doing this, I can say with confidence that George Will, for example, does not make the occasional forgivable error in argument, but rather engages in a systematic and morally despicable kind of activity, that is to say, sophistry. The same goes for the other frequent offenders–see the archives for them.
Sophistry, I think, is a very bad thing. Too many well educated people simply cannot distinguish good arguments from bad ones. They either don't have sufficient factual expertise or they simply don't know what makes a good argument.
For a discussion of one such person, see here.
Over there
I think the health care reform debate, if one can even call it that, ought to be grounded in reality. One aspect of reality relevant to the debate regards what is empirically possible. People seem to take it, for instance, that covering more people and having better outcomes necessarily entails either spending a lot more or getting a lot less. Other countries succeed at it, so perhaps we should at least patiently and honestly discuss what they do. Just a thought.
Clownface
Few people could seriously claim the behavior of the Obama administration has been socialist by any stretch. It is characterized, in the minds of many progressives, by its adherence to Bush-era policies, giveaways to the banking and credit industry, and its obvious reluctance to challenge the insurance industry in enacting health reform. In a sign, however, of just how no amount of democratic caving will satisfy some people, George Will writes:
As memories of the Cold War fade, like photographs bleached by sunlight, few remember the Brezhnev Doctrine. It was enunciated by Leonid Brezhnev in Warsaw in November 1968 as a retrospective justification for the Soviet-led invasion of Prague the previous August by Warsaw Pact forces to halt Czechoslovakia's liberalization. The doctrine was supposed to guarantee that history would be directional, controlled by a leftward-clicking ratchet. It asserted a Soviet right to intervene to protect socialism wherever it was imposed.
We are already testing whether President Obama and other statists who have given his administration and this Congress their ideological cast have a doctrine analogous to Brezhnev's. Having aggressively, even promiscuously, blurred the distinction between public and private sectors with improvised and largely unauthorized interventions in the economy, will they ever countenance a retreat of the state? Or do they have an aspiration that they dare not speak? Do they hope that state capitalism will be irreversible — that wherever government has asserted the primacy of politics, the primacy will be permanent?
Not only is this comparison ridiculous, it lacks imagination. There are probably a thousand plausible things one could say, from the right, about Obama. Comparing him to long dead Soviet Premier Brezhnev–"who is that, by the way?" the young ones will ask–is just shy of Godwin territory.
Rationing
I think right now we have a system that rations health care. It denies it to the 47 or so million people who don't have insurance; it restricts health care to the people who don't have enough insurance; it denies it those people who get sick or have a preexisting condition; and it limits it those people who can't afford the limits and co-pays. The real worry, however, for Michael Gerson, is whether (1) somehow people can afford abortions–a procedure which is legal; (2) whether there will be rationing. To be fair, he admits–sort of–that there is rationing. Rationing done by insurance companies.
The same is likely to be true of end-of-life issues. Talk of "death panels" is the parody of the debate — hyperbolic and self-defeating. But a discussion about the prospect of rationing in a public health system is not only permissible but unavoidable. Every nation that has promised comprehensive, low-cost health coverage for all citizens has faced a similar dilemma. Eventually it is not enough to increase public spending or to reduce waste. More direct forms of cost control become an overwhelming priority. And because health expenditures are weighted toward the end of life, the rationing of health care often concerns older people most directly.
Keith Hennessey, former director of the National Economic Council, puts the dilemma simply: "Resources are constrained, and so someone has to make the cost-benefit decision, either by creating a rule or making decisions on a case-by-case basis. Many of those decisions are now made by insurers and employers. The House and Senate bills would move some of those decisions into the government. Changing the locus of the decision does not relax the resource constraint. It just changes who has power and control."
So he admits it. It would be nice at this point to talk about the effectiveness or the fairness of the current program of rationing. But no.
Because no one likes to ration directly, nations such as Britain and Germany employ "comparative effectiveness research" to lend an air of science to the process of cost constraint. Are "quality-adjusted life years" worth the public expense of a new drug or technology?
This type of question is unavoidable when resources are scarce and planners take charge. They seek to rationalize the inefficient medical decisions of families, doctors and insurance companies. But the very process of imposing a rational structure gives government extraordinary power. And the approach taken by planners is, by necessity, utilitarian — considering the greatest good for the greatest number. Decisions cannot be made on a human scale.
On the rough ethical edges of life and death, American health care has adopted messy, inefficient, decentralized compromises that a nationalized system is likely to overturn. Particularly if that system is imposed on a "go-it-alone" Democratic strategy, the divisiveness is only beginning.
The weird thing about this argument is that the insurance company is now the victim–not the perpetrator–of rationing. On the current system, they're the ones who decide who gets covered and who doesn't. The basis of their choice is a very simple and efficient one: (1) who is not sick; (2) who can pay. The very idea of alternative system, one which bases decisions on care on some kind of principle (and no for Pete's sake it doesn't have to be by necessity "utilitarian") to Gerson raises the specter of Soylent Green. It's people folks, it's PEOPLE.