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Nice Cost Containment Structure You've Got There... Shame If Anything Should Happen To It

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Will health care reform help slow down rising costs? The Congressional Budget Office, even while totally discounting the slew of new cost-containment methods in the Senate bill, says yes. Conservative skeptics say no, arguing that Americans won't tolerate cuts to even totally ineffective spending on medical care. The Washington Post's Lori Montgomery summarizes the conservative case for skepticism:

Many budget experts also worry that lawmakers may not have the stomach to keep the new taxes and spending cuts intended to pay for the package. Republicans are already planning to offer an amendment to strike more than $400 billion in proposed Medicare cuts from the package, a move that would blow a huge hole in financing for the bill.

Along the same lines, the Weekly Standard editorializes (in an editorial chock full of misinformation and misleading claims):

As for comparative effectiveness research, the reaction earlier this month to new guidelines for breast and cervical cancer screenings shows that Americans don't like it when government panels interfere with individual health care decisionmaking. And congressional Democrats want to go further. The bill's main claim to control costs is the Independent Medicare Advisory Board (IMAB), an unelected body recommending cuts to Medicare.

So, Republicans argue that cost controls can't work, and their best evidence is that 1) Republicans are opposed to cutting Medicare overpayments and 2) Republicans are fanning the flames of public hysteria over cancer screenings. The Standard is also upset that an unelected body can make recommendations to cut Medicare, because that body would be immune from said hysteria (though Congress could still override its recommendations.)

In sum, the argument is that cost control can't work because Republican demagogues are determined to subvert it. I suppose this argument could prove correct over time. But it doesn't strike me as a persuasive case for letting the Republicans win.

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What He Said

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Fred Kaplan articulates an ambivalence that I largely share about an Afghanistan escalation. The bottom line is that there are no good options here for the U.S., and choosing the least bad is a combination of hopeful guesswork and prioritizing national costs and risks.

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Life Just Got a Lot Harder for Arkansas Inmates

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The most obvious tragedy of the Washington police shootings is the deaths of the four police officers. The fact that the suspected gunman is a convicted felon from Arkansas whose 95-year prison sentence was commuted by then-Governor Mike Huckabee in 2000 is a tragedy for anyone currently in prison in Arkansas who might hope to one day receive executive clemency. Just consider what happened in Massachusetts after Willie Horton.

As Michael Blanding wrote in the Boston Globe Magazine a few months back:

In Massachusetts, however, there hasn’t been a single commutation approved by a governor since 1997 -- and there were only seven in the previous 10 years (four for murderers). Over the past 22 years, more than 650 petitions have been denied. In that same period, Delaware has approved hundreds, 12 for convicted murderers. Michigan’s Democratic governor has approved 23 in the past five years; in the prior 12 years, her Republican predecessor approved 34. And from 2003 to 2007, Maryland’s Republican governor granted 15 commutations, including five for life sentences for murder.

It’s no secret why Massachusetts has lagged behind: the memory of Willie Horton, the convicted murderer who terrorized a couple, raping the woman, in 1987 after escaping while on a weekend furlough allowed by then governor Michael Dukakis. The act pretty much torpedoed Dukakis’s presidential campaign a year later when ads showing Horton’s picture and images of inmates going through a revolving door hit the airwaves. Even years later, it lays bare the thorny political calculus of letting a felon out of jail. There is almost nothing for a governor to gain and everything for him to lose should the criminal commit another crime. “Ever since what Willie Horton did to Mike Dukakis, governors are going to think not twice but 10 times before they ever commute anyone,” says retired judge Robert Barton, who presided over the Donovan case. Tufts University political science professor Jeffrey Berry agrees. “If I was a governor’s adviser,” he says, “I would recommend he be very cautious.”

Just last week, Arkansas Governor Mike Beebe granted 10 pardons. If Massachusetts is any guide, it might be a while until he grants another one.

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Whack-a-Mole in Pakistan

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The Pakistani military finally got serious, more or less, and launched a big offensive into Talibanland in South Waziristan. But this important LA Times story says the results have been something less than dazzling:

Pakistani military commanders say that after five weeks of fighting, they are in the final stages of their offensive aimed at crushing Islamic insurgents in South Waziristan, a rugged expanse of mountains and plateaus that for years has served as the primary base of operations for the Pakistani Taliban and as a sanctuary for Al Qaeda fighters.

When the offensive began Oct. 17, Pakistani military leaders said they faced a fighting force of as many as 10,000 battle-hardened militants. Thus far, however, the army has put the number of militants killed at 500.

None of the Pakistani Taliban's top leaders have been reported captured or killed. And accounts from villagers in nearby districts suggest that many militants simply fled South Waziristan.

The story quotes Pakistani officials saying that simply dislodging militants from their hideouts throws them into disarray and weakens their networks. Here's hoping. An important question is whether Pakistan means to follow through and make sure this is the case, or whether this offensive will amount to sweeping dirt under the rug.

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You Rub Our Backs, We'll Enter You to Win Some Books and 5 Gift Subscriptions

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Hey readers, we need your help. Please take this brief reader survey and share your insights on why you can't bear to live without (or with?) us. Complete the survey and we'll enter you to win a package of TNR staff writer books and 5 gift subscriptions, which you can give to friends, family, frenemies, etc., at a cost of $0 to you.

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Trouble for Zardari Means Trouble for Obama

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It's hardly convenient for the White House to see Pakistan's prime minister* president on the brink of toppling just as Obama rolls out his new(er) strategy for Afghanistan, which we care about in large part because we want to see a stable Pakistan. That said, Zardari has been a hapless and ineffectual prime minister president, and it seems that the military basically holds Pakistan together anyway. Dictatorship under Musharaff wasn't exactly a noble condition, but democracy hasn't fared much better.

*Correction: In haste, I called Zardari Pakistan's prime minister; I know better than that. Apologies.

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Does Dubai Matter? Ask Ireland.

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Presumably the rulers of Dubai and Abu Dhabi are currently locked in negotiations regarding the exact terms that will be attached to a “bailout” for Dubai World. We’ll never know the details but if, as seems likely, the final deal involves creditors taking some sort of hit (perhaps getting 75 cents in the dollar, at the end of the day), does that matter?

Dubai probably has around $100bn in total liabilities, if we include off-balance sheet transactions, so total credit losses of $30-50bn need to be assigned. The direct effects so far seem small. HSBC leads the pack, in terms of exposure, but our baseline estimate is a 3 percent loss relative to its equity--not good, but manageable (and the stock already fell 5 percent on the news). The impact among other financial institutions that lent to Dubai seems fairly spread out and mostly within continental Europe.

Korean construction companies and Ukrainian/Russian steelmakers are also affected by the likely fall off in construction activity, but the broader boom in emerging markets is unlikely to be disrupted. The repricing of risk so far does not apply significantly to East Asia or Latin America.

However, there is a worrying impact on Ireland.

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Today at TNR (November 30, 2009)

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As always, be sure to check out economic news on The Stash, environment and energy coverage on The Vine, the latest on health care at The Treatment, metro policy debate on The Avenue, and Marty Peretz's The Spine. Also be sure to take a look at TNR's new blogs by William Galston, Simon Johnson, Ed Kilgore, Damon Linker, and John McWhorter.

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Cheney for Fisherman

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Jon Meacham is clearly an intelligent person and skilled writer, but his judgment about America and what America needs is somewhat inferior to that of my cat Lexie. Last November, he was telling us that the election affirmed the nation’s conservatism. Now he is urging Dick Cheney to run for president in 2012.  It would be “good for the country,” he argues, “because Cheney is a man of conviction, has a record on which he can be judged, and whatever the result, there could be no ambiguity about the will of the people.”  

Let’s leave aside dated comparisons to leftwing parties in Europe urging stark choices between left and right in the hope that the right would discredit itself, and let’s just talk about America. This country has functioned best when there is a widely shared worldview about Constitutional government (e.g. separation of powers), equality (e.g. safety net for those at the bottom), and America’s role in the world (e.g.  important, but not imperial). Think of America under Franklin Roosevelt, Dwight Eisenhower and John Kennedy, for instance. Much of our current woes – epitomized by the sheer craziness of the Republican Congress after 1994 and of George W. Bush’s two terms – is the result of the erosion of that consensus from the right, and the emergence of a frankly supra-Constitutional nationalism on the right.  Cheney began his career as the rightwing of the Old Guard Republicanism of Gerald Ford, but he became sometime during the ‘90s a spear carrier for this new, dangerous right.

It amazes me that someone who has written books about American history, and presumably knows something about the subject, would assume that stark choices between left and right bring about a plausible middle-ground. Politics doesn’t work like mathematics.  Having Barry Goldwater on the ticket in 1964 didn't lead to a more sensible centrist foreign policy, and George Wallace's candidacy in 1968 or 1972 didn't encourage an affirmation of civil rights.   Instead, stark choices embitter and skew and polarize our politics and give credibility to notions that can only bring disaster to the country. Let Cheney enjoy the pleasures of retirement, and let the country enjoy a respite from his dreams of unitary executive and a pre-emptive imperial power.

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1989 All Over Again?

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In a New York Times story on Pakistan and Afghanistan, David Sanger writes:

Inside the Pakistani Army and the intelligence service, which is known as the ISI, it is an article of faith among some officers that the United States is deceiving them, and that it will replay 1989. If that happens, some Pakistanis argue, India will fill the void in southern Afghanistan, leaving Pakistan surrounded by its longtime enemy. So any talk of exit strategies is bound to reaffirm the belief of some Pakistani officials that they have to maintain their contacts with the Taliban — their hedge against Indian encroachment.

According to Matt Yglesias, this makes no sense because:

[It] seems in tension with the other popular theory that we need to stay in Afghanistan because a Taliban takeover would destabilize Pakistan. Or perhaps it’s better to say that the reasoning is circular. To win in Afghanistan we need to convince the Pakistanis that we’re staying forever, since otherwise they’ll back the Taliban and we won’t be able to beat the Taliban which we need to do as a favor to the Pakistanis. See!

I don't see the circularity. Yglesias is assuming that if we leave, and if the Pakistanis decide to once again back the Taliban, that decision will be in the best interest of Pakistan. In fact, as Pakistan is learning all too well, supporting the Taliban can boomerang, and weaken Pakistani security instead of fortifying the country against India. What makes us so confident that this same cycle will not repeat itself?

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TNR on Football

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What's the meaning of football in American life? Over the years, TNR has not been silent on the subject. Read our best archived pieces on the game:

"The Moral Equivalent to Football" by Wilcomb E. Washburn. July 23, 1977. Why football reflects the true--not the ideal--nature of the American character.

"Goodbye to the Bear" by Howell Raines. January 24, 1983. The football coach who was segregationist George Wallace's alter ego.

"Football Morals" by T.S. Matthews. November 26, 1930. College football is not a game. It is war, and every college its own barbarian state.

"Linebacker Labor" by Nicholas von Hoffman. November 1, 1982. Football strikes, capitalism, and American life.

"Becoming a Pro" by James Cramer. November 12, 1977. At the Eagles' training camp, meritocracy really works.

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Slideshow: Eating Holidays Around the World

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Today is Thanksgiving, the holiday in which Americans count their blessings by binge eating, seeing family, and watching television. But we aren’t the only ones who mark time with massive feasts. Click through this TNR slideshow to see holidays from around the world in which other cultures stuff themselves.

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