February 26, 2010

President Barack Obama

Senator Harry Reid Majority Leader

Senator Max Baucus, Chairman, Committee on Finance Senator

Tom Harkin Chairman, Committee on Health Education Labor and Pensions

Congresswoman Nancy Pelosi Speaker of the House of Representatives Congressman

Charles Rangel Committee on Ways & Means

Congressman Henry A. Waxman Committee on Energy and Commerce

Congressman George Miller Committee on Education and Labor

Global warming tends to receive the bulk of attention these days, but it's worth remembering that hotter temperatures aren't the only consequence of putting more carbon-dioxide into the air. As the oceans keep absorbing more CO2, the chemistry of seawater is changing at a fairly rapid clip—steadily becoming more acidic.

Our political debates, our public discourse—on current economic and domestic issues—too often bear little or no relation to the actual problems the United States faces. 

What is at stake in our economic decisions today is not some grand warfare of rival ideologies which will sweep the country with passion, but the practical management of a modern economy. What we need is not labels and clichés but more basic discussion of the sophisticated and technical questions involved in keeping a great economic machinery moving ahead.

The national interest lies in high employment and steady expansion of output, in stable prices and a strong dollar. The declaration of such an objective is easy; their attainment in an intricate and interdependent economy and world is a little more difficult. To attain them, we require not some automatic response but hard thought.

--John F. Kennedy, Commencement Address at Yale University, June 11, 1962 

We deliberate, not about ends, but about means.

--Aristotle, Nicomachean Ethics III. iii

Harvey Mansfield, the well-known conservative professor of political philosophy (and—full disclosure—a longtime friend) has penned a serious and civil critique of what he takes to be the animating impulse of the Obama administration. The nub of his argument is that Obama is a “progressive” whose purported non- (or post-) partisanship is designed to put certain issues “beyond political dispute” so that arguments are about means, not ends. And once the argument is about means, the door is opened wide to “rational administration” and the rule of experts.

Take health care. Mansfield interprets Obama’s statement that "I am not the first president to take up this cause, but I am determined to be the last" as an effort to take the issue out of politics once and for all—to decide, by side-stepping, the fundamental issue of principle. In his view, that issue is: “Should the government take over health care or should it be left to the private sphere?” The question precedes, and trumps, the myriad technical issues that transform the reform impulse into impenetrable, trust-destroying 2,000-page bills. By pursuing reform without dwelling on that question, he writes, Obama's worldview “wants to put an end to politics. It considers its measures to be progressive, and progress to be irreversible.” The problem with progress, so understood, is that it is at war with political liberty, rightly understood. One cannot seek to place matters of principle beyond politics without wanting “an imposed political solution.” Some human beings—and by implication, political parties—love progress more than they love liberty; others reverse the hierarchy. Mansfield stands with the party of liberty, the republican principle, against the party of progress, the party of rational administration, which is “more suited to monarchy than to republics.”

Our political debates, our public discourse—on current economic and domestic issues—too often bear little or no relation to the actual problems the United States faces. 

What is at stake in our economic decisions today is not some grand warfare of rival ideologies which will sweep the country with passion, but the practical management of a modern economy. What we need is not labels and clichés but more basic discussion of the sophisticated and technical questions involved in keeping a great economic machinery moving ahead.

Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.

At a low moment of the Second World War, a breathless young aide barged in on Winston Churchill to report some bad news. Showing the aplomb one fully achieves only within the pages of one’s own memoir, Churchill quotes himself responding: “I’ve heard worse.” That’s the resilience Democrats need.

Treatment readers already know that many health policy experts across the political spectrum support House passage of the Senate bill, with an accompanying fix of the bills various shortcomings through the reconciliation process. Like Paul Krugman, Jonathan Cohn, Ezra Klein, and Jacob Hacker, Tim Jost and I very much agree that this is the best approach.

Yesterday, Tim and I crafted a simple letter (shown below), which we emailed other health policy experts we know. Some are progressives who identify with a single-payer approach. Others are more politically moderate economists, sociologists, and political scientists. Still others identify with organized labor, medicine, or public health.

Within several hours, many outstanding scholars, activists, and practitioners signed on. Signers include Henry Aaron, David Cutler, Jon Gruber, Theda Skocpol, Paul Starr, and many others, including Anna Burger, Secretary-Treasurer of SEIU.

Some people we contacted could not sign on, but reported that they are seeking the same goal through more private means. Virtually no one we contacted disagreed with this letter on either political or policy grounds. Our letter represents a broad consensus of those supporting health care reform.

We are so close to enacting a historic reform. Now is the time for calm and resolute Congressional action. The Massachusetts election was a setback. Democrats still have large majorities in both the Senate and the House. We’ve heard worse. It’s time to act.

This is an inside New York story that I read in the New York Post. But it's really an international story with serious ramifications. This is actually a postscript to the twelve Danish cartoons of four years ago, one of which was the image of a bomb in Muhammed's turban.

Here is a gathering of books that appeal to the sense of touch and the sense of sight. You will want to read them, of course, but in many cases you will also want to feel the quality of the paper and the binding and let the beauty of the reproductions fill your eyes. There could be no better gift at a time when the book business is on the defensive. These are books that cannot be repackaged as eBooks. They are magically physical objects.  

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University. An expert on the politics of U.S. health and social policy, he is author, coauthor, or editor of numerous books and articles, both scholarly and popular, including The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream (2006; paperback, January 2008) and Health At Risk: America’s Ailing Health System and How to Heal It (2008).

Now that the core demand of progressives has been removed from the Senate health care bill--namely, the public health insurance option--should progressives continue to support the effort?

For me, the question is particularly difficult. I have been the thinker most associated with the public option, which I’ve long argued is essential to ensuring accountability from private insurers and long-term cost control. I was devastated when it was killed at the hands of Senator Joe Lieberman, not least because of what it said about our democracy -- that a policy consistently supported by a strong majority of Americans could be brought down by a recalcitrant Senate minority.

It would therefore be tempting for me to side with Howard Dean and other progressive critics who say that health care reform should now be killed.

It would be tempting, but it would be wrong.

Charles Dickens

Michael Slater

Yale University Press, 696 pp., $35

I.

For a long time, everyone has known that Paris was the capital of the nineteenth century, the city where the modern was invented: the society of the spectacular. But everyone was wrong. The capital of the nineteenth century was London. Think about it. Walter Benjamin’s symbol of the Parisian modern was the arcade. The arcade! In London-according to the social campaigner Henry Mayhew, there were 300,000 dustbins, 300,000 cesspools, and three million chimneys. It was there that the truly modern was invented: industrial, overpopulated dirt. Its symbol was the slum. London was managed by a majority of minority trades, all in the business of garbage: bone-pickers, rag-gatherers, pure-finders, dredgermen, toshers. And London’s greatest describer, who converted the ghostly industrial city into a new world of words, was a novelist who could taxonomically and poetically enumerate, say, the varieties of polluted fog: “Even in the surrounding country it was a foggy day, but there the fog was grey, whereas in London it was, at about the boundary line, dark yellow, and a little within it brown, and then browner, and then browner, until at the heart of the City--which call Saint Mary Axe--it was rusty-black.”

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University. An expert on the politics of U.S. health and social policy, he is author, coauthor, or editor of numerous books and articles, both scholarly and popular, including The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream and Health At Risk: America’s Ailing Health System and How to Heal It.

"Godfather of the public option...endorsed the Medicare buy-in compromise." That was the crucial opening line of a blog post Wednesday. It sounds pretty noteworthy: The guy who brought you the public option supports killing the public option.

Only he doesn't, and I should know, because "the guy" is me.

What I said (on PBS "Newshour") is that I like the idea of a Medicare buy-in for uninsured Americans aged 55 to 65, and I do. We don’t know the details of the buy-in--and the details matter a great deal for whether it is a workable idea for this age group and their families--but this could be a simple, popular way of providing affordable coverage. It’s also one, valuably, that could be made available almost immediately, not almost a half decade from now, like the rest of the Senate bill’s big steps.

I also said, however, that I think the hazy substitute for the public option that's apparently part of the proposed deal--having the Office of Personnel Management (OPM) contract with one or a few national private plans--is an "inadequate" substitute for the public option. It won't contain costs and won't provide the "choice and competition that President Obama spoke about." That's not an endorsement.

I didn't have time to elaborate on why the OPM idea is bad during the Newshour segment.  But I'm happy to do so now.

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University. An expert on the politics of U.S. health and social policy, he is author, coauthor, or editor of numerous books and articles, both scholarly and popular, including The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream (2006; paperback, January 2008) and Health At Risk: America’s Ailing Health System and How to Heal It (2008).

As the Senate debates the health care bill put together by Majority Leader Reid, the scramble is on to come up with a new compromise regarding the public option--the public health insurance plan modeled after Medicare that will be offered within the new health insurance exchange to Americans who lack workplace health insurance (and to workers in small firms that decide to buy coverage through the exchange).

The goal of the current effort is simple: to get sixty votes to overcome a filibuster and pass a bill. Four of the sixty Senators who caucus with the Democrats have expressed, with varying degrees of certainty and specificity, that they don’t like the public option in the current bill. So the search is on for a compromise, any compromise, that will bring on these four, or allow one or two of them to be bypassed by picking up the support of Republican senators Olympia Snowe or Sue Collins.

The public option in the Senate bill, it should be emphasized, is a compromise of a compromise already. The first compromise was to have the public plan negotiate its rates directly with providers, rather than set them based on Medicare’s rates. This compromise meant that the Congressional Budget Office was unlikely to score the public plan as producing the huge savings that it projected for a plan that used Medicare-based rates. Whether CBO was right in discounting the negotiated-rate plan’s savings is another matter--as I have written on this site, it’s likely underestimating the cost-containment potential--but the CBO’s numbers rule on Capitol Hill.

The second compromise was to allow states that did not want to have the public plan operating within their borders to “opt out” with the passage of a state law. How many states will take advantage of this option is unclear, but it’s certain to reduce the impact of the public plan even further. Indeed, the CBO is now projecting—again, pessimistically in my view--that only a few million Americans will enroll in the public plan. Yet none of this has apparently appeased the handful of hold-outs. Emboldened by the White House’s lack of clarity and pressure on the issue, they are digging in their heels and spewing false claims about the public plan (for example, that it’s a budget buster when there are no special government subsidies for it and the CBO projects it will exert downward pressure on private premiums, thus lowering the price tag of reform). Hence the new push to find some kind of middle road.

The problem is that the “middle-ground” ideas that are currently flying around aren’t in the middle at all.

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University, author of The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream, and an occasional contributor to The Treatment.

Diane Archer is the director of the Health Care Project at the Institute for America's Future and the founder and past president of the Medicare Rights Center.

How short memories are in Washington. A few weeks ago, when it looked possible that Nancy Pelosi could marshal enough Democratic support to create a “robust” public insurance option with rates tied to Medicare’s, everyone was talking about the big savings and reduced premiums that a series of estimates by the CBO showed this option could create. Then, the concern was that the public insurance plan would put private insurers out of business by using the government’s bargaining power to drive too hard a bargain with providers, creating an “un-level” playing field.

Now, however, the punditocracy is abuzz about the latest CBO estimates that show that the public plan eventually embraced by Pelosi--one that would negotiate rates with providers, rather than base them on Medicare’s--might actually charge higher premiums than the average private plan. No matter that the CBO estimates clearly state that the higher projected premiums reflect its expectation that the public plan will disproportionately enroll less healthy Americans--which might be seen as a virtue, since these are folks private insurance tends to serve most poorly. And no matter that a subsequent CBO letter to the House stated that even a public plan with negotiated rates would still place “downward pressure on the premiums of private plans.” Suddenly, in the commentariat, the public plan isn’t a fearsome predator. It’s a complacent kitten. Initially not worth having because it would be too strong, it’s now, according to critics, not worth having because it would be too weak. 

In truth, both the initial fears and current dismissals are overblown. The CBO’s declining estimates of savings certainly make a strong case for having the public plan use modified Medicare rates, as we have long argued. It’s a shame the House will not be considering a bill that shows how substantially a public plan can contribute to freeing up federal dollars to help Americans afford coverage. But we should keep in mind that the prime argument for the public plan has never been about a particular payment formula. It has been that a public insurance plan is vital as an institutional check on private plans, its role evolving to reflect the emerging weaknesses (or strengths) of regulated private competition. Put simply, health reform is much more likely to succeed with a public health insurance option, even one with negotiated rates, than if private insurers are left to run the show.

Are representations of the Prophet Muhammad permitted in Islam? To make or not to make images of the Prophet: that is the question I will try to answer. It is an unexpectedly burning question, as the newspapers regularly demonstrate. But both the answer to the question and the reasons for raising it require a broader introduction.

There have been many times in recent years when one bemoaned the explosion of media that have provided public forums for so much incompetence and ignorance, not to speak of prejudice. Matters became worse after September 11, for two additional reasons. The first is the propagation of a climate of fear, of ever-present danger from ill-defined foes, which led in the West, and especially in the United States, to a plethora of security measures ranging from reasonable and useful to ridiculous and demeaning. Penetrating and perverting institutions and individuals, this fear collided in the Muslim world with a complex ideological and psychological evolution that led many people in Muslim countries and communities to a reflexive and often self-destructive brutality in reaction to the slightest whiff of verbal or visual provocation.

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University. An expert on the politics of U.S. health and social policy, he is author, coauthor, or editor of numerous books and articles, both scholarly and popular, including The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream (2006; paperback, January 2008) and Health At Risk: America’s Ailing Health System and How to Heal It (2008).

As closed-door discussions continue in the Senate, the idea of triggering the public health insurance option is once again on the table. Advocates of the trigger cast it as a compromise that will attract the support of the small number of conservative Democrats who have expressed reservations about the public option, as well as Republican Olympia Snowe, who has proposed a trigger. But to be a compromise between public plan skeptics and the majority of Senators who support a public plan because it is central to ensuring affordable coverage while limiting the budgetary costs of reform, a trigger must have some prospect of working—and a trigger inserted into the two Senate bills now being merged would not.

Why Photography Matters as Art as Never Before

By Michael Fried (Yale University Press, 409 pp., $55)

I.

Michael Fried,who shot to intellectual stardom in 1967 with an essay in Artforum called "Art and Objecthood," is an intimidating writer. He looks very closely. He has passionate feelings about what he sees. And he shapes his impressions into a theory that fits snugly with all the other theories he has ever had. Whatever his chosen subject--Diderot, Courbet, Manet, Kenneth Noland--he comes up with an interpretation that is as smoothly and tightly constructed as a stainless-steel box. His writing amounts to a set of matching stainless-steel boxes. He puts potential critics on notice that the best they can hope to do is leave a few fingerprints or scratches on these perfectly polished surfaces. And so many people back away. Fried wants us to feel that we could as easily demolish the Great Pyramid of Giza with a pick-axe as successfully question his interpretations of his chosen themes--which now include the art of the camera, in his new book, Why Photography Matters as Art as Never Before. This is Fried's first extended foray into photography, and although it was a subject of discussion in academic circles even before it appeared, it has not received the more general attention that it deserves. Fried brings audacious arguments to old controversies about the relationship between art and photography. I find the arguments troubling, even wrongheaded, but only a man with a bold, wide-ranging, and fearless mind could have dreamed such stuff up.

In 1943, the Polish poet Czeslaw Milosz, who was living in Nazi-occupied Warsaw, wrote “Campo dei Fiori,” his great poem about the coexistence of normality and atrocity. The Campo dei Fiori is the plaza in Rome where, in the year 1600, the heretical philosopher Giordano Bruno was burned alive by the Catholic Church; “before the flames had died,” Milosz writes, “the taverns were full again.” The same willed blindness could be noted in Warsaw, the poem declares. Just outside the wall of the Warsaw Ghetto, where the Jews were being starved and shot, a Ferris wheel was operating: “The bright melody drowned/the salvos from the ghetto wall,/and couples were flying/high in the cloudless sky.”

Spies: The Rise and Fall of the KGB in America

By John Earl Haynes, Harvey Klehr, and Alexander Vassiliev

(Yale University Press, 637 pp., $35)

James Fenimore Cooper: The Early Years By Wayne Franklin (Yale University Press, 705 pp., $40) Click here to purchase the book.

The Occupation of Iraq: Winning the War, Losing the Peace
By Ali A. Allawi
(Yale University Press, 518 pp., $28)
 

John Ruskin: The Later Years by Tim Hilton (Yale University Press, 656 pp., $35)

The Essential Reinhold Niebuhr: Selected Essays and Addresses

Edited by Robert McAfee Brown

(Yale University Press, 264pp., $19.95)

Protest at Selma:

Martin Luther King, Jr. and the Voting Rights Act of 1965

by David J. Garrow

(Yale University Press; $15.00)

Americans, from William James to Jimmy Carter, have been searching for a “moral equivalent to war”: some commitment to high purpose which benefits mankind yet evokes the same degree of discipline and self-sacrifice that war does. Because the vision of such a state is so attractive it has figured rhetorically in the expressions of many presidents, most notably Teddy Roosevelt, Woodrow Wilson, Franklin D. Roosevelt, John F. Kennedy, Lyndon B. Johnson and Mr. Carter.