RED GENES BLUE GENES

Health Care Reform -- My Comment on Obama's Op-Ed

Our greatest presidential writer since Jefferson, Obama has penned an Op-Ed for the NY Times on Health Care Reform.  You can read Obama's piece here.  I can't say he's really at the top of his form here, but it's probably because the article was written by a team of speech-writers.  Here are my comments:

"1. The President is going to pass some kind of Health Reform Bill this fall because he's got the numbers. The final bill will be a classic political sausage, which is better than nothing.

2. Liberals will be disappointed because the reform won't go far enough, conservatives will be furious that it went too far.

3. This Bill will only be the beginning of Health Care Reform, not the end. The health care sector will in the future receive the continual scrutiny of the Congress, the Executive Branch, the Press, and the citizenry who make use of our new medical system. There will be a need for continual updating, refining, revision, etc. There will be many opportunities to fix mistakes, and there will doubtless be many mistakes to fix. There will be Republican Presidents and Congresses in the future, and this new health care system will have to be robust enough to survive the review of such conservative administrations.

4. The \"Town Hall Brouhaha\" is a good example of \"political irrationality,\" the fundamental structural flaw of our republic. Since our government is based on the perpetual conflict between left and right, all innovations, whether coming from the left or the right, will be opposed by about half the voting public. Liberals are correct that conservative protests at the Town Hall meetings are irrational; but they are incorrect to think that liberals are any different when faced with likely government actions which they oppose.

5. The most important principle missing from the President's proposal is citizen oversight and involvement. As with all other massive government initiatives, citizens rightly fear government inefficiency and corruption. Regulators are not the answer because they are bought off by lobbyists. The right approach is to involve \"citizen juries\" -- like grand juries but with an administrative oversight capacity. This concept was developed partially in the U.S. but has already been put into use by Gordon Brown in the U.K. and is supported by Segolene Royal in France."

To comment, click on the Comment button below.  The author will  respond to comments on topic.

5 Easy Clicks to Understanding Health Care Reform

the patient is ready...

Surveys show that Americans virtually never know what they're voting about (e.g., Philip Converse's classic studies, repeatedly confirmed).  However, our lack of knowledge doesn't stop most people from getting heated up.  A lot of people are now developing -- or parroting -- opinions on health care.  Do they know what they're talking about?

Conservative Republicans are absolutely furious that socialized medicine is about to descend on America. Liberals are disgusted that stupid, ignorant conservatives can make such misguided assertions -- but most of them can't tell you what's in the health care proposals, either.

Before you make up your own mind, why don't you find out a few facts?  I've saved you the effort of Googling, by choosing 5 easy clicks to get you up to speed:

1.  What's happening right now in Congress?  Don't worry so much about the Town Hall grand-standing, this Aug. 1 NY Times article gives you a very clear idea of where we are now in the legislative process: steps away from a partisan-line vote which will create a national health care system with mandatory universal coverage.  There is more consensus in Congress than would seem apparent from our news coverage, which focuses on polarization.

2.  Want to understand the context and history of the health care debate?  Better start again with the Old Gray Lady, as the NY Times has built an excellent web-center with a very clear intro article here.

3.  By this point, your next question might be, why do we need to go through this?  Do we really need reform that badly?  Now you should glance through the Obama administration's economic analysis of our health care system -- in a report (PDF file) prepared by the Council of Economic Advisers.  It shows that we can't afford NOT to undertake reform.  Our health care system is the most expensive in the world for reasons that no one can justify.  We're not getting our money's worth, and without reform, the situation would get much, much worse.  In short, bad health care makes us all poorer.

4.  By now you're worried you're not getting a balanced view.  What are the critics of reform saying -- are any of them sensible?  Start with this Fortune magazine column on the potential costs and downsides.  Columnist Kelly argues that we will eventually be forced into a government-managed system that will reduce options and freedoms, and will also be more expensive for some people.

5.  Finish up with the criticism from the right-wing columnist Charles Krauthammer, who argues that we are re-making the whole health care system when it would be easier just to cut out the largest inefficiencies.

You've now been exposed to the facts!  Now you can start thinking about this issue -- and make up your own mind.

Political Irrationality and Health Care: It's Time for a Deliberative Poll

“It is not clear how fully the public understands the complexities of the government …proposal…”
— NY Times, June 20, 2009, “In Poll, Wide Support for Government Run Health”

“The People are that part of the State that does not know what it wants.”
— Hegel

The health care debate has become bitter and explosive because the Obama administration is actually on the verge of accomplishing something significant. We can tell this from the way its opponents are now pulling out all the stops.

The problem with our national debate on this issue, as with so many other issues, is that it inevitably devolves into a nonsensical partisan howling.

As soon as an important public issue becomes politicized, our partisans draw a line in the sand and force the rest of us to choose sides. Liberals and conservatives duly line up on opposed sides of this line, but without any clear understanding of the issues. No one knows what they’re talking about, but they argue anyway, and get rather heated up. This is a powerful example of “political irrationality” – a concept in political psychology which posits that most people are irrevocably biased in their political perceptions (see the essays under the "Political Irrationality" category on this blog).

In a recent book, The Opinion Makers, David Moore shows that most of the large polls routinely exaggerate public knowledge on complex policy issues. The truth is, almost no one has the facts straight.

Our politicians are no help here because they adopt absurdly unrealistic partisan positions – Conservatives pretend we don’t need health care reform, when it’s obvious that we do, and Liberals pretend that they know how much it’s going to cost, when it’s obvious that they don’t.

The problem with Town Hall meetings to discuss public issues, as with many other devices in our democratic arsenal, is that they are not deliberative. No one is forced to learn anything before talking, no one is forced to reflect, no one is ever held accountable for any vote they cast. Under such conditions, people resort to reflexive partisan programming and end up hurling slogans at each other. 

I call this "political debate via screaming."  The process is worse than a waste or time, it’s terribly counter-productive, spawning hatred and mis-information.

Consequently, we should just admit that Town Hall meetings are a publicity stunt; sometimes the stunt favors one side, sometimes the other side, but it’s no place to learn the facts.

Scholars James Fishkin and Ned Crosby have proposed a much better alternative – citizen panels or juries in which ordinary citizens are exposed to information and discussion periods before being polled (see for example: http://cdd.stanford.edu/polls/docs/summary/ ). 

Prof. Fishkin has developed a methodology known as the “Deliberative Poll” which would be perfect for a discussion of health care reform. In a Deliberative Poll, a large sample of ordinary citizens is polled on their opinions about a given public issue. Then, they are exposed to two or three days of meetings, lecture, debates and briefings on the topic. They not only get a chance to interrogate experts, they get a chance to debate their fellow citizens. At the end of the process, the participants vote again. The second vote reveals what I call “the arrow of reason” – it indicates which way reasonable people have been moved by the evidence. That should be enormously convincing.

I would strongly recommend that the Obama administration consult with Fishkin or a similar scholar to develop a national deliberative poll or citizen jury on the final health care proposals. There would be no more reliable barometer of true public opinion than a sample of ordinary Americans asked to invest a few days in really learning the facts.

The Definitive Analysis of the Henry Louis Gates Arrest

 

Did we settle for peanuts?

The Definitive Analysis of the Henry Louis Gates Arrest

Learning the Wrong Lessons

We are now a million words deep into our national analysis of the arrest of Prof. Henry Louis Gates.  Like a media-created prism, Gates’ arrest and our reaction to it have been enormously revealing of the diversity of American political perceptions.

As usual, the lessons that most Americans are drawing from the event are superficial or just plain wrong.  The emerging consensus is a mushy wash of opposing viewpoints:  1) Yes, racial profiling is a serious problem, but...2) Not in this case, which was more a matter of two grown men over-reacting to a minor conflict.

Did Crowley violate Gates’ constitutional rights?

This incident provided the perfect opportunity for Americans and their police to come to a greater understanding of how the Fourth Amendment works in practice.  As we will see, the courts have witnessed a long history of official police misunderstanding of Fourth Amendment requirements.  Sgt. Crowley committed a clear and obvious violation of Gates’ Fourth Amendment rights, but neither Crowley nor the Cambridge Police Department, nor indeed any other police department or policeman’s association, has admitted the obvious illegality of Crowley’s entry into Gates’ residence.  The Fourth Amendment gives Americans an astonishing level of protection from government intrusion into our homes.  Many Americans – including our police -- find it truly hard to believe we Americans really have that much freedom.  We really do. 

A second constitutional lesson is related to the First Amendment, which protects our freedom of speech.  Both citizens and police should take this opportunity to learn that insulting and abusive words alone are virtually never sufficient to justify a disorderly conduct charge.

Our police officers are often acting in good faith when they follow “standard police procedures” but that is no justification when these procedures violate the constitution.   We need to better police our standard police procedures – they must be brought in line with the Constitution.  Not most of the time -- all the time.  The Constitution is not optional.

Was Crowley guilty of Racial Profiling?

The next set of teachable moments relates to race.  Sgt. Crowley was indeed guilty of racial profiling, as is established by the discrepancy between his police report and witness Lucia Whalen’s recorded 911 call.  

The emerging consensus view that Crowley was not guilty of profiling is based on the fact that the event was widely discussed in the media before Ms. Whalen’s tape was finally released.  Most people had already made up their minds by then, and the “Beer Summit” had already been scheduled.  Crowley’s fellow officers, blacks and Latinos included, had already come out in his defense.  It was widely known that Crowley taught a course on how to avoid police profiling.  Crowley had made his deep admiration for Obama patently clear.  Crowley came across as a good guy.  Could such a guy really be guilty of profiling?  Unequivocally, yes.

Crowley’s profiling was arguably of a very minor, tenuous sort.  It’s not as if he wouldn’t have responded to the call if the alleged burglar were white.  As Crowley approached Gates’ residence it seems that Crowley was thinking “I have to be careful, there may be armed burglars within the residence.  It seems likely that they are black.”  The problem is that Crowley had no reason for assuming that the alleged perpetrators were black. Where did that come from?

It came from a place beyond the reach of logic, or even awareness.  The most common kind of racism in America, and indeed in the world, is known as “implicit racism,” which means that it is sub-conscious.  If you don’t believe in the possibility of such sub-conscious bias, I urge you take some of the tests on the Implicit Associations Test available at the Harvard web-site.  Most of us harbor some kind of racial bias, black people and Latinos included.  It’s silly for all of us to pretend to be perfectly un-biased.  Anyone who has grown up in a multicultural environment acquires stereotypical thinking.  The trick is to learn to monitor our authorities – such as our police – to make sure that they do not act on their implicit judgments.

Red Crook, Blue Crook: Political Irrationality and Corrupt Politicians

If the people can only choose from amongst scoundrels, they are sure to choose a scoundrel.
-- V.O. Key

Most elections are a choice between Bum A and Bum B.
-- Curtis Sliwa

Gail Collins and Ross Douthat engage in an interesting New York Times debate on the issue: is one party more corrupt than the other?  You can find their discussion here.

I think Collins and Douthat take a pretty superficial approach, but it seems Douthat digs a little deeper into the issue.  Collins briefly brings up the cultural aspect, but then doesn't do much with it.  Culture is obviously very relevant to political corruption and is a factor that can outweigh the size of government.  Nigeria is more corrupt than Finland or Singapore for reasons other than the size of the state sectors in those countries.  Anyway, it's kind of sad to make a cross-cultural reference to corruption without citing the fascinating annual survey on global corruption by Transparency International, which you can access here.

My own take is to harp on political irrationality, my favorite theme.  Partisan bias blinds us to the fact that Americans are red sheep and blue sheep, and the sheep part is more important than the red and blue part.  We are shorn by the political class, red sheep farmers and blue sheep farmers.  It's the shearing that should concern us more than the color of the farmer's overalls.

Politicians (of either party) can never be trusted to be fully honest because they have overwhelming incentives to lie. Politics is a game played on a slippery ethical slope, a bit like Dante's descent into hell, except that most of these folks go downhill ski-ing into the pit at full speed.

Of course we need politicians and government officials in a complex, modern society -- so what can we do?  

The answer is: watch them. Citizen oversight.  Citizen panels need to take on an administrative and budgetary audit role. Regulators appointed by politicians can never be the final answer, because the regulators are appointed by the politicians.  Just as we have grand juries to keep an eye on prosecutors, we need grand legislative and regulatory juries to keep an eye on our representatives and their appointess.  More details in the concluding chapter of Red Genes Blue Genes.

My answer to Collins and Douthat was as follows:

Gail, as a result of the phenomenon of political irrationality (principally driven by partisan bias), both liberals and conservatives fail to perceive the overlap between their parties’ respective approaches to the size of government.

Conservatives have repeatedly contradicted themselves by increasing the size and expense of government (Bush and Reagan’s military buildups) while Liberals have contradicted themselves by reducing the size and scope of government (Clinton’s welfare and deficit-reduction initiatives).

The conservative economist and social philosopher Friedrich von Hayek built a persuasive case that government power tends inevitably toward inefficiency and corruption. However, the recent global financial collapse has shown us the perils of too little government and insufficient regulation. Therefore, we should not be simplistically making assumptions that big government is liberal and good, or that small government is conservative and bad. Rather, we should seek the optimal size of government to deal with particular social problems, taking into account the extent of market failure that has created a need for a government intervention in the first place.

In other words, we should all learn to look at political issues on a case-by-case basis, rather than through the simple reflex of adopting a so-called liberal or conservative position.

Sometimes big government is needed (the CDC, W.H.O., FDA, etc — who would want to live without them?), while in other cases it leads predictably to abuses (the military-industrial complex has been looting our treasury for decades).

What’s the answer?

Citizen oversight. Just as we have grand juries to oversee the conduct of our prosecutors, we need legislative and administrative juries to oversee the conduct of our political representatives and their appointees. 

This concept has been developed substantially by scholars such as James Fishkin and Ned Crosby. We can never trust politicians to root out the corruption because the political system is based on overpowering incentives for politicians to lie and cheat. 

Trusting politicians to stop taking suspect campaign contributions is like asking athletes to stop taking steroids — naive. It’s not going to happen.

Please feel free to comment, by clicking on the Comment Button below.  You'll be informed by email of the author's replies to your comment.