Categories
culture

Hillarycare and the Media


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This post is not intended to mock or even evaluate the positions espoused by Hillary Clinton now or in the past. I chose the title to be short and to grab attention. The purpose of this post is to summarize and evaluate how the news media covered the issue of health care reform during the presidency of Bill Clinton. I think that the fact that the proposal is now known as Hillarycare is as telling about the media coverage as anything else I will say here.

James Fallows calls the health care debate of the mid 1990’s “The Press’s Vietnam War.” The image being that there could be no winners in the debate, only combatants. I will follow the format of his coverage – as a seven act drama – to show how the media coverage of the day served to hinder the average citizen from ever getting a clear view of what what being discussed and what might be best for the country.

Emerging Issue

Health Care as a political issue began to be noticed during the Democratic primary. Rather than evaluate the proposals by Bill Clinton and Robert Kerrey (the candidates most closely tied to that issue) the media coverage focused on how the differences in their proposals (whether to try a single-payer approach or not) would play in the primary race. People could gain no understanding of the issue from the coverage, all they could learn (if anything) was the potential political fallout. Once Kerrey dropped out the coverage ended because there was no political confrontation involved anymore.

Crafting the Bill

The Clinton team had been studying the issue of health care reform long before the presidential election and when Bill became president they intended to hit the ground running – and they did. In doing so the press later complained that they were operating in the dark because they spent their time communicating with congressional leaders etc. rather than running their work past the press for public vetting of their ideas.

Scandal Reigns

When the plan was first unveiled the uniform reaction was positive but positive does not make for exciting press coverage. Fate stepped in to make the lives of reportes more exciting. Just when President Clinton was starting a tour to promote the Health Care Bill a crisis erupted in Somalia which diverted his attention and gave the press more exciting things to cover. At the same time this provided an opportunity for opponents of the bill (notably the insurance industry) to stage a counter-attack. By the time the news coverage focused on health care again the president was plagued with more energized opposition and a number of scandals.

Fear-Mongering

I was excited to read about the work of  Robert Pear who carefully delved into issues and provided in depth reporting. What interested me however was the effect of his work. Neither Mr. Pear, nor anyone else in journalism took the time to consider the whole health care proposal. Mr. Pear focused on one item, one leak at a time and evaluated it. Each time he would show who stood to lose over that particular aspect of the plan. The result was something like the reverse of Hitler’s ethnic cleansing in Germany – instead of one ruling group peeling off layers of “undesirable” elements of society each aspect of the plan reported by Pear drew the attention of a small group who stood to lose on that particular facet of the bill. As the groups combined, each focused on their pet issue, they grew to the point that they stopped the final bill. It may be that none of them realized or considered the potential positive effects of the whole bill.

Focus on Conflict

Kathleen Hall Jamieson, the dean of the Annenberg School for Communication relates an interesting experience of attending a presentation by Hillary Clinton on the health care reform bill.

She went into the substance of the plan, and took on virtually every argument that had been raised against it. . . When she was talking about her plan, the reporters had clearly heard all of this before and found it completely uninteresting. They talked to each other passing notes around.

But as soon as she made a brief attack on the Republicans, there was a physiological reaction, this surge of adrenaline, all around me. The pens moved. The reporters arched forward. They wrote everything down rapidly. As soon as this part was over, they clearly weren’t paying attention anymore. They were writing on their laptops as they began constructing the story of how the First Lady had attacked her opponents.

(emphasis added)

The press would always prefer to talk about alternate bills and problems with the current idea than actually talk about the whole issue and have people work towards a solution. Solutions make for a day of coverage while problems can be exploited day after day.

Misinformation

Eventually there was someone who read the whole bill and attempted to put it into perspective. Her name was Elizabeth McCaughey (pronounced “McCoy”). When she did so, whether she intended to or not, she included some crucial pieces of misinformation that made the bill sound draconian. The difference between her evaluation of the bill and the actual text of the bill is similar to the difference between what the people behind fightfoca.com say about the Freedom of Choice Act (FOCA) and what the actual bill says. (I discussed this difference last week.) No journalist ever explored the accuracy of her statements.

Out of Sight, Out of Mind

When the health care bill died the news coverage of the health care issue died as well until about 2006 when it was again a central issue for a presidential campaign season. During all that time the issue of affordable heath care has been at least as important as it was when it first started garnering media attention during the Democratic primaries for 1992.

Categories
National

FOCA


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My sister-in-law suggested that her generally apolitical blog was not the place to engage in a  debate on abortion. She’s probably right, but such a debate fits just fine here. In many ways the debate on abortion is settled. An absolute ban on abortion is not likely to ever be a reality in this nation and truly unrestricted access to abortion is also a very low probability. Despite heated rhetoric, the fact is that both sides are entrenched and committed to making incremental gains related tot his ever simmering topic. Camille’s post was specifically about fighting the Freedom of Choice Act (FOCA) which Obama told Planned Parenthood he would sign as his first act as President. I think we can be very confident that it will not be his first act (because the economy is his first priority now) but that is no consolation to those who oppose this bill.

As always, I like to start with the actual legislation in question whenever possible. The claim by opponents is that this would eliminate all state and local statutes against any abortion. The text of the bill states:

Congress finds the following:

. . .

(4) The Roe v. Wade decision carefully balanced the rights of women to make important reproductive decisions with the state’s interest in potential life. Under Roe v. Wade and Doe v. Bolton, a woman’s right to choose to terminate her pregnancy is absolute only prior to fetal viability, with the state permitted to ban abortion after fetal viability except when necessary to protect the life or health of a woman.

. . .

SEC. 4. INTERFERENCE WITH REPRODUCTIVE HEALTH PROHIBITED.

(a) STATEMENT OF POLICY- It is the policy of the United States that every woman has the fundamental right to choose to bear a child, to terminate a pregnancy prior to fetal viability, or to terminate a pregnancy after fetal viability when necessary to protect the life or health of the woman.

(b) PROHIBITION OF INTERFERENCE- A government may not–

(1) deny or interfere with a woman’s right to choose–

(A) to bear a child;
(B) to terminate a pregnancy prior to viability; or
(C) to terminate a pregnancy after viability where termination is necessary to protect the life or health of the woman;

(emphasis added)

Sounds like the claim by the bills opponents is a bit overstated.

Those who support the bill obviously believe that this would remove some state and local restrictions on abortion that are unconstitutional. The problem here is that the Constitution has no position on the issue of abortion. The only restrictions on abortion related legislation are rooted in supreme court opinions. All those state and local regulations that push the boundaries are challenged in court. The language of this bill is so vague that it only reinforces the message that is supposedly set by existing rulings. In other words, all the laws that they expect to remove can already be challenged, and any that would be upheld still could be upheld when challenged.

What this bill really accomplishes is to place in a statute what has already been placed in precedent. Perhaps this is an admission by abortion proponents that the ruling in Roe v Wade is a  lousy ruling that amounts to an opinion not grounded in law. Anyone who has actually read Roe can see that it’s a huge logical leap from any law then existing.

My position is that FOCA is meaningless at best and reinforces the most illegal Supreme Court ruling I have ever read at worst. After having actually read the text of FOCA (it’s not very long) if you still want to sign the petition that Camille linked to, please do. I did.

Categories
National

Our Tranquil Times


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I’m glad that our country has so few problems that, in order to feel useful, we have a Representative proposing a bill to end the BCS system. I’d hate to think what kind of legislation we would be getting out of such a Congress if we were living in turbulent times with a depressed economy, poor foreign relations, and/or large social issues that fuel the passions of voters (like altering the definition of marriage).

Oh, wait – I guess we get the worst of both worlds right now.

Categories
National State

“Free Market” Health Care


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The call for Lawyers to join health-reform efforts was a not so subtle reminder to me about how "free" our health care market is currently. We can’t really pretend that the cost of services or the services rendered are determined by patients and providers. In fact, they are not even determined by a combination of patients, providers, and insurance interests.

Malpractice lawsuits, whether as threat or reality, skew a provider’s treatment decisions to the legal safe side, members of the Legislature’s Health Care System Reform Task Force were told Tuesday. That approach, in turn, adds to the amount of redundant testing and is a significant but so far unaddressed factor in the reform process.

The cost of malpractice-insurance premiums for providers also is rising rapidly, Rep. Gregory Bell, R-Fruit Heights, and an attorney, told fellow task force members.

We have developed a pricing and practice environment based on a staggering concoction of laws, medical knowledge, middlemen, and advertising. Patients may demand unnecessary services or medications based on what they hear from advertisements. They may also have unreasonable expectations regarding how flawless our medical system is or should be – in other words, they may feel entitled to compensation for unavoidable tragedies. Governments step in to define what "unavoidable" means by specifying standards of practice which may bear little connection to medical necessity. Insurance companies can, by choice or accident, inflate the costs by demanding standards of practice and levels of compensation that can’t possibly take into account all the factors that should define the practice of health care and the commensurate compensation for care.

Care must cost more when malpractice insurance rates rise. Prices will increase when the salaries and profits of insurance companies must also be covered in the process of receiving health care. Checks against unnecessary care will disappear when those receiving care are not sensitive to the costs of individual procedures. Medical decisions will be skewed when manufacturers provide kickbacks to doctors and advertise their wares directly to customers who have no medical background.

While we use the Brass Serpent (the Nehushtan) as the symbol for the field of medicine we might find it convenient to use the Hydra as a symbol of the cost of health care.

The Hydra - photo by Craig Stephen
Hydra – photo by Craig Stephen

Somehow we need to slay this monster but while the sword of government may have a place in the battle it is not sufficient to complete the task – by itself the sword of government makes the monster more dangerous.

Categories
culture life meta State

Make “the Silent” a Minority


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Recently my niece approached me to ask questions about politics. She’s a young teenager, years short of being able to vote, but she wants to become informed and involved so that she could positively participate by the time she can vote. The conversation served as a reminder to me of how important it is for our young people to be able to obtain information on political issues that is not tainted by the rancor that often pervades political discussions. In other words we need a clearinghouse for civil civic conversation. I decided that I wanted to form an organization that would work for that purpose.

When I read the plea at Ladies Logic regarding our atrocious levels of participation in Utah (and remembered my own pleas to encourage greater levels of participation here), I realized that the time to act was now and that the need was not only for our youth who are approaching or recently passing the age where they can vote but also for every citizen who can’t bring themselves to really participate in the dirty game of politics – many of whom simply stay out of the discussion and vote without becoming well informed on the issues. We need to reach “the silent majority.”

The group I will be forming will be open to, even encouraging of, participation by people of all political perspectives. The only requirement for participation is a commitment to avoid the playground politics of name calling and guilt by association. The aim of the group will be to draw people out of the silent majority until the silent become the minority by fostering civil dialog between people of differing perspectives. We will not aim to come to a consensus except the consensus that wider participation is better than narrower participation. I would like the group to seek to engage other group members in public discussion of issues so that people who have been silent will have a chance to be exposed to various positions on important issues without the likelyhood of being personally insulted by those who disagree with them. I also would like the group, individually and collectively, to engage in discussing issues with candidates for office and elected officials with an emphasis on local candidates and officials and a balance of local, state, and national issues.

In addition to my own energy, and knowledge I need the energy and experience of others who can help me to spread the word, engage effectively with public officials, organize group efforts, and generate ideas to further these aims.

I would ask anyone who believes in the importance of broad political participation, especially if you are in Utah, to please contact me publicly or privately to help me get this off the ground. Leave me comments or drop me an email if you have interest in participating, ideas about what can and should be done, or if you know of people who could help me in this.

Categories
National

Willing Suspension of Disbelief


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Reports from the CBO that a Universal Health Coverage Bill would be budget neutral are obviously based on the third kind of lie (namely statistics). Commonhealth sums up the effects of the bill like so:

The legislation:

  1. gets rid of employer based insurance (employers that contribute to coverage would give employees that money at first, and eventually shift to a federal health coverage tax)
  2. requires all Americans to have health insurance
  3. offers subsidized coverage up to 400% FPL (Mass is up to 300%)
  4. sets up purchasing pools (like the Connector)

Could someone please point out to me where this plan gives health care providers an incentive to provide efficient, high-quality care? It seems to me that insuring all our uninsured citizens will never pay for itself in a system that thrives on inefficiency – as the current system does. Adding inefficiency couldn’t possibly pay for itself.

Ending employer based insurance is potentially a good thing. Requiring everyone to buy insurance looks like an incentive for more inefficiency and even price gouging. And one of my senators is sponsoring this. I think he should have his head examined.

Categories
culture

Government is a Tool


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LaVarr Webb asks Utah Policy readers if they think government is always a necessary evil or if it can be a force for good. Since my answer to that question goes directly to the heart of what my blog is about I thought I’d share my answer here.

Government is not always necessary (an isolated group of people who were respectful of each other would not need any government – if it were possible to be really isolated anymore), and it is certainly not always evil. Can it be a force for good? The answer depends on what you mean by “force.” It is not possible to force people to be good so when government is being used to force people to act a certain way then you can be sure that it is not good.

Government, like any tool, is good so long as it is being used for its proper purpose. The purpose of government is to protect individual rights. Once people start using government as a force to mandate the will of the majority on the minority, or even the will of the minority on the majority, then government is not good. Unfortunately that is how too many people view government today, as a force to promote their own view on society as a whole.

No matter how well intentioned (and most of them are well intentioned) an activist is in their efforts to make the world better through some government action, they are using the tool of government incorrectly and there will be undesirable consequences.

Take the example of racism. Government cannot be used as a force to make people be not racist. It can be used to force students of different skin colors to attend the same school building, but that is not the underlying problem. The underlying problem can only be solved by using a different tool.

Racism is not right or good, but it is the right of each individual to be racially fair-minded or racially biased. Where racism is concerned, the proper place of government is to ensure that appropriate action is taken when one person tramples the rights of another. In fact, the government need not even consider whether racism was the cause of that infringement of rights, only that the rights were infringed and what the appropriate response is towards the person or persons who did the infringing.

Categories
General

Free Marketer’s Dilemma


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I’m a proponent of the value of free markets and their ability to enrich people. The problem is that the free market only works in a closed system, in other words a free market is not favored when intersecting with markets which are being manipulated. The issue of how to compensate for intersecting our supposedly free market with other markets which impose duties and protective tariffs on imported good led me to think of the Prisoner’s dilemma from game theory.

Briefly, the prisoner’s dilemma is a situation where the results of your actions will vary depending on the actions of others over whom you have no control. If one market imposes tariffs and the other does not the market with tariffs benefits at the expense of the other market. If both markets impose tariffs then the playing field is level, but both are worse off than if neither of them impose tariffs.

Thankfully there may be a solution to the problem by studying the prisoners dilemma. Our economic interactions specifically resemble a specific form of the prisoner’s dilemma called The iterated prisoner’s dilemma. Under this specific variation the interactions are repeated so that the participants have a history of interactions. In a competition of computerized players the winning algorithm was one called “tit for tat” (later improved versions have been classed as “tit for tat with forgiveness”). This kind of a strategy encourages others to play nice without simply being a doormat for those who wish to use tariffs.

Does this sound like it would work in international economics?

Categories
National

Rhetoric Overshadows Facts


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The well titled post, The World Is Not Going To End This Weekend, illustrates how easily an issue can be skewed simply by blurring the facts. Quoting from a post at the Politico which contains the rhetoric surrounding the debate about extending the Protect America Act Timothy Lee goes on to show the truth:

. . .” a measure to extend the Foreign Intelligence Surveillance Act as the deadline approaches. The measure, which failed 191 to 229, would have extended the bill an additional three weeks”. . .

FISA is not expiring this weekend. FISA was passed in 1978 and isn’t slated to expire ever. What’s going to expire this weekend is the Protect America Act, which gave the president some additional spying powers beyond those he enjoyed under FISA. And in fact, even that is misleading, because all that’s really going to expire is the ability to authorize new surveillance activities. The PAA allowed the government to authorize surveillance programs for a year, which means that any surveillance programs that have already been approved will continue to be authorized until August at the earliest.

What this means is that the only real effect of the PAA’s expiration is that if a new terrorist suspect comes to the government’s attention, and he makes a phone call or sends an email that passes through the United States, then the government would need to fill out the extra paperwork required to get a FISA warrant in order to surveil that call. This paperwork can be filled out after the interception begins, so we’re not talking about the NSA missing any important phone calls, we’re just talking about [a bit more paperwork].

This same kind of fudging happens from activists on both sides of most issues. It’s no wonder that the average voter who only knows what they see in the media has such a hard time seeing any debate completely clearly. Their views are almost always being skewed based on the news they receive.

In the midst of all our government social engineering maybe we could make a law to outlaw such abstraction in our news – but I guess that would be counterproductive every time a politician wants to make an emotional appeal to the country.

Categories
National

Feeling Bloated


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As if the Republican party (thanks largely to the current administration) had not long ago lost any credibility to apply the “tax and spend” label to the Democrats, the American Enterprise Institute has now published a report on just how fat our favorite Elephant is. (hat tip Cato @ Liberty)

Allowing for our military expenditures, making the Bush tax cuts permanent, adding prescription drug coverage to Medicare, removing the alternative minimum tax, and this years stimulus package we would still be spending hundreds of billions less this year than we are and we would have a balanced budget through 2017 if Bush had otherwise maintained the discretionary spending levels that Bill Clinton left to him.

Before the Democrats and our current Clinton get too puffed up over this fact we should all be reminded that the budgets left by President Clinton were the result of 6 years of struggle between a Republican Congress and a Democratic President. The excesses of President Bush are the result of 6 years of cooperation between a Congress and a President from the same party. One year of a Democratic Congress and our spendthrift Republican administration does not seem to have brought us noticeably toward the relative fiscal restraint we had achieved by the end of the Clinton presidency.

That struggle between the different ideals of the two parties looks like a good thing in practice, not just in campaigning. It almost makes me hope that we never again have a President and a Congress who essentially agree on most issues.