January 31, 2006
Link of the Day: Blogging Jumps the Shark Edition
Exactly how's this going to work?
Three Million HSA Users Can Be Wrong
I really don't know what Kevin's concerned about here:
there are plenty of proposals Bush could make that would be pretty popular among people who already use HSAs. For example: increasing the contribution limit; expanding the range of services covered by HSAs to include things like hearing aids and maternity care (which isn't covered by many plans); allowing money to be withdrawn for nonmedical purposes after age 65 (or even better, 55); and so forth.
My point here is mainly a political one. Fighting HSAs on philosophical grounds is one thing, but people who already use them would be pretty pleased to see some concrete, money-saving improvements to HSAs — and wouldn't much care about their abstract virtues or defects. If we're going to fight the HSA-ization of healthcare, we'd better be prepared to be on the opposite side of some motherhood and apple pie proposals from the White House that might sound pretty good to current users.
There are -- top estimate -- 3 million users. 1 percent of Americans. If Republicans can be on the wrong side of the 45 million uninsured folks, we can go against the interests of the few HSA users even paying attention.
The answer to Bush's marginal tweaks on HSA's is pretty simple. Kate had it earlier today. "Small fixes won't work." Republicans had no end of fun painting Democrats as stewards of broken, aged ideas. Democrats can have a similarly enjoyable time lashing Republicans to the busted status quo on health care. Premiums are skyrocketing, hundreds of thousands die from medical errors, doctors have yet to discover computers, we pay twice as much as any other country...and Bush wants to tweak the tax deductibility of care? Does Frank Luntz know?
Bush and Polls
In advance of Bush's State of the Union, this cautionary from John Cole strikes me as important:
Can I ask you commenters a favor? Quit citing poll after poll after poll of Bush’s approval ratings. They suck. They are historically low. I will concede they are probably going to stay that way, barring a miracle. So until they change dramatically, quit citing them.
Why? Because they DO NOT MATTER. This administration CLEARLY does not give two hoots in hell about poll numbers. They have both houses of Congress (and, barring a total disaster, will retain them in 2006), they have the White House, they just rammed through two very conservative Supreme Court Justices, they are filling the State Department and the CIA and every agency with young conservative political appointees, and they are simply having their way with the government and the country.
Bush and Cheney and Rove do not care about the poll numbers. If they did, they would change their behavior and do all sorts of popular little things like the famous Dick Morris triangulation schemes (school uniforms, etc.). But they aren’t, and they won’t.
That's wrong, save in myth. The President's poll numbers will likely decide the 2006 election. Karl Rove and Dick Cheney and George Bush surely do care about retaining Congress, if for no other reason then the rash of investigations that would result from Speaker Pelosi would end the Bush Presidency as a policy-making institution. And while there's little doubt that the triumvirate at 1600 Pennsylvania don't see low poll numbers as a constraint on action, they do see it as a constraint on conservative action. Their rhetoric tonight will be a perfect reflection of high polling priorities, led by the highest polling domestic worry of all: health costs.
A couple years back, Josh Green wrote an excellent article on this very subject. As he put it, the president doesn't believe in polling -- just ask his pollsters:
Republican National Committee filings show that Bush actually uses polls much more than he lets on, in ways both similar and dissimilar to Clinton. Like Clinton, Bush is most inclined to use polls when he's struggling. It's no coincidence that the administration did its heaviest polling last summer, after the poorly received rollout of its energy plan, and amid much talk of the "smallness" of the presidency. A Washington Monthly analysis of Republican National Committee disbursement filings revealed that Bush's principal pollsters received $346,000 in direct payments in 2001. Add to that the multiple boutique polling firms the administration regularly employs for specialized and targeted polls and the figure is closer to $1 million. That's about half the amount Clinton spent during his first year; but while Clinton used polling to craft popular policies, Bush uses polling to spin unpopular ones---arguably a much more cynical undertaking.
That last is a particularly important point. Polling gets a bad rap, but in theory, it's a Democratic godsend. In a country with 300 million people, some sort affordable method of gathering popular priorities and preferences is exactly what the polity needs to continue functioning. A town hall here or there excludes the busy, the immobile, or the civically apathetic, the mailbag excludes most everyone. Polling, in theory, can take public temperature at low cost, enabling politicians to quickly hear and address the concerns of their constituents.
But polling, in its more cynical, routinized form, does quite the opposite. It seeks to convince that the politician's priorities are, in fact, their desires. Tonight, George W. Bush will announce his renewed support for Health Savings Accounts. His support, notably its phrasing and emphasis, will have been heavily polled. But none of those polls will have returned a public cry for more out of pocket spending, or disgust with their overly-comprehensive insurance. That's because the policy preceded the poll, and all the focus groups and surveys simply sought to pin down the most benign, inoffensive way of evading the reality of HSA's.
Bush cares about polls. Don't believe for a minute that he doesn't. But he doesn't care about what polls say about voters, only what they say about him. He cares about his own popularity because that decides his efficacy, and he uses polls to convince American's that business priorities, which are Bush's priorities, aren't actually as bad as they sound at first blush. He's very, very good at it. So good, in fact, that smart guys like John don't believe he does it.
January 30, 2006
Link of the Day: Hard Truths Edition
Why intelligently rationing health care is the worst system -- except for all the others. And while reading, keep in mind that we already ration health care, we just do it by income, wealth, and region. Moreover, we overtreat, particularly at the end of life, to a truly remarkable degree, one that has little or no impact on mortality rates or longevity.
More on the Baby Boom
As follow-up to my last post, Here's The Heritage Foundation's predictions:
The baby-boom generation will begin to retire in about 10 years, and the fiscal consequences will be profound. The combined deficit from Social Security and Medicare will rapidly expand, climbing to 1 percent of GDP in 2015, 2 percent of GDP in 2020, and 3 percent of GDP in 2025. To put that figure in perspective, 3 percent of GDP today would be almost $344 billion, or more than $3,000 per household.
Yep, truly unprecedented increases in tax revenue. Let's go to the numbers:
In 2004, the OECD publication reveals, Sweden once again had the highest tax-to-GDP ratio among OECD countries, at 50.7% against 50.6% in 2003. Denmark came next at 49.6% (48.3%), followed by Belgium at 45.6% (45.4%). At the other end of the scale, Mexico had the lowest tax-to-GDP ratio, at 18.5%, against 19.0% in 2003. Korea had the second lowest, at 24.6% (25.3%), and the United States had the third, at 25.4% (25.6%) (See Table 2).
The average? 36.3%. By contrast, America's national tax rate ate up 28.4% of GDP during the dismal economy of 1999 (growth rate: 4.2%). 28.4%, happily, is 1% more than The Heritage Foundation thinks we'd need to cover the Boomers. And so there ya go, the solution to the unsolvable: raise taxes to the level they were at during the massive growth of the economy, create some smarter programs, and the Baby Boomers will make much less noise. And the sooner you do it, the smaller the hike could be.
The Baby Boomers Get Old
A bit boring, sure, but I think this may be useful. There's a certain subset of commentators and pundits who like to engage in a lot of eschatological posturing about the Baby Boomers coming retirement. The implication, always, is that we must either become a nation of paupers or leave our parents to beg on the street, there is neither a desirable middle ground nor the slightest sliver of hope. This isn't to understate the cost issues or pretend there are no tradeoffs, but it's worth thinking a bit about how big the baby Boom really is. So here ya go:
And that's, well, it. For you USA Today readers, here's the same data in pie graph form:
Granted, you can't deal with a demographic crunch by cutting taxes, running up massive deficits, and crafting new entitlements in the most expensive, inefficient ways possible, but if you're serious about creating good public policy and willing to raise taxes to levels more in line with other Western governments, the coming retirements are fully absorbable. Add in a smarter immigration policy (immigrants tend to pay in much more than they take out from long-term entitlements), a renewed seriousness towards cost control, and a diminished willingness to sacrifice savings for industry profits and the insurmountable problems we face become instantly more surmountable. The Baby Boom will force soem touch choice, sure, but only because our legislators have been so profoundly unserious, ideological, and short-sighted thus far.
2004 The Remix
While we're talking about Tim Kaine again, another thing that concerns me about his selection: The Democratic Party has a tendency to fight the last battle when it's time for the next war. Kaine's selection is an explicit attempt to address the "values question". His claim to fame is not simply winning election in a pink-tinged state (Brad Henry or Evan Bayh would be more impressive on sheer triumph-over-registration grounds), but doing so through constant, authentic, and successful invocation of his Catholicism.
See? The Democratic Party is religious!
But setting aside my hand-wringing over the implications of his win, the battle du jour isn't religion, but corruption. Republicans would love for us to make 2006 a reprise of 2004's lame protestations of piety. What they'd prefer not to deal with is a focused critique on the nexus of Republican dominance, lobbyist influence, and corporate power. Deploying, say, an Elliot Spitzer to argue that case would make sense. It would be relevant. Tim Kaine, however, is not the party's most visible or credentialed spokesperson on anticorruption issues. He's uniquely relevant to 2004's election, but not 2006's. The question is, which one do Democrats think comes next?
I should say, by the way, that I quite like Tim Kaine. I'm glad he won in Virginia. I'm sure he'll be a good governor. But I don't think he's the right face for the party. Televised speeches are superficial affairs and they're judged on superficial grounds. Thinking him wrong for this job is not the same as thinking him a bad guy, or even a bad Democrat.
January 29, 2006
Katrina Throws Down
Yeah, I guess I deserved that. You know what? Never mind. Katrina vanden Heuvel's slap at me for knocking Tim Kaine's appearance while not looking like Brad Pitt purposefully misses my point. In politics, looks matter. That's why the cover of Katrina's new book features her in a miniskirt. That's why a study found voters could look at pictures of two Senate candidates they'd never seen before and predict the winner with 72 percent accuracy. Kaine will be giving the State of the Union response on behalf of the entire Democratic Party. He will be doing it on television, a medium acknowledged as visual ever since John F. Kennedy won a beauty pageant against Richard Nixon. In this context, just about nothing could be more relevant than his looks.
On a slightly different note, Katrina writes:
For liberal bloggers who want to get exercised about something really important: Where are the Democrats or liberals talking about Ford laying off some 30,000 workers, the end of middle class benefits for working Americans, IBM's gutting of pension security, and the collapse of American manufacturing?
In order, how about here, here, here, and here? There's lots to be said against me, but insufficient attentiveness to the collapse of the corporate welfare state just doesn't stick. Also, one post on something doesn't mean I'm exercised about it. I think this this is a perceptual gap between folks who began in print and those who started on blogs, but I write, between my three sites, about ten different posts a day. That five or six of them orbit health care is fairly good evidence that the subject upsets me; one post on one day focusing on Kaine really doesn't rise to the level of obsession.
Bush Lays Out the Case Against Hillary
Okay, he didn’t really lay out the case against Hillary, but he did lay out one of my basic objections to the thought of President Hillary Clinton in 2008:
President George W. Bush says Bill Clinton has become so close to his father that the Democratic former president is like a member of the family…
Bush jokingly referred to speculation that Sen. Hillary Rodham Clinton, the former president's wife, will seek the Democratic nomination for the presidency. He had earlier referred to the former first lady as "formidable."
"Bush, Clinton, Bush, Clinton," he said, referring to how Bill Clinton had followed his father, and Hillary Clinton could follow him.
I have all kinds of reasons for not being thrilled about Hillary as the Democratic nominee, most of which are more substantive, but the thought that members of two families could be running the country for a minimum of twenty-four consecutive years (thirty-two, if you count George H.W. Bush’s vice presidency) is just ridiculous.
(And, in a broader sense, it is part and parcel of substantive issues like how power plays out in American politics and the primary process and other things, but generally speaking, it’s just sort of yucky.)
Two Words to Make the Democrats Quake: Cindy Sheehan
By Pepper of the Daily Pepper
This announcement is more than enough to send a rumble through DiFi's base:
In a move that dang near trumps Kerry's call of a filibuster from #@$%# Switzerland, Dianne Feinstein pulled an about-face and is now calling for a filibuster:
Sheehan earlier had criticized Feinstein for not immediately backing a filibuster of Supreme Court nominee Samuel Alito.
Feinstein announced on Friday that would in fact support that filibuster, the same day Sheehan issued a statement saying she would run against the senator if she didn't take a harder line.
Is it Kerry's mobilization that has pushed Feinstein to move against Alito? No. It's more likely the realization that the looming Peace Momma could seriously damper Feinstein's fundraising prospects.
I have no illusions that Alito can be stopped at the last minute, but I was shocked at how easily DiFi - the only woman on the Senate Judiciary Committee - rolled over when it came to Alito. She represents a liberal state, full of liberal women who might, I don't know, like to see their rights preserved.
Of course, Sheehan has been in Vanity Fair and is hanging out with Hugo Chavez, so her chances of being taken seriously are slim, but many people who supported Feinstein because she was a Democrat are disillusioned. Catherine of Poverty Barn wrote DiFi a scathing open letter, and Sheehan could walk off with a sizable chunk of DiFi's base. Methinks Sheehan gave DiFi just the scare she so richly deserves.