Health Care Repeal

Well, it looks like the Republicans are determined to push for full repeal of "ObamaCare" and have no intention of doing any sort of negotiation to improve the law and insert some of their own priorities.  This is no surprise of course- their base would destroy anyone who tried to compromise in any way. 

I could imagine an alternate universe in which Republicans proposed getting rid of the individual mandate or inserting tort reform in return for dropping plans for repeal and/or dropping attempted lawsuits.  In this world, however, they can't do it.

So what's going to happen?  Republicans are clearly going to fight like hell, with every weapon they can think of at their disposal, to destroy health care.  They'll use the courts, they'll use the filibuster, they'll use the budgetary process, and of course they'll continue to lie and demogogue it.  We know all this.

What we don't know is what Democrats will do.  Will they fight back?  Will they huddle in the corner sucking their thumbs?  Will they whine about how Republicans are abusing the filibuster?  Or will they stand up for what they supposedly believe in?

I wish I were more optimistic.  This fight isn't over yet.  The other side is bringing it- are the Democrats ready to keep fighting?

As an addendum, I'll just note that the Democrats are apparently making no changes in filibuster rules, so I fully expect Republicans to stall court nominations among other things.  Then I fully expect Democrats to express lots of predictable outrage while doing nothing about it.  Then, when Republicans are in charge of the Senate and the presidency, I fully expect them to eliminate the filibuster themselves without a second thought when Democrats start to use it, in the face of more Democrat outrage.  Republicans play hardball, and good for them- at least they believe in what they want enough to actually fight dirty for it.  If only their policies weren't so moronic....

Climate Change and (in)action

It's tough for me to put out a wonky discussion of Climate Change, since it involves the hard sciences, which is a lot harder for laymen to understand than economics or other social sciences. It's easy enough for Climate Change deniers to dig up some wacko academic who disputes the common wisdom of the field and has a PhD, but I think one has to look at what the consensus is among scientists in that field, and it's pretty clear.
But I come back to this line of reasoning: there's a good possibility that Al Gore is right, and that Climate Change will keep accelerating, that we'll continue to see year after year set new records as hottest on record, that polar ice caps will melt putting Bangladesh under water, that deserts will grow and more of the planet will become uninhabitable, etc etc. If the worst of the predictions are correct, we're going to be REALLY sorry we didn't act, because every year we wait the problem gets harder to solve.

Now of course it's possible that the scientific consensus is wrong- after all, there was once agreement that the world was flat, and that diseases were caused by witchcraft. If that turns out to be the case, we'll have lowered carbon emissions for no good reason. Well, even that isn't right, because I think everyone agrees that carbon emissions leads to unhealthy air to breathe, smog, etc so there's some benefit even if Climate Change scientists are wrong.

So think about the relative downside of going the wrong way on either side: either we do nothing and confront a catastrophe, or we do too much unnecessarily and waste resources we could have used for other economic growth. Which one is worse? Seems pretty obvious to me. And to top it all off, the odds of Climate Change being real seem much better than the odds that it's not, seeing as nearly all climate scientists agree that it's real.

The Manufactured Social Security Crisis

Amidst all the forecasts of doom regarding the budget deficit, I keep hearing about how politicians have screwed up social security so badly that it's out of money and we have to make huge changes to fix it.  We got some of this from Simpson-Bowles of course, and I keep hearing it from my conservative correspondents too.  Social Security is paying out more than it's taking in!  The Trust Fund is a fiction!

But think about it this way: Social Security is just a Math problem, and a really simple one at that.  We pay a certain rate to Seniors.  Workers pay a certain percentage of their salaries to fund benefits.  A percentage of people get on Social Security Disability at a younger age.  All of these formulas can change.  So the ways to fix Social Security are:

1. Increase the tax rate for FICA for everyone (we just lowered the rate in 2011 from 6.2% to 4.2% as part of the lame duck tax deal)
2. Increase that tax rate for high income people only (currently we only tax the first $106,800 of income- we could increase that)
3. Decrease the benefit level slightly
4. Increase retirement age
5. Means-test benefits, so rich people don't get paid out
6. Toughen up requirements for disability

And of course we could go with some combination of more than one of the above solutions.  These are tough choices of course, and my preference is to go with #2, but reasonable people could disagree.  I am strongly opposed to #5, which would lead to erosion of support for Social Security over time as it would come to be seen like welfare, in which poor people are seen by the Right as sponging off the hard-working. The reason SS has been so successful for so long is that we're all in it together.

So there's really no "crisis" in Social Security.  There's a demographic change because baby boomers are retiring and the population is going to get much older, so there are fewer workers to pay benefits.  That's not because we've become a lazy country or there's some moral failing- just blame those WW II GI's making all those babies at the same time when they got home.

So yes, Social Security needs to be fixed, and can't be left as is.  But there are lots of ways to do it, all of which will definitely work.  It's just a question of enough people in Congress and the President agreeing about our priorities.  All big problems should be so easy and un-complex.

Republican Response

Paul Ryan drives me crazy.  Why?  Because he has managed to get himself considered the "responsible" Republican on spending.  Meanwhile he voted for tax cuts that weren't paid for, Medicare drug benefits that weren't paid for, and it goes on and on.  He says he wants spending cuts first- sounds great! But of course there are no details there at all, and I predict he won't actually propose realistic spending cuts that can pass- he knows spending cuts are much less popular than tax increases on the Rich when you actually start cutting stuff- everyone likes cuts in the abstract, until it affects them.

State of the Union

I'm really really trying to watch and listen to the SOTU tonight, but it's so hard to do. Last administration I thought I just hated listening to GW Bush talk (which I did).  But now I realize that it's just hard to sit through political speeches in general.  Maybe it's just me, but I don't find political speeches exciting or inspiring- I'm much more a creature of the written word.

But as to the content: more of what we've learned to expect from Obama; playing the role of the Reasonable Adult in a room full of squabbling children.  And I guess that's appropriate for SOTU, which isn't a time for Fire and Brimstone.  I just hope that comes later when he hits the road.  I was glad to hear the push to end the tax cuts eventually.  I was less glad to hear about freezing government spending, as I think that just cedes too much ground to Republicans right now.

But it's so hard to listen to, that I couldn't pay full attention.  Got my checkbook balanced, though!!

Our Idiotic Punditry

I was talking with a colleague at work today about the Arizona shooter.  Both my colleague (PT) and I are mental health professionals with lots of experience with quite mentally ill people.  PT noted that he had seen some television pundits on the air talking about mental illness and what could have or should have been done with Jared Loughner and might have stopped the shooting.

First of all, under current mental health law and practice, being psychotic isn't enough to get someone locked up involuntarily.  A person has to be a danger to self or others, or so impaired that he/she can not take care of him/herself (that's the wording in my state, but I believe they're all similar).  Loughner was acting strangely, but not dangerously; yet talking heads that PT saw were claiming someone should have seen the signs and locked up this guy.  Of course those of us who work in psychiatric settings know that even if an ill person is locked up and medicated properly, there's nothing to stop him from discontinuing his medication as soon as he gets out, and the cycle repeats.  We see it all the time.

So the pundits (whom I didn't see- don't know who), generic TV talking heads, have no idea what they're talking about, as anyone who has worked in mental health could have told them.  That doesn't stop them from spouting off, of course.

But I want to make a larger point about TV punditry.  They don't know much about anything. Except politics and media.  And when I say politics, I mean it very narrowly: they understand how Democrats and Republicans frame arguments and play the games of electoral politics.  But they don't know much about policy.  That's why it's so hard to find out by watching television anything factual about something like the Affordable Care Act.  Since the media only uses their tired formula- "he said, she said", they allow one side to frame the debate with lies or distortions if they so choose.  With health care, that side is the Right of course, but the Left can just as easily benefit.

And the pundits can't really cut through the crap because most of them don't understand or try to understand the intricacies of policies.  They're not wonks, and they're proud of it.

So for all the mainstream media's heckling of basement-dwelling bloggers, the internet is really the place to go to get policy facts and actually learn something about the policies that affect us every day.  Ezra Klein and Jonathan Cohn and Jonathan Chait and Matt Yglesias and Paul Krugman actually know something about policy, not just about politics.  I don't know nearly as much as any of them (hey I only do this in my spare time!), but I think I know a lot more about health care policy than Pat Buchanan, Joe Scarborough, Sean Hannity, and James Carville.  And it shouldn't be that way- those guys should be learning about policy and telling us about it, but they don't.

A Note About this Blog (posted by DT)

Well, my former partner in crime, AS, has faded from view here on this section of the intertubes, and I have decided to try to soldier on alone.  Hopefully he'll comment from time to time, but for now I have obtained full control of this little kingdom.