Is This The End?

Maybe, maybe not.  For now, though, we will take a break from this site to focus on new challenges and spend more time with our family.   

Thanks for reading during the last year.  We had a ball thinking and writing about politics and thank you for your readership.

The Editors

Pigouvian Tax

Be sure to check out Friedman's exhortation for a gas tax in his Sunday column.  It is amazing, as he puts it, that a gas tax is considered a 3rd rail of politics but sending soldiers to risk their lives is pushed through with limited debate, especially when you consider that in the absence of a gas tax we are financing both sides of the middle east wars and Al Qaeda.

One leading Republican economist (and Bush advisor), Greg Mankiw, has long voiced support for gas and other so-called pigouvian taxes.  Check out his ideas here.

The Dole

In case anybody wants to know what happens in a truly distributive, socialist state, we recommend this commentary about the U.K. welfare system. 

The fundamental problem is that the incentive system here encourages staying on the "dole" over working.  The system, seeped in language of compassion for the "jobless," and "low earners" needing "wage support," is a hugely expensive, inefficient, and misaligned attempt at compassion that creates a permanent underclass instead of lifting those who need help.

The reforms highlighted here would simplify the system, but do not challenge the premise that the government should be handing out billions without any expectation from its able recipients.     

Healthcare Pyschology

In a recent issue of the New Yorker, James Surowiecki ponders America's inability to enact meaningful healthcare reform. Why, if many public opinion polls show widespread support for change in theory, is it so hard to achieve change in practice? While it is easy (and obvious) to point to the fear and doubt campaigns advanced by the increasingly shrill far right, it appears that there is also a subtler psychological issue at work.

Specifically, most of us "are prey to the so-called 'endowment effect': the mere fact that you own something leads you to overvalue it." According to Surowiecki, 70% of Americans report that they are satisfied with their current coverage. "What this suggests about healthcare is that, if people have insurance, most will value it highly, no matter how flawed the current system." This in turn plays into what economists call the 'status quo bias,' which means that given a choice, most people will prefer to keep things the way they are rather than to opt for change. Which is another way of saying that we fear loss more than we appreciate gain. So while we might say that we are pro-healthcare reform, in reality most people 1) overvalue the insurance they have, 2) would prefer not to change things unless improvement is a sure bet.

The way forward? For one, Obama should quit talking about cost cutting, which "makes people think about what they might have to give up. And that makes them value what they have more highly." It would be more effective for now to reassure people that they can keep their current coverage (even if it isn't very good). Then, once clearly more attractive options are in place, they will come around. Palatable reform should be sold as being in the service of protecting the sacred status quo, not shattering it. Interesting idea!

Is it Racism?

Maureen Dowd's Sunday column alleging that racism may have something to do with right-wing opposition to Obama has attracted the attention of many writers.  The NY Times Opinionator aggregates a number of the more compelling takes on this angle, and is a very interesting read. 

We were particularly interested in the commentary at the end about "shadow projection."  The psycholically astute insight is that the right is projecting its own fears about itself onto Obama: unable to tolerate that it was their party that oversaw unchecked public spending, that initiated spying on its fellow citizens, and that flubbed the war in Iraq, many choose to see the worst of themselves in the "foreign other" (in this case Obama).   

Eat Food. Not Too Much. Mostly Plants.

Michael Pollan, author of "In Defense of Food: An Eater's Manifesto," with an interesting column discussing the intersection of obesity and rising health insurance costs.  

Pollan explains how "Big Food" and the Health Care Industry have a symbiotic relationship today: BF fattens up the population with low-price high-fat foods which in turn provides a steady stream of profitable patients (remember that insurance companies deny coverage to sick people or wiggle out of paying the insured, so high rates of diet-related disease do not disrupt this relationship). 

Pollan posits that regulations requiring insurance companies to provide a base-level coverage without regard to pre-exisiting conditions will create a powerful counter-force to "Big Food"--the Agribusiness interests that make junk food cheap and fresh produce expensive (and pollute the waters in farm states).  Insurers will suddenly have an incentive to discourage consumers from soda and junk food to avoid the high costs of disease management for say, Type II diabetes.

Interesting idea...and an unconventional way of looking at the changes that might come even with modest health care reform.

Tweedle Dee & Tweedle Dum

Check out Friedman's column in today's Times, where he writes about the perils of a one-party democracy:

The G.O.P. used to be the party of business. Well, to compete and win in a globalized world, no one needs the burden of health insurance shifted from business to government more than American business. No one needs immigration reform — so the world’s best brainpower can come here without restrictions — more than American business. No one needs a push for clean-tech — the world’s next great global manufacturing industry — more than American business. Yet the G.O.P. today resists national health care, immigration reform and wants to just drill, baby, drill.


We have argued for years that Republican neglect of the law-and-business-center was an opportunity for Democrats to strategically pick-up centrist conservatives (i.e. not primarily "religious" voters) by re-framing standard debates: climate change is not about tree hugging, but about national security; healthcare reform is not primarily a moral cause, but a cost-cutting imperative.  Alas, one party control seems to be pulling the party further left, to the detriment of good policy and possible election dominance. 

Dowd's column today is not her best, but she does a fantastic job of explaining what so many of us dislike about both political parties:

In the absence of more vivid presidential leadership, the Democrats have reverted to their old DNA — self-destructive scrapping and spending. And the Republicans are sticking to theirs — being mean-spirited and shameless, attacking big government spending while taking no blame for their own.

R.I.P. Van Jones

For a quiet news day, there is a lot of fluff about the resignation of Van Jones, one of Obama's "green" advisors.  Before you accept Glenn Beck's characterization of the man, check out this January New Yorker profile of Jones before he was invited to serve in an advisory capacity. 

Short version: Jones, a Yale Law grad, founded and ran a group called "Green for All" dedicated to addressing two separate problems, climate change and chronic underemployment in poor neighborhoods, by creating clean energy jobs and providing the requisite training to "underserved" communities.

Status Quo

This is our weekend reading: "How American Health Care Killed My Father" from The Atlantic.  It was sent to us by a close friend (thanks, MA) and recommended by David Brooks in his op-ed column today. 

What Might Have Been

You may recall that Tom Daschle was supposed to be the HHS cabinet secretary who would shepherd health care reform through Congress.  Like many appointees, he ran into trouble and was forced to withdraw.

Today's WSJ op-ed by Mr. Daschle makes me wish he had been appointed anyway.  He is the first Democrat to make a clear case of what health care reform is about:

The goal of meaningful health reform should be to expand coverage, reduce projected costs, improve health-system quality, and enhance health-care options for all Americans.

Back to Work

Apologies for a quiet week from The Informed Voter.  It's not that we aren't reading and reviewing potential posts...it's just that nothing has tickled our interest enough to ask for your time.

As we shift from summer to autumn this weekend, putting the seersucker away for next spring, the political world is gearing up for an interesting period.

The "big" headline today is that Obama will finally wade into the healthcare debate with an address to Congress.  Next time, perhaps, he will start with such an address and frame the debate first?  We are cautiously optimistic that he will be able to turn the tide and build a public consensus in favor of some incremental reforms: epanded coverage of children, subsidies for other Americans to buy insurance, and regulation preventing insurance companies from denying coverage based on a pre-existing condition.  To date, the President has been too aloof, not clear in what he wants to achieve and why we should all share his goal, and so he must dig deep and save himself again--just as he did several times on the campaign trail.

Coeur de Lion

The next few days will see extensive coverage of Senator Kennedy's life. It is unlikely, however, that any other organization will so thoroughly capture the highs and lows of this most influential senator's life as The New York Times has in this detailed report.

What Would Reagan Do?

From the 1961 "Operation Coffee Cup Campaign Against Socialized Medicine," Ronald Reagan (before he became a politician) describes how health care reform leads to socialism.

Two thoughts:

1) We have wondered why anything Obama does, no matter the area, he is branded a socialist by his most vocal opponents. This helps make sense of that charge: proponents believe that anything the government creates a slippery slope to total control. A bit paranoid, perhaps, but at least this explains the vein of thought.

2) Obama could use his own "Coffee Cup" campaign to explain why health care reform is important. Obama and Reagan may both be great communicators, but what Reagan mastered--and Obama has not--is the art of making complex ideas seem simple.

Selling Change

As a corollary to the Peggy Noonan piece we posted last week about the Obama administration's failure to make the case for health care reform, this editorial from today's Financial Times suggests a way forward in both policy and rhetoric.

The argument:

The overriding priority should be universal or close-to-universal access to a basic insurance package...Mr Obama must therefore say what he has so far avoided saying – that universal coverage comes at a price and the price is worth paying.

A Simple Idea

Peggy Noonan oscillates between brilliant and incoherent. Fortunately for any Democrat wondering how Obama and his team botched the roll-out of healthcare reform, her column today is very insightful.

The key take-away:

Every big idea that works is marked by simplicity, by clarity. You can understand it when you hear it, and you can explain it to people. Social Security: Retired workers receive a public pension to help them through old age. Medicare: People over 65 can receive taxpayer-funded health care. Welfare: If you have no money and cannot support yourself, we will help as you get back on your feet.

These things are clear. I understand them. You understand them. The president's health-care plan is not clear, and I mean that not only in the sense of "he hasn't told us his plan." I mean it in terms of the voodoo phrases, this gobbledygook, this secret language of government that no one understands—"single payer," "public option," "insurance marketplace exchange." No one understands what this stuff means, nobody normal.

Gotcha! Gang

If you follow politics and enjoy William Safire's "On Language" column, you will love this Vanity Fair edit of Sarah Palin's resignation speech. The article is an excellent example of bad writing edited and finessed into good communication.

Enjoy, red pen and all!

Thank you to HN for alerting us to this piece.

Crazy Like a Fox

The Daily Show does two things especially well: 1) show that a person's previous convictions/statements contradict his or her current position on an issue and 2) make fun of Fox News. Combine both, and you have tv magic.

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Fox News: The New Liberals
http://www.thedailyshow.com/
Daily Show Full Episodes Political Humor Healthcare Protests

Formidable Opponent: Glenn Beck vs. Glenn Beck

The Daily Show presents video of Glenn Beck--idiot, blowhard, racist--against U.S. healthcare before he was for it. Bite-size, at just under 4 minutes.

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Glenn Beck's Operation
http://www.thedailyshow.com/
Daily Show Full Episodes Political Humor Spinal Tap Performance

Healthcare Round-up

One of the points that Democrats and Republicans have missed in the health debate is that no matter the outcome, the U.S. will continue to have a multi-tiered healthcare system wherein those with money will have access to better care more quickly than those living on more modest means. For Democrats this would require acknowledging that the reforms will not lead to equal healthcare for all, and for Republicans this means admitting that even a national healthcare plan will allow those with money (and no pre-exisiting conditions) to purchase premium care.


In Britain, which has become a punching bag for national healthcare, the system is also tiered. The baseline care is provided by the National Health Service (NHS), which, with the exception of dentistry (insert joke about English teeth here) offers a full range of medical services. Every single person is covered by NHS.

However, many individuals or employers also purchase private supplementary policies (nationally, the figure is about 1 in 10 Britons). These policies are designed to mitigate the weaknesses of the NHS by allowing you to go into a private network for additional care as needed, and without delay, which is one of the chief weaknesses of the NHS. For employers, a supplemental policy can make a great deal of sense as it helps keep workers working, and not taking time off on sick leave while waiting to see a doctor.

Finally, some individuals purchase private insurance, which gives them access to any private doctor's practice, hospital facility, etc. This is the most expensive option, and the small irony is that in some cases (particularly emergencies) you will still be shipped back into the national care system because--gasp--it is better at critical care.

We fall into the second camp: NHS plus supplementary insurance. In the two years we have lived here we have never needed the supplementary care (good news), and fortunately our experience with the NHS has thus far been very positive.

The bottom line is that the NHS provides excellent critical care, ok to good regular medical care, and plays an active role in preventive care and well-being, providing nutrition classes, etc. Most importantly, it gives every single resident guaranteed healthcare whether or not they lose their job, and nobody here ever files for bankruptcy due to medical bills. It is also immensely freeing to leave a doctor's office and know that you won't be haggling over co-pays and other charges with your insurance company for months into the future.

Last week President Obama compared government healthcare to the Post Office co-exisiting with private options like FedEx and UPS. This was largely decried as politically inept (it probably was), but may have been more revealing about how healthcare reform might play out. A national health plan will in fact probably be a bit like the post office: full service, but maybe not quite as reliable as FedEx.

For the vast group of Americans who are uninsured, and for the many more who are under-insured to various degrees, reliable baseline care would be a huge relief and safety net. Economically, it would lift the risk of medical bills for serious care, could make it easier to be an entrepreneur (leaving a job with healthcare would no longer be such a scary proposition), and should lead to lower medical costs with the government as bulk purchaser of many goods and services. Morally, it is an imperative to make sure that our fellow citizens have access to healthcare as a birthright of citizenship. The government should do few things but do them well, and organizing healthcare access is, to us, one of those things.

But don't just take our word for it. There have been so many interesting angles on the debate-- we have highlighted a few below.

For a perspective that dovetails closely with ours, read today's op-ed from Sarah Lyall in the NY Times; Ms. Lyall is an American living in Britain who recently wrote a wonderful book about being an expat in London called "The Anglo Files."

For some insight into why it might be a good idea for Republicans to think very carefully on how they will want to play their stance as defenders of healthcare to people over 65 (ground more traditionally tread by Democrats), see Ross Douthat's clever editorial.

And finally, a physician named Richard Dooling asks us to ponder an admittedly tough question-- at what point must Medicare be rationed for the aged? -- in an Op-Ed in today's NY Times. Fascinating and controversial.

There has also been some great stuff coming out of the BBC and the Guardian about the US healthcare system as seen by outsiders. More to come!

Healther Skelter

An instant classic, from The Daily Show:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Healther Skelter
http://www.thedailyshow.com/
Daily Show Full Episodes Political Humor Spinal Tap Performance