Health Care Reform: Those “Irreconcilable Differences,” Part II
Mar 7th, 2010 | 30 responses
A couple of days ago, I posted a piece called “Health Care Reform: Those ‘Irreconcilable Differences.’”
The post basically conveyed my opinion that just as our legislators—mostly Democrats, with some Republican support—stepped up to the plate in 1935 and 1965, and enacted Social Security and Medicare, respectively, Democrats today must act similarly on health care reform, given that:
Democrats honestly believe that Americans (especially the 30 million uninsured ones) indeed deserve a better health care system—-there is really only one choice, and that is to proceed full steam ahead and “damn the Republican torpedoes.”
As to those so-called “irreconcilable differences,” I said:
I may be wrong, but I sincerely believe that when we look back upon these “irreconcilable differences” twenty years from now, most of us who are still around will say that the major factor that made those differences irreconcilable was the politics of the day.
As expected, the post generated some good comments with respect to the validity of my claims as to the degree and the timing of Republican support for Social Security and Medicare.
Soon, however, the discussion expanded into the “health” and sustainability of programs such as Social Security, Medicare, and Medicaid, and into whether to sustain such programs we are “robbing Peter to pay Paul” and, more interestingly, whether these programs increase the “wealth gap;” whether they represent “collective care for our rich elders,” “inter-class wealth transfers,” “cross-generational subsidy programs,” or “inter-generational wealth transfers;” even whether those programs could represent wealth or subsidy transfers from the “have-nots to the haves.”
The discussion is now again expanding and shifting to broader economic issues such as government regulation (and de-regulation), tax policies, the shift of wealth from public hands to private hands, the shift of debt from private hands to public hands, etc.
As to regulation and de-regulation, I found one of the most recent comments particularly interesting, especially in how the writer used analogies:
• Virtually all major deregulation directly causes a shift of public wealth to private hands.
On the contrary, that’s the result of *increasing* regulation. The more spending you funnel through the government, the more susceptible it is to hijack by lobbyists. Indeed, the more people and corporations *have* to spend on lobbying if they hope to protect their interests.
Deregulation, on the other hand, leaves more wealth in private hands to begin with. The fly in the ointment is that that the private sector allocates wealth toward economic efficiency, which is to say “badly” if you were hoping for more social justice or ecology or other worthy goals.
Regulation is therefore the spider we swallow to catch the fly. The spider dooms us to statism and corporatism, where decisions are made centrally and driven mostly by corporate lobbyists. No one seems very happy with this state of affairs.
It’s here that liberals and conservatives part company. Conservatives argue that since we don’t like spiders, we should swallow as few as possible. Liberals want us to down another plateful, and then to swallow the bird of first amendment restrictions, in the hope of micromanaging the lobbying spiders, that they might do a better job of catching the flies.
Perhaps we’ll die.
Why am I bringing all this up?
Two reasons:
1. I find this “comments thread” to be one of the most lively, interesting and informative threads I have seen in a long time on TMV. I am learning a lot and I am sure many of our readers are, too.
2. As so happens after a post has been “out there” for a couple of days, it—and the comments—begin to drop “below the cyber fold,” and unless one is actively monitoring and commenting on it, it generally just “peters out.”
It would be a shame for such to happen to this discussion. Thus, I am posting this “Part II” in the hopes of either transferring the great discussion here, or encouraging readers to keep reading and commenting at the original post location here. (Last time I checked, there were 58 comments)
30 Responses to “Health Care Reform: Those “Irreconcilable Differences,” Part II”
Ooops!
There is a great discussion on similar issues going on at “CBO Projects Ten Billion in Extra debt.”
http://themoderatevoice.com/65070/cbo-projects-…
Scratch all of the above…
This is one of the most interesting and far-flung discussions we've had, and remarkably reduced in name-calling with but a few exceptions. I even find myself agreeing with some points of my usual sparring partners.
In the case of the above block quote, though, I have to disagree. In fact the point is specious. If government regulates less, it is not less subject to “hijack” by lobbyists. There's no need for lobbying when the industries that hire these lobbyists already got their way. For example, lobbyists fought to deregulate emission of mercury, a neurotoxin, into the atmosphere. Well sure, if we had no mercury regulations at all, we wouldn't need to fear lobbyists trying to eliminate the regulation. But that's not the point at all. We actually don't want people consuming mercury, it's not about the relative cost of regulating it v.s. not regulating it. It's about government serving the public good, not private gain.
Sure, it costs us less NOT to regulate advertising, in terms of government spending. But what does false and misleading advertising cost in money, public health implications, unfettered quick-buck hucksters, etc?
To the block quote, I really think it depends.
As green points out, regulation against things that are physically harmful is probably necessary and, although it does produce lobbying and other inefficiencies, there is not, in my opinion, a better way to do it.
Having said that, there's a lot of regulation that doesn't fit that bill. Let's take the low flush toilet as an example on the other end of the continuum. All that regulation does is create an army of people seeking to legally or somewhat less legally get around the regulation. If water usage is priced correctly, it's not clear what the regulation accomplishes.
So it's not an entirely black and white issue, although I'd say in terms of raw numbers, there are a lot more regulations of the low flow toilet variety than there are of the mercury variety. I'll freely admit that's a perception, not a fact.
GD ans steveinch:
Thanks for picking up the discussion here. I am sure Dr. J. and others will join in.
I agree with you, GD:
, and I look forward to following it, albeit my limited economics, fiscal knowledge will not let me participate as much as I would like.
Thanks
Dorian
This may seem simplistic or be simplistic…but…
If we take private funding out of the political process…can't we then efficiently regulate? We don't have to eat the spider.
“Deregulation, on the other hand, leaves more wealth in private hands to begin with.”
Not only that, but abuse of regulation, especially in the federal government which should be the last, not the first, party sought for regulation, goes back in this country to lefties being enamored of fascism and how well planning is carried forward, and the preference for a “managed cartel” in place of the ugly kind of free-for-all and “cutthroat competition leading to consoliation, increasing size of fewer players with ever larger market shares, a tendency to oligopoly or monopoly power.” (Left unsaid is how that works in our plurality voting system and the entrenchment of the two-party system with the currently losing plurality constituting some kind of opposition to which party is currently ruling.)
It's no surprise not only that some advocates of government regulation would prefer the “managed cartel” from the start, rather than taking it over by regulation sometime in the future, and that the big business interests are happy often to involve themselves in the regulatory (especially federal) environment.
*** Regulation adds to overhead, capital requirements, and other barriers to entry by numerous small competitors to the cartel members and to the cartel.
But, what if you eat the spider because you like the fly that the spider has swallowed
Sorry, couldn't resist that, and absolutely no offense intended to anyone.
As I said I am not an economics/finance expert, thus it might be better if I stay out of this from now on. Please continue. I will not interrupt.
In our drought-ridden Southwest, there is a recognized need to conserve water. Without regulating flushes, contractors put in cheaper wasteful fixtures and cash-strapped buyers buy it despite the higher water bill. (seriously, how many buyers would say, great house, great price, but sorry, wrong toilets?) Anticipating your “raise water rates” response, there is some level of wealth at which people would not be bothered by high water prices, but there are many who would be hurt by them.
If the national (state, county, city) goal is to achieve lower water use for all, this regulation makes perfect sense. Same with all green building codes. You may disagree whether we need to, or should be “forced to” conserve water or energy, but government in the public interest needs to achieve goals as directed (ideally) by a majority of voters, and not leave it to each individual to decide whether or not to use more of EVERYONE'S water.
Shannonlee, I would have hit 'like' several times for that comment. Not simplistic. Sometimes the simple solutions are the best. The corrosive effect of money on politics and on media are at the heart of many if not most of our national problems.
Well I live right next to a really big lake so I'm not sure it applies. I understand the argument but as a general rule price mechanisms are better regulators than restrictions of other sorts.
If the lobbyists are the problem then take them out of the game. Use Teddy Roosevelt's idea to eliminate private funding of elections. No money no influence over our politicians other than the old fashion under the table bribe now and then.
Corruption will always be a problem as a certain portion of the populace are crooks including those in positions of power both public and private. That is why government regulation is a necessary evil to control the greedy and unscrupulous from harming the country and its people.
The problem with government regulations is not these regulations which control things like toxic materials using GreenDreams example. The problem is when government lets regulation get out of control and over regulates. With for example unnecessary paperwork and red tape, which over burdens small businesses and people who don't really need that much regulation at least on a Federal level.
I think most Americans would like to see entities like the banking industry regulated so that things like this last economic meltdown won't occur. It is very plain that the people responsible for the current disaster got off unscathed while ordinary Americans are suffering the consequences. I would certainly give up a few points of GDP to insure that a economic situation like the one we are facing will not happen again.
As DdW said, “I am not an economics/finance expert” either so I probably should have had the same wisdom and kept my mouth shut. So please forgive me if I have said something stupid in my above statement. I am just trying to make some sense of this terrible economic downturn. Why did it happen? Why didn't the experts, and our congressmen with oversight, see it coming? How can we stop it from happening again?
If we take private funding out of the political process…can't we then efficiently regulate?
How? Forbid anyone but Congressmen from entering Washington? Disallow citizens and groups of citizens from writing, speaking, making movies, or any other way they might try to influence large numbers of people? That's a pretty big bird to swallow.
“In our drought-ridden Southwest, there is a recognized need to conserve water.”
The future here in the Southwest requires augmentation of supplies. As with electricity production and even with transportation, conservation alone won't solve the problem and never is seriously expected to.
Is there a “need”? No, but it makes sense, if it can postpone the need to augment supplies later, giving us more time to plan and prepare for what else we have to do. I have no problem with xeriscaping in the desert, using drip irrigation, all that stuff. (Crops on irrigated farms might be changed to something less water-intensive, which would be an incentive if realistic pricing for irrigation as well as other uses began to happen with water.)
Note that something badly neglected with water, and true elsewhere, is realistic pricing of water. That will be attacked the Left often as “market-based incentives” or “solutions,” but it is real. Why have subsidized or otherwise too-low water rates to maintain (water) golf courses in the desert, or fill swimming pools without covering them to fight evaporation? (That large water projects haven't included cost-effective evaporation reduction measures — covering reservoirs and open aqueducts, as well as creating ground water sites underground to combat evaporation losses — is something else expensive but possible someday if we must resort to it, eventually.) Anti-development and anti-water transfer and anti-water project reflexive opposition is nonsensical, but on the more realistic side, why should water be provided to people subsidized at rates of 80-90 per cent or more in extreme cases, to grow high-water-use crops like alfalfa? Realistic pricing of water will be attacked as “unfair” to the poor*, but can't that problem be addressed separately?
* and don't forget the huge increase in food costs if irrigation water prices matched residential-industrial.
“[With water,] price mechanisms are better regulators than restrictions of other sorts”
And attention to this is long overdue.
The future of the West involves the need to boost water supplies (transfer of water, including between water basins or watersheds, to correct some of the maldistribution of water in the region). But even with old as well as new projects, who should pay, and how?
It's not just a grand Western phenemonon, but a definitive part of California's development in modern times.
Now after all that, consider how general your remark actually is. What about relieving shortages of gate space at airports by not simply “peak pricing” or other schemes, but full-out auctions and even varying prices, with airports subjecting the airlines to the same kind of “yield management” techniques with which the airlines happily subject their customers (passengers)? (serves the airlines right, heh, heh)
entering Washington??? I'm pretty sure I didn't write that.
I think it would be pretty easy to implement. No private funding of campaigns…making movies or commercials about candidates…concepts okay. Sure, there could be some tough lines to draw, but we could figure it out.
The problem with this sort of change is that it requires people in office to voluntarily put their careers at risk in order to do what is right for the American people….no way this crop of politicians will do that….no way their puppet masters will all those strings to be cut.
I'm tellin'
Well, if you could cut strings, the best way to prevent money from influencing Washington, is to keep Washington from funding corporations in the first place. Those strings run both ways.
I still support subsidizing certain things…but I understand your consistent POV on government intervention.
I think if you take the money out, you get honest subsidizing. We'll have to watch politicians as they leave office for private work….there will have to be no-competes contracts
Shannon,
I just don't see, as a practical matter, how you propose to do that. The more you limit people's access, the more they will work around those limitations. Certainly that's been the lesson of McCain/Feingold.
I'm with ProfE, as long as government has the power, people are going to spend money for influence and I simply don't see how (leaving aside the question of whether it would be Constitutional to do so) you would practically stop people from trying to influence their representatives. Indeed, isn't that what they are there for in the first place, to represent their constituents.
The entire argument you seem to be making requires defining some interests as legitimate and others as not legitimate. Let me give you a simple example.
You probably don't want to prohibit me from calling or writing my Congressman. Do you want to prohibit me from using money to encourage people to call their Congressmen? What about setting up a 1-click website where they can send a message to their Congressman? What about creating a voluntary association where we produce a commercial to run in the district suggesting what the Congressman should do?
My point is that restrictions sound easy but prove to be very challenging in practice because most people proposing them have an implicit view of what constitutes legitimate versus illegitimate speech or influence. It's that view that could potentially be debated. If we agreed on that, maybe we could agree on how to limit things but I strongly suspect that we have no broad agreement on what constitutes illegitimate versus legitimate actors.
The problem with this sort of change is that it requires people in office to voluntarily put their careers at risk in order to do what is right for the American people
That approaches why I don't think it's feasible. Everyone–not just politicians–will quite sensibly strive to influence decisions that affect their lives. You can outlaw outright bribes to politicians, and people will exert their influence through campaign contributions. Cap those, and they'll recruit many individual donors. Outlaw contributions outright, and they'll spend money to lobby voters directly. Outlaw that, and they'll disguise the messages, or use indirect messengers. Crack down on those, and … well, we turned into the Soviet Union a couple steps back.
I'm from Berkeley, and I believe in giving the power to the people. So let's stop wagering more and more of it in a big dice game in Washington and simply give it to them. Like you and GreenDreams say, sometimes the simplest solutions are the best.
Love it.
“You probably don't want to prohibit me from calling or writing my Congressman. Do you want to prohibit me from using money to encourage people to call their Congressmen? What about setting up a 1-click website where they can send a message to their Congressman? What about creating a voluntary association where we produce a commercial to run in the district suggesting what the Congressman should do?”
All of these things are fine…until you have to pay for commercial time. That is where the money comes in. I think these lines can be drawn. We draw them for everything else…well, actually lobbyists draw those lines….why not for deciding what is deemed a monetary contribution?
But you are not giving the power to the people…unless the people are teachers unions and big oil. In the current system, every American will have to belong to some special interest group in order for their voice to be equally heard.
Every American does belong to a special interest group, in fact a whole bunch of them. Which they occasionally support explicitly, such as by paying union dues or donating money to the ACLU. More often they support them implicitly by buying their products. Or they may “belong” in a looser sense of having their interests represented by a group they don't actively fund; for example the environmental lobby may represent causes you care about even if you don't pay them.
Anyway, if you've heard me defending the current lobbyist-centric system, you've missed my point.
Then I must be the only idiot in America that doesn't belong to a special interest group
I understand your point…along with SI. My problem is that I see special interest groups as the cancer that must be chemo'd out of our political system.
But setting up the 1-click website costs money. Spending money to suggest people call or write their Congressman costs money. Everything costs money. We tried to draw lines with McCain/Feingold and wound up with a bunch of “independent expenditure groups” instead.
My only point is it's a lot harder to draw lines than you think it is. I haven't seen any practical solutions recently though it's not something I've heavily researched.
I see special interest groups as the cancer that must be chemo'd out of our political system.
I'm not sure what that would leave. If teachers' unions are special interests, how about consumer advocates, the AARP, or people who want us to end our wars in the middle east? If they're not all “special” interests, what kind are they, and who gets to decide?
IMHO, all interests are special, and government is an arena where they duke it out.
I agree with you shannonlee. It would probably take an Amendment to the Constitution but it would solve the dilemma and level the playing field. Freedom of speech would not be thwarted as people corporations who ever can still grab the soapbox, write to Congress, blog or whatever. Imagine that free speech meaning you can say whatever you want to say (real speech as opposed to speech as defined by lawyers). The real problem is everybody else wants to limit the size of contributions their opponents are giving and not touch their own contributions.
Sorry, Dr J, but special interests that are only advocate groups, like the anti-war groups, are not the same as the AARP and teachers' unions. As I've pointed out before, both the AARP and unions have been found to work against their members' wishes.
As I've pointed out before, both the AARP and unions have been found to work against their members' wishes.
Then you've pointed it out again. And no need to apologize, no one seems to be saying differently.