2013 – Page 122

Hillarycare’s Ghost Could Haunt Clinton

David Corn advises the Clintons to pray for Obamacare’s success:

Hillarycare ended up a political failure and set back the cause of health care reform for nearly two decades. It’s not an episode that Hillary Clinton would want discussed during a 2016 presidential campaign. If Obamacare thrives, there will be no reason to look back to Hillarycare and drag these charts out of the dustbin of history. But should the Affordable Care Act falter or collapse, a question will loom: What would Hillary do about health care? Her past record would be raked over and that would likely not boost her presidential prospects. Having screwed up in the early 1990s, could she argue that she would do a better job in reforming the health care system than Obama?

It would be best for a Clinton 2016 campaign for health care to be off the table—with no need to revisit all this inconvenient ancient history. That means she and Bill should be hoping that the implementation of Obamacare proceeds well—and they should do all they can to encourage that. So Bill Clinton ought to coordinate (closely) with the White House on what stuff he should be explaining. It’s not only the president’s political fortunes that are tied to Obamacare.

A Reversal Of Political Fortune

Domenech is amazed that Obama’s healthcare advantage has disappeared:

President Obama’s signature domestic policy may have accomplished something previously unthinkable: taking an issue where one party had a dominant hold on public opinion, and reversing it in favor of the opposing party. If the latest poll numbers and enrollment figures are to be believed, we could be witnessing a political achievement unequaled in modern political history: the complete demolition of one party’s long-term dominance on an issue area – the Democrats’ ownership of the health care issue – in the space of a few months.

Green remembers the state of affairs last month:

Clearly, the failed rollout of the president’s health-care plan is causing the public to lose faith in him. But let’s remember that congressional Republicans forced the government to shut down, and that it was still shut less than a month ago. Yet today, Americans have more confidence in Republicans’ ability to govern than they do in Obama’s. This is plainly a lesser-of-two-evils situation. But it’s pretty remarkable nonetheless: Republicans haven’t just survived the shutdown, they’ve prospered—at least relative to Obama.

(Chart from Emily Ekins)

Obama Changes Course

He’s going to allow the renewal of plans cancelled due to the ACA. ~~The president is scheduled to speak any minute now~~ Update: The speech has concluded but you can still watch it using the video below:

Barro analyzes the news:

One key matter to watch with the President’s proposal is how many cancellations it will actually prevent. Even if insurers are allowed to offer renewals, they may not always choose to do so, either because of the logistical challenges associated with un-cancelling health plans just 47 days before the start of the new year, or because the Affordable Care Act changes the insurance market in ways that make certain old plans unprofitable for insurers.

State insurance commissioners would also have to cooperate in the renewals, for example by approving premiums for 2014. That would be difficult on the tight timeline.

That’s why Landrieu’s bill, unlike Upton’s, forces insurers to offer renewals.

Before Obama’s announcement, Chait worried about short-term fixes causing long-term damage:

Undermining Obamacare in order to placate angry individual-insurance holders makes no sense even on narrow political terms. People losing individual insurance they like are angry right now, but they’re a tiny minority of the market, and their anger will fade over time as the exchanges come online. Higher premiums would affect far more people, and their impact would be felt much closer to the midterm elections. Imagine it’s next year, insurers are pulling out of the exchanges, rates are rising, all because of a law Congress hastily passed the year before — is that a better situation?

The Worst Days Of Obama’s Presidency

The Fix passes along a depressing chart “from Robert Blizzard, a Republican pollster at Public Opinion Strategies, that details the arc of presidential approval in second terms”:

Ezra assesses the situation:

Politically and substantively, this is a low for the administration. “Things suck right now,” says one Senate Democratic aide. “They suck unbelievably much, considering where we were six weeks ago.”

The question is whether it’s rock bottom. Perhaps soon HealthCare.gov will improve, congressional Democrats will relax, and the narrative will shift to “comeback” mode. In that world, it’s even plausible that Republicans could underperform in 2014 and decide to take another look at immigration reform before their standing with Hispanics dooms them in 2016, too.

It’s also possible, however, that the Web site will continue to fail, the Obama administration’s agenda will continue to flounder, and the damage will simply mount, leading to a disastrous 2014 for Democrats and an early end for the White House’s second-term ambitions.

Given how volatile our politics is right now – remember the conventional wisdom only six weeks ago? – I wouldn’t jump to conclusions. Except this one: a president can survive a judgment of incompetence in a critical area – like the website clusterfuck. And a president can survive being exposed as a focus-grouped liar on a political promise. But both at once? That could be a fatal combination. And Obama really has no one to blame but himself.

This does not mean an indictment of an entire presidency, or even the sign of a failed presidency. In their second terms, Clinton and Reagan were both exposed as liars – in the Lewinsky mess and the more serious Iran-Contra arms-for-hostages scandal. They were deeply wounded by both dramas, but were retroactively deemed successful nonetheless. The average approval ratings for all presidents (via Gallup) makes Obama look typical at this point, not an outlier, and actually more approved than he has been for much of his presidency:

I’m not saying this isn’t his worst crisis yet. It is. He may get pummeled some more in the polls. But if the ACA avoids a death spiral, if the GOP overplays its hand or is exposed as having nothing to propose to fix or replace the ACA, if the media shifts from pile-on to come-back mode, then things shift a little. I stick with my recent judgment: if Obama hangs in for stronger economic growth next year, if the ACA eventually works out, and if he can get to a breakthrough on Iran – so near, yet still so vulnerable – then he remains a transformational president.

He is beleaguered on both fronts – but that is partly because he is attempting two hugely ambitious and history-changing projects. We’ll see now, perhaps more than at any point in his presidency, if he has the mettle to endure. And that’s what this is about right now: endurance, and a battle of wills.

Divorce Equality

With Hawaii this week becoming the 15th state to win marriage equality, a reader looks to a new problem:

I am a subscriber but haven’t been keeping up daily like I used to, so I don’t know if you’ve covered this already but I thought you might find this story interesting. It’s about the fact that same-sex couples that get married out of state and return to a state where same sex marriage is banned cannot get divorced. I know that the fight to be able to begin these marriages is still paramount, but I thought the inability to terminate them (without moving out of state) is very interesting. I am a domestic violence victim’s advocate in Missouri and have run into this problem now several times with victims of abuse wanting to divorce their abusive same-sex partners but cannot.

Previous Dish on gay divorce here.

The Luxury Of Hating Poo

It means we don’t have to worry about predators:

What is really interesting is that domesticated rodents, such as mice and rats bred for laboratory use or for the pet trade, do avoid faeces [as opposed to wild rodents, which prefer poo]. As wild reindeer and primates also avoid faeces, domestication isn’t the key, so what is it? [The University of Edinburgh’s Patrick] Walsh and colleagues believe that for their wild mice, the presence of faeces from other mice at a potential nesting location or near food suggests safety from predators. When the wrong move could land you between the teeth of a bigger animal, perhaps the risk of infection from faecal matter is the lesser of two concerns. Laboratory animals, pets, and livestock are generally at a much lower risk from predators than their wild counterparts, so they can be more selective in their foraging and nesting behaviours. Every animal, the researchers argue, must calculate the trade-off between dodging parasites and surviving another day.

When Art Is An Evil Temptress

A reader asked Rod Dreher for his thoughts on a “theology of engagement with rock and rock culture,” prompting these ruminations on the ethics of art:

[W]hen I listen to the Rolling Stones sing in “Sister Morphine” about the desperate haze of drug addiction, I don’t take it as a recommendation to inject morphine, or to introduce myself to “sweet cousin cocaine,” but rather as a darkly potent representation of the power of drug addiction to consume a life — something that Keith Richards knew about. Similarly with the Velvet Underground’s “Heroin.” Neither are moralizing songs; they just describe the experience, and draw a kind of beauty from the bleakness. …

The danger here is that you might also come to sympathize with the sentiment, seduced by aesthetics, and thereby be corrupted. There is no way around this risk, not with real art. It is also possible that genuine art that embodies and communicates the Good could “corrupt” a soul, and lead them toward goodness and light. That’s what the art of the Chartres cathedral did for me. So, when I consider what my “theology” of engaging with rock music might be, or ought to be, I consider that to encounter true art always involves the possibility of conversion, one way or another.

Millman responds by riffing on a 2010 interview Jay-Z did with the Wall Street Journal:

WSJ: What would you change about hip-hop if you could?

Jay-Z: We have to find our way back to true emotion. This is going to sound so sappy, but love is the only thing that stands the test of time. “The Miseducation of Lauryn Hill ” was all about love. Andre 3000, “The Love Below.” Even NWA, at its core, that was about love for a neighborhood.

We’re chasing a lot of sounds now, but I’m not hearing anyone’s real voice. The emotion of where you are in your life.

“The emotion of where you are in your life” – that isn’t always love, and may not always stand the test of time, but it’s something we, as a species, are not very good at living in. If great art enables us to do that, connecting us more deeply to ourselves by connecting us to somebody else who has connected deeply to him- or herself, then I’m for it. And if we can’t make moral sense of that experience, well, sometimes it’s hard to make moral sense of life. But we can’t escape that problem by not living.

Straight Out Of Dickens, Ctd

A reader writes:

While there is no question that that vaccination denial has negative consequences on public health, there seems to be evidence that, in the case of whooping cough, the current trend isn’t driven primarily by the Jenny McCarthys of the world (though vaccination denial certainly makes the situation worse than it otherwise would be). It appears as if the primary culprit is a change in the vaccine designed to decrease harmful side effects. See here and here for reporting on this issue by Tara Haelle.

From the latter link:

I understand what [Julia Ioffe is] trying to do: she wants to use her experience with a vaccine-preventable disease to convey the irresponsibility of not vaccinating. And with almost any other vaccine-preventable disease covered by immunizations on the CDC recommended schedule, she would have a pretty good case. But not with pertussis. …

In 1997, a new vaccine called the DTaP (diphtheria, tetanus, acellular pertussis) replaced the previous DTP (diphtheria, tetanus, whole-cell pertussis). The DTP was highly reactive, causing a higher percentage of children to experience high fevers resulting in seizures. Although “febrile seizures,” as they’re known, don’t cause long-term neurological or developmental damage, they are frightening, and it’s understandable that parents and clinicians would seek a vaccine that didn’t cause them as frequently. The DTaP delivered that more attractive safety profile, with a vaccine made from pieces of the pertussis bacterium rather than the whole cell. The problem – though it wasn’t identified until pretty recently – is that the DTaP just isn’t as good as the DTP in preventing pertussis over the long haul, as I’ve written about in detail in Scientific American. In fact, rather than lasting about 10 years or longer, as the DTP did, the DTaP’s immunity may wane in as little as three to six years.

Previous input from readers here.

True Moderates Are Rare

A chart from a new paper (pdf), “Why American Political Parties Can’t Get Beyond the Left-Right Divide”:

Seth Masket uses it to explain why moderatism has a small constituency:

As the circle in the center of the graph shows, there are some people who are moderate on both dimensions, but quite a few people are moderate on one dimension but extreme on another. That is, there are some people who are pretty non-committal about economic issues but feel very strongly about their social views.

How does a moderate political party rise to power with the help of moderate voters when so-called moderate voters are actually quite extreme on one dimension? It’s hard. If you don’t really care about changing abortion laws, that might make you appealing to social moderates, but many of those same people feel that taxes should either be much higher or much lower. You take the wrong stance, and you’ve just alienated half of them. Conversely, someone who’s moderate on economic issues might feel very passionate about their civil liberties.

It’s not impossible to be a true moderate on all the major issues of the day, but such people are rare, and the candidate that professes such beliefs will alienate more people than she wins over. In other words, the radical center never rises because, to a large extent, it doesn’t exist.

The Bloated Bureaucracy Of Private Contracting

A reader writes:

The email from the government contractor is so right on it’s sickening. In an effort to reduce the size of government, Republicans – and some Democrats, but can we all agree that the thrust of the PRIVATIZE EVERYTHING argument comes from the Rs? – have us paying twice as much for the same work, and often the work is totally unnecessary. In many cases, the government actually hires contractors to supervise other contractors – this is insanity. Much like the disturbing loop of Hill staffers who work for a few years then move on to become high-paid lobbyists, government workers who move on to become contractors are just doing what makes the most sense for them, but their goals then change to become what is best for the company they now work for, not the government program or taxpayers.

Similarly, agencies are now hiring managers not for their ability and expertise in the field, but for their perceived ability to deal with contractors. Or the opposite happens and agencies have situations like the Federal Protective Service where (among many, many other problems) law enforcement officers are acting as contracting officer technical representatives and spending hours each day conducting contract guard paperwork checks instead of responding to incident calls and patrolling federal facilities. The Government Accountability Office has done tons of reports on the problems of contracts at specific agencies and the federal contracting world in general. All of this is even more scary when you consider that a single contract can be worth more than $5 billion per year, in the case of a contract issued for support services in Iraq and Afghanistan.

Another reader:

IT is what the government and its contractors do worst. Remember the shock of discovering, post 9/11, that the FBI didn’t have a functioning computer system? The kinds of things your reader highlights are exactly why. Not sure if that ever got settled. The biggest shock in the unfolding NSA revelations is that it apparently has capable hardware and software systems.

Of course nothing will happen to improve federal contracting and oversight because the corporations with these contracts are filled with revolving-door politicians, and they employ the usual army of lobbyists. Ironically, Congress has no one to blame but itself for the mess.

Another:

That person with the epic rant was speaking the truth. I also work for a government contractor and find the process very frustrating, to say the least. The ranter is absolutely right about the many flaws in the process.

Our clients are not in the defense industry and our budgets are much smaller than what the “big guys” see. But the waste is still appalling, most often because of poor management by the government officials. They never, NEVER, approach a project as a business would: with clear goals, established benchmarks and metrics, firm deadlines and a willingness to take steps to either meet those goals, benchmarks and deadlines or to make the necessary corrections if they aren’t met.

Contractors almost never get fired and government staff never do. In most cases, they aren’t screwing up because they’re evil, they just don’t have the mindset of “we need to get this to market now, make sure it meets the needs of the audience, and then fix it if it doesn’t.” I think because in most cases the project in question is designed to “do good” that provides them in their minds with a built-in excuse: so we’re behind schedule and over budget and this isn’t exactly doing what it was supposed to do, it’s helping some people.” So that’s good enough.

What really startles me is how many contracts are awarded because one employee at a mid-management level thinks it’s a good idea. It may well be but in many cases, they leave or no one else shares their interest, so money is spent and nothing is done, or projects wither on the vine for years.

I happen to believe in a large, active government because I believe that if the government doesn’t do it, the private sector will not pick up the slack and the country will suffer. But I hate to see our money wasted, especially as we focus on the deficit and debt. Forget the debate over small vs. large government, the real debate should focus on what steps would our leaders take to make sure the government operates efficiently and effectively.

Now, back to work for me.