Will the Public Plan Cost More?

The CBO projects that the public option will likely have higher premiums than private insurance options.

Ezra Klein explains:

[T]he public plan will pay prices equivalent to those of private insurers and may save a bit of money on administrative efficiencies. But because the public option is, well, public, it won't want to do the unpopular things that insurers do to save money, like manage care or aggressively review treatments. It also, presumably, won't try to drive out the sick or the unhealthy. That means the public option will spend more, and could, over time, develop a reputation as a good home for bad health risks, which would mean its average premium will increase because its average member will cost more. The public option will be a good deal for these relatively sick people, but the presence of sick people will make it look like a bad deal to everyone else, which could in turn make it a bad deal for everyone else.

The nightmare scenario, then, is that private insurers cotton onto this and accelerate the process, implicitly or explicitly guiding bad risks to the public option. In theory, the exchanges are risk-adjusted, and the public option will be given more money if it ends up with bad risks, but it's hard to say how that will function in practice.

This also illuminates one of the more problematic inconsistencies in the health-care debate. Insurers have been blamed for, among other things, doing too much to discriminate against bad health-care risks and refusing to pay for care far too often. They've been blamed, in other words, for saying "no." But they've also been blamed for doing too little to control costs.

But that is how they control costs. We saw this in the late-'90s, when tightly managed care brought cost growth down to the 4 percent range but also triggered a public backlash (it did not, however, appear to hurt health outcomes).

I agree with every word of that.

Sullivan Goes Overboard, and Young Follows

I was just reading through some of Cathy Young's old posts and I came across this bizarre assault on Andrew Sullivan:

As I said in my previous post, I have limited sympathy for Sarah Palin.

However, this, from Andrew Sullivan (on top of the never-ending flogging of Trig Palin conspiracy theories), is outrageous. I saw the reference to the “white trash concupiscence” Palin-slam in Douthat’s column and wondered who could have written that. Despite my knowledge of Andrew’s raging PDS, I was shocked . . . . I fully intend for this to be my last visit to The Daily Dish, and I have to say that at this point, if someone started a campaign to get The Atlantic website to drop Andrew, I’d back it. Imagine the reaction if a journalist/blogger writing about a black politician referred to “ghetto concupiscence”, without even using the word “black.” [Emphasis mine]

While I agree that Andrew Sullivan's criticisms of Sarah Palin during the election were often over-the-top (and sometimes downright nasty), I don't quite understand why Young finds this particular comment so uniquely offensive. How else would you describe the Palin Family's never-ending psychodrama? To me, the Levi Johnston affair alone seems like it could easily be described as "white-trash concupiscence" . . . .

Honestly, I wouldn't have expected this kind of politically correct nonsense from Young. In my opinion, she remains one of the most insightful and fair-minded feminist writers out there.

During the Kobe Bryant trial, Young penned a brilliant and well-reasoned op-ed on "rape shield laws." It's probably the most intelligent consideration of the subject that I've ever read.

An excerpt:

Like many such cases, the Kobe Bryant case is primarily a "he said, she said" matter, with ambiguous corroborating evidence that county judge Frederick Gannett characterized as weak even as he sent the case to trial. The woman's sexual activities prior to the alleged rape may well be relevant to the physical evidence; if, as the defense has hinted, she engaged in consensual sex shortly after her encounter with Bryant, it may well be relevant to the question of whether she was raped; if she is mentally unstable, it may well be relevant to her credibility.

These are wrenching questions. Obviously, a woman with a history of mental illness or substance abuse could still be a rape victim. Obviously, the prospect of having embarrassing personal details exposed in court (let alone paraded in the media) may discourage victims from coming forward. Just as obviously, suppressing relevant evidence may result in sending an innocent person to jail. And if it's frightening to put oneself in the place of a sexual assault victim who finds herself on trial in the courtroom, it is no less terrifying to imagine that you -- or your husband or brother or son -- could be accused of rape and denied access to evidence that could exonerate him.

For some feminists, the dogma that "women never lie" means that there is, for all intents and purposes, no presumption of innocence for the defendant. After the 1997 trial of sportscaster Marv Albert, defending the judge's decision to admit compromising information about Albert's sexual past but not about his accuser's, attorney Gloria Allred decried "the notion that there's some sort of moral equivalency between the defendant and the victim" -- forgetting that as long as the defendant hasn't been convicted, he and his accuser are indeed moral equals in the eyes of the law. Wendy Murphy has blasted Kobe Bryant's attorneys for feeding uncorroborated rumors about the alleged victim to the media maw. Yet, appearing on Fox News, she made the claim, highly prejudicial to Bryant and so far untested in a court of law, that the woman "suffered pretty terrible injuries" the likes of which she had not seen despite having prosecuted "hundreds of sex crimes cases."

Doubting Brooks

In his column today, David Brooks trumpets epistemological uncertainty in government decision-making:

Up until recently, people in the financial world bathed in the warm glow of their own self-approval. Hubris in that world always takes the same form: The geniuses there come to believe that they have mastered risk. The future is an algorithm and they’ve cracked the code.

Over the past year, the bonfire of overconfidence has shifted to Washington. Since the masters of finance have been exposed as idiots, the masters of government have concluded (somewhat illogically) that they must be really smart.

Overconfidence in government also has a characteristic form: that of highly rational Olympians who attempt to stand above problems and solve them in a finely tuned and impartial manner. In moments of government overconfidence, officials come to see society not as a dynamic and complex organism, but as a machine, which can be rebuilt. In such moments, governance and engineering merge into one.

If I do become a highly rational Olympian, hopefully I'll be able to maintain some level of humility . . . .

The Moral Certitude of Modernity

One of Andrew Sullivan's readers writes:

I've been reading Marilynne Robinson's book of essays, The Death of Adam: Essays on Modern Thought. Her essay entitled “Puritans and Prigs” sets out to defend the Puritans and contrast them to a group she calls prigs, the sort of politically correct thought police that the right used to rail against in the 1990s. I think her argument also has a lot in common with your indictments of fundamentalism and movement conservatism.

The Puritans' belief that we are all sinners, Robinson says, gives "excellent grounds for forgiveness and self-forgiveness, and is kindlier than any expectation that we might be saints, even while it affirms the standards all of us fail to attain." However, she argues that modernity, of which prigs are emblematic, is essentially Stalinist, in that it believes that society "can and should produce good people, that is, people suited to life in whatever imagined optimum society, who then stabilize the society in its goodness so that it produces more good people, and so on. First the bad ideas must be weeded out and socially useful ones put in their place. Then the bad people must be identified, especially those that are carriers of bad ideas."

. . .

Indeed, much the same could be said of today’s right. For my part, it seems all such prigs (left and right) stem from the fundamental epistemological arrogance of modernity--that all things can be known. This is as true of Darwinism as it is of Biblical fundamentalism. The older I get, the more folly such claims seem to contain. This is not a new insight: one need only look at Ecclesiastes. Efforts such as political correctness and movement conservatism are destructive of civil society and are based on nothing more than a chasing after the wind.

I think this is a brilliant summation of the problem with both the contemporary right and the contemporary left. Forgiveness and understanding are no longer virtues.

They've been replaced by self-righteousness and moral certitude . . .

Cowen on Mandates

Tyler Cowen comes out against health insurance mandates:

The paradox is this: Reform advocates start with anecdotes about the underprivileged who are uninsured, then turn around and propose something that would hurt at least some members of that group.

Right-Wing Extremism Again

I just re-read two excellent posts from Conor Friedersdorf, tearing down Glenn Beck and Rush Limbaugh. So good.

Check them out: here and here.

International Health Care Comparisons

A friend (who blogs at Dissection and Introspection) directed me to this article in the WSJ, which reflects on the difficulty of international health care comparisons. Very insightful.

I've commented on this previously here and here.

Confronting Empirical Reality in the Health Care Debate

Ezra Klein delivers the bad news.

Does Social Security Create Poverty?

I recently came across this piece by Edgar Browning -- the author of my microeconomics textbook -- in which he suggests that Social Security actually increases poverty rates among elderly Americans by crowding out private investment.

It's an interesting contention, though I'm not quite convinced by it.

Putting Browning's argument aside, though, I think there's a pretty obvious problem with a Social Security system that simply collects taxes and disburses benefits without affording Americans the opportunity to make their own financial decisions.

Today, financial literacy in the United States is pretty dismal. I can't help but feel that most Americans would be a bit more savvy if they actually had more personal control over their money . . . and if their retirement really depended on them making good decisions.

(Interestingly, a strong plurality of Baby Boomers may be collecting Social Security income at age 62, rather than the "normal retirement age," due in part to financial necessity.)

Update: Freakonomics's Stephen Dubner points to this study on financial literacy:

[F]ewer than one-third of young adults possess basic knowledge of interest rates, inflation, and risk diversification. Financial literacy is strongly related to sociodemographic characteristics and family financial sophistication. Specifically, a college-educated male whose parents had stocks and retirement savings is about 50 percentage points more likely to know about risk diversification than a female with less than a high school education whose parents were not wealthy.

The Basic Problem of Social Security Reform

A brief primer, for anyone who's interested:

For more than 70 years, the federal Old-Age, Survivors, and Disability Insurance program (OASDI) – commonly known as Social Security – has provided social insurance to a substantial number of American citizens. Though it was initially envisioned as a safety net for elderly retirees, the program has been expanded intermittently since its inception to include additional categories of Americans. In 2005, the Social Security Administration (SSA) disbursed benefit payments to more than 47 million Americans, with retirees still composing the largest group of beneficiaries (28 million).

The OASDI program is financed through a dedicated federal payroll tax, and its revenue stream depends entirely on current wage earners. In recent decades, the ratio of wage earners to retirees has narrowed substantially as birthrates have declined and life expectancies have increased. With the Baby Boom Generation beginning to collect benefits, this “dependency ratio” will continue to tighten, further diminishing the program’s revenue base in the upcoming years. By 2016, the OASDI program’s outlays to beneficiaries are expected to exceed revenues. Thus, if current trends continue, the Social Security program will likely face a long-term deficit in the coming decades.

Reforms passed in the early 1980s have enabled to the OASDI program to move away from its original pay-as-you-go structure and build up a substantial revenue surplus. These additional monies have been invested in U.S. securities and placed in trust. While the assets in the Social Security Trust Fund will help to maintain payments to beneficiaries after OASDI outlays begin to exceed revenues, these assets can only fill the revenue gap for a short time. According to best-guess assumptions, the Trust Fund will be depleted as early as 2037. After this point, projected receipts from payroll taxes will only cover approximately 76 percent of all benefit payments.

The goal for policymakers and other interested parties is to address this looming deficit crisis, and to confront the trade-offs among different reform options. There are a number of important considerations in crafting a solution to the problem of Social Security reform. Those who seek to resolve the deficit crisis must first develop a set of evaluative criteria to assess the impact of various policy options. Applying these criteria to different options will enable decision-makers to systematically assess the merits of each approach, and then choose the most appealing alternative.

Is Rush Limbaugh the Problem?

This is a really great commentary from LZ Granderson.

I'm not a big fan of professional sports, so I've never read Granderson's ESPN column. But he's a great writer.

Oh, and just for the record, Rush Limbaugh is a racist . . . .

Hate Crime Legislation

Today, Andrew Sullivan linked to an old piece that he had written for the New York Times Magazine ("What's So Bad About Hate?"). It's a brilliant exploration of hate crime legislation and the standard concept of "hate." Definitely worth reading.

Here's a short excerpt:

So the concept of "homophobia," like that of "sexism" and "racism," is often a crude one. All three are essentially cookie-cutter formulas that try to understand human impulses merely through the one-dimensional identity of the victims, rather than through the thoughts and feelings of the haters and hated.

This is deliberate. The theorists behind these "isms" want to ascribe all blame to one group in society — the "oppressors" — and render specific others — the "victims" — completely blameless. And they want to do this in order in part to side unequivocally with the underdog. But it doesn't take a genius to see how this approach, too, can generate its own form of bias. It can justify blanket condemnations of whole groups of people — white straight males for example — purely because of the color of their skin or the nature of their sexual orientation. And it can condescendingly ascribe innocence to whole groups of others. It does exactly what hate does: it hammers the uniqueness of each individual into the anvil of group identity. And it postures morally over the result.

In reality, human beings and human acts are far more complex, which is why these isms and the laws they have fomented are continually coming under strain and challenge. Once again, hate wriggles free of its definers. It knows no monolithic groups of haters and hated. Like a river, it has many eddies, backwaters and rapids. So there are anti-Semites who actually admire what they think of as Jewish power, and there are gay-haters who look up to homosexuals and some who want to sleep with them. And there are black racists, racist Jews, sexist women and anti-Semitic homosexuals. Of course there are.

The PWC Report and the Tax on High-Cost Health Plans

Ezra Klein rips into Megan McArdle for her long-winded defense of the PWC report (pdf) that was comissioned by AHIP, a political advocacy group for the American health insurance industry.

He writes:

McArdle goes to bat for the most indefensible element of the analysis: the decision to avoid estimating the response to the tax on high-cost insurance plans (which is, in fact, the whole point of the tax), and simply pretend that everything will remain unchanged except that a lot of people will pay a large new tax that they don't have to pay. Moreover, she conscripts the Congressional Budget Office to help with the argument: "You might think that everyone is going to structure their benefits to get around this tax," McArdle writes. "But the CBO expects us to collect quite a bit of money from this tax."

Not quite. The Congressional Budget Office projections (which are, in this case, the Joint Committee on Taxation's projections, as the CBO doesn't estimate tax revenues) actually suggest that the bulk of the tax's revenues will come from the response to the tax, not the payment of the tax. As the New York Times reports, the JCT believes that "about $142 billion of the 10-year total of $201 billion to be raised by the [excise tax] would come from increased income and payroll taxes." In other words, the vast majority of the revenues would come because employers would "structure their benefits to get around this tax." Workers would receive more of their compensation in wages and less in health-care benefits, and because wages are taxable and health benefits aren't, tax revenues would go up.

(Megan did, in fact, acknowledge this error prior to Ezra's post.)

There is at least one broader issue with Ezra's point. Common sense tells you that a tax on "Cadillac" health insurance plans will encourage employers to offer cheaper benefits packages. It's ridiculous to argue otherwise, unless you have strong empirical evidence to back up your claim. Pigovian taxes are, after all, designed to alter behavior in exactly this way. So Ezra is clearly right on the merits here.

But, if Ezra is right, isn't this a huge problem for the administration? If workers with good health benefits will likely be forced into cheaper plans, how can the president continually claim that those who like their health insurance can keep what they have?

FactCheck has already called out the president for this canard, but his argument seems particularly disingenuous now that JCT is actually basing its revenue projections on the idea that some employers will offer cheaper benefits packages if the America's Healthy Future Act (pdf) passes.

Don't get me wrong, I'm a big fan of taxing health insurance -- especially Cadillac plans. I think it's good policy, and it's a step away from the employer-based health insurance system. What frustrates me is the president's insistence that we can have our cake and eat it, too.

If we want to control health care costs, we have to discourage overuse of the system. That means pushing people away from big benefits packages, not telling them that they can always keep their current health insurance.

Update: One more point about Ezra's previous post on the PWC report. Ezra apparently takes exception to the authors' assumption of "full cost-shifting of cuts to public programs." This is another way of saying that doctors and hospitals will try to make up for cuts to their reimbursement rates from public programs by increasing their reimbursement rates form private programs.

He writes:

Have you ever heard of that before, in any industry? If Blockbuster decides to cut costs to consumers by negotiating lower payments to movie studios, does Netflix send out a sorrowful e-mail explaining that it will have to increase its membership fee because it now needs to make higher payments to movie studios?

Well, no. But that analogy makes absolutely no sense. The health care industry is different from the movie rental industry -- and pretty much every other industry -- for a number of reasons. (I would again encourage you to listen to the latest episode of This American Life.)

Ezra must know this. Paul Krugman -- whom Ezra once interviewed -- has repeatedly argued that the health care market is like no other market . . . and, in fact, shouldn't be treated as a market at all.

So why is Ezra suddenly trying to pretend that buying health care is in any way equivalent to renting videos? Maybe he's right that cost-shifting won't be a problem, but this comparison is totally spurious.

Update II: Ezra takes a more nuanced position on cost-shifting:

To be clear on my position here, I think there's probably some level of cost-shifting that's between the zero percent that some advocates would like and the 100 percent that the insurance industry suggests. The Lewin Group estimated (pdf) 40 percent, and that sounds reasonable enough to me, though I'd be open to further evidence.

He also makes another rather obvious point:

It's true that a hospital's costs are relatively inelastic on a year-to-year basis, but they're more elastic over time: if they had to adjust to less revenue than they'd like, they'd make certain changes to the way they do business.

Well, yeah. Isn't that, like, the definition of the long-run?

Incentive Problems and the American Health Care System

If you're willing to spare an hour to consider some of the incentive problems inherent in the American health care system, I'd recommend listening to the most recent episode of This American Life.

The episode is called "More is Less." And it's actually very, very interesting.

Public School Song in Praise of Obama

There are two things that strike me about this video of New Jersey public school children singing songs in praise of President Obama's agenda and accomplishments.



First, it's not that big a deal.

This is a relatively trivial issue that conservatives have been eager to exploit for political gain. Rush Limbaugh has been pounding away at this story for more than a week, and Fox News has been feverishly churning out exposés and airing clips about the incident.

In some cases, the hysteria from right-wing pundits has been extremely offensive. Tucker Carlson, for example, recently likened the song lyrics to Khmer Rouge tactics. We should all be extremely concerned about this kind of hyperbole in our political discourse.

Second, some of the lyrics to these songs were inappropriate, and I can't believe that anyone on the left is trying to argue otherwise.

Here's a good example:

Hooray, Mr. President we honor your great plans, To make this country's economy number one again!

Whether or not you personally believe that President Obama's economic policies are admirable, public school children should not be 'honoring' the president's "great plans" to "make this country's economy number one again." Many of the president's fiscal plans are highly controversial, and instructing young students to honor his plans amounts to political and intellectual coaching. If these same public school children were expected to sing songs 'honoring' the economic plans of Ronald Reagan, many parents on the political left would be justifiably upset.

Elementary school teachers should never give the impression that they are endorsing a sitting president's plans in a specific policy area. Yes, Tucker Carlson is wrong, but that doesn't make the teachers in this story right . . . .

Is the Baucus Plan the Way to Go?

David Brooks has another brilliant column in today's NYT.

Please, please read it.

Has the Nobel Peace Prize Jumped the Shark?

According to Alex Massie, it has.

I like President Obama and I admire what he's trying to do, but after less than ten months in office, this seems a bit premature.

Can Obama already be "the person who [has] done the most or the best work for fraternity between nations, for the abolition or reduction of standing armies and for the holding and promotion of peace congresses"?

Slate's John Dickerson says no.

The Peace Prize Committee has suggested that it's merely trying to encourage the president to hold fast on his commitments to diplomacy and nuclear arms reduction. Thorbjoern Jagland, the head of the Committee, said today, "It was because we would like to support what he is trying to achieve."

This seems like a well-intentioned argument -- we certainly should support many of the goals that the president has outlined -- but I think earning a Nobel Prize makes the president's job more difficult in ways both practical and political.

WaPo's Glenn Kessler has a good analysis of the problems that could arise from awarding this kind of "aspirational" Peace Prize so early into President Obama's first term.

Update: The president strikes the right tone:

"Let me be clear: I do not view it a recognition of my own accomplishments but rather as an affirmation of American leadership on behalf of aspirations held by people in all nations," he said.

“To be honest, I do not feel I deserve to be in the company of so many of the transformative figures who have been honoured by this prize."

Update II: I think Megan McArdle is right:

I guess I must hate America, but I actually think it's kind of ludicrous that anyone is even trying to argue that Barack Obama truly deserves this Nobel Peace Prize. Could he have deserved it, after he'd had more than nine months in office? Easily. But he hasn't had time to, y'know, accomplish anything. Unless they're giving out the Prize these days for stimulus bills and banking sector interventions. The committee claims they awarded it for his "extraordinary efforts to strengthen international diplomacy and cooperation between peoples"? Can even his most ardent supporters come up with any effort he's made that really qualifies as more extraordinary than those of everyone else in the world?

It's not like I want to take the prize away, and I'm certainly not angry about it . . . but I'd rather have seen Barack Obama honored for something besides not being George W. Bush.

I couldn't agree more.

Certainly, the reaction from many conservatives has been overstated (and in some cases, down right offensive), but it's absurd for some on the left to suggest that questioning whether President Obama actually deserves this award amounts to being unpatriotic.

I assume this criticism would also apply to the president himself?

Update III: NPR political commentators E.J. Dionne and David Brooks discuss whether the president should have accepted the Nobel Peace Prize.

Update IV: Peter Beinart, who blogs for The Daily Beast, writes:

The Nobel Prize Committee should be in the business of conferring celebrity on unknown human-rights and peace activists toiling in the most god-forsaken parts of the world; the people who really need the attention (and even the money). It should be in the business of angering powerful tyrants by giving their victims a moment in the sun. Choosing Barack Obama, who practically orbits the sun already, accomplishes the exact opposite of that. Let’s hope Obama eventually deserves this award. And let’s hope the Nobel Committee’s decision meets with such a deafening chorus of chortles and jeers that it never does something this stupid again.

Ezra Swallows His Pride

This is why I respect Ezra Klein:

I've been a big proponent of affixing calorie counts to menus. There's substantial evidence suggesting that people wildly underestimate the calorie content of dishes at restaurants, and have a lot of trouble reliably guessing whether one dish is lighter than another dish. There's also evidence that people want to eat better than they do. It seemed like the sort of situation where information could result in action.

The first big study out of New York City, however, suggests that menu labeling has been a bit of a bust in changing ordering habits at fast food restaurants in low-income neighborhoods. The researchers identified 14 outlets and, using Newark (where there's no calorie labeling) as a control group, conducted interviews and receipt checks to see how ordering patterns changed. The answer? They didn't. If anything, the calories per order went up a smidge.

. . .

I'm still a supporter of calorie labeling on the simple grounds that people should have this information, no matter how they choose to use it. But so far, the evidence suggests that it's not going to make a dent in obesity rates.

Why Doesn't Ken Conrad Support the Public Option?

In a recent interview with Ezra Klein, Ken Conrad explained:

I don't think a government-run plan best fits this culture. A plan that's not government-run has the best chance of succeeding in being passed into law.

Second, and this is very important to my thinking, the public option as defined by the committee of jurisdiction in the House, the Ways and Means Committee, is tied to Medicare levels of reimbursement. My state has the second-lowest level of Medicare reimbursement in the country. If my state is tied to that reimbursement, every hospital goes broke. People say, "Just fix it." I've been on the Finance Committee more than 15 years. I've been trying to fix the unfair aspects of Medicare reimbursement all the time. We run into the House. Membership is determined by population, and the big population states write levels of reimbursement that unfairly treat hospitals in states like mine. My hospitals get one-half as much as urban hospitals to treat the same illnesses.

A key argument against the "strong" public option -- one that would pay Medicare reimbursement rates -- is that we already have an enormous degree of cost shifting onto private insurance plans. Another Medicare-like plan could potentially widen the gap between government reimbursement rates and private reimbursement rates, and ultimately do little to reduce aggregate health care costs.

Conrad's position is quite different, and I think far more interesting. He's doesn't seem to be concerned about the cost shifting. Instead, he's focused on the regional variations that we've seen among Medicare reimbursement rates.

According to Conrad, these variations are impossible to correct because the membership in the House of Representatives is, by Constitutional design, proportional. Thus, hospitals in states with larger populations -- and more Congressional representation -- will always see relatively decent Medicare reimbursement rates, while hospitals in states with smaller populations will always get shafted.

The senator suspects that we would see a similar pattern with a "strong" public option that offered a Medicare-like payment scheme.

But what about the "level-playing field" public option proposed by Chuck Schumer, which would not be empowered to dramatically undercut private insurance rates? Why did Ken Conrad vote against this version of the public plan?

My guess would be that Conrad simply doesn't trust the claims of his big-state party members . . . .

What do you think?

Moore's Immoderation

Judith Warner questions Michael Moore's approach to activism:

I listened to Moore talk, in the morning, of “us.” (“I know where you come from,” he addressed an absent Barack Obama, his tone oddly menacing. “You come from us.”) I listened, in the evening, to him talk of “them”: “the rich … the Goldman boys.” I heard him threaten Blue Dog Democrats (“We will come after you, and we will remove you from office”), watched him whack a meaty fist into his palm — thwack! — as he recalled the hardball tactics of health care reform’s most stalwart opponents, and as he reveled in the thought of bringing down those who now oppose a public option: “It will make what was going on at those town meetings in August look like a tea party!”

“This is why some of us admire the other side,” he said. “Because they’re relentless. They never stop.”

. . .

And I found myself thinking, over and over again, of Molly Melching, the founder and executive director of the nongovernmental organization Tostan, which works to teach human rights and democracy and has helped more than 4,000 communities in Africa end the traditional cutting of girls. Melching, who has succeeded where any number of other women’s rights and global health organizations have failed, explained to me in an interview this summer that the secret to her group’s success lay in the fact that she had learned, through years of trial and error, that to reach people you had to meet them where they were. Respect them. Acknowledge their social norms, beliefs and practices. Find common ground. Build on shared human aspirations — for safety, for dignity, for a better life for one’s children — then discover how those shared aspirations might reasonably translate into ending practices that cause suffering. “If you come in and say, ‘You are awful people,’ people tune out and say, ‘Who do you think you are?’” she told me, speaking first from Senegal, where she has lived for the past 35 years. “Making people feel bad about what they’re doing doesn’t work; they only get defensive. What does work is getting people to discuss together what are their rights and what they mean. It’s not just a question of blaming and shaming people but educating and empowering them.”

“It’s a question,” she elaborated in her D.C. office last month, “of changing the script.”

. . .

These thoughts came back strongly while listening to Moore chuckle and brag, and while sitting through his new 127-minute opus of vilification. Moore’s script is the farthest thing possible from Melching’s truly radical — and, as it turns out, effective — vision of change. In fact, watching “Capitalism,” it felt as though he’d dusted off an old playbook, as though he was reliving the battles of the beleaguered Bush/Cheney years, just for the sheer fun of it.

Evolving African-American Studies

John McWhorter -- whom you may recognize from some of his brilliant commentaries on NPR -- has written an excellent piece on "What African-American Studies Could Be" (via Andrew Sullivan).

McWhorter summarizes his argument here:

It’s time that African-American Studies departments let go of the sixties imperative to defend blacks as eternal victims of racism. Black people can do their best even under imperfect conditions--and if that reality is irrelevant to an African-American Studies curriculum, then we must question the value of said curricula to those whom they purport to speak up for: real people in this real world. This real world which will never be perfect--even for descendants of African slaves.

In 2009, the study of blackness must be the study of a race most of whose members are now victors, not victims. Certainly the victims must be studied--but only within a genuine commitment to saving them, not chronicling them as helpless until America turns upside down in a fashion no one could seriously imagine will ever happen.

Two things are crucial in my piece at Minding the Campus.

First, I do not argue that African-American Studies departments should not exist. Any claims that this piece is “against Black Studies” will be, as Obama said in his speech on health care not long ago, lies.

Second, I do not assail teachers within them as charlatans or anarchists. At all. I know they are all working at the top of their abilities. I just question what the guiding imperatives of their departments are, and ask them to address a wider range of arguments.

This piece is simply a call for a true African-American Studies paradigm: a study of black people entire, with ample room for views from all sides. Black conservatives should be read alongside Du Bois and Baldwin, with no clucking and hedging. Any hovering consensus that leftist positions are “truth” should be a mark of failure.

Two Posts to Read

First, Megan McArdle destroys Paul Krugman for this excercise in partisan hackery.

Second, David Brooks offers a really interesting (and philosophical) op-ed on our current political options.

Obama's Gay Problem

Andrew Sullivan blasts President Obama over his party's substantive failure on gay rights:

In some ways, Obama's fealty to the big gay lobby rather than to the real gay community is testimony to why Democratic party politics remain repulsive to me. HRC has achieved nothing substantive for gay equality on a federal level in the twenty years I've been observing them. But they sure know how to milk donors at swanky black tie affairs. They are the Rotary Club for affluent gays, and their prime job is to explain to the gay community why it is never in the Democratic party's interest to do anything for gay people that might actually resemble equality. Oh, yes, we'll get a lovely Obama speech. Like that costs him anything or proves anything. There is nothing Obama can say at this self-satisfied, well-heeled Rotary Club dinner that he hasn't said before.

. . .

If Obama wants to support gay equality, he knows what to do. If Pelosi and Reid want to support gay equality, they know what to do. If HRC believes in gay equality, they also know what to do. So spare us the schmoozing and the sweet-talking and do it. Until then, Mr president, why don't you have a nice steaming cup of shut-the-fuck-up?

Ouch.

The Supreme Court, States, and Gun Rights

TIME magazine has a good roundup of the "Five Supreme Court Cases to Watch This Term."

I'm most interested in McDonald v. Chicago. Hopefully, the Court will finally incorporate the Second Amendment against the states. As I've said before, I am a strong proponent of total incorporation.

Unsurprisingly, the libertarian Cato Institute has filed an amicus brief in this case, arguing in favor of incorporation. It's worth a read, if you're interested.

The Morality of Grayson

I've never been a big fan of Matt Yglesias -- and I've never understood why Andrew Sullivan apparently finds him so fair-minded that he named an award after him.

Anyway, I'm glad that Sullivan finally called out Yglesias for his strained justification of Alan Grayson's vicious ad hominem against Republicans on the floor of Congress.

Yglesias's defense amounts to: "'So what?' Republicans engage in this kind of abusive rhetoric all the time. That's the real issue."

This seems to be the same moral logic that I used in grade school, when I tried to convince my mother she should overlook my cookie-stealing habit because what I had done was relatively less offensive than some of the things my friends had done.

They were the real problem children, after all . . . .

Update: There is another aspect of this controversy that's been bothering me. In an interview with Wolf Blitzer on Wednesday, Grayson called congressional Republicans "knuckle-dragging Neanderthals."

Grayson said:

What I mean is they [Republicans] have got no plan. It's been 24 hours since I said that. Where is the Republican plan? We're all waiting to see something that will take care of the pre-existing conditions, to take care of the 40 million Americans who have no coverage at all.

I've been hearing a lot lately that health care reform has been stalled by Republican "obstructionists." But are Democrats really waiting for the Republican plan, or is Grayson just posturing?

Right now, there are three bills floating around in committee: the House tri-committee bill, the Senate Finance Committee bill, and the Senate HELP Committee bill.

One major sticking point here is the public option, but there are many other points of contention (Ezra Klein offers a good summary of the main disagreements here). In the Senate, the Finance Committee bill (the "Baucus Plan") does not include a public option, while the HELP Committee bill does.

It's true that the virtually all Republicans (with the possible exception of Olympia Snowe) have refused to support either of the bills in the Senate, but the House Blue Dog Coalition is also largely opposed to a public option. More importantly, Blue Dogs seem to strongly favor the deficit-neutral Baucus Plan. The Democratic leadership, on the other hand, seems to be leaning toward the HELP Committee bill.

If the Democrats could unite on a single plan -- and perhaps convince Snowe to come on board -- they could easily pass health care reform. The problem is that they can't.

It's not Republican "obstructionists" who are holding up health care reform at this point. Most Democrats have already abandoned all hope for a bipartisan compromise.

The central conflict is now within the Democratic party.

The Two Faces of the Public Option

Clive Crook writes:

My view on the public option has always been that I'll know whether I like the idea when I see it explained. The problem is that the idea has been pitched as all things to all men. Centrist voters are told it won't make much difference. Progressive voters are told it will make so much difference that the entire project is a waste of time without it.

. . .

The public option cannot be both an ordinary competitor, leaving your circumstances unchanged if you choose not to take it up, and a force that can balance the budget by squeezing hundreds of billions out of public health-care costs. It can be one of these or the other, but not both.

Democrats have been debating whether a "strong" public option should pay Medicare reimbursement rates, something an ordinary competitor could not do. If it did, this would drive down costs and have many other (not necessarily intended) consequences. It would be a big step towards Medicare for all. As I have argued before, there are worse things than Medicare for all, including in my view the present system. But this outcome is one of the things that the administration is saying it does not want.

If you want Medicare for all, do what some Democrats do and make the case. If you don't, stop proposing a public option that would push the system towards it.

I couldn't agree more.

Update: According to Gallup, the majority of Americans (61%) believe that it is not the responsibility of the federal government to guarantee health insurance to all its citizens. (The sampling error is +/- 4%.)