The Sovereign Mind

Free thought on politics and real life

Obama: Changing the Tone of Our Politics

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There were a lot of things to like about President Obama’s State of the Union address. But I’d like to focus on this part for now:

But what frustrates the American people is a Washington where every day is Election Day. We can’t wage a perpetual campaign where the only goal is to see who can get the most embarrassing headlines about the other side -– a belief that if you lose, I win. Neither party should delay or obstruct every single bill just because they can. The confirmation of — (applause) — I’m speaking to both parties now. The confirmation of well-qualified public servants shouldn’t be held hostage to the pet projects or grudges of a few individual senators. (Applause.)

Washington may think that saying anything about the other side, no matter how false, no matter how malicious, is just part of the game. But it’s precisely such politics that has stopped either party from helping the American people. Worse yet, it’s sowing further division among our citizens, further distrust in our government.

So, no, I will not give up on trying to change the tone of our politics. I know it’s an election year. And after last week, it’s clear that campaign fever has come even earlier than usual. But we still need to govern.

Right on, Mr. President. This is something I can get behind. We really do need to change the tone of our politics.

We want to debate the issues respectfully and listen to opposing views with an open mind:

And we need to stop taking cheap-shots on the opposition. Intelligent people often disagree, so we shouldn’t be belittling people’s character or intelligence:

And we certainly shouldn’t be criticizing our opponents because of their age or disabilities, particularly when those disabilities are due to war injuries. That would just downright dirty politics:

Despite all of your efforts, Mr. President, the tone of our politics hasn’t changed much. But keep up the good work. Your consistent example is appreciated and is sure to bring about the change we hoped for eventually.

Written by Mike

January 28, 2010 at 12:16 am

In Defense of the Court

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As if the United States Supreme Court needs a defense from me…

The Supreme Court ruled last week that the government cannot prevent organizations, including corporations and labor unions, from weighing in on political campaigns. The reaction I’ve seen has been almost all negative, with some claiming that it is the end of democracy as we know it. While I think that’s a bit of an exaggeration, I am concerned that this will make it even easier for corporations to gain political influence. However, what strikes me about that argument is that it is completely irrelevant: if something is unconstitutional, it doesn’t matter if we like the consequences of it or not.

Glenn Greenwald starts with that point and then goes on to make several other good points in defense of the court ruling, including linking to this response to those who say that money is property, not speech, and also posting a follow-up on the subject.

As someone with a lot of opinions but not much time to write, I’ll just ask the reader to consider Glenn’s writings on this subject to be mine (in the non-plagiarism sense, I mean), because I think I agree with him entirely.

But since I can’t bring myself to write an entirely “go read this guy” kind of post, let me add this thought experiment:

Is it unconstitutional to restrict a person from expressing his political views? Of course it is unconstitutional.

Is it unconstitutional to restrict that person from gathering with like-minded people to pool their voices together? Of course it is unconstitutional.

What if that pool of people decided that they needed to engage in fundraising efforts, such as selling stuff, in order to raise money to get their message out? Would it be unconstitutional to ban that? I think it would be, and I don’t see any real difference between that and a corporation or labor union buying air time to get their political views heard.

Now, as I said, I do worry about the influence of special interest groups in politics, but the way to fight them is not to take away the rights of the people in those organizations–it’s to exercise ours. Corporations may be considered “people” in some sense (although really I think that line of reasoning is a distortion of the decision–that’s not really what it said), but clearly they are not fully “people”. They cannot vote, and as long as they can’t, they can only be as powerful as we, the voting kind of people, allow them to be. That might sound overly idealistic–to believe that the people will rise up to think and act for themselves instead of allowing themselves to become the pawns of higher powers–but it also happens to be what the founders were counting on when they went all in on this new experiment called democracy.

Written by Mike

January 24, 2010 at 11:02 pm

The Tragic Miscalculation: Where Democrats Went Wrong on Health Care

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Last August, as health care town hall protests broke out across the country, the Democratic National Committee issued a statement which included these words:

The Republicans and their allied groups – desperate after losing two consecutive elections and every major policy fight on Capitol Hill – are inciting angry mobs of a small number of rabid right wing extremists funded by K Street Lobbyists to disrupt thoughtful discussions about the future of health care in America taking place in Congressional Districts across the country.

However, much like we saw at the McCain-Palin rallies last year where crowds were baited with cries of ‘socialist,’ ‘communist,’ and where the birthers movement was born – these mobs of extremists are not interested in having a thoughtful discussion about the issues – but like some Republican leaders have said – they are interested in ‘breaking’ the President and destroying his Presidency.

Of course, hindsight is 20/20. As it turns out, that group of “right wing extremists” just won a senate seat in blue Massachusetts. Tragically, the Democrats underestimated the public discontent with health insurance reform from the beginning. Instead of downplaying and marginalizing the opposition, they should have taken it as a signal to moderate. Instead, they dug in even more, and that is tragic, not only for Democrats but also for the American people. Although I don’t support health insurance reform in its current form, I do want something productive done. Unfortunately, thanks to the Democrats’ fumble, we might have squandered our opportunity.

Written by Mike

January 19, 2010 at 10:19 pm

Would You Rather Lose a Leg or a Mistress?

(Assuming you were of such a character as to take a mistress, that is.)

Adam Smith makes an interesting point:

The loss of a leg may generally be regarded as a more real calamity than the loss of a mistress. It would be a ridiculous tragedy, however, of which the catastrophe was to turn upon a loss of that kind. A misfortune of the other kind, how frivolous soever it may appear to be, has given occasion to many a fine one.

(In case it’s not clear, he is using the word “tragedy” here to mean a form of art depicting suffering, as in “Shakespearean tragedy”. I had to read it a few times before I got that, but maybe you’re smarter than me.)

Written by Mike

January 16, 2010 at 9:31 pm

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Why Does Health Care Cost So Much in the US?

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Matthew Yglesias cites an NPR prodcast exploring the question: Why does an MRI cost 10 times as much in the US as it does in Japan? (Note: I haven’t listened to the podcast but the same question is explored by NPR in text form here).

This question is a variant of one that has been asked before many times: Why does health care cost so much in the US, compared to other nations? Many times the assumed answer is that the difference is because of waste and excess profits in the system. While I don’t dispute that there is some of that, there are also many other logical reasons why health care costs differ from country to country. The argument from those who propose a single-payer system, or at least that we move in that direction, are based on the implied assumption that our costs would be as low as other nations if we would just mimic their system. That is not true because there are factors that influence the price that are completely independent of the health care system itself.

The two main components of health care costs are technology and people. Let’s look at each one individually.

Technology

The CBO estimates that the adoption of new technology is the leading contributor to rising health care costs. However, rising costs isn’t the question here. The CBO also says that health care costs are rising in all nations. The question here is not the increase in costs, but why there is a difference between costs in the US and elsewhere.

There are a number of reasons for this, some of which were touched on in the NPR article above. I want to explore one of them that also applies to the pharmaceutical industry. When NPR asked US doctors and hospitals why MRI machines cost so much less in Japan than in the US (emphasis mine):

Japan sets the price they pay for MRIs super low. And so to get into the Japanese market, the manufacturers lower their prices. They charge more here in the U.S. because we will pay more. How come? Well, I called a number of American hospitals and doctors and I got basically two reactions. The first and most popular: a shrug. We could never get those prices.

So, MRI manufacturers are selling the machines in Japan at a lower price than they are selling them in the US. Why is this? Maybe it’s the same reason that drugs cost less in Canada:

They are engaging in what economists call “price discrimination”–that is, charging different prices to different buyers of the same product. Price discrimination works in the drug industry because drugs are very expensive to develop, but fairly cheap to manufacture. As long as companies can recoup their research and development costs by charging high prices in the United States, they can make a profit in Canada and elsewhere by merely covering the cost of making the pill (or tube of ointment or whatever).

To restate, developing a drug (and I imagine the same hold true of advanced medical equipment like an MRI machine) the cost to develop the product itself is high. Once you have a design that works, you can crank them out on the assembly line relatively cheaply. So, if there is a market that is only willing to pay a certain price you can still make a profit by selling to them, but only if you have another market that you can sell to for more in order to recoup the cost of R&D. In other words, if the US set price controls for MRI machines like Japan does, or if Americans were not as wealthy and could not afford the high cost of the machines, there wouldn’t be any MRI machines because manufacturers wouldn’t be able to recoup the cost of R&D and therefore they would not be profitable.

We should not expect technology to cost the same in different countries. There are many factors that play a role in the cost, and this is just one of them.

People

The second major component of health care costs is people: doctors, nurses, lab technicians, and many other high-skill professionals. Health care is inherently a labor-intensive industry, and not just any labor: high-skill labor. According to the International Average Salary Income Database, general physicians and nurses in the US make about 75% more than their Japanese counterparts. Although the numbers for more specialized physicians aren’t listed, we know that in the US they make much more than general physicians and so the gap is likely to be even larger.

So the solution to our cost problem is simple, right? As one commenter on Yglesias’ post said (I’m not sure if he or she was serious): “force nurses, doctors and teachers to work a lot longer for a lot less money.” Not so fast. First, we need to look at the reasons why health care professionals are paid so much more here. Are they just more greedy? Well, how about we compare them to similarly educated professionals in other industries. The US pays a much higher price for high-skill labor across all industries, while the price of low-skill labor is comparable to other nations. This should come as no surprise to those familiar with the high and rising income gap in the US.

So what would happen if we force doctors and nurses to accept lower wages? Fewer post-grad students would choose to go into medicine, and instead would choose other paths such as law or dentistry. That would quickly lead to shortages of medical professionals, something already being experienced by nursing staffs. I believe one of the best ways we can combat this problem is improving our education system so that we produce more highly educated graduates to compete for those jobs, but that is a different discussion. The point is that, at least with respect to this contributor to health care costs, it is not the health care system that is the problem. The labor cost is driven by factors outside of the health care system that cannot be adequately addressed by health care reform alone.

Conclusion

Again, let me reiterate that I do believe there are steps that can be taken to lower the high cost of health care. However, comparing the cost of health care in the US with the cost in other nations exaggerates the problem since it does not take into consideration factors that are beyond the scope of the health care system itself, and some of which are not necessarily bad things. We should focus on reducing the growth of health care costs, but let’s not fool ourselves into thinking we can cut it by a factor of 10, or even that we should.

(I should note that I am doing some research on the side regarding the rising cost of health care. I was going to do a post, or a series of posts, in the future. I wanted to response to Matthew’s post, however, so my arguments in this post are a work in progress. Critique, as always, is welcome.)

Written by Mike

November 23, 2009 at 11:23 pm

Old News: LDS Church Doesn’t Hate Gays

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Salt Lake City Temple

The LDS (Mormon) Church recently shocked almost everyone (except for Mormons) when they announced that they would support a Salt Lake City ordinance protecting housing and employment rights for homosexuals. After last year’s battle over Proposition 8 in California, some in the media are calling this a “huge change” and indicative of the church wanting to get Mitt Romney elected.

Let me be clear: As a member of the Church of Jesus Christ of Latter-day Saints, I support my church’s position on the matter. However, I wouldn’t necessarily be disappointed if this did really represent a change. But the truth is that this is not a change from any previous policy, and the fact that so many think it is indicates the success of the smear campaign that has been waged on the church since its involvement in Proposition 8.

At the time that the church was involved in Proposition 8, it issued a statement which included this:

The Church’s opposition to same-sex marriage neither constitutes nor condones any kind of hostility towards homosexual men and women. Protecting marriage between a man and a woman does not affect Church members’ Christian obligations of love, kindness and humanity toward all people.

In 1999, the late President of the church, Gordon B. Hinckley, said this to all the members of the church during its bi-yearly conference:

We believe that defending this sacred institution [of marriage] by working to preserve traditional marriage lies clearly within our religious and constitutional prerogatives. Indeed, we are compelled by our doctrine to speak out. Nevertheless, and I emphasize this, I wish to say that our opposition to attempts to legalize same-sex marriage should never be interpreted as justification for hatred, intolerance, or abuse of those who profess homosexual tendencies, either individually or as a group. As I said from this pulpit one year ago, our hearts reach out to those who refer to themselves as gays and lesbians.

Any opposition to gay rights expressed by the church has always been targeted specifically at gay marriage, not other protections. This has not changed. What has changed is that apparently some, swayed in some measure by the attempts to paint Mormons as the poster-children for bigotry, assumed these statements were just lip service. But they now are finding out that the church actually meant what it said. This comes as no surprise to most Mormons who were paying attention to the counsel of their church leaders.

I have to give credit to Andrew Sullivan. Although he has not been kind to the LDS Church in the past, he respects its (perceived changed) position:

They have made a distinction – and it is an admirable, intellectually honest distinction – between respecting the equal rights of other citizens in core civil respects, while insisting – with total justification – on the integrity of one’s own religious doctrines, and on a religious institution’s right to discriminate in any way with respect to its own rites and traditions….

And what I have long observed among Mormons – unlike some other denominations – is also an American decency that tends to win out in the end. I’ve never met a nasty Mormon. They put many Christians to shame in their practice of their faith and the civility and sincerity with which they live their lives. And this decision in Salt Lake City – not an easy or inevitable one – to make a clear distinction between civil marriage and other civil protections is one worthy of respect.

Gee thanks, Andrew.

The Next Best Thing for Health Care Reform

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As a supporter of the free market (although not a purist), I tend to prefer a solution to our country’s health care problems that enhances the advantages of the market, rather than places more government bureaucracy on top of it. But a bill that decreases government involvement in health care, rather than increases it, is about as likely to get passed as a white male was likely to have been nominated for Justice Souter’s seat on the bench. So that begs the question: if the conservative approach to health care reform is not viable politically, what is the next best thing we can hope for?

What about the much maligned status quo? Even critics of the reform proposals agree that our current system has problems, but would doing nothing be better than the current proposals? Even if some believe that to be the case, few politicians would admit it for fear of being labeled a defender of a broken system. But is the best option on the right to try to block reform and stall, in hopes of gaining political power in future elections, thus making a more conservative approach more viable? That might be tempting, but given the track record of Republicans on getting any major reform done in our health care system, I wouldn’t bet on that approach working out. A few of us are in the unfortunate circumstance of needing the liberals’ zeal to get something significant done and the conservative ideas to get the right thing done. It’s tough to have both at the same time.

What about a compromise approach? The Senate finance committee has recently come out with a bill that it believes to be more moderate than its counterparts. No public option. Less harsh mandates. Almost universal disapproval. Does compromise mean pulling in all of the best ideas from all sides, or the worst ones? In this case, we have none of the cost controls and all of the government bureaucracy. In an attempt to find common ground, it appears the finance committee has found no-man’s land. Worse still, if something along those lines passes, it is likely to give the impression that something has been done, when in reality nothing has been done except complicating the system even more. This impression is likely to cause real reform to be significantly delayed as we have an endless debate about whether the plan is really working or not (see the current debate about whether the stimulus is working).

How about this for the Next Best Thing for conservatives? Let the liberals’ plan pass. Yes, that’s what I said. Put in that strong public option and individual mandates. Punish those greedy private insurance companies and those evil employers that don’t provide insurance to their employees. Why might that be The Next Best Thing? Because when someone asks, “Why can’t I find a plan a low-premium catastrophic plan?” We can tell him that the government didn’t think that would be good for him. And when someone says, “I got laid off because my employer couldn’t afford the health insurance he’s mandated to pay for.” We can say, “Thanks for taking one for team.” Or when someone on Medicaid Advantage reports that their plan has been discontinued, and they are now forced to find another, we’ll just tell them they were part of the waste in the system that had to be jettisoned. Maybe then there would be more pressure to consider more conservative-minded approaches. (Or, maybe it would actually work. Either way, the American people win in the end.)

There was nothing like prohibition to solidify the idea that alcohol ought to be legal. Nothing like Vietnam to make the public wary of the casualties of war. Nothing like repealing Glass-Steagall to remind us of why it was there in the first place.

Does this idea sound good to me? No. I don’t want to see people in our country suffer. And it would likely take decades to undo the programs that would be put in place. I didn’t say it was The Best Thing. I suggested that maybe it is the Next Best Thing. If conservatives believe that liberal health care reform would be a harmful to our country, should they let the liberals prove it? Just a thought.

Written by Mike

October 23, 2009 at 10:03 pm