Health Care Reform — Why Change is Needed

I believe in the free market, and that is precisely why I am for major healthcare reform and the introduction of a public option.

I’ve detailed my argument in this previous post so I will only summarize here.  Free markets work because they permit supply to meet demand at a market clearing price.  Free markets insure that we spend the fewest resources we can to provide the things that people most desire. This does not work for health care because there is no proper, independent demand curve for health care services.  In simple terms, consumers do not know what health care services they want.   When demanding health care, consumers only know the outcomes they want.

In health care, as in many other industries, outcomes and services are de-coupled.  For the most expensive to treat, most pressing health care needs, doctors cannot know for sure what services will lead to the desired outcomes.  The variation across patients and the variability of complicating factors is too great.  This gap between services and outcomes is especially large for preventative and diagnostic medicine.  The sicker a person is, the greater the immediate risks to their life or particular bodily functions, the clearer the need for intervention.  But for long term care — managing risks of heart disease or diabetes, treating cancer — we just don’t know.  We don’t know enough about how well any particular treatment, test, or procedure will work to tie it to an outcome with an appropriate price.

The impact of this service-outcome disconnect is most evident in the proliferation of unhealthy behaviors in early and middle life.  What, for example, is the appropriate price for a service that sends you a sarcastic, disparaging text message (via your iPhone/Blackberry) every time you try to eat a cheeseburger?  Given today’s information, few young people would sign up for this service.  But given what they know in 20 years, when many people realize they have heart disease, many might. That is, when people find out later that their desired outcome (long life) is improved by a particular service, they’ll desire it.  But there is a good chance that, regardless of how many cheeseburgers one eats, there will be no heart disease.  There are too many complicating factors — we just don’t know.

Since we can’t expect the price of health services, particularly for long term outcomes, to be accurate, we can’t expect that a system that uses price to allocate resources and decide outcomes to be efficient.  In other words, for the resources people would desire to spend on healthy outcomes, the current system does not maximize health.

The current system performs exactly as we would expect it to perform.  It over-allocates resources to services that can be tied directly to outcomes, specifically, drugs and surgeries, particularly close to the end of life when consequences to inaction are imminent.  These are the services for which there is robust demand.  At the same time, suppliers spend resources trying to avoid these high demand customers — the sick and the elderly — in favor of low demand customers, i..e customers for whom no services are required to meet their desired outcome — the young and the healthy.

A crucial source of efficiency is lost in this shuffle.  We don’t spend enough on making young people healthy and this makes our old people sicker.   Or, in other words, we could have a lower cost, higher outcome system if we found a way to get young people to take better care of themselves.

Now here is the trick.  In whose interest is it to make this happen?  Insurance companies?  No.  As described above, this is fundamentally a demand side problem.  An insurance company cannot make more money off of healthier young people unless it can capture their health expenditures over their entire lifetime.  That is, if the demand curve was for a total lifetime expenditure, insurance companies could profit by making you healthy now so that you were healthier later.  What about employers?  No.  Same problem.  Only if the health plan is part of a vested pension would the company save money if people were healthy after they retired.  What about the individual?  This is the original point of the critique.  The individual lacks the information necessary to make an appropriate decision.

As I see it, there are only two entities that could conceivably gain from addressing this inefficiency:

The Government

The Family

These institutions can gain because they are the only institutions that stay the same for people throughout their entire life-span.  There are exceptions, of course, but for the most part people remain in the same country their whole lives, and people remain in close bonds with their parents and children their whole lives. Thus, these institutions stand to gain from better allocation of health care resources and are the biggest losers in the current, poorly allocating  system.

I will debate the pros and cons of these approaches in a subsequent post.

Response to Di Rita’s Criticism of Shinseki

The following is my response (submitted as a comment on WP.com) to this Op-Ed in today’s Washington Post criticizing General Eric Shinseki and his supporters for viewing his actions favorably:

I am confused by Di Rita’s essay.  I must have misunderstood.

As I understand it, the argument on behalf of Shinseki’s wisdom and courage is as follows:  Shinseki had a different estimate of the troop requirements than the administration did.  The administration discouraged the communication of views, such as troop estimates, that differed from its own.  Shinseki was one of a very small number of participants in the decision-making process who voiced his difference of opinion.  The wisdom of this opinion was ignored and Shinseki was punished in some way for expressing it.  Thus, Shinseki took a personal risk on behalf of the country to advocate an plan from which the country would have benefited.  Therefore, this action is deserving of our respect, and the actions of those who sought to discourage him are worthy of shame.

I do not see what aspect of this argument is refuted by Di Rita.  In fact, he seems to be supporting it.  Most tellingly, he offers that “At no time, even as a surge was being considered, did anyone recommend doubling U.S. forces to the ’several hundred thousand’ troops Shinseki said might be needed.”  Right.  That is the whole point.  No one, other than Shinseki, recommended this course of action, even though it might have had serious advantages.

Why wasn’t it recommended?  There are two competing hypotheses:
1) because it was unrealistic — it didn’t really merit serious consideration
2) because it was just the kind of idea that the administration sought to discourage.

We have at least three facts that support the conclusion that the answer is #2, not #1. Two of these are provided by Di Rita himself.  First, there is the basic fact (not provided by Di Rita) that the Iraq invasion has failed in comparison to the standards offered by the administration prior to the invasion.  This means that either the administration knew things would be worse than they said, meaning they deliberately deceived the rest of us, or they sincerely mis-estimated the situation.  If the latter is true — their assessment of the situation was seriously flawed — then, necessarily, their assessment of alternative courses of action was also flawed.  Thus, Di Rita is in no position to claim that any strategy was not worthy of consideration on its merits — he and his colleagues clearly didn’t know what the merits were.  This is evidence against choosing #1.

Furthering this case is the fact that Di Rita, now, even with the benefit of hindsight, offers no critique of Shinseki’s argument.  He says nothing in this essay about why 300,000 troops would have been a mistake.  He merely appeals, again, to the fact that no one recommended it (other than Shinseki).  This defense is predicated on the belief that the process by which recommendations were brought forth and entertained was a sound one, yet it is precisely our doubt of this process which makes Shinseki’s testimony compelling.  Thus, it is precisely the situation where some other defense is called for, something that indicates that there was good reason, other than a flawed decision-making process, to ignore Shinseki.  The absence of any such defense in such a circumstance is at least some evidence that no such (credible) defense exists.

Finally, there is the tone and emphasis of Di Rita’s essay, which is to blame Shinseki for what he claims, initially, is a media phenomenon.  According to Di Rita, it is Shinseki’s fault that public opinion has turned against Rumsfeld.  I wonder, did Di Rita talk like this when he was working in the administration?  Because if he did, that sounds to me like exactly the kind of insinuation that would discourage people from stepping forward and voicing disagreement.

Di Rita’s argument matches closely to the logic we have observed the Bush administration use in many contexts: Since, before events occur, we know we are right, debate that exposes the weaknesses of our rationale is purely disruptive dissent and should be suppressed.  Then, after events occur, when it is clear we were wrong, we claim that we “couldn’t have known any better” because everyone agreed our rationale had no weaknesses, and so the fault lies with those who didn’t speak up.  In this case, the fault lies with the person who did speak up for not speaking up even more.

It’s the Executives, Stupid

I think the Big 3 can be saved and there is a good case for the long term national benefit of such a rescue.  But I very much doubt they can be saved by the same people who got them into so much trouble.  Congress should open the debate to outside investors and managers who can argue for more innovative approaches, and the replacement of top management should be a part of any bailout package.

Lead the Brains

Tom Friedman wrote this column in today’s NYT about the shamefulness of Detroit’s inability and unwillingness to innovate.  In response, I wrote the following to him.

Another reason Detroit can’t innovate: lack of talent.  Top engineers and creative business students simply do not go to work in the auto industry.  They go to work in computers and finance.

The market has been mis-allocating brains to industries that can pay the biggest (but most volatile) bonuses.  The government should intervene in the talent market and shift incentives to encourage the best students to serve the national interest.  That means creating rewards programs for talented students to enter the auto/energy/conservation technology industries.

These rewards need not cost the government any short term cash.  Student loan forgiveness programs that vest over time can provide a cash light financial incentive.  More importantly, a President Obama can channel the enormous esteem and enthusiasm he has garnered from young people into a reputational incentive that costs zero dollars.  Create a national service program called “The President’s Select Corps” for top graduates.  Participants get to meet the President and receive public honors in 10-20 years when the energy problem has been solved.  Forward thinking students will recognize that, 30 years from now, they will be able to tell their grandchildren that they saved America, and they will have a medal and a letter from President Obama to prove it.

Sincerely,
Drew Margolin

Could it be?

I will now propose a thesis that will appear both obvious and absurd.  Obvious because, though it may not be true,  it certainly fits the available data, but absurd because it is currently un-American to even consider such an idea.  Here it is:

Barack Obama was elected president because the American people are better educated than they have been in the past.

Over the years, the electorate has shifted, but the politicians haven’t.  Obama alone recognized that a voting majority could be culled together by speaking intelligently to voters, because voters are used to being spoken to intelligently.  Why?  Because they have gone to college.

The data (this is taken from the 2007 census.  Table A-1. Years of School Completed by People 25 Years and Over.  So it does not include voters age 18-24).  This President’s name stands in for the year in which he was first elected.

Columns      No HS    Some College    Col Grad
Obama          6%           54%                  29%
Bush II          7%           51%                   26%
Clinton        10%          43%                   21%
Bush I          12%          37%                  20%
Reagan        17%          32%                  17%
Carter          21%          28%                  15%
Nixon           30%         20%                   10%
Johnson        34%         18%                    9%
Kennedy       40%         16%                    8%
Eisenhower    43%        15%                    7%
Truman         60%         10%                    5%

Because I think Obama represents a paradigmatic shift from Reagan (the previous paradigmatic president), I like to look at that comparison.  In 1980, 17% of adults had not attended high school and 17% had graduated college.  In 2008, those numbers have shifted dramatically and equivalently.  11% fewer people have not attended HS (6% vs. 17%) and 12% more have graduated from college (17% vs. 29%).  I can’t imagine this shift wouldn’t have an enormous electoral impact, and I it seems to me that Barack Obama’s campaign took clear advantage of it.

Think of it this way.  In 1980, only 1 out of 3 people had ever been exposed to a college professor.  In 2008, the number is more than 1 in 2.

Now here’s the rest of the story.  Obama mops up with non-white voters, that we already know and is a huge part of this election.  But he also makes major inroads with white college graduates, who are now 29% of the nation’s population (the table above) and, according to the CNN exit poll, 35% of the voters in this election.

Columns                      Obama            McCain            Other

White College Graduates (35%)	47%	51%	2%
Whites – No College (39%)	40%	58%	2%
Non-White College Grads (9%)	75%	22%	3%
Non-White – No College (16%)	83%	16%	1%

Amongst whites who are college grads, Obama is 4 pts behind McCain — virtually even. Amongst whites who are not college grads, he is 17 pts behind. But these folks are only 39% of voters, whereas in past elections they were a majority. By my rough calculations, white non-college grads were approximately 66% of the electorate in 1980, when Reagan was elected.

Or, in other words, if I take these percentages and shift votes merely on demographics.  That is, I keep the Obama/McCain breakdowns the same but change the number of voters in each category to reflect the make-up of the country 28 years ago, here’s what I get:

Columns                     Obama          McCain           Other/No Answer

White College Graduates (15%)*	47%	51%	2%
Whites – No College (68%)	40%	58%	2%
Non-White College Grads (1%)	75%	22%	3%
Non-White – No College (15%)	83%	16%	1%

*I’ve estimate these based on census reports of population size and voting patterns.  I do not have access to actual exit poll data for 1980 at this time.

If we total this up, we get that Obama loses the popular vote by 48-50, rather than winning it 52-46!  That is, the same voting patterns, just different sizes of voting groups.

The increase in voter education can also help explain the reduction in national division.  In this year’s eleciton,  education appears to be a moderator.  Minority (non-white) college grades are less likely to vote for Obama (3 out of 4, 75%) than less educated minorities (6 out of 7, 83%), even though educated whites are more likely to vote for Obama (~1 out of 2, 47%)  than less educated whites (2 out of 5, 40%).  Amongst college grads, 71% of Obama’s votes come from whites.  Amongst non-college grads, only 54% come from whites.

It should be noted that hypothetically, if from 1980-2008 the ethnic demographics changed but the educational demographics did not change, Obama would have still won his 52-46% victory.  But, similarly, if hypothetically the educational demographics changed — more people went to college — but the ethnic demographics did not, i.e. whites were still 83%, instead of 74%, of the electorate, Obama also wins (though it is closer, 51-47%).  He has thus, in a way, gained a firmer victory than it might appear, though the two do not combine to make a landslide because, as discussed above, the two trends tend to cancel each other out to some degree because educated minority voters are less likely to vote for Obama.

We are a more diverse, better educated, less divided country than we were 30 years ago.  That shift preceded Barack Obama and it is more fundamental than his personality and charisma.  His genius was recognizing it and having the courage to and foresight to mobilize it.

A Naked Emperor Means a Naked Empire

Things in our economy, and our society, are going to get worse before they get better.  Why?  Because we haven’t heard all of the bad news yet.  But it is coming…

We all know the story of the “Emperor’s New Clothes.”  The story is a symbolic representation of the power of social pressure to suppress dissent leading to the public acceptance of absurd ideas.  The cycle is broken only when someone who does not know enough to understand the pressure (the child) expresses dissent.  The story serves its purpose as a cautionary tale — beware of the implied opinion of the crowd.  But as an illustration of the problem — what it looks like, and, more importantly, how it is ultimately resolved — the story barely scratches the surface.  In particular, the story leaves out three critical aspects of any real world “Emperor’s New Clothes” scenario.  And since this is what we are going through, now, I thought it would be valuable to describe them in detail.

1. It isn’t just the clothes

The story centers on the clothes because this is a clear symbol that points the mind in the necessary directions.  While it is doubtful that any actual emperor, or any leader, ever actually went naked while believing he wore magical thread, we all understand the implication.  Sometimes people come to believe in falsities that are so absurd that it is humiliating — in fact completely destructive to their reputation and the reputation of the institution they serve — to admit they are anything but true.  This creates tremendous pressure on other people to act as though they are true, too.  And so the falsity is not only perpetuated but promulgated.  The emperor not only walks around the palace, naked, he organizes a parade to show off his (non-existent) “new” clothes.

The story involves the clothes because they are this ultimate, plainly identifiable absurdity.  What it fails to mention, however, is that the “new clothes” were not purchased arbitrarily, and they were not purchased in isolation.  Their celebration and adulation were not the result of a “magical” sales pitch nor merely a stupid emperor. The purchase of the clothes was merely the final, most absurd (and ultimately untenable) decision built on a series of increasingly foolish decisions that built absurdity into an institution.

Beliefs are not held in isolation.  You cannot believe that a naked emperor is wearing invisible clothes without, at minimum, adjusting some of your other beliefs about the physical properties of clothing and the universe.  For example, where and how are the new clothes washed and stored?  How do servants avoid disputes over who has them or how they should be handled?  What if someone is accused of stealing them?  It is not impossible to convince an entire staff to act as though, or perhaps to believe, that non-existent garments are in fact beautiful and magical, but it requires assembling a set of beliefs and procedures that evade challenges to this belief.  That is, a set of beliefs and procedures that evade challenges from empirical reality.  In other words, for an emperor to “buy” such new clothes, he had to live in a palace that could “handle” sustained absurdity of belief across a variety of domains.

2. The clothes are the effect, not the cause

Since I think most people would agree that the “new” clothes are a symbol of corruption at the highest level, the preceding assertion is not likely to be controversial.  We can all agree that the “new” clothes were part of a systematic corruption in thought.  But this immediately raises the question: where does this systematic corruption come from?

This is an extremely complex question that cannot be answered fully, but I would like to distinguish the merits of two basic answers.

Answer 1: New clothes as cause.  The clothes appealed to the emperor, and, motivated by his greed, vanity, pride (what have you), he re-made the system of thought and procedure to support his belief that they were magical.  In simple terms, the emperor bought the clothes, and then he pressured everyone to conform their activities to support his decision.  The system was corrupted because of the emperor’s new clothes.

Answer 2: New clothes as effect.  A system of thought and procedure existed which could support any number of false beliefs.  The Emperor happened to be taken with these “new” clothes (because of his greed, vanity and pride) and so he bought them and then dropped them into the system.  In simple terms, the system was corrupt and so facilitated the emperor’s new clothes.  The emperor’s new clothes were purchased because the system was corrupt.

The difference between these two is profound.  In particular, I will argue that Answer 2 is both far more likely to be the truth and far more foreboding if it is the truth.  Thus, we should be prepared to assume it is, in fact, Answer 2.

Answer 2, the new clothes are the effect, is far more likely because setting up coherent systems of thought and procedure to maintain a false belief is an extremely complex task.   If the new clothes are the cause, there is the enormous challenge of implementing a system that keeps the idea of their magic alive.  How do you know who is going to challenge whom, who is already skeptical, who is trusting, and who is pressing for advantage?  Two servants with an intense rivalry and a lack of scruples will almost certainly blow the case, each framing the other for theft or deceit.  The critical problem is that while the risk of challenging the emperor’s judgment, and by implication the “reality” of the clothes and their properties, is implicitly forbidden, the logical consequences of his judgment include contradictions.  It is not possible to draw a single, consistent set of conclusions from contradictory premises.  (For example, if 2+1=3 and 2+3=6, then 6-3=2 and 3-1=2, so  6-3=3-1, so 6=6-1).  Thus, “just following orders,” which require some logical deduction from order to action, leads to conflicts.  These conflicts then threaten to expose the falsity (a servant could logically and defensibly claim that he had 6 “magic socks” whereas another would logically and defensibly claim that he had only 5).  The emperor can order that conflicts be resolved, for example, by decreeing that 5=6, but he cannot anticipate their location in advance.  Thus, in order to be resolved, they must first pop up.  It is the “popping up” that undermines the system of false belief.  These expressions of dissent, even if temporary, serve the function fulfilled by the child at the parade — they call the accepted belief into question.

But while anticipating where the contradictions might pop up is extraordinarily difficult to do, taking advantage of contradictions that are already tolerated is relatively easy.  The emperor cannot anticipate that he will have to declare that 5=6, but if it has already been declared, or, more likely, accepted as true, then this is one source of potential conflict that has been eliminated.  In fact, this accepted contradiction can actually be used to erase a host of potential conflicts.  That is, there is now a set of controversies that should “pop up” but won’t.  For example, when the servants disagree over whether they possess 5 or 6 magic socks, they are held as insubordinate, seeing as they are clearly disobeying the known rule that 5=6.  This means they are at risk of punishment if they even mention their dispute.  Therefore, they keep it quiet, and the controversy does not “pop up.”

This logic extends beyond simple math problems.  The acceptance of contradiction and nonsense in any case increases the ease with which contradiction and nonsense can be accepted in other cases.  That is, nonsense breeds nonsense.  At first, large-scale, “obvious” nonsense is not tolerated, but over time the scope of nonsensical justification increases.  Thus, the emperor does not need to design anything in order to buy his magic new clothes.  He “waits” to buy the new clothes until the system has already evolved to a point where magic clothes will be accepted as real.  He simply matches the absurdity of his decisions to the tolerance for absurdity already present in the system.  The emperor does not begin by buying magical, invisible clothes.  He enters a system with some nonsense and increases it with his greed and vanity.  He buys the magical “new” clothes at the culmination, at a point where even the most obviously nonsensical can be justified as rational within the (now absurd) system of understanding.

Some might argue that the idea that an emperor would purchase magic, invisible clothes and parade around as though they were beautiful is extremely unlikely, anyway, and so it does not make sense to say that the former explanation is less appropriate than the latter.  But while this particular abuse of power is unlikely, the fact that some such abuse will result from a corrupt system where contradiction and nonsense are tolerated is inevitable.  The emperor happened to purchase new clothes, but he could have chosen any number of absurdities.  He could have invaded another country on false pretenses to gain access to their resources, then failed to obtain said resources.  He could have praised incompetent bureaucrats for doing a “heckuva” job when they were doing a terrible job.  He could have promoted borrowing money to purchase assets that provided no growth in real value.

3. After the parade: the implications of nakedness

The fable is a powerful, succinct, cautionary tale.  As such, it stops when the false belief is recognized.  But for the citizens of that empire, the recognition is just the beginning of their pain.  If the clothes are the cause, then the removal of the clothes, the rebuke of the emperor, and the punishment of the tailors is all that is required.  But if the clothes are the effect, as I have described above, the problem is much larger.  The clothes are, after all, only one particular expression of some portion of the false, nonsensical and contradictory beliefs that are embedded in the system.

We are beginning to see this in the news from the economy.  Corporations, particularly banks, are trying to explain their failures in terms of a reliance on magic clothes.  “We’re sorry,” they are saying, “we’ve lost a lot of money because of the magic clothes [mortgages].”  No, the magic clothes are not the cause.  They are the effect.  They’ve lost a lot of money because they were making nonsensical decisions for years and then relying, in part, on the “magic clothes” to make their nonsense appear to be sense.  If 5 = 6, then $50 million in profits can be reported as $60 million, an so on.  The fact that the clothes are now accepted to be non-existent, rather than magical, merely invites them to start admitting all of their nonsense.  It is a time, in other words, when any nonsensical decision that has been made in the last 10-12 years can be explained by a belief in magic clothes.  And since everybody agreed the magic clothes were real, the rest of the nonsense is excusable.

This brings us to two important consequences.  First, there is going to be bad news for a long time.  The emperor is naked, we now acknowledge, and now we are going to be told that he also has a drinking problem, that his ministers are insane, that there is no storage of grain.  Banks and financial services companies will write down enormous losses on bad debt, companies will re-state earnings to reflect appropriate accounting, and workers will be laid off.  We will be told that this is because of bad mortgages, because of the non-existence of the magic clothes, but this is false.  Companies lost money because they believed in nonsense.  They will not begin to make real profits again until they learn good sense.

The second consequence is that, despite our intense desire for retribution, there is really only one thing we can do.  Start thinking good sense, and waiting patiently for it to replace the nonsense.  In the meantime, expect things to get worse.  How do we distinguish good sense from nonsense?  That’s a topic for another post, but here’s a start: contradictions are bad, and conventional wisdom is not necessarily good.  If “common sense” recommends something but it appears to have a contradiction, the common sense is probably wrong.

Many nations and empires have gone through this.  Too often, they have ended up relying on the most costly and devastating means of undoing the nonsense — massive mobilizations of violence.  The innocent and guilty alike are killed and tortured until every promulgator of nonsense has either died or been ostracized as a monster, with only the sensible retaining their credibility.  But there is another way.  Sensible people can begin cutting down the nonsense in their own backyards.  The nonsense started growing there, and the new sense has to start growing there, too.

Herbert Simon on energy

I came across this while reading Herbert Simon’s The Sciences of the Artificial today.  The book (the 3rd edition) was written in 1996.

embedded in the energy-environment problem that confronts us today [1996], we can see three almost independent aspects.  The first is our immediate dependence on petroleum, which we must reduce to protect ourselves from political blackmail and to achieve a balance of international payments.  The second is the prospect of exhaustion of oil and gas supplies, a problem that must be solved within about a generation, mostly by the use of coal and nuclear energy.  The third is the joint problem of the exhaustion of fossil fuels and the impact of their combustion on the climate.  The time scale of this third problem is a century or so.  

Herbert Simon won the Nobel Prize in Economics in 1978 (full bio from Wikipedia here).  He died in 2001, but before 9/11.  But he was not a macro-economist nor an expert in energy, and this book is largely about cognition, artificial intelligence and problem solving.  

In other words, he doesn’t use this example to make a point about energy, he uses it as an illustration of some other point.  And he can do this because this understanding of our energy problem is obvious and well known.  Obvious and well known, in 1996!! Yet here we are, 12 years later, including 7 years after a devastating attack that proved his aspect #1 convincingly, and this is the first major political election where energy is one of the top issues.  I blame everyone who has been in Washington since 1996 (if not earlier) for this.  

The problem was obvious then. You wasted 12 years doing nothing.  Go home.

What to Watch for Tonight? The Gesture

Something I’ve been thinking about. For years we’ve seen politicians copy the “Bill Clinton fist waggle.” It’s that thing he does where it looks like he’s weighing his own fist. It’s an odd mixture of firmness (it is a fist) and gentleness (the shake is very unvigorous). Several such fist shakes were on display over the last couple of days (though Bill himself seems to have moved on, he didn’t use the fist once last night).

Obama uses a different gesture. It’s the “point-point-fly.” He look starts by making a couple of jabs with his finger, as though he were pointing at a person or, perhaps, a word in a document. Then he accelerates his finger forward, like he’s “broken through” a barrier and his finger is now in the clear. I’ve notice it because I’ve notice myself copying it in conversation with people.

I think these gestures are fundamentally representative of the thoughts of the speaker. Use Obama’s gesture and you will feel it. It says “I know exactly where the problem is.” I don’t quite know what Clinton’s means, I find it awkward to use and a bit icky to watch. It’s kind of fake-mushy. Clinton didn’t use them last night and I thought he was great — better than whenhe was president. I’m looking forward to getting those finger jabs tonight. And I’m looking forward to a generation of leaders copying them!

The Scariest Change (to some)

The media’s obsession with Hillary’s supporters and Obama’s alleged inability to “connect” has started me thinking. When a behavior or phenomenon is so consistent, and so enduring, it is almost impossible not to ask “why?” More specifically, it is almost impossible not to question its face value. Very few real phenomena are as consistent as this storyline, and so the more consistent it is, the more you have to think.

The following occurs to me as an explanation: there are really two elections going on here. That is, the eventual, tabulated votes of the American people can decide two questions. The first question is: who will be President of the United States? The other question is: is inane media bloviation relevant?

Imagine the following scenario. Barack Obama does not follow the advice of the bloviators. He does not try to appease the psychological wounds, inflicted by the world, not him, on estranged Hillary supporters. He does not try to appear like a “regular guy.” He seeks to forge a connection with voters, not by showing that he can be on the level they feel most comfortable with but by showing they can feel comfortable on the level he is on. He continues to appeal to our better natures rather than our worst. “Sure,” he says, “I drink beer. But I’m not the sloppy guy who starts yelling at everyone and looking to get in a fight. I drink beer the way John Adams drank it, not John Daly. “

Let’s say he were to try this and he were to win. Who really loses? Certainly not the American people. They get a President they know and trust just the same. But what of the media? What of CNN and MSNBC and CNBC and of the free agent pool of bloviators? They would be in trouble. If gutteral opinions, uninformed speculation, and absurdly overdone graphics don’t represent what people “really want,” if they are not the “real pulse” of the country, then what are they for? They provide no public service, no one is made better for listening to them. They tolerate and promote the degradation of discourse and behavior — running ads with Paris Hilton in a bikini over and over, spreading rumors, insisting that questions be answered to fit their theories rather than listening to the responses. They produce garbage and degrade themselves and their viewers. But for years they have clung to the justification that degradation of themselves and their viewers is necessary because those who are not thusly degraded are “out of touch.” To refuse to be degraded is to “fail to connect.”

An Obama victory under such circumstances is death to the bloviators. Only Fox News would survive. Fox makes no pretensions about the fact that its loyalty is to its audience and its desires. It fills a need. There are millions of John Daly’s and they want, and should get, their news, too. But there is no need for (expensive) imitations. After such a victory, there would be no more need to pretend that the majority of Americans are John Daly, because they are not.

I think the media knows this. I think they know that an Obama campaign that refuses to appease their storylines is dangerous. And they have gravitated to a very clever strategy. “We will validate you if you validate us.” They hype the Hillary issue and the race/connection issue as much as they can neither because it is empirically valid nor because they are biased against him. They hype it because it gives them a way to participate in his success (or failure), that is, because it makes them relevant. If they can get him to change his campaign, and then he wins, they can explain his victory as resulting from this change. They can, and will, say “he won because he appeased our national need for degradation. Thus, this degradation is essential and politically relevant. Therefore, we are justified in continuing to provide it.”

Let me be clear here as I expect what I am saying will be misunderstood. I am not, in any way, saying that people who prefer Hillary Clinton or John McCain to Barack Obama are degraded or less intelligent or anything like that. Degradation comes not from one’s opinions but from one’s reasons and whether they are appropriate to the choice one is making. There are good reasons for Hillary supporters to refrain from supporting Obama until they see more of him: because they are concerned about his lack of experience, because they may prefer McCain’s policy views, because they just don’t yet feel ready to decide. These are good reasons because they are consistent with the purpose of the choice, which is to get the best leader for the country we can. Then there are bad reasons to refrain from supporting Obama: Because they need “closure,” because they are angry/hurt that Hillary lost, because they don’t like black people. These reasons have nothing to do with what is best for the country. These reasons turn a grand responsibility into a personal indulgence. They trade virtue for pleasure. In a word, they are degrading.

Another example is his “connection” to the “working class.” Good reasons for a working class voter to be skeptical of Obama: I don’t understand his proposals or how they would work, I don’t think he understands the situation I am in and so I don’t think he’ll be able to help me. Bad reasons: he doesn’t seem like he’d be fun to drink with, he chooses to eat different foods than I do (e.g. arugula). A good reason is one which, even if the candidate answered every other concern you have, would still be cause for you to reject him and to feel that you have honored your duty as a citizen in doing so. That is, if a voter says “I do understand his policies and how they work and I do feel that he understands my situation and how to improve it, but I am not voting for him because he drinks wine instead of beer,” should that voter be proud of their decision? There are plenty of good reasons not to vote for Obama, there is no need to degrade oneself by relying on the bad ones.

Just as I am not saying that all those who reject Obama have bad reasons, I am also not saying that I know what reasons reluctant (to support Obama) Hillary supporters or undecided working class voters are choosing. They might all be relying on good reasons, and my guess is that most of them are. My point is, these are not the reasons that are being reported in the media. What is being reported are junk reasons, irrespective of whether anyone actually holds them. That is, the media is taking intelligent, well justified voter opinions and converting them into indulgent, childish ones. Thus, the considered and valuable contributions of these voters are being degraded by the media.

For years the bloviators have made their living by promulgating this degradation. And, sadly, I think they’ve found a way to continue the life of their craft through this next election. Obama has, I think, done enough for them to validate their role. Certainly enough for them to claim he did so though leaving them enough space to say he didn’t do enough if he should lose. On the bright side, though, Obama is a leader. There are many more anti-bloviators on the way.

Time to Lead

This is Frank Rich’s column from Sunday.  It explains precisely what America needs and what the Obama must deliver.  If Obama delivers it, there is no doubt in my mind that he will win.  If he doesn’t, it’s a toss-up.  

Rich articulates the point clearly and with useful details, I’ll just summarize here.  The United States of America is at a crossroads.  The world has been changing around us for some time.  We haven’t adjusted.  We act like nothing is wrong, like things will be ok just because we are “America.”  And so we have abandoned the very thing that makes this country great — clear minded, decisive action.  We have elected instead to live with comforting, self-congratulatory fantasy.  And so we have put off what we should have been done yesterday to tomorrow.  Result: Weakness, debt, confusion, anger.   

Tomorrow has become today.  The time to act is now.  And yet the time for arbitrary, foolish, shoot-from-the-hip action is never.  Thus, this election is not just about recognizing that we are off course, it is about identifying why, using that understanding to think hard and unflinchingly about what needs to be done, and then mustering the hope and courage to do it. 

That is it.  Yes, we need to “bring people together” in this process and this process necessarily entails “change” from the past, but those are consequents, not causes of our action.  We need a leader to say “this is what we need, as a nation, and this is what I’m asking of you, as a citizen.  Let’s step forward together and do it.”

Barack Obama can do this.  John McCain cannot.  If Obama does this, the concerns about madrassas and the bitter feelings over Hillary will feel small.  We Obama supporters won’t be pleading with people to see our point of view, we will be insisting they join with us.   

I firmly believe that Obama is going to deliver a clear vision of the path we must take.  And if he does, he will win.