NOT EVEN PAST JULY 6, 2011
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Remember when liberals believed and conservatives feared that Barack Obama might become another Franklin D. Roosevelt? On its cover, Time depicted the president-elect smiling from the driver’s seat of a 1930s roadster, cigarette holder pointing toward the welcoming sky. That dream—or nightmare, for Republicans—of Obama as both a great reformer and beloved statesman was quickly extinguished by the toxic mixture of a stagnant economy, unending GOP filibusters, the health care legislative muddle, and the president’s own failure to use his rhetorical skills to empathize with troubled citizens and inspire the nation.
But Obama has fallen short of FDR in another, equally consequential way: Unlike the jaunty chain-smoker who swept four straight elections, Obama appears to have no strategy for creating a long-term majority—either for his party or for the progressive causes he believes in. For all his talk about “winning the future” (and his undeniable intellectual gifts), Obama seems to think that solving immediate problems is the key to political victory.
In fairness, the economic collapse has provided a surfeit of crises that must be addressed, and quickly. But, from the Great Depression until the great stagflation of the 1970s, Democrats dominated national politics by balancing crisis management with the building of a multi-ethnic, cross-class coalition tied together both by such programs as Social Security, the National Labor Relations Act, and Medicare, and by expressing a generous ideology and moral perspective Roosevelt in 1941 called “the Four Freedoms”—freedom of speech, freedom of worship, freedom from want, and freedom from fear.
Much has changed in America since then. We fret more about obesity than hunger and fear a handful of terrorists rather than another world war. But the recipe for extended political success has proved quite durable: a compelling vision of what kinds of policies Americans need and a set of powerful institutions that can motivate and mobilize voters. To date, Obama has yet to use this recipe. And, if he doesn’t soon, progressivism in American will suffer the consequences.
OBAMA HAS MADE little attempt to challenge conventional political wisdom and stand firmly behind those policies and institutions most critical to American liberalism. While his studied pragmatism is preferable to the ideological rigidity of his predecessor, Obama neither tangibly defines “winning the future,” much less “hope and change,” nor rallies Americans to his opinions and his side. Obama clearly understands that Keynesian stimuli, strict regulation of the financial industry, and decent health care benefits are the only policies, here and abroad, that can stabilize a capitalist economy and boost the morale and life-chances of the populace. But, as long as he refrains from making a strong and repeated case for these and other progressive ideals, Grover Norquist and his pledge-happy disciples will keep filling the vacuum with a dogma Grover Cleveland would have shared.
Neither has the president who once spoke so eloquently about the role of social movements in U.S. history appreciated the need to nurture and support their weaker counterparts in the present. With the partial exception of gays and lesbians, none of the groups in today’s Democratic core has powerful institutions that can recruit volunteers and mobilize voters. Obama has avoided giving any serious aid to struggling labor unions, which, for all their woes, still represent almost 15 million workers of all races and play a critical role in such swing states as Pennsylvania, Ohio, and Nevada. What’s more, the remarkable grassroots mobilization we witnessed during the 2008 election has shrunk into the tame and conventional campaign apparatus that is Organizing for America. Such a passive citizenry cannot sustain a vibrant progressive coalition—particularly in the long term.
Of course, the blame doesn’t fall entirely on Obama’s shoulders. The knowledge that ineptitude and venality are bipartisan sins has turned many Americans into hardened cynics about government actions of almost any kind. Indeed, when corporations, enabled by a Supreme Court majority, seem willing to spend whatever it takes to get their way in Congress and the states, it is difficult to stay sanguine about the potential for serious reform. Last year, when Senator Richard Durbin blurted out that bankers “frankly own” the most powerful legislative body in the world, he was pointing to one of the many formidable structural obstacles that progressives confront.
Furthermore, liberals, and the Democratic presidents they support, have been on the defensive for decades. Since the racial crisis of the 1960s and the debacle of the Vietnam War, they have been afraid to assert the justice of their beliefs and the value of their accomplishments. Although Jimmy Carter and Bill Clinton temporarily managed to win back some white Southerners who had fled the party of civil rights, neither put forth a fresh notion of what the government should do or found ways to unite progressive activists, unionists, black and Latino voters, and sympathetic businesspeople behind a common program. While each had sound reasons to abandon the old liberalism, they offered nothing to replace it other than vague talk about “a government as good as its people” and a “Third Way.” As a result, conservatism has remained the default ideology of the political class.
Meanwhile, on the right, Republicans have consistently appreciated the value of long-term planning. In the 1970s, they mobilized the troika of movement conservatism—religious traditionalists, business-minded libertarians, and neocon cold warriors (who later morphed into cheerleaders for the war in Iraq)—to supply the ideas, money, and institutions to push a simple message about slashing government (except the military) and supporting “family values.” That formula has helped the GOP win a majority of white votes in every presidential election since Richard Nixon squashed George McGovern.
By the turn of the century, Karl Rove and George W. Bush realized the nation’s changing demography would soon jeopardize their party’s electoral edge. So they proposed immigration reform to appeal to Latinos, and No Child Left Behind and the faith-based initiative to woo African Americans. That program, notes historian Gary Gerstle, “possessed a coherence that liberal critics of the administration too often overlooked.” The multiple disasters of Bush’s second term made a hash of the administration’s dreams. But, if Republicans are able to use the electoral foundation that the last White House built and win even two-fifths of the non-white vote—which, admittedly, would require softening their views on immigration—they would still be likely to cement a majority for several decades to come.
DESPITE HIS DISAPPOINTING performance so far, Obama still has an opportunity to prevent this from happening. With nativists in command of the GOP, his base among the swelling number of Latino and Asian American voters is relatively strong, and he enjoys the unshakeable support of African Americans. Against a party still led by evangelical foes of homosexual rights, Democrats can also count on the growing ranks of culturally tolerant professionals who live in most metropolitan areas. What’s more, Republicans are not likely to nominate a candidate in 2012 who can appeal to young whites the way the affable Reagan did. As Ruy Teixiera and John Judis have been arguing for the past decade, the demographic potential for a Democratic majority is there.
Yet, if Obama wants to realize this potential, he will have to do more than just win re-election, which may be difficult enough. He will have to show confidence and execute a strategy that clarifies what is at stake in our politics. Toward the end of his own second presidential campaign, FDR asserted, “Government by organized money is just as dangerous as government by organized mob. Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me, and I welcome their hatred.” Obama should speak so forcefully today.
It is important to remember that, contrary to liberal legend, Roosevelt did not glide from triumph to triumph. In fact, during the 1930s, a majority of Americans often disagreed with a given New Deal policy and were troubled by the growth of federal power it represented. Still, they were hungry for protective and vigorous leadership and trusted FDR’s concern for their plight, which he expressed and acted upon, clearly and often. This trust helped anchor the Democrats’ majority for years to come. Obama might not be another FDR. But he can become a tougher, more farsighted politician; that would be a change worth believing in.
Michael Kazin is the author of American Dreamers: How the Left Changed a Nation, to be published in August. He teaches history at Georgetown University.
108 comments
Thank you.
- roidubouloi
July 6, 2011 at 12:11am
"Obama clearly understands that Keynesian stimuli, strict regulation of the financial industry, and decent health care benefits are the only policies, here and abroad, that can stabilize a capitalist economy and boost the morale and life-chances of the populace." Does he? What evidence do we have that he understands any such thing? WE understand these truths, and we have a tendency to think that anyone as apparently intelligent and well-educated as Obama must understand them too, but this, it seems to me, rests upon a fallacy. Judge the man by his actions not on the basis of whatever beliefs you assume he must hold in his head. On the basis of his actions, Obama is a class A dud. The only reason I have given BHO the benefit of the doubt this long is because the Republican alternative is so scary. No more. I'm done. I'm hoping for a Democratic primary challenger, though I'm not holding my breath. But even if there isn't one, Obama won't have my vote. I'd write in Bugs Bunny before I voted for this Reagan Republican again.
- AaronW
July 6, 2011 at 12:44am
"DESPITE HIS DISAPPOINTING performance so far..." I continue to be baffled by the second guessing of the President's political strategy, and the downplaying his accomplishments.
- wkwami
July 6, 2011 at 1:05am
Amen. There was speculation, earlier, that we'll have ourselves a real debt crisis, Obama will use the 14th Amendment solution, or something analogous, and subsequently be impeached for it. I was initially aghast, but if that's what it takes to wake the man up, maybe it'd be a good thing.
- Curran1
July 6, 2011 at 1:35am
Aaron, I think I'm about as disappointed as you, but a primary challenger 1) Won't happen 2) Is an epically horrible idea--like, Ted Kennedy trying not to shake Carter's hand in 1980 horrible. And the stakes are the same. The right is looming. A challenger would be taken as evidence of the Dems' disarray and lack of confidence in their leader. In any case, let's be fair: Obama isn't a Reagan Republican. He's an Eisenhower Republican, maybe.
- Curran1
July 6, 2011 at 1:39am
I agree with AaronW. Obama needs to articulate an economic message which recognizes that we have had low taxes for 10 years and there is no evidence that it works. And President Obama needs to overcome the conflation of higher taxes with welfare. The Republicans prepared their ascension in 1973, when Karl Rove was President of the College Republican National Committee, and in 1981 when Jack Abramoff was chairman. Kids who came to believe that affirmative action was stealing their college slots grew up to believe that if you work hard, government will take your money and give it to someone lazy.
- Nusholtz
July 6, 2011 at 1:53am
Curran, at what point does a person stop looking at voting as a choice between the lesser of two evils and going just along with the whole shitty farce? You're correct, the right IS looming, but unless voters stand up and demand that the Democratic opposition start doing its job of, you know, OPPOSING and make Democrats in office feel the pain, where's it going to end? Obama has governed exactly like a Republican. It is arguable that Nixon was more liberal than Obama. The only reason Obama SEEMS like a Democrat is becuase the nominal Repubs are so far off the reservation that anybody whose knuckles don't touch the ground looks like FDR by comparrison.
- AaronW
July 6, 2011 at 2:43am
that's "just going along" not "going just along"
- AaronW
July 6, 2011 at 2:44am
I agree with AaronW and Nusholtz; and it's interesting to learn that Rove began his foul career (my opinion) in 1973, because the 70's marked a time when we started to decline economically - by "we" I mean workers; the '80's were a disaster in many ways - did we not begin to lose our ideals and embrace materialism and expediency? For example - arming the mujeheddin, trying to play the Great Game, Iran/Contra; Iran/Iraq, Latin America, the S & L disaster.... So. The right is so terrifying I can't imagine not voting for Obama. Even if he is a Republican; unless a compelling challenger with a real chance of winning the election comes along. If the Republicans or should one say, The Far Right win the White House or any more seats in Congress - one shudders to think what could happen; as it is the damage to and by the Supreme Court alone has been profound, and in the states real human rights, women's rights, are being eroded, union rights, environmentalism, animals are losing protection, Republicans run on a platform dedicated to repealing health care, Medicare, "reforming entitlements..." The ideology of fear, fear of the other, racism, that's gotten worse in the last few years than I would have imagined possible. That is not Obama's fault, it reflects something deep and ugly in America that has yet to be expunged. I was talking to a friend the other day, an African American woman who said Jesse Jackson cried when Obama was elected. I thought she meant it was because he is a Republican, but in fact I believe she she meant, it was too soon; people can't deal with it, nothing has changed and things have gotten worse, not better. And the bad economy is exacerbating things in this city at least... Even Brooks seems to see that something is terribly wrong on the Right. So I hope people don't throw their votes away.
- Sophia
July 6, 2011 at 2:46am
It is a nice article, but it's been done a couple of times now. Obama will make some noise, like he did before the 4th, and then disappear. So what?
- jet
July 6, 2011 at 3:17am
I forgot to add "In the 1970s, they mobilized the troika of movement conservatism—religious traditionalists, business-minded libertarians, and neocon cold warriors (who later morphed into cheerleaders for the war in Iraq)—to supply the ideas, money, and institutions to push a simple message about slashing government (except the military) and supporting “family values.” That formula has helped the GOP win a majority of white votes in every presidential election since Richard Nixon squashed George McGovern." So, is it Obama's fault, or the Democratic Party's fault that Obama isn't cutting it? Obama was just elected in 2008. The easy answer would be both, but if the above line is correct, then more of the blame belongs to the party. The article implies the same savvy for planning with Rove and Bush moving on to immigration. What are the Democrats plans for 20 years down the road? Simply waiting on John Judis and Ruy Teixiera's changing demographics is not a plan.
- jet
July 6, 2011 at 3:28am
Jet, to me the Obama/Democratic Party distinction is uniteresting and irrelevant. Democrats have been triangulating, moving to the center, whatever you want to call it at least since 1980. Obama is merely this movement's apotheosis. Does he deserve all the blame? Of course not. Does it make any practical difference? Not a bit. Time for a new plan. We can argue about whether it makes more sense to fight this battle within the Democratic Party or outside it, but wherever the fight gets fought, Obama is not the solution; he is a big part of the problem.
- AaronW
July 6, 2011 at 4:04am
Look, another Republican presidency with GOP control of both houses of Congress scares the shit out of me too. BUT if every four years we vote for dogs simply because they aren't swine, then we are doomed to be led by dogs. Also, a big part of me feels that the Republican right is like a chronic disease. Reelecting Obama won't cure the disease; it will merely keep it under partial control. What America really needs is for the disease to reach a crisis so that we can cure ourselves of it once and for all.
- AaronW
July 6, 2011 at 4:13am
The Republicans have thrown away their thermostat.if I were younger I would emigrate to Canada or France. Obama is doing OK but I feel sorry for him. He deserves better.
- paskunac
July 6, 2011 at 6:49am
It's a sign of how badly Obama is doing that one-time Obama champion Michael Kazin is now criticizing him. And Kazin is right and smart in doing so.
- hkaye
July 6, 2011 at 6:56am
What is interesting is that in today's economy, you would expect a groundswell of support for liberal policies that address the vulnerable, but somehow the T-Party, with its small government emphasis, has drowned that out. It's quasi swift boating Obama, in the sense that it is a small group with a position of questionable merit that has a large influence.
- Nusholtz
July 6, 2011 at 6:58am
It seems to me that it's not the 1930s, despite the recession, and that Obama is counting on the Republicans to sound continually so batshit crazy that the independents (= conservative voters who don't like the extremist style) will stick with him in 2012. Boring and uninspired? Yes. But potentially successful.
- ironyroad
July 6, 2011 at 7:27am
What is missing from Kazin's essay and these comments is the difference between FDR and Obama as candidates. When FDR ran for his first term in 1932 the economy had been in a tailspin for several years and his campaign centered on the economy. By contrast, Obama ran as the post partisan candidate, someone who would mediate between the two parties, the fincancial collapse coming at the end of the campaign; indeed, his campaign changed little, at least in terms of the advisors who would guide his administration, after the collapse. When Obama took office and his administration successfully shepharded the stimulus through Congress, Obama almost immediately pivoted, claiming that the stimulus was just right and that "green shoots" were sprouting in the economy, and he and his administration then spent almost a year in post partisan mode in a futile attempt to craft a post partisan health care bill. I'm not criticising, just pointing out the fundamental difference between FDR the economic crisis president and Obama the post partisan president. Obama the president, like FDR the president, is no diffferent from Obama the candidate. And no matter how much we would now prefer an FDR, Obama isn't him, never was, and never will be.
- rayward
July 6, 2011 at 7:43am
Agreed, rayward. Trouble is we don't need a postpartisan president. I voted for him thinking that the postpartisanship line was just that, a useful fiction. Mea culpa.
- AaronW
July 6, 2011 at 8:19am
Unfortunately, America is engaged in yet another iteration of anti-incumbent, e.g. Nixon begat Carter, Carter begat Reagan, Clinton begat Tom DeLay, and Iraq2 begat Obama. What the Democrats need is a re-incarnation of Harry S. Truman, which can never happen because he did not go to Harvard.... Despite the very real risk that 2012 will once again result in one-party Federal rule, it is not yet clear that a hard-right ideologue will win the GOP nomination. What will help the GOP is that they seem to have more governors who are succeeding in managing at the state level, and devolution of power back to the states, e.g., Medicaid, may become a keystone issue. America is at an historical moment where a plurality of voters understand the two-party duopoly system for choosing their candidates is failing to generate political leaders. If Geithner does leave, then whoever Obama can get confirmed as SecTreas may just decide the election. He has that one chance to prove that he can actually manage the Executive bureaucracy, and can include someone with private sector, real (not financial) business experience. Unfortunately, America is engaged in yet another iteration of anti-incumbent, e.g. Nixon begat Carter, Carter begat Reagan, Clinton begat Tom DeLay, and Iraq2 begat Obama. What the Democrats need is a re-incarnation of Harry S. Truman.
- K2K
July 6, 2011 at 9:02am
Give me a break, people. Lenny Bruce said, "The truth is what is. What should be is a fantasy--a terrible lie someone gave the people long ago." Let's talk about the world as it is for a minute. President Obama has faced the worst economic downturn since The Great Depression; intransigent Republican senators; and Big Business Democrats from conservative districts/states too afraid to vote for liberal policies. And that's not all he's had to deal with (Afghanistan, etc). Meanwhile, he has always presented himself as a moderate; that's what irks me the most. No one can read "The Audacity of Hope" critically and conclude that President Obama thinks like Dennis Kucinich. But considering the world as it is today--how can any of you say that President Obama has not accomplished much? I'm serious. The world AS IT IS today. Not the fantasy scenarios you have in your mind in which Democrats held the line and forced through a $1 trillion dollar stimulus, or a Public Option, or the strictest of Financial Reg bills. The votes were not there. These things don't become law without votes. I realize that people are frustrated. It sucks that the DREAM act didn't pass. It sucks that very little has been done to further alternative energy (eight or nine billion dollars in the stimulus). But give me a break. Sure, President Obama probably could have tweaked countless things and achieved better results. But the notion that he could have had some radically more accomplished presidency in this polarized climate and economic freefall is the most ludicrous and disingenous crock of nonsense I've ever heard.
- maxhencke
July 6, 2011 at 9:47am
K2K, I'm not sure how your "begats" apply to the present moment. All of those party flips you list occurred because independent voters and weak partisans switched allegiance. What's happening now is that strong partisans of an admittedly unknown number--though I'm one of them--are abandoning their party leader. max the "realist", the world as it is the world Obama inherited but it's also the world he created. Obama defenders need to drop the intransigence-Republican-senators crutch. The Democratic majority was 59/41, and if those threatened filibusters were so crippling--and it seems they were--the nuclear option was there to be employed. But, no, Obama was too enamored of his own ability to bring people together across the aisle. And as for the recession, if Obama had tried and failed to get a bigger stimulus through Congress, one not so heavily weighted towards tax cuts, and if he had refrained from repeatedly blowing economic sunshine up the nation's ass you might have a case.
- AaronW
July 6, 2011 at 10:12am
Preach, maxhencke, preach!
- wkwami
July 6, 2011 at 10:25am
Roosevelt and Obama how appropriate! Roosevelt closed the doors to my family attempting to flee the Shoa, you all call The Holocaust inappropriately. They went up in smoke as a result of Roosevelt closing the doors to Jews trying to survive. Obama? Speech in Cairo to Muslims and his regarding Israel as his major problem in the whole Middle east to solve. Darfur, South Sudan ignored because there the multitudes slaughtered are only Black people by Arabs who calls them usually "Abed" (Slaves). That is how Arabs call Black people in the Middle east like it or not. I will vote for anyone running against Obama and by the way, today I am an ex- long time Democrat.
- Poupic
July 6, 2011 at 10:40am
"The Democratic majority was 59/41, and if those threatened filibusters were so crippling--and it seems they were--the nuclear option was there to be employed. But, no, Obama was too enamored of his own ability to bring people together across the aisle." Oh yeah, and said majority had Blue Dogs both in the Senate and the House. The Senate passed PPACA with a filibuster proof 60/39 votes. What it took to get the Blue Dogs on board? You guessed it, some serious compromising. Call it Obama being too enamored... Point is it as difficult, if not more so, to win over the Republicans in your own party than Republicans themselves.
- wkwami
July 6, 2011 at 10:53am
This article would be great. except he passed universal healthcare. The real question: what causes self-deceiving liberals to whine so much?
- Virginia Centrist
July 6, 2011 at 11:03am
"I am an ex- long time Democrat." -Poupic Oh, that explains it. You're a racist!
- Virginia Centrist
July 6, 2011 at 11:05am
AAron: Obama has governed exactly like a Republican. I am with maxhencke, repeal of DADT, the administration is no longer defending DOMA in courts, the affordable care act, getting Osama Bin Laden (Republicans didn't), treaty with Russia, financial reform, a Consumer protection agency, 2 Supreme Court Liberal women (both minorities, one jewish the other hispanic) added to the Court. Yeah, McCain would have done the same thing.
- blackton
July 6, 2011 at 11:31am
And Poupic, you would vote for Michelle Bachmann over Obama? Sorry, but you are crackers. Obama has done NOTHING to hurt Israel except to try to get the Palestinians and Israelis to the negotiating table. Oh wait, he put pressure on Israel not to build settlements, many of which would have to be torn down if a peace treaty is ever brought about. And your likely blithely stating that the West Bank settlements are part of Israel kind of makes the whole point of negotiation impossible. So vote for Bachmann, I am sure she will urge Netanyahu to expel all the arabs from the We---sorry, Judea and Sumaria to make room for Jeebus. That will make things ever so much better. And your faux concern for the South of Sudan is pure unadulterated bullshit. South Sudan is now independent. If we had dropped bombs on Khartoum the situation would be far worse, or are you saying we should have invaded them too. Hell, lets invade everyone, but not you personally though.
- blackton
July 6, 2011 at 11:40am
I don't think that Obama should be renominated by acclamation. His weak domestic leadership and confused Middle East policy are fair game. Since this article by Michael Kazin concerns "Obama’s Short-Sighted View of U.S. Politics", we should do some long-range thinking of our own. Who can be nominated instead of Obama? What coalitions can be built within the Democratic Party and in the general electorate?
- amidut
July 6, 2011 at 11:58am
"...we should do some long-range thinking of our own" You mean you haven't considered doing any long range thinking of your own until now? I say let's nominate Dennis Kucinich.
- wkwami
July 6, 2011 at 12:08pm
The comments here display the Democratic party disease in microcosm. Kazin is talking about politics, the political work that Obama, and the Democratic party following his lead, have to do to cement the power that lets them, us, achieve the agenda. Immediately, posters cannot refrain from touting policy achievements in the fact of obstacles. This completely misses the point. Policy and politics are not the same thing. Democrats as a party are dominated by wonks and obsessed with policy. As a result, they cannot summon the will to do the necessary political work and what should, in the wake of the Bush disasters on every front, have been a generation at least of Democratic governance is now in jeopardy after only a couple of years. Political malpractice is what Kazin is talking about. He is in my opinion absolutely right. I have been trying to say the same thing here, far less eloquently and persuasively, for years already. Among other things, perhaps chief among them, Obama refuses to accept that he is the head of the Democratic party, and that if the head won't lead, the party is headless and leaderless and destined to flounder even if Obama manages to get re-elected by a whisker.
- roidubouloi
July 6, 2011 at 12:31pm
Hey, I'm as much of a New Deal fan as any progressive, but I think comparing Obama, whatever his faults, with FDR overlook any number of things, some of which have been listed by others here. One critical difference I think is that Roosevelt had much larger legislative majorities, something like 69 Democrats to 27 Republicans at one point. So no filibuster to impede him. Also, Obama's detractors overlook FDR's shortcomings and bad decisions, such as internment camps for Japanese-Americans and refusal to take on segregation, including supporting an anti-lynching bill, despite desparate pleas from black leaders of the day. And how about his premature cutting of spending in 1937, touching off another recession (the so-called Roosevelt Recession of 1937-1938)? I agree with maxhencke and blackton--Obama has accomplished a lot, despite fierce opposition from a more powerful GOP than Roosevelt had to face. Some context is needed here.
- ballston
July 6, 2011 at 12:42pm
Max: You don't know what the F--- you're talking about, if you think a stranger financial reg bill couldn't have been passed. People were afraid to vote against whatever came up. The political dynamics there favored the left; the left was just too stupid to make use of that. As for the rest, removing the filibuster would've substantially decreased the difficulty of passing other strong bills; the House is not the Senate. And, incidentally, a 1 trillion dollar stimulus would still have been far too small.
- Curran1
July 6, 2011 at 12:47pm
Ballston, After the election of 1936, FDR and his party had 76 out of 96 seats in the senate. Talk about a majority. Though, actually there wasn't much great legislation passed that session, due to the conservative revolt. As for the rest, Obama accomplished more than the median president, in his first two years. Unfortunately, much more was demanded, given the problems we're facing.
- Curran1
July 6, 2011 at 1:10pm
roidubouloi, I don't get that. It is all politics to you? What is the point of winning political debates if you don't have any policy agenda that passes? We have achieved most of the agenda. The key now is to only ensure that it survives in face of a sociopathic opposition party that hates Democracy. Long term these inbred teabaggers will die off to be replaced by minorities who will migrate to the Democratic party as being the only sane one there is. The simple truth is no amount of politics were going to change these braindead teabaggers, and a very harsh recession coupled with mid terms gave Republicans one House of congress. My only criticism of Obama is he believed the first stimulus was going to be enough. He relied too much on his economic experts who proved to be not so expert. Given the choice to do it again I am sure he would have fought like hell to get a higher stimulus, even then it wouldn't have been enough to prevent a bad mid terms, a lot of the shovel ready projects would be coming online now.
- blackton
July 6, 2011 at 2:09pm
I think the observation above, that the far right is like a chronic disease, is accurate and wise. They aren't going to go away are they. Also, though, the comment that Truman didn't go to Harvard - well, there's something to that. The political class in America is largely wealthy, they are not governing from among the people, Tea Party or no Tea Party. None of them seem willing to confront big bucks, there are certain industries which seem to have us by the neck, insurance is one, extraction is another, and who has the power or will to confront them or the super rich?
- Sophia
July 6, 2011 at 2:14pm
Blackton: Hey there. Re: your comments to Roid, I think you're missing the point. It's not all politics, not at all. Rather, politics is the art of the possible, and if your desired result is good policy, then good politics is a necessary precursor to achieve those results. Roid is not advocating abandoning policy. Of course not! What would be the point, right? Just like you said. Rather, Roid is saying that, if you don't take care of the other half, public rhetoric, messaging, coalition building, etc, further policy successes become impossible. There's one comment of yours that confuses me, though. I don't know what to say about your assertion that 'We have achieved most of the agenda.' ...Seriously? What about real, structural financial reform? Right now, we're vulnerable to another collapse. Climate change and investments in something, ANYTHING, other than carbon-based energy? Dead on arrival (other than the eight or nine billion in the stimulus...). The rest of the world, unfortunately, is now following our lead, and also doing nothing--western Europe partially excepted; if the worst polluter won't reform themselves, why should anyone else sacrifice to lift a finger? Beyond that, Healthcare reform is good as far as it goes, but the cost controls are inadequate, there's no public option (which would have increased competition), and it's not truly universal. And, because we lost the battle of public opinion, it's vulnerable in the courts, and Medicare is vulnerable, as well. These are failures of politics. I'm not so sanguine as you about the first two years; we did all right. But the failure to convince the public we were acting on their behalf has made it very difficult to get anything else done for the next six years, i.e. the rest of the Obama presidency (hopefully). This is a huge problem, no? I think you're slightly in error that it a bad mid-term election was a given. Frankly, I was never as optimistic as the writers of this magazine were, after the 2008 elections--publishing articles titled 'the death of conservatism,' and all that--what with the economy's difficulties and the predictable ruthless counterattack from the right. But there was political space that wasn't used, a great deal of political mileage to be gotten from standing up to the banks and taking a populist tack---Dems won four straight wave elections from 1930-36 by doing that. Instead, Obama's instincts have guided him to take a middle course in terms of policy, and be conciliatory in terms of rhetoric, and now he is largely viewed as part of the problem--largely because he's not offered a competing narrative. Those angry at the banks have turned right for the lack of a competing model on the left, and I think that's partly where the Tea Party comes from. I'm not saying the 2010 midterms were ever likely to be a great victory, but, if the politics had been handled better (including, as you suggest, a bigger stimulus), it seems to me likely enough that we could have about broken even in the congressional vote, rather than losing emphatically. Perhaps matched the 2004 map. That would've made a huge difference. The irony of all this is, we'll be on the defensive for the next ten years, because the GOP is drawing most of the legislative maps for all that time. The 60s, and Medicare, etc. happened partly because Dems maintained their gains in the election of 1958 in 1960; thus, after 1962 the left had a very favorable electoral map at the national level. Now we're dealing with the opposite problem, and it's partly because big O and the rest of the Dems didn't take care of their politics.
- Curran1
July 6, 2011 at 2:33pm
"The comments here display the Democratic party disease in microcosm. Kazin is talking about politics, the political work that Obama, and the Democratic party following his lead, have to do to cement the power that lets them, us, achieve the agenda. Immediately, posters cannot refrain from touting policy achievements in the fact of obstacles. This completely misses the point. Policy and politics are not the same thing... Political malpractice is what Kazin is talking about. He is in my opinion absolutely right." Roid, as much as I enjoy your commentary, I think you're the one somewhat missing the point here. Let me approach this from another angle... if the Republicans are so good at politics, and if good politics allows for consolidating one's policy agenda, why then did their promised Republican Majority fizzle out so spectacularly, and so soon with nothing much to show for it? Did Obama's policy achievements occur in a political vacuum? Is it possible that the kind of politics and leadership required to accomplish these policy goals, by necessity, have to be different? One thing that I have thoroughly enjoyed about Obama, which some consider incredibly frustrating, is the fact that the political class just can't seem to figure him out. Why isn't he like FDR, LBJ, or Clinton, they ask? He dithers, he's a weak negotiator, he has no strategy, he's abdicated his duties, he's short-sighted and without a plan, etc., so they say. Maybe he's all those things, but may be he isn't, which is where the policy achievements come into play. You can't simply dismiss the policy achievements when criticizing his politics or lack thereof. The two are intertwined. You seem to ignore the limits of rhetoric and political advocacy, or wrose, you assume a guaranteed positive outcome. Yet, with all his political mastery Clinton couldn't pass Healthcare, and worse, gave us DADT. LBJ was a great President, but even he showed the limits of political leadership - he could have passed Medicare for all, didn't. How come? This debt limit debate has been fascinating to watch. Among my black peers (yes, there is a racial angle to all this), we've always understood that the Republicans would love to have the US default under the first Black president, not just for ideological reasons alone. It feeds into something much more sinister. It is why the ACA debate was so toxic, and why further advocacy would not have had the same results had Obama been white. We also understand that Obama, with all his rhetorical gifts, cannot be seen as spiking the football. At least not yet. Obama disagreed with the intelligence/ military commanders and turned out to be right on a host of things, including OBL. Imagine the consequences had he been wrong. In the politics of the policy wars, Obama may not be following conventional wisdom. But that doesn't man he's clueless.
- wkwami
July 6, 2011 at 2:59pm
I've just been watching President Obama on CNN (who has done something incredibly stupid and cancelled Eliot Spitzer but that's another story, so now I'll watch Keith) - but anyway, he sounds wise, reasonable, rational, and smart and I will vote for him again. YES I wish he hadn't caved to the GOP on tax cuts, so forth; but he is speaking eloquently on the need for improvements in education, energy policy, economic justice, incentives to small business, some solutions to both banking and homeowners on the housing crisis - I'll vote for him again and I sincerely hope that other Democrats, liberals, leftists and Independents don't help put a bunch of radical right wingers into power.
- Sophia
July 6, 2011 at 3:06pm
Roid does not assume a guaranteed positive outcome--he merely points out that, in this theatre, if you don't fight the battle at all, you usually lose. Could LBJ have passed Medicare for all? The social security act of 1965 was, in fact, a compromise that he pushed hard for, negotiating its passage with the powerful heads of relevant committees in congress. Perhaps he might have done more, but it would've entailed a deadlock, and sacrificing much of the rest of his agenda. In retrospect, that's a bargain I'd take, but we didn't know, back then, how much things would change, and how impossible extending Medicare would become. As for the Republican majority, they have plenty to show: a conservative supreme court who's waging an effective war against disinterested government, promoting money in politics, and limiting access to abortion. A fiscal straightjacket that's crippling the Obama presidency. A tax law that's going to be difficult to repeal. Gobs of deregulation, not of the financial industry, but of, say, the oil and gas industry, as well. We won't have much clean water left in PA because of all the fracking they're about to do--and it's because of Bush. Obama isn't clueless. But his instinct to avoid advocating for the common man rhetorically, is a huge error, and has cost the Democrats dearly, and will continue to do so.
- Curran1
July 6, 2011 at 3:17pm
"Beyond that, Healthcare reform is good as far as it goes, but the cost controls are inadequate, there's no public option (which would have increased competition), and it's not truly universal. And, because we lost the battle of public opinion, it's vulnerable in the courts, and Medicare is vulnerable, as well. These are failures of politics. I'm not so sanguine as you about the first two years; we did all right. But the failure to convince the public we were acting on their behalf has made it very difficult to get anything else done for the next six years, i.e. the rest of the Obama presidency (hopefully). This is a huge problem, no?" Where do you guys come up with this stuff? We didn't get public option because we lost the battle of public opinion? Seriously? It had nothing to do with Blue Dog Democrats having ideological differences with the public option? It is hyperbole to claim that failure to convince the public has made it difficult to get anything else done for the next 6 years. Guys, believe it all you want, but ACA lack of popularity has very little to do with convincing the public. It will gain popularity once it actually kicks in and people being to enjoy the benefits, just like Medicare and Social Security.
- wkwami
July 6, 2011 at 3:24pm
Best call for an inspiring core theme and agenda that I've seen, and the best expression of what is needed for real leadership. Maybe the FDR historic example has much to teach us about getting through hard times
- ripsmith
July 6, 2011 at 4:31pm
Sophia: I'm with you, although I'm more sanguine about the tax cut deal. Yes, the Bush tax cuts should expire, but what was Obama supposed to do--let the unemployed hang out to dry? In return for the tax cuts, unemployment benefits were extended and we got further middle class cuts, so much so that the right's Charles Krauthammer argued that Obama actually pulled off the "swindle of the year" by actually getting a second stimulus. He was essentially complaining that Obama got more out of the deal than the Republicans. How bad could the deal have been if one the country's leading conservative commentators complained about it?
- ballston
July 6, 2011 at 4:33pm
It seems we remember what we gave up and forget what we got in exchange. But that's the nature of compromise, you give something to get something.
- wkwami
July 6, 2011 at 4:54pm
Didn't the GOP then also cave on DODT and the missile deal with the Russians? If these were implicitly part of the deal, then it was even better.
- ballston
July 6, 2011 at 5:01pm
Curran, sadly I don't think there is much that can be done about Climate change, the world will have its say later on about that. How can we pass laws when these teabagging nutjobs don't even agree with basic science? And I don't see Democrats being on the defensive for 10 years, their midterm success makes keeping the gains impossible. Texas is picking up 4 seats but this is due largely to gains in Hispanic population. Right now Texas is a minority majority state, in 15 years it will be a voting minority majority state. This will mean the end of the Republicans in Texas and in electoral politics for the most part. The Republicans can only dice and slice it so many ways, and since they did mid decade redistricting, Democrats will return the favor later on. Ohio is losing 2 seats, but Democrats only hold 3 Congressional seats, they are also determined to get rid of Kuchinich, that will mean losing 2 seats to get rid of one, and they will doubtless screw over who ever holds Cincy to keep Boehner safe. This will be a Dem. gain of 2 seats there and 2 seats in Texas.
- blackton
July 6, 2011 at 5:18pm
Roi gets to the heart of the matter: it's the politics, stupid. ACA was a laudable achievement won in the face of adversity (though arguably more adversity than necessary), but how can anyone view the fact that almost as soon as the bill was signed into law a majority of Americans viewed it as a collosal failure as anything other than political malpractice? Obama has shown by his actions that he believes that the job of the president is to do deals behind closed doors, failing to understand that to do deals successfully you need leverage and more importantly that the single biggest piece of leverage at the president's disposal is the goodwill and support of the American people. He has done hardly anything to elicit such support. He seems to think either that he can do without it or that we the people should grant it simply by reason of his manifest brilliance and suavity. Another thing, you Obama supporters talk about the "intransigent Republican opposition" as if it were a natural phenomenon, a millstone around Obama's neck over which he has had no influence. Rubbish! The GOP has owned the airways for all of the first three years of Obama's presidency. Why? Was there nothing that Democrats could have done to mitigate that fact? Is it unimportant? Republicans won a landslide victory at the midterm elections that has crippled Obama's ability to accomplish anything further and this month is poised either to plunge us into even deeper economic strife or precipitate a constitutional crisis and possible impeachment. Is that colossal political failure no one's fault? Rayward, above, argued correctly that Obama has been exactly what he told us he would be: postpartisan, postpolitical. Unfortunately the Republicans are hyperpartisan and hyperpolitical. Apparently Obama thought that he could make postpartisanship the mode du jour. He was wrong, disastrously so, and the imbalance between Obama's coolness and the GOPs heat is threatening the very foundations of our democracy. Maybe Obama can wake up. For the sake of the nation, I hope so. But I'm not holding my breath.
- AaronW
July 6, 2011 at 5:53pm
Blackton, Of course good policy is the purpose, but if you don't have the power, you cannot make good policy or sustain it. For better or worse, in a democracy, or what passes for one, political power, which means public support, is the pre-requisite for policy. And, like it or not, good policies, present or prospective, are far from adequate, indeed at times almost irrelevant, to achieving and sustaining public support. In my first and only run for office, I was at the Board of Elections watching the count of votes in a third-party primary. Thus, it was an initial face-off between me, on the Democratic line, and my Republican opponent. I was chatting with his campaign manager, an extremely savvy and experienced guy. I don't remember what I said that prompted the remark, but his response to me was, "People vote with their emotions, not with their heads." Only with time did I come to appreciate how absolutely accurate and how fundamentally important this is for successful politics. It is also hardly the case that the Democratic agenda has been achieved, as you say. To the contrary, we are now in the position of defending New Deal gains that were made decades ago. We have an absurd and regressive tax structure, growing moreso. Growing income inequality. Millions out of work with no relief in sight. Structural trade deficits. Structural budget deficits. An out-of-control healthcare system that will not be brought under control by ACA, even as it resolves some health insurance issues. A still dangerous and very under-regulated financial system. Nothing meaningful to address atmospheric carbon and climate change. An increasingly unaffordable and socially stratified system of higher education. A failing system of primary and secondary education. In short, we have enormous problems that Republican policies exacerbate and only timid, tentative Democratic efforts to address them. What is missing is strong public support. That does not appear from heaven. It must be fought for and won, every day, inch by inch. This is the essential work that Obama refuses to do or to lead. It is Kazin's point.
- roidubouloi
July 6, 2011 at 5:54pm
wkwami, We are talking past each other. I think Obama has had middling policy success: a too small stimulus that included a huge chunk of inefficient (from the stimulus standpoint) tax cuts, a fig leaf of financial re-regulation when we need very strong re-regulation, an ACA that lacks any of the alternatives that would put us on the path to serious cost control with Medicare under assault as a result, extension of the Bush tax cuts. Better than what we would get from the Republicans, to be sure, but hardly what I would crow about. Perhaps the best that could have been achieved, but with stronger public support, I have no doubt that more could have been achieved and the concessions would have been much smaller. Is there a guaranteed path to public support? No. Is it guaranteed that you can bend the legislature to your will if you have strong public support? No. Nothing is guaranteed, except that if you will not contest for public support, you will not have it. That's where Obama has left us. Perhaps because he thinks he is "post-partisan" and will not accept his role as leader of the Democratic party, perhaps for other reasons, he has simply failed to do the work to secure either public backing for himself or Democratic majorities in Congress. We just took a whuppin' in the last election. There is no amount of spin that can characterize this as political success no matter what the policy achievements, and they are thin.
- roidubouloi
July 6, 2011 at 6:07pm
One of the things Obama forgot to get was an increase in the debt ceiling to carry through the current budget cycle. That really is incompetent.
- roidubouloi
July 6, 2011 at 6:09pm
Huge problem, mentioned by AaronW: the GOP (the right wing of the GOP) owns the airwaves. That's a fact. Why is this? People complain about "the liberal media" but it seems to me the TV is right wing, CNN just fired a good liberal, who was terrific at exposing right wing craziness and irrationality. Also, Wolf Blitzer and Jack Cafferty actually said people should stand up and put the hand over the heart when people butcher The Star Spangled Banner before NBA games, etc. Now if I were at the NBA game of course I would stand up and salute but I gotta stand up and salute IN MY HOUSE? While watching a game on the tube? And say "under God" or else - heads should roll at NBC because somebody used the original Pledge of Allegiance and not the one mentioning "God"? Jeez I am actually afraid, writing this, that somebody will accuse me of not being a patriot! That is BAD. This is after all America and when a News anchor tells people they have to stand up, put their hands over their hearts and say "under God" IN THE HOUSE before a ball game on the tube, while listening to yet another dreadful version of the national anthem, things are going too far. That is nationalism, too much nationalism, not patriotism -and it doesn't belong on a NEWS program. Period. See, the Democrats, forget the Left, or even the rational, can't get a word in edgewise can we. All the sponsors, the corporate sponsors, not to mention the actual corporations, appear to be hard right, or at least they have vested interests in Government By Corporation do they not? That's what is so ridiculous about the whole Tea Party thing. People, mostly working class, lower middle class people, deluded into believing small government somehow will get rid of big business? Or what? Or that big business is better for people than big government, which theoretically at least isn't profit-driven and self-interested? Or that big business OR government are better than workers, women, the rights of the individual? What's happened here? So yes, I understand why people are upset and say that Obama hasn't taken it hard enough to the GOP. But, admit it, the GOP isn't even Reagan's GOP or even Dubya's; something has happened I think. So who could have predicted this? It is bizarre. Bachmann a serious contender for the White House? C'mon.
- Sophia
July 6, 2011 at 6:21pm
The corporatization of media due to the abandonment of all rules about multiple ownership of media outlets effectively aligned the interests of the media with those of the right. We see the results.
- roidubouloi
July 6, 2011 at 6:37pm
Which deregulation was, of course, predicated upon--you guessed it--POLITICS.
- AaronW
July 6, 2011 at 7:03pm
Nutz writes: "What is interesting is that in today's economy, you would expect a groundswell of support for liberal policies that address the vulnerable, but somehow the T-Party, with its small government emphasis, has drowned that out. " The government is larger than ever. In 2005 dollars, Clinton's last year was $2T. We are at $3.4T today. In % GDP, Clinton's last year was 18%. We are at 25.5% today. In 2005 per capita, Clinton's last year was $7100. We are at almost $11,000 today. Going way back to the JFK, we were only spending $3000 per person in constant dollars. That's right, our government today, per capita, is almost 4X larger than under Kennedy. We are spending more than ever. A lot more than even when Clinton was in office. The war in Iraq is just 3% of our budget. The tax cuts on the rich are just 2% of our budget. Dont' bring those up as the source of our problem. And besides, Obama has more wars going that Bush ever even dreamed of. Where has all this money gone? When people complain about the government, this is exactly the reason. The government today is almost 2X larger than it was under Clinton. And what is better?
- seattleeng
July 6, 2011 at 7:04pm
I just wanted to echo roidubouloi's post number one. Kazin's essay really says it all much better than I could/did. Thank you, Prof Kazin.
- AaronW
July 6, 2011 at 7:04pm
@seattle, so what? In 1960 health care accounted for 5.2% of US GDP. Last year health care accounted for 18% of US GDP. Given that the US government spending accounts for approximately half of all health care outlays in the United States, it should not be surprising that the size of the government measured as dollars spent should have increased. Argue for less government spending all you want, but be honest about what you're talking about. To achieve the kinds of spending reductions that would make you happy, you'd need to deny medical treatment to millions of older Americans. Is that what you want? Maybe it is. But if so, say so.
- AaronW
July 6, 2011 at 7:22pm
The United States now consists of 50 states instead of 13. A completely irresponsible expansion of government over the last 225 years!
- ironyroad
July 6, 2011 at 7:41pm
and today Obama suggested extending the FICA tax holiday by one more year.. WTF? this GOP will then make it permanent. Is Obama crazy? oh, no economic advisors, winging it with Biden...
- K2K
July 6, 2011 at 8:04pm
"The only reason I have given BHO the benefit of the doubt this long is because the Republican alternative is so scary. No more. I'm done. I'm hoping for a Democratic primary challenger, though I'm not holding my breath. But even if there isn't one, Obama won't have my vote. I'd write in Bugs Bunny before I voted for this Reagan Republican again." I partly agree with Aaron, but only partly. What saves Obama is the fact that the Republicans are very indecent when it comes to questions of economic fairness. I had similar thoughts to those of Aaron about a challenger, but who is out there that will be able to beat both the sitting President as well as the Republican candidate later on? A primary fight will be so divisive that it may lead to some third party candidate. Whatever our differences anything is better than any Republican including Mitt Romney who is the sanest of the candidates.
- arnon
July 6, 2011 at 8:05pm
Wkwami: "Where do you guys come up with this stuff? We didn't get public option because we lost the battle of public opinion? Seriously? It had nothing to do with Blue Dog Democrats having ideological differences with the public option?" ...You know I didn't say that, right? I said losing the public option was regrettable on policy grounds, whereas the loss of public opinion made the bill vulnerable in the court system. "It is hyperbole to claim that failure to convince the public has made it difficult to get anything else done for the next 6 years. " It's not hyperbole! It's just math, i.e. the numbers in the senate. Six years until we get a chance to turn out the heavily right-wing class of 2010, which, as far as I can tell, will be the first time Dems have a chance at a working majority again (we won't make increased gains on the 2006 and 2008 maps, I shouldn't think. If we do, something will be going very, very right and we can all put aside our differences and have a toast :) )
- Curran1
July 6, 2011 at 8:05pm
Blackton: Glad to hear that news about redistricting. As for Climate Change, you're completely right that it's impossible to get anything done with the tea party and business interests around. But, to me, well, this is why we needed to get it done before they got their hands on things!
- Curran1
July 6, 2011 at 8:09pm
Aaron writes: " Given that the US government spending accounts for approximately half of all health care outlays in the United States, it should not be surprising that the size of the government measured as dollars spent should have increased." No. Not true. In 2010 dollars, discretionary spending (per household) from 1990 to 2000 remained flat. In 2001, it started its long climb upwards, such that 2010 is 50% higher than Clinton (again, constant dollars) and it reaches 3.5X Clinton is 2020. Discretionary is nearly 40% of the budget. This isn't chickenfeed. And per-capita health care is $7300. Discretionary today is $30K. Thus, the discretionary part of the budget more than 4X larger. And given we are already spend the commonly-bandied-about 2X more than most EU countries on health care. Drug costs and insurance profits are NOT the reason. Those are very, very small parts. Force the doctors to work for free, force the insurers and drug companies to be profitless and we're still significantly higher than EU countries on medical spending. We are spending buckets on healthcare. With crappy results. We are spending buckets in other areas compared to Clinton. With again, crappy results. And you want more. You cannot identify what is broken. What is wrong. What is not working. And yet you still want more. Ideology, perhaps? It certainly cannot be rationality
- seattleeng
July 6, 2011 at 9:30pm
How about some citation, seattle? Given your history here, I am willing to bet that your factual claims are mostly all wrong. Let's see, shall we?
- roidubouloi
July 6, 2011 at 10:07pm
Curran-- I actually followed the Fin Reg process very closely, and read most of the actual bill. I do not recall the perfect legislation you so desire working its way through the subcommittees and gaining passage by a sixty vote margin. Feel free to vote against Obama. That will be a likely vote for Romney, who definitely could give two craps about the middle class. And if you want to take a stand and vote for a third party candidate, then make your protest. But you will be aiding and abetting Republican policies--not more liberal ones. Call me cynical, but if the choice is between America getting shot in the foot, or shot in the face, economically speaking--I'll take the former option. And that, for me, is electing a Democrat. For you, perhaps, it's electing Nader or something like that. I don't know. I don't really care. Whatever you do or say--our opinions are both equally irrelevant. We are both arguing over BS on this forum that hardly anyone reads. It will not effect change. So shout louder. Maybe congress will hear you and sacks of candy and money will rain from the sky--just because you said something on TNR.
- maxhencke
July 6, 2011 at 10:23pm
No, seattle, I don't want more. I want less healthcare spending. I want do want more healthcare COVERAGE, but I want it at lower cost--like every other industrialized nation. The best way to achieve that would be nationalized health insurance funded by progressive taxation with limitations on treatments provided for patients at life's extemities, either because of age or chronic illness. Of course, members of your party would tar that as death panel tyranny. Never mind that you would ration health care too by the entirely rational criterion of a patient's ability to pay. Would my plan increase the size of government? Probaly, yes. But it would simultaneously eliminate the private health insurance bureaucracy, and if done right would cut healthcare as a percentage of our GDP 5-7%. So which is worse, public bureaucracy or private bureaucracy? Don't tell me, seattle, I know your answer already. But ask yourself, is your answer based on rationality or...ideology?
- AaronW
July 6, 2011 at 10:58pm
Max: Props to you for actually reading most of the bill, no sarcasm intended. As for the rest, it's strange, posters' insistence here on arguing against me using a grab bag of mischaracterizations, false dilemmas, and lazy reading. You've ascribed to me the false position of supporting a primary challenge to the president when, in fact, on this very thread, I am on the record as arguing that exactly this would be an 'epically horrible' idea. Your Fin Reg argument likewise knocks down a straw man, while saying some unkind things to it in the process.
- Curran1
July 6, 2011 at 11:05pm
Also, seattle, I suspect, is overlooking the unbelievable costs of these wars. TRILLIONS. And that isn't just on war expenditures - the cost of helping the wounded veterans will extend far into the future, plus, I don't see how people are becoming more in love with the US, or less radical do you? This is the huge elephant in the room. Genghis Khan and Alexander couldn't win in that region, not for any length of time; the Soviet Union fell apart over Afghanistan; our adventures in Central Asia, beginning probably under Carter, have been far worse than a waste of blood and money. And Iraq still isn't stable - how could it be, insofar as its borders don't reflect any kind of rationality given the tribal, ethnic and religious issues? Nation states are in themselves a fairly new concept in this region - So what are we doing? Oh ps we undertook whatever it is we are doing in the Middle East and Central Asia at the same time we cut taxes. Duh. Oh. Am I the only person who remembers hearing the Iraq, The Thinking Man's War, would pay for itself?
- Sophia
July 6, 2011 at 11:58pm
This, on the other hand - yikes - now I am mad at Obama again: http://www.washingtonpost.com/business/economy/in-debt-talks-obama-offers-social-security-cuts/2011/07/06/gIQA2sFO1H_story.html?wpisrc=al_politics
- Sophia
July 7, 2011 at 12:04am
Okay, to save time and account for both population growth and income growth, I took the 2000 budget and the 2011 and adjusted them to percent of GDP. In 2000, the Federal budget was 15.7% of GDP. Now it is 25.1%. What accounts for the changes? First, to get a sense of scale, given the current GDP, the difference is 9.4% which is $1.4 trillion of additional spending above what we would be facing if the percentages had remained unchanged since 2011. seattle's figures are, as usual, wildly off. I suspect he took them from some tendentious, ideological source (polite phrase for right wingnut website), but we don't know because he doesn't tell us. The real increase in the budget adjusted to GDP is 59% since 2000, not 3.5 times, 4 times, and all the rest. Of the major budget categories, non-security discretionary spending is the least of it, a 31% real increase that represents an additional $125 billion of spending in the current period. Not trivial, but clearly not the primary cause of any fiscal problem. Security spending is u 124%. That is $468 billion. Whether you think that is a problem or not is a different matter, but we have declined to raise taxes to pay for this. Just the reverse. The right wants its military and security spending but won't pay for it. But we knew this. Social security is up 36%. Since these figures are already adjusted for GDP growth, there are two potential components, growth of social security per payee at a rate higher than per capita GDP growth (I doubt this) and the increase in the number of retirees (most likely). This is what Gore wanted to plan for by running surpluses, the metaphorical lock box. But Bush preferred to squander the opportunity on high-end tax cuts. We knew this too. Health care is up 76%, $329 billion. If the growth were just at the same rate as social security, the increase would be only $157 billion. The additional $171 billion is our healthcare system run amok, something that the right refuses to address other than with absurdities. Other mandatory programs are up 103%, for $308 billion. This includes items like nutrition programs, unemployment insurance, family support, and veterans, and military and civilian Federal pensions. Worth analysis, but the combination of recession and the skewing of income to the wealthy, surely results in a large portion of the increased eligibility that this represents. Overall, the real spending increases from 2000 to 2011 are due to: Security, 33%, Mandatory programs, 60%, non-security discretionary, 9%, and interest, -2%. Can we afford this increase of 9.4% of GDP? Well, we certainly cannot afford Medicare on its current trajectory because we cannot afford our healthcare on its current trajectory. Take out the excess medical costs, and we have an increase of 8.1% of GDP. Over the same period of time, the income share of the top 20% has increased by 4%. That alone covers the non-military non-recession-related change. Here's another take: The 2011 deficit is $1.15 trillion. One chart shows that restoration of Clinton era rates would raise $700 billion in 2011. Guestimate $200 billion as recession-related spending, that is, income support of one kind or another, appropriately funded by borrowing. If we were able to maintain the growth in healthcare at the rate of growth of social security over the period, the deficit would be gone, and that is before taking account of the spending on Bush's wars. Same old, same old. This comes right back to what Chait has posted repeatedly, the entire deficit is due to Bush's tax cuts, Bush's wars, and Bush's recession, and healthcare costs are going to overwhelm us if we do not get them under control. Seattle's account of the sources of the deficit is a fiction. US healthcare is broken. Social security is not. Our military is bloated. The rest of the Federal government is not. Our tax structure is ridiculously regressive, especially in the face of levels of income inequality not seen in 100 years. That too contributes to the need for income support at the low-end. We have huge numbers of unemployed. More income support. That's pretty much all you need to know. The rest really is chicken-feed. Wanna fix the whole problem? 1. Spend a trillion that we need to spend on crumbling infrastructure. 2. Get health care costs under control with single-payer. 3. Raise taxes to Clinton-era levels at the very least. We'll pop up lie a cork. If we cut military spending on top of that, we'll be flush. On top of that, institute a managed trade policy that eliminates our trade deficit and thereby increases labor demand and we are on top of the world. Bye, bye China. That's all. The end. (Oh, and ignore libertarian and supply-side economic nuttery.)
- roidubouloi
July 7, 2011 at 12:07am
Sophia writes: "Also, seattle, I suspect, is overlooking the unbelievable costs of these wars. TRILLIONS." Not true. Iraq at its peak was around $100B/year. Our annual spend is $3.5T
- seattleeng
July 7, 2011 at 12:34am
You're funny, seattle. You respond to Sophia because she got her figures wrong but offer no response at all to roi. Maybe you're working on it as I write this. We wait on bated breath.
- AaronW
July 7, 2011 at 12:57am
Roid, relying on custom spreadsheets again, eh? Unfortunately TNR makes it such a pain to post links. Link #1 below federal spending. You can set the controls to show constant dollars, per capita, whatever you wish. Link #2 shows inflation adjusted discretionary spending. www.usgovernmentspending.com/federal_spending_chart www.heritage.org/budgetchartbook/federal-spending-per-household dont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the linkdont eat the link
- seattleeng
July 7, 2011 at 1:55am
AaronW writes: " Of course, members of your party would tar that as death panel tyranny. Never mind that you would ration health care too by the entirely rational criterion of a patient's ability to pay." Name a government supported health care system that does not decide who gets treatment? The UK system is well known. Look up QALY to understand this. Yes, this is a death panel. And private insurance has these death panels too, but I can pay more or less to decide how severe the death panels are. It must pain you so to know that Palin was right. Eh?
- seattleeng
July 7, 2011 at 1:57am
Roid writes: "The real increase in the budget adjusted to GDP is 59% since 2000, not 3.5 times, 4 times, and all the rest" First, you need to accurately attack what I said. Not what you think I said. Re-read what I wrote, Roid. I wrote: " In 2001, it [discretionary spending in 2010 dollars] started its long climb upwards, such that 2010 is 50% higher than Clinton (again, constant dollars) and it reaches 3.5X Clinton is 2020." Look at the chart from Heritage I cited. They show that discretionary per-capita spending in 2000 was just a hair over $20K. They show that today it just a hair under $30K. That is a 50% increase. As I said. For those that are math challenged, that also means 1.5X. They also show that in 2020 it'll be $36K. That is a 3.5X increase. As I said. You wrote: "The real increase in the budget adjusted to GDP is 59% since 2000, not 3.5 times, 4 times, and all the rest." Which has nothing to do with what I said. But thanks for playing.
- seattleeng
July 7, 2011 at 2:45am
First of all, seattle, you have misread the Heritage chart. It is a chart for total Federal spending per household, not discretionary spending. So, thanks for playing yourself. Second, if you are going to use second hand charts or data that has already been massaged, especially by tendentious sources like Heritage with a political ax to grind, you really have to understand how they construct it, which you clearly do not. 1. Per household is an odd presentation as opposed to per capita. 2. You have to account for the fact that per capita real income grows, which means the per capita real income of people who work for the government or produce things for the government grows too. The way Heritage organizes its data, the more productivity grows, and hence the higher per capita real income growth, the more it appears that government spending is growing. This is outright deceptive. No surprise considering the source. 3. Since a large part of the Federal budget is entitlements, including social security and Medicare, you have to account for changing demographics. Everyone knows that we have a bulge of retirees, the baby boomers, and have had an increase in retirees as portion of the population due to increased longevity. Here again, improvements in life span make it appear that government spending is uncontrolled. 4. When you adjust for population and real income growth, the non-security contribution to discretionary spending growth since 2000 falls to only about $50 billion. There has not been some huge change in the pattern of appropriations except for military spending which has skyrocketed. Somehow I don't think this is what Heritage actually wants to cut. They just want to create the impression that spending is out of control and don't mind incorporating military spending to boost the growth rate even though they don't want to cut that spending. What they are really saying is that, because military spending has skyrocketed, we have to cut everything else, instead of raising taxes to pay for those increases. 5. Bottom line is that most of the changes in Federal spending are due to demographics, then huge real changes in military spending, then real growth in healthcare costs which, as we have discussed before, have still been at a significantly lower rate that the increases in private healthcare costs. If you believe, as Heritage surely does, that the security increases are necessary, then the whole big deal that we are talking about over 11 years, the point at which you claimed the steep climb in discretionary spending began, is about $50 billion. The rest is demographics. Was this the point you were trying to make? Somehow I think not. You should know better than to quote Heritage. And, yes, if you are going to use the source documents, as I prefer to do rather than a third-party reworking that you don't understand, you had better know how to use a spreadsheet. Try it. Maybe you can get the hang of it.
- roidubouloi
July 7, 2011 at 3:42am
Since when is 36,000 3.5 x 20,000?
- AaronW
July 7, 2011 at 4:33am
seattle, the vast majority of public health systems in the advanced world are, except in very rare cases, ones in which doctors exercise primary decision-making authority as regards patient care. Your statement that you can "pay more or less to decide how severe the death panels are" is magnificent in its meaninglessness, as (a) the point of universal coverage is to avoid forcing people into making such decisions at exactly the time when human beings are most in danger, (b) the insurance companies are loathe to accept patients who have a serious condition irrespective of ability to pay (and the ACA will change this), and (c) not even the most ardent defender of the current idiotic system can pretend that medical insurance is like car insurance, where an informed consumer can shop for the best deal. You may never have a road accident in your life. You will get sick, and women will get pregnant and have children, and kids will get sick too. This isn't the usual context the argument happens in, but most of all it seems to me unethical in terms of the Western tradition to claim that medical treatment can be an entirely commercial good/service, and attempts to reform and expand coverage recognize that.
- ironyroad
July 7, 2011 at 7:33am
Don't waste your breath, irony. Seattle lives in a universe where medical care is like any other marketable item. He tries to argue that it should be treated no differently than other "essential" goods such as housing, forgetting that available housing options in the USA include everything from 30-million-dollar mansions to one-room shacks of corrugated steel with drop toilets, and that those who can't afford the one can still survive if they're forced to settle for the other, while in the healthcare zone if you have an infarct and blow out your mitral valve, you need mitral valve replacement surgery today with no cheaper option other than a pine box.
- AaronW
July 7, 2011 at 8:26am
"Also, a big part of me feels that the Republican right is like a chronic disease. Reelecting Obama won't cure the disease; it will merely keep it under partial control. What America really needs is for the disease to reach a crisis so that we can cure ourselves of it once and for all." The thing is, it did reach a crisis! What would you call 2008? If things didn't turn around then, we have to ask ourselves why. How do Republicans continue to hold any credibility in this country? What would be needed for a Democratic President and Congress to turn things in the other direction? How can we achieve that? Before we precipitate another crisis by handing power back to the loonies on the right, let's be very sure we know the end result. We may indeed be voting for dogs (though I would apply that description to Congressional Blue Dogs more than Obama) to avoid being led by swine, but that doesn't mean we should just hand over the keys to the swine.
- Dausuul
July 7, 2011 at 10:43am
Roid writes; "Was this the point you were trying to make? Somehow I think not" Roid, the data is irrefutable, so it will be there in just about any source. Here's CBO data. Refer to table 3-8, Defense and Non-defense Discretionary as % of GDP For 2000: 6.3% (total discretionary outlays as % of GDP) For 2010: 9.4% (total discretionary outlays as % of GDP) Whoah, that is a 50% jump too. 1.492X to be precise. My original points stands: 1) Discretionary was essentially flat under Clinton (% of GDP) 2) Discretionary spending is 50% higher today than under Clinton (% of GDP) 3) Non-military discretionary spending is 42% higher today than under Clinton (% of GDP) What on earth makes you guys dig in and try to assert the government is NOT massively larger today than it was under Clinton? We've looked at this from several angles now, and they all say the same thing. www.cbo.gov/ftpdocs/108xx/doc10871/Chapter3.shtml
- seattleeng
July 7, 2011 at 11:04am
Irony writes: "seattle, the vast majority of public health systems in the advanced world are, except in very rare cases, ones in which doctors exercise primary decision-making authority as regards patient care." Absolutely not true. Read the link below about QALY. This is decison making in terms of what treatments are available has largely removed from the hands of doctors as the cost of treatment increases. It requires the doctor to take into account your age, life expectancy and quality of the remaining years. A 70 year old does not get the same heroic efforts as a 30 year old when it comes to bad tickers. This is also known as a death panel. Say aloud. It's not a bad word. It's how society allocates scarce resources. We collectively decide the 74 year old doesn't get a heart transplant and that we save the heart for the 38 year old mom. www.medicine.ox.ac.uk/bandolier/painres/download/whatis/QALY.pdf
- seattleeng
July 7, 2011 at 11:11am
Aaron writes: "Seattle lives in a universe where medical care is like any other marketable item. " Why should it not be? What is so special about it? How does it differ from food and water and housing? Health care in a life threatening situation should be available to all without regard to cost. And it is today. By law. But outside of that, your level of health care should be a function of how well you plan. Just like everything else. If I prioritize XBox and cable TV over health insurance, then yes, my health care options should suck.
- seattleeng
July 7, 2011 at 11:15am
Aaron writes: "Seattle lives in a universe where medical care is like any other marketable item. " "Why should it not be? What is so special about it?" Sigh. Seattle, this has been explained to you several times, just in the comments section. Cohn and others address it, at times, too. I suggest you go back and look at the second page of comments for a hint. Short answer: because consumers aren't in a position, and don't have the time, to rationally assess cost-benefit ratios, in many situations that involve consuming health care. Meanwhile, the fact that insurance pays much of the cost distorts the incentive to do so. And it's often difficult or logistically impossible to shop around for the best deal--especially when the consumer lacks the specialized knowledge to effectively do so. That's just the start. "Health care in a life threatening situation should be available to all without regard to cost. And it is today. By law." Yeah. This is part of the problem. Emergency healthcare available by law is much more expensive than good preventive care, and often accomplishes less than said care. It's also a product that others end up having to pay for--the hospital system, and, ultimately, other consumers. You don't see a problem there?
- Curran1
July 7, 2011 at 11:43am
Curran writes: "because consumers aren't in a position, and don't have the time, to rationally assess cost-benefit ratios" They do not have time? The average person watches how many hours of TV per day and spends how many hours per day on the web? I cannot fathom that for health care planning a person, even a single parent, cannot spend 3 hours per year on something so important. Cannot rationally assess cost-benefit ratios? Are people too dumb to manage their own life? Insurance has been around since the 1600's. People readily grasp the concept. It's widely used on cars (by law) and on property. This is not a new concept at all. The premise is simple: You pay money up front in case you get really sick. If you do get really sick, you won't have to pay a lot of money. If you don't get sick, you lost the money. The reason I continue to ignore the suggestions on why health care is different than a house is because of absurd explanations such as yours. Health care is not at all complex. Try again. Tell me how health care differs from a house. This time using something modestly persuasive.
- seattleeng
July 7, 2011 at 1:09pm
Let's try this, seattle. Here are the figures right out of the actual budgets for the years in question and the percentages relative to GDP: 2011 2000 GDP 15,299 11,226 Security 895 5.9% 286 2.5% Non-Security 520 3.4 306 2.7 Tot Discretionary 1,415 9.2 592 5.3 Mandatory 2,166 14.2 959 8.5 Interest 253 1.7 215 1.9 Total Budget 3,834 25.1 1,766 15.7 The real increase in the non-security discretionary budget, as a percent of GDP, is 3.4% divided by 2.7%, and computed precisely to the data it is an increase of 24.7%. If the non-security discretionary budget were the same percentage of GDP today as it was in 2000, then it would be $417 billion instead of $520 billion. Try the algebra yourself. It is not hard. Divide the 2000 figure by the 2000 GDP and multiply by the 2011 GDP. Ergo, the "massive" growth that you are talking about amounts to $103 billion out of the budget deficit of $1.15 trillion. This pales in comparison to every other source, the $700 billion of Bush tax cuts, the more than $400 billion growth in security spending, and the $860 billion growth in mandatory spending, the latter two by using the same technique, taking the old percentage applied to current GDP and the current spending. $103 billion is not trivial and it is worth examining whether we are getting our money's worth, but your contention that Federal spending is out of control is objectively ridiculous, unless perhaps you are talking about military spending. The changes in mandatory spending are due to the aging population, the shift of more of pre-tax income to the wealthiest, which makes more people at the bottom eligible for benefits, as it should, and the out-of-control cost of healthcare. The population is going to age whether you like it or not, unless you want to kill them or starve them. Why don't we means-test their benefits? Healthcare will remain out of control until we get some form of single-payer, which the right resists fanatically. The income shift to the wealth is appalling but should at least be mitigated by the tax and benefit system. Even after paying back a part of their gains to support this, the wealthy would still have a vastly larger share of after-tax output than they did 30 years ago. Do you want to cut military spending sharply, seattle? Or do you imagine that we can close the $1.15 trillion deficit entirely from the $520 billion of the non-security, discrtionary budget, the entire Federal government other than the military and transfer payments? You understand nothing of what you read, seattle. Seemingly, you cannot even add 2 + 2 and get 4 reliably.
- roidubouloi
July 7, 2011 at 1:52pm
Seattle, I have a staff that annually reviews all of the available health insurance plans. We switch carriers about every two years. I once tried to buy Cigna's health insurance subsidiary. I know a little bit about insurance and health insurance in particular. It hardly matters. The costs are out of control and all insurance can do is spread them, which ironically has the effect of allowing them to remain out of control. Unless and until there is a monopsonist buyer -- government -- to control costs through some version of single-payer, the system will remain out of control. If the private market could solve this problem, it would have solved it by now. Indeed, the private market is the problem. This has nothing at all to do with people's ability to shop for insurance and everything to do with the fact that the payor, the insurance company, cannot control costs without denying care, but we don't want to deny care. The only other alternative that exists in this universe is directly to control costs as does every industrialized nation but ours. Get real. Spouting these libertarian platitudes has nothing to do with the way markets actually function or fail to function.
- roidubouloi
July 7, 2011 at 1:57pm
Excuse me, I don't think I got my figures wrong. WaPo cited 3 trillion, their estimate in 2008, this is more recent, at 1.29 trillion but I don't believe that's counting OTHER WOT expenses. http://www.infoplease.com/ipa/A0933935.html
- Sophia
July 7, 2011 at 2:33pm
"Try again. Tell me how health care differs from a house." Er . . . because you can have several different kinds of house in your lifetime, and move from one to the other as your economic circumstances dictate, but only one body? Nothing may happen to any house you ever live in. You will however get sick, whether you like it or not, or your wife will be pregnant, or your kid will have an accident, and this can potentially go beyond individual fate to impact public areas in general (an epidemic as one type of crisis, or the effects of health on children's educational progress for another). Therefore both the ethical and the common weal arguments come together to make the case for a comprehensive system of coverage. The examples you continually advance about death panels and the like are essentially outliers, seattle, that do not form the bulk of individuals' interactions with their doctors or hospitals. I can tell you that almost nobody in the UK, France, or Germany, apart from the very rich perhaps, would swap their system (not perfect) for ours. Why? Because they aren't stupid.
- ironyroad
July 7, 2011 at 2:34pm
Example of war expenses not counted directly into Iraq/Afghanistan: Pakistan, Libya, Yemen, things we probably don't even know or think about - plus one really huge side effect: the indirect costs of increasing oil prices. This has other effects, depressing business for example and costing the economy in untold dimensions, which in turn reduce revenues to the government - and to business - so - I'm wrong? How?
- Sophia
July 7, 2011 at 2:36pm
"Curran writes: "consumers aren't in a position, and don't have the time, to rationally assess cost-benefit ratios" I note that, in rebutting my argument, you left out the qualifier that made it meaningful: "in many situations that involve consuming health care," i.e. during end of life care or serious illness that requires immediate treatment, when the consumer lacks the time, and possibly the data, and almost certainly the specialized background, to judge whether operation A, operation B, treatment c, (all of which cost tens of thousands of dollars) or no treatment, has the best outcome or is most efficient. You may have hours or minutes to make the decision, which is a lot more difficult and involved than deciding whether to include property damage above 50,000 on your car insurance. Likely, there won't be good head-to-head data on all the options. Furthermore, you've already payed for the product, so why not use it? And your provider, the only person present who can judge the subject with any authority until you go back and spend dozens of hours you don't have on research, has a financial stake in recommending a more expensive outcome. Yet, to choose a cheaper option might, for all you know, doom your loved one. Is that different enough from figuring out the right car insurance policy, or need I go on? It's not just a matter of being a rational consumer with a few hours and some capital to spare. I recently had a serious health problem; determining the (most likely) correct treatment, which, incidentally, is very expensive, took me several hundred hours of my own time spent on research, over the course of the last several years, as well as some luck. So, no, I don't think consumers are incompetent or stupid, but many or most people can't or don't have the available man-hours to conduct such a search, and they may not have the leisure. Medicine is complicated, and in some respects, it's still an art, not a science.
- Curran1
July 7, 2011 at 5:22pm
Roid writes: "Tot Discretionary 1,415 9.2 592 5.3" Yes, as you note, total discretionary jumped from 5.3% GDP to 9.2% GDP. That is a 74% jump in terms of GDP. Aka 1.74X. Congrats. You have affirmed my point. That's in terms of % GDP. Now let's look at constant dollars. In terms of constant dollars (FY2005$), total non-defense discretionary jumped from $375B in 2000 to $619 in 2010. That is 1.65X. Total discretionary in FY2005 $ jumped from $737B to $1231B, or 1.67X So we've looked at this many ways. And all are huge jumps over a decade. Much larger than when it was the good ol' days of clinton. Do you now agree that we've had massive growth in discretionary spending? Which in fact was my original assertion. You'll find the constant $ figures in the table 8-8 referenced here: www.gpoaccess.gov/usbudget/fy11/hist.html
- seattleeng
July 7, 2011 at 9:45pm
Sophia writes: "Excuse me, I don't think I got my figures wrong." You didn't, the figures were right. But you need to put them in context. Note that each year the war spending is $100B. And our total gov budget is $3.5T. So the war cost is 3% of our annual budget. If you want to emphasize the big scary number, then you need to put it alongside 10 years of our budget. Which is roughly $35T. It still is just 3%. Now some like to count the interest. But we could count the interest on anything and make it look awful.
- seattleeng
July 7, 2011 at 9:49pm
Roid writes: "This has nothing at all to do with people's ability to shop for insurance and everything to do with the fact that the payor, the insurance company, cannot control costs without denying care, but we don't want to deny care. " This article is a good read. This doctor has taken a similar approach to what the Whole Foods CEO did, which is to put the spending in the hands of the patient. Note how this doc can take something like a $5000 annual diabetic bill and trim it to $450. When you put the front-line spending choice in the hands of the consumer AND then back that up with catastrophic care policies (which are reasonably priced) it is a winning recipe. Adn then have the government backstop anyone that is spending more than 8-10% of pay on medical (as Obamacare does) and it's a winning recipe for cost control I think. A sure recipe for disaster is where anyone can walk into any doctor and get treated for any ailment and not see the bill. That's almost where we are today, and Obamacare will add another 35M into that pool. http://www.kevinmd.com/blog/2011/07/direct-primary-care-reduces-primary-care-costs.html
- seattleeng
July 7, 2011 at 9:56pm
Curran writes: "You may have hours or minutes to make the decision, which is a lot more difficult and involved than deciding whether to include property damage above 50,000 on your car insurance." Overwhelmingly the response is "do whatever it takes". There is no thought here. Many doctors have written that patients will tell them "When my time comes, my time comes. I don't want to be hooked to a machine" but when confronted with being hooked to a machine or dying in the next few hours, everyone suddenly wants to be hooked to a machine in the narrow hopes that they'll pull through. Cost be damned. And even those with amazing insurance and resources will face huge issues here. The decision is not one of cost, but instead quality of life. That will trouble everyone, from Bill Gates and Warren Buffet on down... Curran writes: ". So, no, I don't think consumers are incompetent or stupid, but many or most people can't or don't have the available man-hours to conduct such a search, and they may not have the leisure. " Again, it's not a time or study issue. All you can do is hear the odds and decide whether or not to go with them or not. You can always study more. But at the end the of the day, a doctor tells you "If it were me, I'd skip this operation" and you get a second opinion and he tells you "No question, I'd do this operation in a second." Then what? There is no amount of study that can tell you the right answer here. That's why you pay doctors a crapload of money, and when you get a serious illness, you find the doctor that has dealt with it the most. Thankfully, most of these doctors live in the US (judging by our cancer survival rates)
- seattleeng
July 7, 2011 at 10:06pm
Seattle sez: "Again, it's not a time or study issue. All you can do is hear the odds and decide whether or not to go with them or not. You can always study more. But at the end the of the day, a doctor tells you "If it were me, I'd skip this operation" and you get a second opinion and he tells you "No question, I'd do this operation in a second." Then what? There is no amount of study that can tell you the right answer here. That's why you pay doctors a crapload of money, and when you get a serious illness, you find the doctor that has dealt with it the most" Sorry, Seattle. It's just not that simple, or that easy, or that rational, or that reducible to numerical odds. Even, often, by the best doctors. And, incidentally, most of us peasants can't just up and 'find the doctor that has dealt with it the most.' I'm going to hazard a guess and say you've never worked in medicine, which is fine. But don't pretend you're an expert on the patient's role in her own care, or mechanisms of cost-control. It looks to me like you're just applying your ideology to the issue, rather than taking a hard look at the details, what works and what hasn't.
- Curran1
July 7, 2011 at 11:06pm
No, Seattle, it is not a sure recipe for disaster as you claim because what you claim is a disaster is the practice in every other industrial democracy and it is our costs that are out of control, not theirs. In every case, in every discussion, you consider your unsubstantiated fantasies to be more reliable than the evidence from the real world. I assume you are a creationist and climate change denier too, right? I may have misunderstood your point seattle. If we were spending the same percentage of GDP in the discretionary budget as in 2000, we would be spending $600 billion less. But of that, $500 billion is in military and security while only $100 billion is in everything else. Is your point then that military spending is out of control and should be slashed by $500 billion? If we want to go back to the policies of 2000 and rescinded the Bush tax cuts, the additional $700 billion of revenue together with the $500 billion of cuts in defense and security that Bush would not raise taxes to pay for would eliminate the deficit. So, is that what you are propoing? Year 2000 tax rates and security budget? Do tell. Because I don't think you would accept either of those let alone both, which would mean you arevjust blowing smoke, complaining of budget changes that you in fact support in order to create the appearance of a point.
- roidubouloi
July 8, 2011 at 12:07am
Roid writes: "No, Seattle, it is not a sure recipe for disaster as you claim because what you claim is a disaster is the practice in every other industrial democracy and it is our costs that are out of control, not theirs." No. Every country is having problems with runaway medical costs. The core issue is medical remains a 1:1, high-touch business with a stream of never ending "improvements" for the patient. I don't think there is an OECD country that has substantially lower YoY cost increases than the US. But if there is I'd love to see it. Roid writes: " Is your point then that military spending is out of control and should be slashed by $500 billion?" My point is that the government today that everyone thinks about--the money spent on roads, education, EPA, Agriculture, space and technology, housing assistance, etc., is substantially larger than it was 10 years ago. What drew my initial comment was Nutz asserted: ""What is interesting is that in today's economy, you would expect a groundswell of support for liberal policies that address the vulnerable, but somehow the T-Party, with its small government emphasis, has drowned that out. " The implication there is that the government has shrunk as is smaller than ever. When in fact it is larger than ever. Not just in social. But in the area of roads, education, science, EPA, etc. The 10 years since Clinton has seen, as your data shows, that non-defense spending has increased from 2.7% GDP to 3.4% (your data). In constant dollars, it has almost doubled, from $375B (2000) to $610B (2010). Thus, the non-military government today (roads, schools, science, etc) has almost 1.65X more funding than it did a decade ago. Nutz statement seemed to be trying to assert that non-military government today had substantially less than a decade ago. That just isn't true. PS. I understand your desire to compare everything to GDP since that makes it easy to keep growing government ad infinitum. The GDP comparison still shows large jumps in government spending. However, my salary doesn't grow in relation to GDP. Government size should not grow in relation to GDP either. And yet still, the growth of non-military government has outpaced even GDP.
- seattleeng
July 8, 2011 at 10:50am
Curran writes: "I'm going to hazard a guess and say you've never worked in medicine, which is fine. But don't pretend you're an expert on the patient's role in her own care, or mechanisms of cost-control." No, not a doctor. But as I sent in the link, there are many that are doctors that have some amazing experiences to share. And there are many CEOs (Whole Foods) who have also implemented amazing cost controls. We learn from those that have. Do you not think it amazing that in the link I sent the doctor has turned managing diabetes from a $5000 problem to a $450 annual problem? And let's not pretend that doctors have any innate ability here. Most are not good business people.
- seattleeng
July 8, 2011 at 11:11am
"My point is that the government today that everyone thinks about--the money spent on roads, education, EPA, Agriculture, space and technology, housing assistance, etc., is substantially larger than it was 10 years ago." That's what I thought your point was. You weren't talking about military spending at all. AND THIS IS A FALSEHOOD! So in character, seattle. You cannot discuss government finance and economics without immediate resort to falsehoods. The increase in everything other than defense/security in the last ten years, adjusted to GDP, is $100 billion. That's it. Not peanuts, but not the cause of our deficit and small compared to the $500 billion of real increases in defense/security and the missing $700 billion of revenue due to the Bush tax cuts. There are a number of ways to think about real growth in government, but the simplest way is to adjust for GDP growth (and let's not pretend you are capable of a more detailed analysis). By adjusting to GDP, you take in at the same time, population growth, inflation, and real income growth. As a base case, we should expect the cost of government to expand with all three. Why? Inflation seems obvious. Population growth too seems obvious. And if real incomes grow, we can expect that the real incomes of people who work in government will grow too. Do you expect that the salaries of people who work for the government in all capacities are just going to shrink compared to the private sector? Isn't that self-evidently ridiculous? Indeed, for any sector, such as government, which is on balance labor-intensive, we should expect the percentage of the economy represented by government to grow because the gains to labor costs are not offset by increases in labor productivity through capital additions to the same extent as in the economy as a whole. Of course the cost of government has to grow with GDP. It has to keep up with inflation, the change in the value of money, with population growth, and with real income growth. Not only that, given the inability of a modern industrial economy to generate adequate demand for full employment, it has to grow to maintain employment. And, given that income is ever more skewed to the wealthy, there is inevitably greater need at the bottom, starved as it is for income share. We could close the budget deficit exclusively with taxes on the wealthy and they would still have a larger share of after-tax GDP than they did 30 years ago before we walked off the economic cliff with Ronald Reagan. Had we been spending more money during the Bush years rather than giving it, pointlessly, to the investor class via tax cuts, we would not be in the middle of a disaster now. Your economic nostrums are a demonstrated failure, seattle. All we have to show for Reaganomics, and its over-the-top caricature, Bush-o-nomics, is slow growth, fiscal deficits, trade deficits, anemic job creation, asset bubbles, recessions, unemployment. The stream of bad economic news was briefly interrupted when Clinton reversed the libertarian fiscal insanity that has gripped us since 1980, with salutory results. Then Bush undid Clinton and now we are really in the shitter. We have nothing but failure to show for Reaganomics. How much evidence does it take for you to recognize that the real world simply does not operate according to your economic fantasies anymore than the earth is flat, was created in six days, and is not warming due to greenhouse gases?
- roidubouloi
July 8, 2011 at 12:33pm
The medical article you link to is a case in point of your inability to understand what you are reading, seattle. You keep insisting that things are as bad or worse in industrialized economies that use government to manage healthcare prices and utilization. But we know, for example, that France spends 11% of GDP (a smaller GDP per capita than ours) for universal coverage and medical outcomes as good as ours. We are an extreme outlier relative to other industrialized countries at 17.5% of GDP and rising. This means that your claim that other countries are having the same difficulties we are having IS ANOTHER FALSEHOOD. The gap between our spending as a percent of our larger per capita GDP and everyplace has been widening, not shrinking or even staying the same. Against the examples of other entire economies, you give us the anecdote of a single case where, with proper care, the woman's costs dropped from $5,000 to $450 per year. But nowhere does the article tell us how or why. Was she simply not receiving the proper care before? The reason I say you don't understand what you read is that this is a demonstration of the fact that properly managed care can produce better outcomes at a lower price. This is what single-payer and universal protocols are about. Ensuring enough treatment, the right treatment, but not more than is efficacious. Beyond that, the article reports that a large part of the savings in the practice described is due to eliminating the costs of filing and pursuing insurance claims. Yet, in every prior discussion, you have insisted that this is but a trivial contribution to the overall cost of medical care in this country. The article you cite is a good anecdotal case for a system in which most medical care providers are employees without a direct stake in the price and quantity of the care they provide. You read, but you do not understand.
- roidubouloi
July 8, 2011 at 12:44pm
"And there are many CEOs (Whole Foods) who have also implemented amazing cost controls. We learn from those that have." ....Whole foods is absurdly expensive. "Do you not think it amazing that in the link I sent the doctor has turned managing diabetes from a $5000 problem to a $450 annual problem? " It's great! But it doesn't address the fact that our current, relatively free-market system leads either to huge expenditures (17.5 percent of the economy!!!!!!!!!), denial of reasonable care, or both, while countries with more public supervision, and mechanisms like the medicare pay advisory board (or much stronger ones, like in Japan), typically spend half as much as we do with equal or slightly better health outcomes overall, and much better coverage. I think we actually agree on some of the problems, but shouting free-market, free-market isn't, in the end, going to help much.
- Curran1
July 8, 2011 at 3:21pm
Roid writes: "The increase in everything other than defense/security in the last ten years, adjusted to GDP, is $100 billion. That's it. Not peanuts, but not the cause of our deficit and small compared to the $500 billion of real increases in defense/security and the missing $700 billion of revenue due to the Bush tax cuts." I never said it was the cause of our deficit. For the 3rd time, I was pointing out to Nutz that the discretionary part is substantially larger than it was under Clinton. And your data shows that too. Yes, military is a big chunk. So is non-military.
- seattleeng
July 9, 2011 at 3:43am
Roid writes: "But we know, for example, that France spends 11% of GDP (a smaller GDP per capita than ours) for universal coverage and medical outcomes as good as ours." For the umpteeth time, read the McKinsey report to understand the difference. If we adopted their system verbatim, our costs would not drop to 11%.
- seattleeng
July 9, 2011 at 3:47am
Curran writes; "....Whole foods is absurdly expensive." Not their food. Their health insurance. their CEO testified before congress during the passing of Obamacare because they and Safeway have actually managed to do much better on cost control than others and the employees are happy with the plans. You sound as if you are a bit behind here. Go ahead an catch up. It's interesting for sure.
- seattleeng
July 9, 2011 at 3:51am
Curran writes: "I think we actually agree on some of the problems, but shouting free-market, free-market isn't, in the end, going to help much." And screaming "public option" won't either. OBama had a chance to do that. He reviewed it. He passed. Because it wont' work. The numbers don't add up.
- seattleeng
July 9, 2011 at 3:52am
Seattle, do you have a source indicating that 'the numbers don't add up' on the public option? No, of course you don't. There isn't one. It's hard to know what numbers you're even talking about, since no one claimed that option would immediately cause large savings. Obama didn't 'pass' on the public option on policy grounds. He made clear he supported it, but that, if dropping it was the ideological price it took to pass a bill, he accepted the compromise. To pretend that this happened because it was bad policy is disingenuous or uneducated. In any case, I didn't 'shout public option' in a way equivalent to your instinctive, evidence-free reliance on the free-market. It's only one way to achieve savings; the models of the healthcare systems of other industrialized nations show there are many ways of achieving cost-savings. All, however, require some sort of public regulation, price-setting, or manipulation of the market.
- Curran1
July 9, 2011 at 2:55pm
Seattle, I doubt we'll come to a quick agreement over this, but I do note that you've at least answered some of my objections with support from empirical evidence and analysis. I don't currently have the time to go into the Whole Foods example (i.e. I don't know much about it), though I'm instinctively skeptical of the economic contributions of an enterprise whose profits come from creating a new boutique market that adds huge surcharges to the cost of the goods and still turns a profit; it's the cadillac health insurance plan of groceries. :) However, that doesn't mean they can't be doing good things in health insurance (though I'd question why those savings don't seem to be passed on to the consumer). But, beyond that largely marginal question, is what Whole Foods is doing expandable to the larger economy? That doesn't seem to be happening, at least not with any speed, and I wonder why not, given the (potentially) vast savings available. The question is not rhetorical.
- Curran1
July 9, 2011 at 3:32pm