This is hard – Obama on Healthcare.

Healthcare policy is such a curiosity, but the political landscape of it is downright fascinating. Over the past few months, with a meaningful ability of the Republican Party to repeal the Affordable Care Act (“ACA”), we’ve all been reviewing two things: first, the successes and failures of the ACA, and; second, what happens after any repeal.

This has forced me to review our approach to this debate and how its metrics have changed over time. How do we measure success of the ACA? Is it that more people are covered? Or is it by how expensive coverage is? Further, we have poll numbers about favorability of the ACA, but how do we break that down between people who do not like government dabbling at all, people who think the ACA did not go far enough (i.e., people who originally wanted a single payer system and still do), and those who do not like the ACA as it has been portrayed by politicians, but nonetheless like the benefits they’ve derived by its implementation.

If I can recommend two good listens, they would each be Vox podcasts. The first is The Weeds episode where Sarah Kliff interviews folks in Kentucky about why they voted to Trump relative to their thoughts on the ACA. There are a lot of interesting revelations here. Primarily:

  • There are a lot of people who like the benefits they’ve received from state expansion of Medicaid as a result of the ACA, but it is coined by a different state-specific name, and therefore do not associate their likes with the ACA.
  • There are a lot of people who do make that connection but are hedging their bets against Trump, i.e., they think that Trump either will not be able/try to repeal the ACA or that, if he does, it will be better.
  • Most interestingly (in my opinion), was the woman, Kathy, who has been signing people up for the ACA and is disappointed in the fact that it’s so difficult to navigate and so much more expensive when it comes to the working poor — those who make enough money not to qualify for poverty-based programs for Medicaid but don’t have the dollars on hand to eat the cost of increased premiums, nor the time to navigate the requirements of the ACA. Essentially she feels it’s wrong the people who do not work have access to an easier single payer system (though she doesn’t call it that) but those who are working and struggling have to deal with this additional bureaucratic stressor.

I think I really took for granted in my own wonkish bubble just how much Republican market arguments didn’t resonate with many of their voters. This splits in a few ways.

The first is that a lot of people who voted for Trump – who might not actually be historically Republican voters – don’t give a lick about free markets or government power abuses, and really just resent the encumbrance and preserved unfairness of their new healthcare decision-making tree. This is the more populist faction found primarily in rural, southern areas (Robert Leonard has an excellent article detailing how the south has a more determinative populist streak than anything.)

The second is we have a lot of people who have crafted an identity around this Republican orthodoxy in that they want to identify Republican and have internalized the arguments around freer markets and freer people (a sentiment I still largely agree with, though have lightened up on, especially with healthcare, but I digress.) However, on daily terms, their desires translate to the opposite:  like Kathy, they practically want the ease of access and lower costs provided by programs like Medicaid, but philosophically oppose the underlying proposition that this requires turning healthcare into a single-payer public good.

This is in stark contrast to the narrative that Republicans have crafted in the past. Only time will tell if this will harm them, since all voters seemingly have short memories (I’m not immune to this, myself.) I do think it’s going to be a difficult balancing act to reconcile their Constitutional arguments against the ACA – the principled attack that this is an unconstitutional extension of government power regardless of what the Supreme Court says – with their newfound vigor in repealing the ACA but then committing to replace it with something else. That’s government involvement by any name; the question is whether they name it something that sells better to the bloc committed to this narrative.

Similarly, on top of the above, the question remains what the replacement will be. Let’s set aside the repeal-and-delay tactic for the moment. If we have an entire bloc of people that traditionally vote Republican on principled grounds, the Republicans presumably want to keep them. That requires some adherence to a narrative that presents a limited government, fiscally responsible, constitutionally-ordained approach.

The wrinkle is the folks who generally like the benefits received by single-payer, Medicaid-esque options. If you want to replace the ACA with something that gives them those benefits, you need to wrap that up in a narrative that is couched in the above precepts for both the true believers and those who find it important to identify as Republican regardless of actual policy.

Here is where I’d like to insert my second suggestion, which is yet another Weeds podcast, this time an interview with President Obama and his reflections on the ACA as well as his long-term expectations for Republicans. We actually get to hear from Kathy, who asks Obama directly about the concerns mentioned in the original Weeds Podcast. I think this is an excellent deep dive. If anything, the implementation of the ACA let us see a lot of the incentives at play both as a market and politically. I think there are a lot of lessons to be learned from it, especially for those who are wonkish and intent on mulling over solutions to its failures.

Moving on, you have this this populist group that is very outcome-oriented. The kicker for them will be whether or not their lives feel better in the short term. This is probably the largest hurdle:

  • Short term results in policy initiatives is difficult;
  • This is especially true with healthcare policy, at least good healthcare policy, because you’re often dabbling in a long game;
  • As the Democrats have learned, success is heavily dependent on people making the tie between your policy and their sense of a better quality of life. Democrats hedged the ACA on the understanding that people, once covered, would accept the ACA because of the improvement in their lives. This proved untrue not just because, for many people, the increased sense of unfairness overwhelmed any real benefits, but also because the tangled web of the ACA made it difficult to tie even those real benefits back to the ACA.

In short, the Republicans did a really good job of taking the burdens of the healthcare industry and thrusting them wholly on the ACA. There’s just a lot of tough nuts to crack in healthcare, and the ACA has its failings for sure, but Republicans were able to take all hurdles and frame them as Democratic failures. In contrast, Democrats did a really bad job of distinguishing between what was actually caused by the ACA, and illuminating the ways in which the ACA specifically caused better healthcare coverage.

I think the salient point here is that most Americans implicitly view healthcare as a public good. It would be vastly unpopular and politically impossible to get rid of Medicaid and Medicare. The latter is exceptionally popular, and is basically single payer for retirees. It doesn’t suffer from the same image problems of Medicaid because we don’t view seniors as people who should be working.

Medicaid might not be visually popular, but we know getting rid of it would have political backlash once broad swaths of impoverished people no longer had access to that safety net. States in particular are likely to fight back against this, even Republican-majority ones, because at best the cost would be need to be covered by states. More likely, you’d just have a lot of folks experiencing true burns, not hypothetical ones, and feeling galvanized to push back. As we saw this election, that threat can be real.

Likewise, it’s clear based on our post-mortem of the Obama presidency that even conservative-leaning, or at least Republican-identifying, Americans, as well as Trump voters, desire access to a Medicaid-esque system that has lower barriers to entry and lower costs than the ACA scheme they’ve just been thrust into. It will be interesting to see if Republicans actually try to manage these competing demands, and if this means recasting their position in a frugal-yet-involved light or simply repealing and hoping to delay the political implications until later elections, thus spreading the political cost to Democrats as ACA failures.

It could also be a long-term attempt to defeat the narrative that government healthcare is at all helpful, allowing the establishment to recoup and recover after populist usurpation (slight editorial comment on my part.) If everything fails just right and at just the right time, more orthodox Republicans could see a new opening for bona fide privatization.

Universities are not the Real World (TM)

So I’ve been listening to Amicus for some time, and the most recent podcast had snippets from a symposium on free speech on campus. It was broad, but the three themes were: safe spaces, trigger warnings, and political correctness.

Each of these could be a post in their own right. I’ll begin by saying that these are three distinct concepts, and before any conversation can be had, it would behoove us to agree upon a definition. But the focus of my post isn’t to whittle these down to their component parts and try to dissect their importance (or lack thereof) on college campuses. Rather, I want to talk about this idea of free exchange of ideas vis-a-vis the “real world.”

Frequently this conversation begins with the role colleges play in young adult lives. The fact of the matter is that we don’t allow adolescents much exposure to real world conditions and, for those fortunate enough to go to school, we view this step as much one of personal maturation and exposure as we do academic learning.

This can be true on some fronts. You need to consider what you’re paying for college,  budget your money, budget your time, network, determine what a proper major is and how that will relate back to employability, etc etc.

But when it comes to the conversations we have on campus, this is not the real world, and I don’t mean that in a protective way. I generally subscribe to the idea that universities are sacrosanct as a place of research and intellectual dialogue. It’s important to preserve these forums; historically, they have been the epicenter of academic exchange. More importantly, unlike other contexts where we exchange ideas  (like political contexts), the norms here are more attuned to civil discourse where parties are there to learn and probe at each other’s ideas, with the ideal being the “better” idea wins. This isn’t how it always plays out, and there is the risk of giving unequal proposals undeserving equal dignity, but these are exceptions to what is otherwise a good general rule.

Which brings me to my point: this is not what we do in the real world. The conversations you have on a college campus would probably land you in HR real fast at your real world job. We joke about how politics and religion are no-go places during dinner conversations and family events. Topics we discuss with peers we frankly don’t know very well are welcomed in universities, whereas there are some conversations we simply will not have with people we care about because they’re too divisive, sticky, or otherwise hazardous terrain to navigate.

There are some peculiar situations, like law schools talking about rape law, where this exposure really is both professional and personal, but I’m not willing to make such a broad statement about universities and young people based on a specific post-graduate profession and a class of people who, frankly, are going to be much older than the those we commonly think of when we talk about college.

So when we talk about college being a place for kids to become adults – a place where they can wade into real world waters – let’s remember that this truly entails. The need to maintain robust conversational landscapes at universities is crucial, but you can’t argue that it occupies this unique space in liberal society on the one hand, and yet have it be something so pedestrian that you will perish in the real world without it. The real world is a carefully curated place, at least when it comes to the conversations we have for the vast majority of our day, and ultimately that’s primarily what this debate centers around: what we can say and to whom we say it. It’s fundamentally disingenuous to portray college students as uniquely sensitive when an entire professional and social culture has revolved and grown around previous generations’ careful cultivation of manners and etiquette the exclude the same, if not more, topics.

Blogger’s Remorse.

I’ve been quiet the past few weeks. In large part, that’s because of the holidays. I’d be lying, however, if some part of that wasn’t fear of blogger’s remorse. Blogger’s remorse is the retrospective embarrassment of having permanently written down your thoughts somewhere, only to reconsider them or regret them for fear of being wrong or saying something stupid.

Then I listened to the Ezra Klein Show – or maybe it was The Weeds – where Klein contrasts his experience building Vox with his experience as an early blogger. He laments that now, as a more established journalist, the dialogue is more about establishing and potentially proving a thesis (paraphrase) rather than the more exploratory task of musing on a blog. With a blog, he recounts, it felt more like a conversation where a person was free to be wrong, but there was a net intellectual gain in that exploration, so it wasn’t viewed negatively.

I’m trying to bear this in mind as I continue practicing my blogging. The whole point of using this was to memorialize my thoughts. If I come back and change my mind, fine, that’s good, reflection is good. If people who read it think I’m an idiot, they can go fly a kite. Besides, my audience is small, and most of them know me personally enough to actually have a conversation stem from these posts, and I’d consider that a pretty beneficial thing.

We’re All Dudes

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Tim Ryan, former challenger to Nancy Pelosi’s House leadership, was on Politico’s “Off Message” podcast, doing the same post-mortem of Election 2016 we’ve all been doing. The lens was, as usual, what the Democrats did wrong and how that diagnosis informs what to do next. And, at the risk of alienating quite a few people, I’m going to put my feminist hat on and hash out some thoughts of my own. This is a conversation I’ve been having in my head for some time, so I accept that the only person part of it is me and I likely have a lot of blind spots I haven’t considered yet. For the time being, however, I want to toss my own food for thought out here.

I’m going to be using Ryan’s language here because it mirrors so much of what I’ve heard on other podcasts and in print media as well. For example, Chicago Mayor Rahm Emmanuel was part of a recent Brookings Institute discussion, and his thesis was roughly the same: too much focus on identity politics and not enough focus on policy — specifically, economics.

The general line of thought here is as follows: economics affects everybody. Identity sections people off and, at best, makes it hard to appeal to the electorate in broad strokes. At worst, it alienates people who are not actively being courted. An example of this would be the white working class who, for the most part, are not actively hostile towards minorities, but nonetheless feel like voting for Trump forced the political class to acknowledge their pains explicitly as a white working class. The rationale as a voter was to effectively shout “HEY OVER HERE” in whatever way possible, which is why it’s frequently so hard to understand why people who don’t think Trump is suited for office nonetheless voted for him. Whatever his faults, he was a catalyst to this conversation.

I want to push back on two parts here:

The first part is that when we talk about economics, we’re talking about everybody. At first blush, I agree. The economy is people; it’s just a conglomerate of economic acts individuals take (i.e,. buying things, selling good and services, etc. etc.)

When we focus on economics in the context of this post-mortem, we are not talking about “just” economics. We are talking about a manufacturing sector. In Tim Ryan’s interview, he refers to “these guys” in Youngstown and other manufacturing towns hit hard by the transition from manufacturing economy to a service/information economy. He laments that there is a swath of people who want to continue making things with their hands and experience anxiety about not being able to provide for their families.

Men are disproportionately represented in manufacturing. (PDF) And, if I were betting real money, I would bet that people who miss making things with their hands are likewise men. Similarly, while all people experience anxiety as non-contributors, men in particular are hit hard by this stressor. Right or wrong, accurate or inaccurate, people do not exist in a vacuum. We are all impacted to some extent by socialization and men who have been working in manufacturing a long time and no longer have that opportunity are probably those who grew up with an understanding that they supposed to be breadwinners to their families. This doesn’t mean they’re neanderthals who resent working women, but it does mean they put a premium on gainful employment that is probably above average. This is an anxiety that has actually been cited in more than a few studies on the opioid epidemic, but I digress. I just mean to say that I’m not pulling this wholly out of my rear.

When Bernie Sanders, Tim Ryan, and the pundit class begin talking about needing to focus on economics rather than identity politics, this is at odds with each other. Economics, here, really means the concerns of the working class not benefiting from a globalized economy: manufacturing workers. Implicit in this class of people is a primarily (though not exclusively) male identity.

If we were really talking about just economics, we would be saying How can we get these people into the service sector? There are jobs in the service sector. There will be jobs in the service sector. We would be saying How can we effectively transition this manufacturing class to a service or information class?

But we’re not really talking about just economics. This is identity politics by proxy. In fact, I think most politics is effectively identity politics even if we’ve only just put a name on it, but I’ll get to that in a moment. Implicit in this focus-on-economics argument is an appeal to a predominantly male group, appealing to their identity as breadwinners and people who build things. This isn’t an indictment on that identity, and I agree with Ryan that it’s important that people work in fields that make them happy and ambitious because it makes them more ambitious and likely to take reasonable risks. This makes the economic pie grow.

What I won’t agree with is the characterization of this as identity-neutral. It’s not. It operates on the same principle as men are people, women are women (or any other historically marginalized group.) If it’s something that reaches out to our typical conception of a voter – a middle-aged man (probably white) – then it can be “just” economics or “just” healthcare or “just” whatever. So embedded in allegedly indiscriminate public policy issues is race and gender that we don’t need to specify it, and are forced to bucketize all the other groups of people only recently vying for space in the conversation in order to lay claim to that space. The result is an inappropriate framing of default white/male issues as issues of everybody.

Yes, there are people in an awkward logistical position, namely those who are nearing retirement and really do not have the meaningful option to simply train for new jobs. There are a lot of reasons for this: it takes time to train and receive new education (if necessary); when they enter the field, they’re competing with a younger group of people who present a better long-term investment, and; as people who probably have families, had a lifestyle tethered to a particular income, and are eyeballing retirement, they have stronger demands on a possible employer than a younger counterpart who can be more flexible on all of these fronts. Ultimately, however, we’re talking about systemic hurdles, and we don’t make rules for institutions based on exceptions; we make them based on rules. This is a problem to be dealt with but it’s not the governing factor.

The second topic I’d like to focus on is the notion of identity politics being a new phenomenon or that it is responsible for further divisiveness. This should be short, and might be more rant than exploration.

The simple fact is that, since this country’s inception, and really since time immemorial, we’ve siloed people off into labels. Part of this is practical. Public policy can’t scale if we work on an individualized basis, particularly not as we move higher up the government chain.

But the reasons for bucketizing people are different. Historically, black people were not siloed off in any benevolent way. Women were not either. These were used to exclude whole demographics. Likewise for the gay community, and now the trans community, and probably other communities as society progresses. To use a personal example, I’m really not sure how I can convey the need for women’s healthcare coverage when it’s in a normal state of reacting to assorted government parties treating healthcare for women as fundamentally unique and peculiar.

Yet, somehow, talking about this a women’s issue is marginalizing when I do it. It allegedly exacerbates a divide between men and women, plays on a gender card, and normalizes the conversation about women’s healthcare as it is. Fair play, maybe, to that last point, but in prioritizing my battles, I’d rather get the best policy outcome first, and then get the nomenclature right second.

When people show up laying claim to a space under the umbrella previously delineated by other people in society, they are not “Making the conversation about X.” The conversation had already been informed that way by institutions, be it government, churches, businesses and so on. It really should not be galling to us that, for example, laws that target Group A galvanizes people under Group A to use the same language when wanting to address their public policy concerns.

It’s impossible to solve a problem without diagnosing its roots first. Perhaps one day we’ll have a post-racial, post-gender, post-whatever society. For the time being, in order to address assorted social ills, it’s necessary to acknowledge the disproportionate impact siloing has had on affected groups, and consider that those people probably also have a disproportionate interest in their resolution even if they ultimately affect society as a whole in some form or another.

Real reckless disregard for the truth.

Bolton: Russian hacks could actually have been by Obama administration.

While important, it is almost low hanging fruit to point out when Donald Trump “bucks” a norm. I’m using quotations because the better word, I think, is subverts. I’m making this distinction because Trump et al isn’t merely undermining some tradition like pardoning a Turkey. These norms and customs are the most bedrock ways we govern because everything can’t be put into writing. We can’t anticipate every conundrum and we don’t have the resources to police each situation that arises. Norms are effective guidelines for behavior and that facilitate the rules we do have in place.

That’s why Bolton’s proposition is so dangerous. “Normalization” is the word of the moment so, yes, this normalizes further subversion of institutional norms and customs, but the real issue is that it actively chips away at the already deteriorating faith the American people have in public institutions. In a democracy, this faith is pivotal. If people feel like the system isn’t working the way it’s supposed to, they have little reason to feel beholden to its outcomes, whether that’s the election system and who becomes president, or something already discussed at length, such as the justice system and how it metes out punishment.

If I call out false flags, that’s potentially dangerous. It’s potentially dangerous because I have some minimal impact on the people who read and listen to what I say. Ultimately, though, the probability is small. I’m not influential and I don’t work in any official capacity for these institutions, nor have I ever.

However, if Ambassador John Bolton makes these claims, they have credibility. They have credibility because he was, at one point, formally a part of the government apparatus. They have credibility because his statements are newsworthy, and therefore necessitate reporting, thus widening the range of his influence. This also mainstreams a view that was previously preposterous and marginalized and for good reason: the people propagating the claim were of little public import and, in order to become mainstreamed, would have to offer up some evidence to lend credence to their claim. In a “post-fact” moment, one that has been primed by the President-Elect, this is no longer a requirement.

I wish I had more to add here than a basic lamentation of the abdication of personal responsibility public figures feel they have to the American public. Maybe they never had that expectation but norms certainly did, and they’re becoming less and less beholden to those. I’m not sure what the next step is to hold on to what little trust is left in these public institutions when the people who operate and are a part of them continuously subvert integrity for no cause other than their reckless machinations and lust for power.

The value of print media.

On the whole, I have heard a lot of journalists wax poetic about print media. I think there’s a lot of romanticism going on here, but there is one thing of value I’ve been mulling over, and that’s the value of having limited real estate.

By “real estate,” I mean the physical space on which words are printed. There are only so many pages one can use, and only so much space on that page. This creates an increased imperative of prioritization that doesn’t exist in digital media.

Prioritization exists in both print and digital media, but I think the increased amount comes from the limitation of finite space. With digital media, you can (theoretically) put every bit of information on your site and prioritize therein. With print media, you need to decide which information even gets to the paper and prioritize from there. The result is that there is a likely cut of stories that have a de minimis political, social or cultural value.

Another way to put it would be like having an open-book test that lets you bring a one-sided notecard. Maybe you’d be tempted to lug around your textbook or thirty pages of notes if given the chance, but the physical space forces you to only include the most important information. From there, you probably put the most likely to be tested information at the top and prioritize in descending order.

What spurred this thought was a conversation about why I don’t care much about cable news. If I have it on, it’s probably to have noise in the background, not because I think it really gives me a lot of necessary information. There have always been twenty-four hours in the day but has there always been twenty four hours worth of news? While we can certainly argue about the news value of some lighter stories, if CNN et al. didn’t have the objective of filling in that time, a lot of stories probably wouldn’t make the cut. In fact, some of these stories probably wouldn’t be proposed, as I think there’s a high likelihood that a lot of non-news is dramatized to fill that space.

Likewise with websites that, I feel, don’t have any nefarious intent or machinations to mislead or distract, but nonetheless try to occupy the space given to them, which is a lot. It’s possible we’re, as a journalism-heavy society, woefully out of practice when it comes to sifting through all the news in a given day and deciding which stories are of consequence and which are not. Perhaps if journalists and readers alike had to revive this exercise, we’d not only be less saturated in “light,” irrelevant, dramatized, or clickbait stories, but we’d also be better practiced at deciding which stories are worth consuming and which are merely placeholders.

Too simple? Low hanging fruit? Let me know. I’m curious to hear others’ perspectives.

Deus Ex and Search and Seizure

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I’ve been playing Deus Ex: Mankind Divided. The basic plot revolves around technological advancements that have allowed human beings to augment themselves with advanced robotics. Several themes play out in this game series, including the obvious robots v. humans/playing god/what makes us human/government abuses/terrorism/etc.

I’m going to spend the next few blog posts outlining the relevance of some of these developments to Fourth Amendment law – specifically, search and seizure. The game takes place outside the US (as of right now) but I’ll look at it as though the law applies.

I think this will be a fun and interesting lens through which to learn more about how the Fourth Amendment works. Further, I’m going to tie it into the search and seizure debate, hopefully explaining in more down-to-Earth terms what search and seizure really is so that it’s more easily digested by non-lawyer audiences. This, I think, could clarify a lot of details I think were lost in the debate and never illuminated by anyone involved.

Off the top of my head, this is my basic outline:

  1. Incorporation of the Fourth Amendment against the states;
  2. When the Fourth Amendment applies and what behavior it captures;
  3. Consequences of the government not complying with the Fourth Amendment’s warrant requirement;
  4. Exceptions to the Fourth Amendment;
  5. Stop and Frisk, specifically;
  6. Applying the above lessons to the actual situation in the US, using the now-unconstitutional NY program as an example.