Health Care reform in less than 600 words

Being succint is not a strength of mine, so I enjoyed the challenge of summarizing my thoughts on health care reform in less than 600 words for the NCSU Technician.  Here you go.


Lessons from Iraq

We were very fortunate to have Brigadier General HR McMaster come and give a talk at NC State today sponsored by my department (actually, the School of Public and International Affairs).  Great thanks and credit to my friend and colleague Bill Boettcher for making this happen.  McMaster was one of the innovative implementers of counter-insurgency doctrine while most officers were still hopeless mucking things up in Iraq.  He's prominently featured in this New Yorker article detailing the shift in strategy.  He also plays a significant role in this terrific This American Life episode about the Iraq War.  His talk today basically outlined the evolution of the conflict in Iraq.  It was largely a story of the insurgency evolving and adapting much faster than American forces.  During the q&a, he was quite careful not to place any particular blame on civilian leaders, i.e., Rumsfeld and Bush, but it was pretty obvious where the blame lied.  After the talk, I was fortunate enough to get a few individual minutes with him and asked my question: "why did the insurgents adapt so much better and faster than American troops."  He answered that it was basically because our initial assumptions about what we were facing were just so far off, it was almost impossible to adapt quickly enough.  Hmmm.  Wonder who was responsible for those incredibly faulty initial assumptions?

James Madison and the Republicans

Sometimes The New Republic really just nails it with their editorials.   I'm especially fond of this one which relies heavily on James Madison's Federalist #10, which I used to always make required reading to start off my political parties class (I finally took it off the syllabus this semester because it never seems to inspire quite the level of discussion I hope for from my students).  Basic point: Madison's worst fears about the problems from political parties, i.e., "the mischiefs of faction" are manifested in the contemporary Republican party.  Anyway…

"Among the numerous advantages promised by a
well-constructed union, none deserves to be more accurately developed
than its tendency to break and control the violence of faction," James
Madison wrote in Federalist Number 10. "The friend of popular
governments never finds himself so much alarmed for their character and
fate as when he contemplates their propensity to this dangerous vice."
Consider us alarmed.

Our sense of alarm has been growing for some time. From the moment
Barack Obama entered the White House, the Republican Party has cast
itself as the Party of No. Whether it was the stimulus bill–which
garnered not a single Republican vote in the House–or the nomination
of Sonia Sotomayor to the Supreme Court–which only nine of 40 Senate
Republicans supported–the GOP has defined itself in its opposition to
Obama. But our alarm has been tempered by the knowledge that, in a way,
this is as it should be: In our form of government, the minority party
should be the opposition party; and, while the Obama administration did
make overtures to the GOP on the stimulus and its selection of
Sotomayor, those overtures were largely symbolic. The factionalism,
while regrettable, was understandable. But, this week, as the health
care reform battle reached a crucial juncture, the violence of faction
has become gratuitous…

In almost Solomonic fashion, Baucus crafted a bill that gives
something to–and takes something away from–each faction. Virtually
every industry group–from hospitals to drugmakers to device
manufacturers to insurers–that faces new fees or budget cuts in the
Baucus bill is rewarded with additional revenue from the legislation.
And, when it came to winning over Republicans, Baucus went more than
halfway: eliminating the public option, strengthening protections
against federal funding of abortions, and lowering the legislation's
price tag.

And what did all of Baucus's efforts get him? Well, from most key
interest groups, outright support or, at the very least, not much
indication of outright opposition. But, from one of the two major
political parties that, theoretically at least, is supposed to
represent many of those interest groups? Absolutely no Republican
support–not even from the three GOP members of the Gang of Six…

The Republican reception of Baucus's bill doesn't so much represent a
crisis for health care reform as it does a crisis for our system. The
GOP is no longer representing interest groups; rather, it has become an
interest group itself–and an implacable one. So that a compromise
piece of legislation that achieves a rough consensus among the various
factions in the debate fails to get even one vote from one of the two
major parties.

Strong stuff.  Hard to argue with it, though.  And, of course, fits quite nicely with the previous post (of course even Southerners would benefit from health care reform).




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