In praise of the health care reform legislation

Of course I should have written on the matter after Senate passage on Christmas Eve, but alas, I've been enjoying the Christmas holidays.  As I've said before, I continue to be dismayed by the liberals who want to throw the baby out with the bathwater (this current situation is an almost perfectly apt use for this expression).  The "kill the bill" liberals are far too focused on the insurance companies.  To paraphrase Ezra Klein, if the insurance industry goes from 85th most profitable to 58th most profitable, but millions more Americans can afford health care coverage, that's a deal I'll take. 

I think Jon Chait (who's writing I'm especially loving lately) sums it up great in the title of his article, "The rest is just noise."  It's also a really interesting analysis of the attacks of the legislation coming from the left (and from the right, but those are more transparent and obvious). 

Security Theater

After nearly a week off, I wanted to come back with something really good, but then I realized I better just come back period.  To that end, I'm going to borrow Jeffrey Goldberg's commentary on the TSA response to the latest crazy to try and blow up a plane:

 Sometimes the stupidity is too much to bear. From the new guidelines for international air travel:

U.S.-bound passengers aboard international flights must undergo a
"thorough pat-down" at boarding gates, focused on the upper legs and

Thanks for letting us know, TSA, that the search should be focused on the upper legs and torso. As I've said on numerous occasions,
pat-downs that ignore the crotch and the ass are useless. We recently
saw in Saudi Arabia the detonation of a rectal bomb, so it really
doesn't take much creativity to imagine that terrorists will be taping
explosives to their scrotums. Of course, TSA is not going to be
feeling-up people's scrotums anytime soon, so the question remains: Why
does our government continue to make believe that it can stop
terrorists from boarding civilian planes when anyone with half-a-brain
and a spare two minutes can think up a dozen ways to bypass the
symbolic security measures at our airports?

Next item:
"Passengers must remain seated for the final hour before landing.
that time, they may not have access to their carry-on baggage or hold
personal items on their laps." But what about their underwear? Can they
have access to their underwear, which is where our latest would-be
Muslim martyr apparently hid his bomb? And why can't we have access to
our laptops, if they've already been screened?

It is pathetic and depressing that the agency charged with keeping us safe seems much more interested in doing things to pretend they are keeping us safe than actually doing us things that will keep us safe.  Virtually all the rules, from the new pat-downs, to shoes, to liquids can be easily subverted by a terrorist with an IQ over 100.  Fortunately, it seems that there just aren't that many people who want to get on a plane and blow it up.  If you haven't read Goldberg's classic article on our security theater, you should.   Matt Yglesias also has a nice post about the problem of too much information when it comes to dealing with potential terrorists. 

Why this is a big deal

Terrific post over at the Wonk Room that wonderfully, graphically sums up all the good that passing health care reform will do:

Here is a graphic representation of the choice lawmakers face:


 The ostensible purpose of the post is to refute the nutty liberals, led by Jane Hamsher, who somehow think it would be a good thing to kill this legislation.  Of course, Ezra Klein can be counted upon for an effective point-by-point rebuttal.  Ever more persuasive, Nate Silver explains why the nutty liberals hopes of reconciliation are simply not realistic in the real political world.  On a side note, I have to mention how impressed I am by Silver.  Here's a guy who's expertise is in baseball statistics.  He turned his statistical abilities into an amazing site on the electoral college that all of us election junkies became completely hooked on in 2008.  And now, he does a not bad job at all as a policy wonk. 

A few more health care thoughts

1) All the public option absolutists should be tied up and forced read Jacob Hacker— the political scientist who basically invented the public option– advocate for passing the final bill.  Key point– work for more subsidies/affordability; we can still make progress there.  

2) Did the Republicans totally misplay their cards?  Jonathan Chait says yes.  Key point: Democratic moderates were so desperate for a "bipartisan" bill, that they would have been willing to sign off on pretty weak reform– much weaker than we got– if only some Republicans had been willing to actually (rather than pretend to) play ball.

3) Speaking of which, was Olympia Snowe actually acting in good faith earlier, or simply doing her best to remain the belle of the press corps ball as a beloved Senate "moderate"?  The final Senate bill has pretty much everything she wanted, so she's left to explain her "no" vote by saying the process was too rushed.  Riiiight– it was too quick. 

4) Pretty interesting story of how the Dem Senators finally worked out a bill with Ben Nelson on abortion.  It's pretty ridiculous, with all that's at stake in this, how much attention has been focused on such a tangential issue to the major aspects of health care reform. 

5) Nonetheless, Bart Stupak has now vowed to deny health insurance to millions of people because he doesn't like the Senate compromise.  I wish bad things for him.

It’s going to happen

As much of a health policy junkie as I've become, I have to admit I was a little surprised with myself at just how excited I was by today's news that the Senate has reached a deal and will pass health care legislation this week.  But, this is a really big deal.  This is the biggest progressive legislation since the Great Society, and most importantly, will bring health insurance (and thus better health) to millions and millions of Americans who previously had to do without.  That is a great thing.  Of course it's not a done deal yet, but in many ways getting the 60 Senators has always been the hardest part.  Of course, if you care half as much about health policy as me, you've already read Ezra Klein's take on this today, as he continues to do yeoman's work on the issue.  That said, a couple of comments:

  • I was a little annoyed by the Post's coverage.  Headline: "Democrats reach deal"; subhead: "GOP excoriates bill."   The average, not particularly informed reader will take from that frame that Democrats have reached agreement on some awful piece of legislation.  Obviously, I don't think that is the most appropriate frame.  Ultimately, just another example of the incredibly pernicious and destructive "he said, she said" bias of the media.  (From what I've seen, the reporter on this, Shailagh Murray, is absolutely the stereotypical lazy and irresponsible journalist in this respect).  It's as if they cannot simply admit this is good news for Democrats (and Americans, quite frankly) without the countervailing GOP spin. 
  • The big GOP complaint: Medicare cuts: damn, that's rich.  Just got to love the party always railing against government waste and inefficiency is so upset because this bill tries to create major cost savings through reducing waste and (mostly) inefficiency in Medicare.
  • The Times has a nice little feature comparing the House and Senate versions.  It would be great to see the final bill take the best of both.  I was just looking at the "public option" part and just shaking my head that recent events have caused so much liberal strife.  The public option in the House Bill is a pale imitation of a real public option (negotiated rates, rather than Medicare rates) that simply would have done nothing to control costs.  Would I rather have it, you betcha, because you can build on it; but to take this weak tea of a public option and make it the end all and be all was always just ridiculous and showed substantial ignorance of how health policy works.  
  • On to the Christmas Eve vote.  Why Republicans insist on drawing it out that long is beyond me.  But alas, they are pulling every stupid trick in the book of the world's most dysfunctional (un)representative body.  Don't they want to be home with their families?  Why do Republican Senators hate Christmas?

Duke basketball, parenthood, and happiness

I’ve been meaning to write a post for quite a while about recent research on parenthood an happiness.  Interestingly, there’s a long string of research that says that people without children are happier than people with children.  (I addressed my doubts about it a couple years ago).

Turns out the answer is that the key measure is not happiness, but rather satisfaction.  That makes a lot of sense to me.  The authors of Nurtureshock (really, should read this book whether or not you are a parent) have a great blog now, and they discussed some of the latest research:

A new analysis from the UK, just published in the Journal of Happiness Studies, concludes that kids make
married couples happier. The first child only barely improves happiness, but the second child takes married parents to a new level of bliss. A third child makes them even happier.

Hey– I’ve got three– I guess I should be a ultimate happiness.  Continuing…

The curious thing is why this seemingly obvious finding is considered newsworthy. In what possible way is it pushing the frontiers of science?

Well, it actually contradicts all the happiness research that’s come before. And that prior happiness research got a lot of mileage, and media attention, for saying that having kids makes people less happy…

Here’s the new research and the proposed explanation:

So, it’s against this backdrop that the new analysis stands out. Luis Angeles, an economist at the University of Glasgow, pulled 15 years of data on 9,000 households from the British Household Panel Survey. Life satisfaction in a variety of domains was part of that survey. According to his analysis, life satisfaction and happiness do indeed go down for those with kids – but that’s for all parents. When Angeles separated out married couples from all the others who have kids (cohabitating couples, separated couples, single parents never married, divorced parents), then a different story emerges: Kids do make married couples a little happier. And the more kids the better (up to three).

Perhaps what’s driving this data is less about kids and more about expectations. The vast majority of people who get married (not all!) want to have kids in their family. Doing so meets that expectation, and happiness is the result. By contrast, people do not expect to get divorced, and most single parents (with some important exceptions) didn’t plan to end up that way. Happiness might go down, but it’s wrong to suggest that kids caused the drop in happiness. It makes more sense that life not going to plan is causing
the drop, and having kids when life doesn’t go according to plan makes getting back on track even more complicated.

That makes a lot of sense to me.  I also think that a key element is looking at “satisfaction” rather than “happiness” per se.  I may not be all that happy when Alex is pouring water down our vents, Evan is throwing a tantrum just because he’s thirsty, and David won’t get off the computer– sure I’d rather be reading a book– but at the end of the day I’m a heck of a lot more satisfied.

So, where does Duke basketball fit in you ask?  I took David to his first ever Duke game in Cameron this past week.  It was only versus Gardner-Webb (Duke won by about 45), but it may have been my favorite Duke game ever.  David has become a huge Duke basketball fan over the past year and that has brought me immense satisfaction and happiness.  The truth is, in parenting, I’ve found that few things are more rewarding that having a child love something that you also love– be it reading, Star Wars, or Duke basketball.  The moments of sharing in shared joys with my children bring a level of happiness that I really doubt can be adequately captured in a typical happiness survey.  They more than make up for a lot of daily frustrations.  One of my theories is that so many people want a same-gender child as them simply because it increases the likelihood that you will have shared passions (e.g., football vs. dance).

So, the short summary is that I’m pleased to see my thoughts on parenthood ultimately confirmed and that more thoughtful research shows I’m not an anomaly in being such a happy parent.  Parenthood is great stuff, it would be a shame if most parents weren’t likewise benefiting.

Who can you trust?

I just finished reading Ezra Klein's chat transcript today (if you are a liberal with concerns about health care reform you really should read it– he addresses most all the concerns quite thoroughly).  Towards the beginning he makes a really good point:

I want to be very clear on this: I think this bill will do more to
help the poor and underserved than anything since the Great Society. I
think it will do more to control costs, and create an infrastructure to
control costs and a politics able to control costs, than anything we've
ever done, full stop.

I'm not alone in this. Writers like Jon Cohn. Advocates like the
Center for Budget and Policy Priorities and Families USA. Senators like
Jay Rockefeller. Among the people who have really been in the trenches
on this for years, there's near unanimity that losing this bill will
be, and will come to be understood, as one of the most tragic and
unnecessary failures in recent legislative history.

I've been a health policy junkie for years now and the truth is guys like Ezra Klein, Jon Cohn, and others have been writing about and demonstrating a huge depth of understanding to these issue for years.  Now liberals are supposed to turn against it because Daily Kos, Glenn Greenwald (whom I love on civil liberties, but is out of his depth on health care), Howard Dean (being a doctor is not at all the same as understanding health policy), are complaining.  What did these guys have to say about health policy two years ago– probably nothing.  The people who have been deeply involved in this policy area for years and whom understand it the best are those most strongly advocating that we need to pass this (admittedly imperfect) legislation– that should tell you something. 


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