The Post On Single Payer

I'll confess I am something of a politics junkie (in case you hadn't puzzled that one out already!) but keeping up with this week's insane Trumpapalooza has been a bit much for me. I honestly started to tune it out and had to read Matt Ygleisas's "Voxsplainer" on the Niger-Ambush-Gold Star-Phone Call-Kelly-Tape Affair (or whatever we are going to call it) matter Friday afternoon.

So let's talk about something other than Trump or the likely upcoming LA vs NYC World Series that will probably suck.

Recently Ed Kilgore wrote a nice piece about the politics of converting our healthcare system to some sort of single payer model. Here's how he sums up the political reality of what single payer advocates are asking for:

Yes, Medicare for All would almost certainly improve insurance for all but a small minority of Americans, and, yes, the tax increases might be more than offset by the abolition of premium payments and big out-of-pocket expenses. But these are arguments, not instantly appreciated facts, and any serious push for single payer will face the largest and most expensive campaign of conservative and insurance industry pushback in the history of public policy. A political calamity not just for health-care policy but for Democrats is a distinct possibility.

If anything I think that's a bit of an understatement. Remember 150 million Americans get their health care coverage through their own or a family member's employment. Market surveys of these people generally show their approval of their plans in the mid to high 60's, which is lower than Medicare enrollees'  satisfaction. But those numbers tend to be in the low to mid 70s so while Medicare-for-All (or whatever) might be more popular than "Obamacare", I really doubt "you lose your nice healthcare plan and existing medical networks for an vaguely government program" would poll that high.

To put it another way, the Obama Administration caught holy hell for presiding over the cancellation of a few million shitty health care plans that didn't cover much of anything for years. Canceling 150 million employer provided plans that most people like would be YUGE political problem. Even if you promise on scouts honor the new government program is going to be wonderful.

Don't get me wrong, I'm not opposed to a single payer in the least. I think having such a program could have a lot of advantages over our strange jerry-rigged health care system we have now. But I think it's a lot more helpful to think about political efforts in tangible and practical ways, rather than vague platitudes about making something a "right".

Long time health care researcher and writer Harold Pollock put it this way in an excellent article entitled "Single Payer Is Not A Principle":

Single payer is not, in itself, a principle. It is one way to organize health-care financing. A regulated patchwork of private insurers undergirded by public subsidies and the individual mandate is another. In other words, these arrangements are means to an end, not ends themselves. After all, most American progressives would be thrilled to see the Dutch or German health-care systems enacted here, though neither of these is actually single payer in the sense that Medicare is.

Now normally when someone like me whines about the vagueness of slogans like "single payer" or "health care is a right", or reads the laundry list of massive political hurdles that would have to be overcome to enact a Medicare for All system (the fact the Roberts Court would probably rule such a law unconstitutional is my favorite) there is a typical response that goes like this: Most ideas about positive social change begins as a crazy harebrained idea! Be that the idea of a "March of Washington" or letting gay people get married! And yes whinny white liberals like you Longwalk often come up with reasons for why "now not the right time!"

These are fair points, but as I see it this back and forth just sort of shows that there are two possible scenarios for the outcome of what will happen when it comes to the politics of single payer health care. The "optimistic" or "Longwalk is a idiot" school of thought would say that the recent rather impressive move among Democratic elected officials towards embracing Bernie Sanders recent Medicare for All bill is, well, a great first step! Like gay marriage or women being allowed to vote it once seemed crazy, but is now becoming more normal, and liberals like me should embrace this new path or get out of the way.

But as much as I'd actually like this to be true (yes I want to be seen as an idiot on this occasion) I am also growing concerned that single payer is becoming a sort "identity politics" for lots of liberals and more "left" people, even as it remains as devoid of substance as it's ever been. In other words I worry about a "pessimistic" or "Longwalk is a cynical genius" possibility where people keep going on about about "single payer" as an abstract ideal that they demand politicians adhere to, and become cynical and jaded when the "sausage making" of crafting actual legislation fails to live up to these ideals.

In this is "pessimistic" account single payer dreams are becoming something a bit like Trump's famous wall. That is a sort of absurd promise that supporters none the less believe in and become quite jaded when they learn it was a "metaphor" or something.

And we're seeing this all over Republican politics these days. Its' not just that there won't be a wall and Hillary also won't be going to jail. It's also that coal jobs aren't coming back. Culture will keep becoming more liberal. And Trump's "winning" seems have been reduced to shouting at various professional athletes on Twitter.

Political scientist David Hopkins's summed up the price of this style of politics for the Republican Party pretty well back in the summer. As he put it:

...a party that rewards skill at stoking such sentiments rather than policy fluency or governing competence is asking for trouble—and now the trouble is here. Democrats, of course, find nothing to celebrate in Trump's record so far. But Republicans who prioritize the implementation of sound conservative policy are also being primed for disappointment. The GOP is in such a state that it cannot, by its own admission, be counted upon to avoid a government shutdown or a possible default on the national debt this year—much less to develop and enact successful initiatives on health care, taxes, financial regulation, and other topics.

After just four months, a remarkable despondency has set in within Republican ranks about the prospect of a legislatively productive 115th Congress. Despite holding unified control of government, the party is simply unequipped for serious policy-making—a deficiency for which Trump is both cause and symptom.

Does anyone think things have gotten better for the Republican Party since early June when Hopkins wrote that?

One of the stranger and seemingly easiest tasks a political party that's out of power has in our system of democracy is to, well not get all crazy. The Republican Party clearly failed on that part when it came to the Obama years, and thus when the cyclical nature of elections returned them to power the result was the insane Reality TV show that is the Trump White House and a do-nothing Congress that could very well shutdown the government over Christmas.

In other words I hope that I'm an idiot, but I'm growing increasingly concerned that far to many liberal and "left" people are emulating some of the same political pathologies that have made the GOP incapable of functioning nationally.

The last thing we need is outraged liberals screaming about how Sanders betrayed them after he realized on January 22nd 2021 that ending all union negotiated health care plans overnight would be less than ideal. This may seem crazy, but then again lots of people seemed to really have believed, or said they believed, that there would be a giant wall come 2018 that Mexico would pay for.

One dysfunctional political party has already brought the Republic to it's knees, we don't need another.

Clay Davis Was Right

Recently political scientist Scott Lemiuex had a nice rejoinder to a piece written by Libby Nelson at The Splinter about the fact that Hillary Clinton and the Democratic National Committee received political contributions from already former Hollywood kingpin and allegedly monstrously evil person Harvey Weinstein.

I will leave it to others to discuss the life and acts of Harvey Weinstein, but I was struck by Lemiuex's title that "Unilateral Disarmament Is Not A Great Plan" when it comes to how Democrats ought to approach raising money.

Lemiuex quoted the meat of Nelson's argument as follows:

But finding the thousands of dollars Weinstein donated over the many years he has spent as a major Democratic donor, and dutifully Doing Something with it, does not solve The Harvey Problem. The problem does not go away along with his money. Instead, the Weinstein story—and the collateral damage it has caused Democrats—should provoke a moment of reflection: As long as they keep taking money from the super-rich—as long as sustaining the party depends on huge sums of money from people like Harvey Weinstein—things like this will happen. It’s not that every super-rich guy is a predator, though wow, a ton of them are; it’s that when you run your campaigns largely on the donations of rich people, you tie yourselves to them, whether you like it or not, whether you mean to or not.

I'll give credit to Nelson, she points out the ridiculousness nature of some Republicans trying to turn this into some sort of Hillary Clinton "scandal." In addition, she points out some of the very real problems that having a politics dependent on raising large amounts of campaign cash cause in a more sophisticated way than complaining for the umpteenth time we need to "get big money out of politics" because it's "corrupt." And she has the honestly to admit she has no idea (okay she implies she has no idea) about how a "better" way of winning elections could be created. As she puts it at the end of the piece, "If Democrats want to avoid the stink of abusers and untouchable criminals following them to Washington, they’ve got to find a way to get there without their rancid cash."

So there were some fair points, but I have to agree with Lemiuex's response to the implied argument that what the Democratic Party needs to do to win elections is "unilaterally disarm" when it comes to raising money from rich people As he puts it:

I’ve mentioned before how a lot of online lefty discourse — and this tendency, ironically, is particularly strong among people who define themselves as non- or anti- liberal — takes a liberal individualist approach to what are primarily structural problems. The idea that the Democratic Party is just making an unfettered choice to be reliant on rich donors to be competitive is problematic, to say the least. Because of Buckley v. Valeo and its progeny, there will be tons of money in American politics whatever the Democratic Party does. Bernie (and to a lesser extent Obama) may have shown that you can run a presidential campaign relying mostly or exclusively on small donors — but it just doesn’t scale down. There just aren’t enough small donors to competitively fund every marginal congressional and state or local race. And it’s not just venal Democrats who are vulnerable to this money — Russ Feingold can be drowned by PAC money just like Evan Bayh. 

While I think Lemiuex is dead on about this weird tendency in some lefty discourse, if anything I think that he doesn't go far enough. The "collateral damage" Nelson refers to is probably zero when it comes to any upcoming election. And how do I know that? Well because the fact that Donald Trump boasted about doing similar things to what Weinstein is accused of doing on a tape that was then broadcasted on national television over and over again didn't stop him from becoming president!

And Lemiuex is certainly correct that the number of people who can run Bernie style campaigns based on a gazillion small donors is incredibly small, especially considering we live in a polity with literally thousands of elected positions of some importance.

Oh sure there's a moral question about who it's okay to take money from when it comes to legal campaign contributions and who should be refused. A panel of ethicists and philosophers could conduct a very interesting seminar on what constitutes a "deal breaker" when it comes to political donations.

But on a practical level Senator Clay Davis' vulgar maxim about who it's okay to take money from is how campaigns tend to operate.

In a earlier, more simple political time (ie 2012) Lemiuex once wrote a nice post on Garry Wills' review of Robert Caro's classic second book on LBJ Means of Ascent. Lemiuex is a fan of Caro and the book series as a whole, but, well really didn't like that one. There are several reasons for this, but a big one seems to be that Caro spends lots of time talking about Johnson's vulgarity and...uh...questionable campaign tactics, while ignoring what the Good Ol'e Boy LBJ was running against named Coke Stevenson was all about.

In other words LBJ's vulgarity becomes less important when you think of him as a New Dealer who'd be instrumental in helping to bring about the downfall of legal segregation. While Stevenson's "honesty" and anecdotes about his ole timey battered coffee pot and cowboys saluting him as he rode past seem different when one thinks of him as the staunch segregationist and man ideologically opposed to any sort of federal spending on the welfare state that he was as Governor of Texas.

Wills' sums up the problem with this approach to political biography beautifully:

Caro has touched on a serious matter, the problem of maintaining human values in the scramble for power. Seneca faced this challenge in its most acute form, as the court adviser to a corrupt emperor. Addressing it in his dialogue on the tranquil mind, he admitted that honorable men cannot serve in some foul regimes. But even then, he argues, the virtuous man should “disengage with a dragging foot, retiring the standards with a military discipline retained.” It is too easy to conclude, prematurely, that the only “way to save oneself is to bury oneself.” 

In other words while it's true morality has a place in politics, it's not enough for that to be the be all and end all. In fact:

Seneca would judge that a politician who refuses to answer questions has barely been engaged in the first place. Those who decide they are too good for politics may be right, but they are often the least qualified judges, either of their own virtue or the system’s viciousness.

For better or worse money is very important in our political system. You could work to try and change than, but that just means you'll have to find a way to win elections in the "corrupt system" if only to create a new and better system. A system in which say relationships and information would be the driving force, because obviously there's no way for an elite few to monopolize those scarce resources.

Oh wait, that's kind of how Hollywood works?

Nelson may be correct that our current campaign finance system is gross and taints the Democrats in ways that can't be redeemed. But she's probably not that qualified to judge. Unlike Hillary Clinton, who made her choice on the compromises associated with choosing to live a political public life long ago.

Joe Biden Explained

There's a Hurricane headed towards the Gulf Coast, the President is making not-so-veiled threats towards North Korea, and it looks like the next season of American Horror Story could be based on real life and set in Hollywood.

Also the Twins made the playoffs! And were then promptly bulldozed by the Yankees.

So let's talked about something that's not about Trump or baseball.

Recently political scientist Scott Lemieux said on Twitter: "I kind of want Biden to run in '20, just to end the ridiculous fantasy that he wasn't the nominee because Hillary CLEARED THE FIELD" And  my immediate response was along the lines of "But I like Biden, he's a good guy in a lot of ways, and I don't want to see him humiliated...But yeah Lemieux is right about 'Biden Would Have Won' takes."

Let me just say up front that I love Joe Biden in many ways. I love his his ridiculous "Joe Diamond Six-Pack" caricature in popular media. I love his "ladies and gentlemen" line when he wants to emphasize his point. I love the ridiculous anecdotes about him that are apparently all true from Richard Ben Cramer's masterwork "What It Takes" about the men (yeah they were all men) who ran for president in the 1988 cycle.

For example, there was a night called "The Night of The Bronco." This was the night when Biden drove some of his most important staff around all night, in his Bronco in the mid-80s to look at possible houses to buy (Biden is a guy with strong opinions about houses being over or undervalue in the Delaware market in the 80's), and yeah...oh tell them he was going to run for president.

Buy this book. It's just so good.

I also love Biden's successes, most Millennials don't know this but he was instrumental in keep Robert Bork off of the Supreme Court (full argument on why Bork was bad here!) 

And I stand in awe of the most terrible moments of darkness in Joe Biden's life. Such as the horrible car crash that killed his first wife Neilia (nee Hunter) and his one year old daughter Naomi Christina and severely injured his sons Hunter and Beau. Neilia went out to do Christmas shopping with the family when a semi T-boned their station wagon.

According to Cramer, and as far I can tell Biden has never disagreed with this, after the accident (note the use of periods are Cramer's own) this was where he was:

The hospital was in a tough neighborhood, bad streets, and dark. If the boys could sleep, Joe and Jimmy [his brother] would walk those streets, half the night. They'd tell the nurse they were going out for pizza . . . but they wouldn't eat.

They didn't even talk. The sound was their shoes on grit, on broken glass,  . . . Joe was hoping someone would jump out from an alley, come at him. He would've killed the guy. He was looking for a fight. There was no place for his rage.

Sometimes he though it would be easier . . . if he were the only one left . . . then he could kill himself. It was the boys, kept him alive.

Note this happened a month or so after he shocked much of the political world in 1972 by winning a Senate election as a obscure, but charismatic, county commissioner with a hansom young family in tow against an incumbent named J. Caleb Boggs who'd been in Delaware politics since time immemorial.

So yeah I like Biden the guy, and thought he was a pretty good Vice President.

But he's almost certainly not going to be the 2020 Democratic nominee. Nor would he have "won" in 2016 either. Lemieux, who describes himself as a Biden fan, wrote it this way when it came to Biden's previous very real runs for the nomination:

In 1988, Biden was forced to drop out of the race amid a plagiarism scandal. This race was ultimately won by noted superstar political talent Michael Dukakis, who really did run the inept and underachieving campaign Clinton is accused of running. In 2008, when Clinton barely lost to arguably the foremost political talent the Democratic Party has produced in a half-century, Biden ran a bungling, ineffectual campaign that ended in Iowa with zero delegates.

Lemieux is...well...not being that unfair.

And that's not to mention the reality, summed up well by Jamelle Bouie, that lots of black people and younger liberal type people might have found real reasons to object to a President Biden in 2016 due to his work in the Senate. But because Biden really didn't run (at least formally) in the 2016 cycle, because his son was well dying of brain cancer among other reasons, the argument remains theoretical.

The point here is that the "Unsinkable Biden" dream I've heard from people about how he was sure to win in 2016 (or somehow will crush Trump in 2020) only makes sense in the abstract dreamland of a political reality where Biden never actually do the things that "running for president" actually entails.

Lemieux makes the point in his piece that "Joe Biden The Invincible Candidate Of Destiny" arguments are a way of eliding around a major issue about "Hillary Clinton Most Terrible Candidate In History" arguments we are all so used to:

If I may state the obvious, there is zero chance that a woman with that track record would be taken seriously as a presidential candidate. If the answer is that she would if she were vice president, the odds that a woman with Biden’s track record would be nominated as vice president are also roughly 0%.

It’s also not a coincidence that Clinton is treated with far more vituperation on the left than Biden is. Biden is very similar to Clinton — if anything historically a few clicks to the right. But can you imagine, say, Doug Henwood publishing His Turn: Biden Targets the Presidency if Clinton had announced she wasn’t running? And can you imagine a book title implying that it’s somehow unusual and unseemly for a male politician to seek power.

To paraphrase another political scientist I deeply respect but won't name, "'If only Hillary had been a likeable white dude with a lunch bucket in one hand and a Miller Lite in the other she would have won...is a stupid fucking argument!"

Hillary Clinton lost the 2016 presidential election for a number of reason. The Electoral College is one. The political media's decision to cover emails servers more than all other policy issues combined is another. The phenomenon of what I like to call "White Rural Rage" in my Great Lakes States neck of the woods was too.

But Biden wasn't the panacea to this. And he was never a magician who could pull the presidential rabbit out of the hat, as his past campaigns for that job illustrate. As a candidate for the presidency in 2016 he would have probably run into many of the same problems Hillary did, and some more as well.

People who want to be serious about what happened in 2016, or what Democrats should think about when it comes to 2020, should acknowledge this reality.