Sure, It’s Radical, But It’s Also Stupid

Ronald Brownstein has a piece looking at McCain’s health care plan, the centerpiece of which is getting rid of the tax advantage for companies to provide health insurance to their employees and replacing it with an individual tax credit to buy health care. The likely effect of his plan would be a massive flight by the young healthy from employer based, group-risk sharing insurance and instead to whatever care they find to be best:

Some experts fear that younger workers would take McCain’s tax credit and buy inexpensive policies outside work. That could leave employers covering only the oldest and sickest, a change that might drive up premiums to unsustainable levels.

These dynamics could prompt a modest shift from group coverage to individually based insurance–or a massive exodus. The greater the shift, the greater the erosion of risk-sharing, because in the individual market, the old or sick often have trouble obtaining any insurance–and pay much more than young, healthier people when they do get it. Fearing such consequences, Obama and Clinton would bolster group coverage by preserving the employer tax exclusion and adding new subsidies for companies to insure their workers.

But some experts, including centrists such as prominent health economist Jonathan Gruber, would take the gamble of McCain’s tax credit plan. They consider it fairer than the exclusion, which reduces taxes most for affluent workers and penalizes people who buy insurance as individuals rather than through their employers. The catch is that many credit supporters (Gruber included) say it can work only if it is joined with reforms that ensure more risk-sharing and equity in the individual marketplace.

The problems with this are many. The first is that the type of “good” insurance that health experts would want any plan to promote - integrated care like Kaiser - is only available in certain areas and states. Obviously the McCain plan would want people to risk-share in those good areas, but they don’t provide any type of public or default option that anyone could sign up for. So it’s unclear if this unleashing will lead to better types of health care, or if it does, how fast.

The second major problem with McCain’s health care approach is that it won’t guarantee coverage for people with preexisting conditions. And since his plan promotes the unraveling of the imperfect risk-pooling system we have, it essentially lets those with preexisting conditions out to dry. Jonathan Cohn has a great piece on this aspect of the plan: basically, this will force people with preexisting conditions to sign up for state-based high risk pools. The problem with these pools is that insurance companies get subsidized with by the state, but the insurance companies dictate the price to the states. And, shockingly, the care isn’t that great, despite the high prices. Most importantly, they generally don’t cover sickness or care related to the preexisting condition itself for a year following the entry into the pool, and when they do, they generally cap it.

I think the McCain plan may be admired by wonky, centrist types who are already susceptible to see McCain as some sort of Cameronish/fourth way moderate-conservative, but since the actual details are so unsatisfying to those who have the most to worry about vis a vis health care, he should get hammered.

You Endorse What Economic Plan?

When John McCain floated his inane idea for a gas tax holiday, it made it painfully clear that he isn’t on board for doing anything serious about climate change. That’s because, at least in the short term, we need to get fewer people driving, which means learning to deal with a world of high gas prices, instead of short-term gimmicks. One of the best summations of our need for higher gas prices is a piece by Harvard economist Keneth Rogoff in Foreign Policy, in which he talks about the need for 6 dollar a gallon gas.

The first thing the next American president should do upon taking office is to insist that the U.S. Congress pass a huge increase in gas taxes. To be more precise, the United States should implement steep carbon taxes that hit coal, heating oil, and natural gas. The tax should be enough to raise the price of gasoline by at least $2 a gallon.

Pretty drastic, don’t ya think? And certainly not a proposal endorsed by John “gas tax holiday” McCain. But wait, what’s that I see? Kenneth Rogoff endorsed McCain’s economic plan?

We enthusiastically support John McCain’s economic plan. It is a comprehensive, pro-growth, reform agenda. The reform focuses on the real economic problems Americans face today and will face in the future. And it builds on the core economic principles that have made America great.

His plan would control government spending by vetoing every bill with earmarks, implementing a constitutionally valid line-item veto, pausing non-military discretionary government spending programs for one year to stop their explosive growth and place accountability on federal government agencies.

One could argue that a carbon tax is technically “environmental policy,” but that’s a pretty silly distinction to make when a cornerstone of Rogoff’s ideal evnironmental policy is a huge tax levied on everyone who buys and sells carbon. Shouldn’t Rogoff hold out a bit longer before singing McCain’s high praises?

Republicans Stand Firmly In Favor Of Paying Women Less (Or At Least Not Doing Anything When It Happens)

OK, so maybe that’s a bit of an overstatement, but the GOP senate minority did prevent cloture on the Lily Ledbetter Fair Pay Act, which would have allowed for women to sue for pay discrimination within 180 days of any discriminatory paycheck, as opposed to 180 days after the first discriminatory payment, thus functionally overturning Ledbetter v Goodyear. Democrats, to their credit, all voted for cloture on the bill (with the exception of Harry Reid, who voted no for procedural reasons). As Josh Patashnik pointed out, Republicans facing re-election fights, with the exception of Ted Stevens, voted for the bill. I can’t help but agree with Mark Kleiman that this could easily turn into a effective attack on McCain, who opposed the bill. That’s because opposition to the bill is tantamount to opposing Title VII of the Civil Rights Act and any substantive action to combat pay discrimination.

McCain and the Republican Senate have claimed that they support equality in the work place and the reason they oppose the bill is because of the lawsuits it could generate. This is a concern that has its place, but when discussing the Ledbetter Act, it’s totally incoherent. That’s because up until Ledbetter v Goodyear , the Equal Employment Opportunity Commission had never interpreted Title VII to mean that a woman had to sue within 180 days of the initial discriminatory paycheck. As the Washington Post editorial supporting the Act said, the majority of the federal courts had gone along with this approach. So when John McCain says “I am all in favor of pay equity for women, but this kind of legislation … opens us up to lawsuits for all kinds of problems”" he’s trying to have it both ways. If he really had a problem with the lawsuits and the government having ‘too big a role’ in employment decisions, then he should just say that he opposes Title VII of the Civil Rights Act; otherwise, he is in the weird spot of supporting the principle of Title VII, while standing idly by as its enforcement mechanism gets gutted. The “problem” of these supposedely frivolous lawsuits was around from 1964 until 2007. Where was McCain then?

So let’s be honest here. Every Republican who voted against cloture for the Ledbetter Act is substantively opposed to women being able to combat pay discrimination, and is by extension, opposed to Title VII of the Civil Rights Act and the principle that pay discrimination is wrong at all

What’s Worse, Prejudice or Craziness?

Sarah Posner captures what’s really been bothering me about the entire John Haggee controversy, namely that his objectively crazy views about the Middle East and his desire for a war with some Russo-Arab alliance in the Holy Land is much more worrying, and got much less attention, than his supposed anti-Catholicism:

While the viral, Bill Donohue-inspired campaign to spread the idea that Hagee is anti-Catholic got mention in the Yoffie speech, it certainly was not the focus. But Hagee — making the same mistake as his critics — is wrong to focus on Yoffie’s mention of his alleged anti-Catholicism. I’ve heard Hagee speak — in person or on television — countless times, and I’ve read more of his books than I care to admit. And, while I’ve reported that anti-Catholicism is common in Pentecostal circles and more than one person I met at Hagee’s church gave me an eye-roll when talking about his or her own ventures into the Catholic Church, I’ve never found anti-Catholicism to be the focal point of Hagee’s own ideology…

Hagee’s views are not just dangerous because they convey anti-religious bigotry but because they represent a powerful movement that has had a catastrophic affect on our foreign policy. He fosters credulity in the rank and file who are loath to open any book aside from their Bibles in order to understand current events in the Middle East. Isn’t that more alarming than unhinging Bill Donohue?

There are a few things going on here. One, is that in the last 40 years, we’ve become very well attuned
to detecting offensive comments about a sub-group and condemning them. So when Hagee calls the Catholic Church the “great whore” and stuff like that, we essentially go into auto-condemn mode. The second bit is that we’ve become, as a culture, less able to talk about religion in a meaningful way.

While Hagee is certainly more gruff than many protestants in his condemnations of Catholicism, it’s worth remember that Catholics and Protestants have some very serious disagreements that, if taken on their own terms, are disagreements on the how to achieve mankind’s eternal well being. It’s pretty serious stuff. Now, I don’t think it’s necessarily bad that we’ve largely taken religious conflict out the public sphere; I certainly prefer Mitt Romney’s insistence on being a “man of faith” to the horrors of the 30 Years War, but it sure makes it harder to understand people who haven’t accepted the Great Separation (like John Hagee or Al Qaeda).

Another problem with this bracketing off of religious disagreement from the public sphere is that we care more when the lines are crossed (like with Hagee) than when those same pastors make downright crazy statements about, say, American foreign policy in the Middle East. This was especially distressing in the case of McCain because we all focused on the anti-Catholicism, which was really immaterial to Hagee’s endorsement, and ignored the large amount of overlap in Hagee and McCain’s preferred foreign policy.

Here we had an influential pastor who supports hawkish Middle East policies as a means to bring about Armageddon, endorsing the most hawkish presidential candidate in recent memory, and all we could talk about were comments about Catholicism that you could hear in many Evangelical churches. This is not to excuse anti-Catholicism, but the days of Republicans ranting about “Rum, Romanism and Rebellion” are very much in the past, while the days of crusading military interventions in the Middle East are very much upon us.

But He Was Such A Nice Guy

Joshua Kurlantzick has a great piece looking at Bush’s relationship with Musharraf and how it exemplifies the type of lame buddyism that seems to infect so much of his policymaking.  Of course, Musharraf isn’t the only foreign leader whose perfidy is ignored because Bush likes them.  Kurlantzick also points to Putin, Maliki and Uganda’s President Yoweri Museveni.  But Musharraf is a special case, because our policy towards Pakistan is really important and Bush has totally screwed it up. Even as Musharraf was declaring martial law and jailing Supreme Court justices, Bush was backing him up 110%, calling him a committed democrat and loyal ally in the War on terror. And it really seems to be because Bush just likes the guy:

The problem was that Bush “didn’t ask the hard questions [of Musharraf], and frankly, neither did the people working for him,” Husain Haqqani, a leading expert on Pakistan at Boston University, told The New York Times. “They bought the p.r. image of Musharraf as the reasonable general. Bush bought the line– hook, line, and sinker.” Kamran Bokhari, an analyst for the intelligence firm Stratfor, agreed, telling the Times, “Musharraf thinks that Bush has certain weaknesses that can be manipulated.” (Musharraf, unlike Bush, seems to realize the difference between personal and political relationships, telling The Wall Street Journal, “I don’t think relationships between nations are tied to individuals.”) Even many administration officials now admit as much. “We’ve been ignoring those who are rejecting Musharraf,” Xenia Dormandy, who ran the National Security Council’s South Asia desk in 2004 and 2005, said after she left the government. And, when I’ve spoken with administration officials who would like to take a tougher line on Pakistan, they inevitably say it is impossible, given Bush’s attachment to the general.

You should read the entire thing.  Much of the disaster that our Pakistan policy has been can be attributed to Bush being smitten with Musharraf, and with the General convincing Bush that if he were to give up any power, Islamists and terrorists would seize Pakistan’s nuclear arsenal.   These claims are, of course, false and now we have a situation where the parties actually supported by the Pakistani public blame American (not entirely wrongly) for continually supporting an unpopular dictator long after Pakistani public opinion decisively turned against him.  But, for better or for worse, the buddy-buddy relationship with Musharraf is distinctly a fault of Bush, so we can probably hope for some change in the next administration, whether it be Clinton, Obama or McCain. Or will it.

While Bush seems to relate to foreign dignitaries in a Jerry Maguire/frat-boy manner, McCain too has very intense personal opinions of and relationships with people, often based around his militarist ethos of honor and slight. Just look at how McCain doesn’t just disagree with Obama, but really seems to despise him because of disagreements over ethics reform.    And, not too surprisingly, McCain is a big Musharraf fan.  Don’t be surprised if a McCain administration, while they will be less obviously fawning over foreign leaders, will insist that we have to support the likes of Musharraf because of our duty and honor.  Same shit, different president.

Isn’t It Weird How Smart Republicans Disagree With McCain?

Let me just say how happy I am that McCain isn’t listening to David Frum.  Because we all know that playing to the base when all the core elements of your party’s appeal are losing popularity is the right thing to do.  That’s why we Democrats had the glorious run of Carter-Mondale-Dukakis…oh wait.

The Downside of the Iowa Model

One of the supposed benefits of the Iowa caucuses is that due to the state’s small population and the very long campaign out there, candidates can do “retail campaigning” and really connect with voters in more intimate situations. Once you get to primaries in big states like California, Ohio or Texas, there is less face-to-face interaction between candidates and voters and more of the communication is done through the media, ads and big speeches. Because of our collective imagination of the US as some sort of Toquevillian wonderland where our democracy ought to resemble town meeting in charming Puritan churches, it’s pounded into us that the Iowa model of campaigning is best.

The danger of politicians having to appeal to individuals personally is that anecdotal, emotional appeals to candidates can be amplified so as to overwhelm empirical, large-scale objections. I am referring to, however obliquely, the McCain autism incident. John McCain, as even his most loyal supporters will attest, isn’t an intellectual, let alone an epidemiologist. As can be shown from his obsession with honor and his short temper, he is a man who lets his emotions and sub-rational instincts exercise a large influence on his actions and decision making. And so, when he was confronted in Iowa with the heartbreaking story of a mother whose son had been diagnosed with autism at two years, he jumped on the autism-vaccine bandwagon, at her urging. She was convinced that thimerosal -packed vaccines were the cause of her child’s autism. As has been exhaustively documented, there is zero science to back this claim up; even after thimerosal vaccines had been replaced, autism diagnoses actually increased.

But empirical science doesn’t really affect people’s emotional response to a grief stricken mother. The appeal of an aggrieved mother triggers incredibly primal reactions, one’s that will easily overwhelm the emotionally unsatisfying conclusions of science or careful epidemiology. But the problem with politics by anecdote is that one can construe anecdotes and incredibly emotional, heart-wrenching stories to support any position, not matter how absurd. Just look at how easy it was to use the innocent Kurds and Shia killed by Saddam as a means to build up support for the Iraq War. What Iowa politics does is encourage politicians to hear as many “individual stories” as possible, and let themselves be convinced by emotional appeals that lack any context or broad applicability. This tendency is especially worrying with someone like McCain who isn’t exactly a Klingon Vulcan* when it comes to coldly evaluating…anything.

Why McCain’s Autism-Vaccine Quackery Is Especially Disturbing

Pandering is part of presidential campaigns.  The inevitability of pandering is why I turn a deaf ear to Obama’s anti-NAFTA talk in Ohio.  I understand what his real beliefs are on trade, who his advisors are and that he’s not even saying now that he’d withdraw from NAFTA or anything extreme like that.  It’s not perfect, but it’s politics.

But John McCain endorsed the thimerosal/vaccine explanation for autism.  The idea that these mercury-based vaccines are responsible for autism has been floating around for about a decade.  Too bad that every scientific study rejects this hypothesis.  It’s basic quackery that should be rejected.  And yet, McCain supports, or at least, is sympathetic to the idea.  Now, do I think that this will really affect his presidency in any meaningful way?  No, it’s not like there’s some silly policy he can endorse to appease the thimerosal hoards.  But it’s still incredibly worrying.

Why would McCain endorse such crappy, BS, quacky science for seemingly no political gain.  If there was some group he was pandering to, I wouldn’t mind.  But there isn’t.  This just reinforces what I already think of McCain. One, that he isn’t very intelligent.  And two, that he acts in a highly emotional way with many of his positions and policies being shaped either by pure cynicism (look at this long record of flip flops) or to visceral reactions to what he sees around him.  You can observe this in his campaign finance crusading.  As the Times explained in its infamous Iseman story:

Mr. McCain appeared motivated less by the usual ideas about good governance than by a more visceral disapproval of the gifts, meals and money that influence seekers shower on lawmakers, Mr. Feingold said. “It had to do with his sense of honor,” he said. “He saw this stuff as cheating.”

The same impulse is expressed in his scorn and disdain for those who want to withdraw from Iraq or generally with those who are “cynical” about government.  And this is probably what’s behind his autism stupidity.  He sees horribly aggrieved parents, evil pharmaceutical companies abusing them, and then lying to cover up the truth.  This fits his confrontational model of politics, whereby he needs to confront and destroy those who allow the citizenry to be cynical.  It’s a question of honor and duty, not of weighing competing interests or things that most politicians think about.

Maybe I’m reading in to this too much, but let me say this.  When I first read about it, I wasn’t surprised at all.