Liberal. Classically.
I know I haven’t been around much, but the book has actually picked up speed and started action like a book. I figure I’d better take the good news while I can get it.
In the meantime, though, I’ve been reading a book by Steven Pinker called The Better Angels of Our Nature: Why Violence Has Declined.
This is a very long book, and I have been reading it for a very long time. I started on October 1st, and I will probably finish sometime today.
When I do finish, I’m going to have a lot to say, m ost of it not complimentary.
In the meantime, however, I wish to point out that it gave me a piece of information I am very happy to have.
Do you know all those studies that purport to show that liberals are just smarter, brighter, more intelligent than conservatives?
We all roll our eyes and go: politicized social “science.”
And that’s probably true.
But.
It turns out the liberals the study finds to be more intelligent than conservatives are not left-liberals or progressive.
They’re classical liberals.
They’re libertarians.
(At one point Pinker says something about how libertarians have “a lot in common” with classical liberals. That’s because libertarians are classical liberals.)
Anyway, on top of that, the smartest of the classical liberals are the ones who are classically liberal–
Economically.
Free minds and free markets, as the Reason Foundation likes to say.
Although, according to left-liberals, I’m supposed to ate them, because they get a lot of money from the Koch brothers.
At any rate, it was sort of good that that came along to make me happy, because I was having a fairly stunned reaction to the stupidity of conservatives over the last couple of weeks.
Welcome to the shut down and the dumbest political maneuver anybody’s made in a very, very long time.
For those of you who do not live in the US, it’s important to note that the shutdown started on the same day (October 1, again) as the health care exchanges opened for the start of Obamacare.
And it’s also important to know that the shutdown happened because some members of the Republican Party wanted to defund Obamacare in any future continuing resolution, as a step to getting rid of it.
So for the last two weeks, what we’ve had is nothing but stories about the shutdown and the looming debt ceiling crisis and yada yada yada.
Into which have dropped stories here and there about how the launch of Obamacare is coming along.
And when we’ve heard that the launch is not going well, we were told: that’s because the Republicans won’t fund the government.
And the launch of Obamacare has not been going well. In fact, it would be difficult to exaggerate just how badly it’s been going.
Some of the problems have to do with the fact that the software seems to have been designed by a malignant chimp.
It’s the government, so for some reason I can’t understand, they couldn’t just go out and buy a bunch of existing software that had proven workable and fit the paradigm.
Apple didn’t even bid on doing the design. Which says something about the bid process or something.
But the software mostly just doesn’t work, and there are too many and the process is set up in such a way that some mistakes can only be corrected by filing standard appeals, instead of just going in to rework your account.
The system declared a friend of mine to be unmarried and earning no money in 2013 and directed him to Medicaid. He’s married and makes more money than will even allow him to get a subsidy. He has to file an appeal. The system has spoken. End of discussion.
But there’s a lot more that’s going wrong, and it’s not a matter of software.
Practically everybody who has been buying insurance in the individual market is getting royally screwed.
Virtually everybody who has plans from the individual market is having their plans cancelled as of January 1, 2014, because the plans don’t comply with Obamacare requirements about coverage. They don’t include things like maternity coverage, well child coverage, mental health coverage, and a whole laundry list more.
The replacement plans people can buy come with premiums twice as high as the ones they’ve been paying–but with the same large ($4500 or more) yearly deductibles.
A fair number of people are looking at a situation where they will not be able to buy insurance at all, with or without a subsidy, and some of those people are chronically or severely sick.
Even a number of liberal bloggers have started to blow up about this–writers tend to be freelance, and if they’ve got insurance they’ve been buying it in the individual market–and the more official liberal commentators having started calling the whole thing “a disaster.”
That was Ezra Klein. “A disaster.”
In other words, if Ted Cruz and his friends in the House had kept their mouths shut and passed a “clean’ CR, they’d right now be very close to getting that year postponement of the individual mandate, they’d have a country full of people leaning more to their side on the subject of the ACA–hell, they might even be on the way to maneuvering a rollback or a repeal.
Instead, they’ve given the Obama administration the perfect cover, and the Obama administration is going to use it.
Chores.
12 Responses to 'Liberal. Classically.'
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Three topics! (And congratulations on the book, by the way; glad to hear it’s behaving itself.)
Brilliant libertarians. Can’t say anything. If I despised this as politicalized pseudo-science when it was used against me, I can’t use it when it is said to tilt my way. Fair is fair.
The shutdown. Yes, a fairly spectacular crash and burn–and a FORESEEABLE crash and burn. That said, we’ve been running on “continuing resolutions” since the 2009 budget–meaning everything, no matter how corrupt and demented Nancy Pelosi passed that year is still being funded. Shaking out the worst of them will be worth a shutdown, which seems to be only postponed. Why the house could not have passed a resolution to the effect that the individual mandate would go into effect only when the corporate mandate waivers expired or were rescinded and dared the Senate not to pass THAT is beyond me.
Bringing us to the individual mandate and the associated website. Expect malignant chimps to be picketing your residence shortly: they didn’t deserve that. Federal bidding contracts are indeed insane. They are alleged to prevent corruption, but I don’t think a Presidential Press Secretary could say that with a straight face. So the system is so gummed up that only the chronically ill and uninsured will persist long enough–50 tries or more–to register, which is worse for the insurance system than it would be if no one could get through at all.
But I have seen Federal websites and databases which work. This one is evidently drawing data from other databases with no way to correct the other databases, so every error is multiplied. Then it was rigged to insist on registration before showing prices for political reasons, and evidently it’s tied to the IRS so that subsidies are based on last year’s income. (Having had a good job last year is, you may have noticed, not a reliable measure of current income, but this is evidently not known to the Civil Service.)
Which brings us to the Center for Medicare and Medicaid Services (CMS) which felt itself competent to act as its own general contractor without any prior relevant experience. Anyone remember Harriet Vane explaining that OF COURSE an Oxford graduate would become an expert cook in no time? After all, she would have “learned how to learn.” (GAUDY NIGHT) I have a lot of respect for Dorothy Sayers, but every time I re-read the novel, catastrophes like this come to mind. Sometimes, you really need training rather than education.
robert_piepenbrink
19 Oct 13 at 2:02 pm
I have to agree with Robert aboyt Brillian liberals and pseudo science.
I know nothing about “Obamacare” but I did spend 40 years working with computers. One lesson stands out clearly. Make major changes slowly and install new systems in stages with fall back to the original system possible.
I’m sure the IT people would have preferred to start in one state with a small population and then add states gradually. I suppose their political masters wouldn’t allow it.
The shutdown seems to have been a disaster. But at least some people in Congress have grasped the idea that the US can not forever continue to solve today’s problems with tomorrow’s money.
jd
19 Oct 13 at 3:04 pm
“It’s the government, so for some reason I can’t understand, they couldn’t just go out and buy a bunch of existing software that had proven workable and fit the paradigm.”
Well, they’re doing something that’s never been done before, so there simply aren’t any off the shelf solutions, and, well;
“… the Health Insurance Portability and Accountability Act (HIPAA) means that the security of medical data is an absolute necessity for any vendor that deals with medical information. And this isn’t just a set of suggestions; datacenters have to meet very strict standards for data protection to be HIPAA certified. The certification steps range from specific training for datacenter workers who have access to protected data, to government audits by HIPAA inspectors that assure that the requirements in the Code of Federal Regulations are met. Additional reporting requirements are required and guarantees must be in place for the security of the data. Breaching those guarantees can result in a variety of penalties.”
Then add on top of that, that as envisioned each state would be running it’s own exchange, tailored to its specific insurance regulations — but something like 37 states opted out of creating their own. So “the health care exchange” is actually 37 different exchanges, each operating in a slightly different regulatory environment.
Then, on top of that, the entire system has to be built within and exactly within any funding already existing. Going in and telling the boss that the projections were way off won’t help, no matter how conclusively you can prove it and show what needs to be done – because the only people who can authorize a single extra penny are already actively trying to kill your whole program.
Meanwhile, whatever you put together has to meet HIPAA regulations and be fully certified before you roll out.
Maybe the ACA will work, maybe it’ll flop, but the one thing that’s clear is that a whole lot of people are working overtime to make sure it does not get a fair chance to succeed.
Which would leave the U.S. as still the only “first world” country where being one of the “working poor” can be a death sentence.
“realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back issue I had since the accident would have been helped by prescribed chiropractic care which would have been at no cost to me. When I asked for prayers for my little brother who had been burned in a camping accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.”
http://www.patheos.com/blogs/permissiontolive/2012/07/how-i-lost-my-fear-of-universal-health-care.html
michaelwfisher@cox.net
19 Oct 13 at 8:00 pm
“Which would leave the U.S. as still the only “first world” country where being one of the “working poor” can be a death sentence.”
And I think that the US is fundamentally (and constitutionally) different to all the other First World countries. Nevertheless, I think the worst aspect of your problem is the historical system that tied health benefits to employment, and then only to those individuals employed by corporations.
You now have a dictatorial administration trying to force people virtually overnight into a system that has been poorly conceived (ignoring the many decades of experience in other countries), poorly designed and riddled with “exceptions”. The systems that exist in other countries have taken decades to plan, implement and refine. Even with that, few if any of them work well, and the “working poor” are still as close as yours to a “death sentence” as victims of constant serious delays in service delivery. Many, many such people die in Australia while on hospital surgery waiting lists.
As JD says, you should have started with a small state as a trial and then expanded from there. Had that been done, the experience may well have proved as it has elsewhere that such bureaucratic monstrosities are as much part of the problem as they are part of any solution. They still don’t deliver essential health services to those most in need, despite all the hype, and tend to do so even less than the much despised systems they seek to supplant.
Mique
19 Oct 13 at 9:26 pm
I used Wikipedia to look up the 10 countries with the largest population and then looked up their life expectancy. The list is below. Only Japan does better than the US and it is a much more densely populated country.
I’ve also shown Australa (20 million people) and NZ (4 million people). Both have national health schemes but life expectancy is only a few years more than the US.
http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
http://en.wikipedia.org/wiki/List_of_countries_by_population
China 76
India 65
US 78
Indonesia 70
Brazil 74
Pakistan 67
Nigeria 53
Bangladesh 70
Russia 69
Japan 83
Australia 82
New Zealand 81
jd
19 Oct 13 at 10:48 pm
“They still don’t deliver essential health services to those most in need, despite all the hype, and tend to do so even less than the much despised systems they seek to supplant.”
I guess Canada must be the happy exception then.
michaelwfisher@cox.net
19 Oct 13 at 11:57 pm
jd, if you can find them, I’m told the numbers on death from natural causes are even more favorable to the United States. Sadly, even a working healthcare web site will not keep our citizenry from driving drunk or murdering one another at rates above those of western Europe. The US white life expectancy and homicide rates look quite similar to the Canadian, Australian and New Zealand rates, too–but I’m never sure whether that’s cheating or not. Depends on whether one thinks of the black and Hispanic populations as separate cultures or an underclass, I think.
But I agree: tying health insurance to employment wasn’t clever. No one did it on purpose: it was a side effect of WWII wage-price controls. But I’m sure Michael F will tell us that all the bugs are worked out and massive government controls no longer have unexpected side effects.
robert_piepenbrink
20 Oct 13 at 8:07 am
Well, there’s nothing like health care to stir up debate!
Michael & Mique, there are significant differences between the Canadian and Australian health care system(s). I think, from what I’ve read, that increased wait times in Australia are a result of their decision to allow parallel private and public health care systems. The UK does this too. Canada and many European countries have much more strict restrictions on the private sector, which I think reduces wait times and increases access, particularly in smaller population areas (like mine!) which could probably not support much if anything in the way of a parallel private health care system.
That being said, there is an issue with wait times in Canada. Just how bad it is, I don’t know. I used to know someone who was studying the issue and just from casual conversation, I gathered that it was extremely difficult to figure out just how bad the problem was because patients might move from one surgeon’s waitlist to another, get bumped up or back depending on the surgeon’s opinion of their condition and that of other patients, want to wait longer for a certain surgeon than get the operation quickly for another. I also know a number of medical secretaries, and although a lot of the bookings (and therefore waitlists) are done centrally, they’re always rearranging schedules as a result of all kinds of factors. I’m sure some people die waiting for surgery. I doubt many do, unless they were so sick that such a result was to be expected. How long I or my friends wait for tests or treatment depends on a lot of factors, mainly just how serious the situation is. Routine stuff can take a long time. You need something fast – I’ve known people who saw a specialist and were scheduled for surgery within 24 hours because their condition was serious. They won’t do that for some minor elective procedure.
I don’t understand the US situation well enough to make an intelligent comment. It sounds like a terrible mess, but it was an extremely complicated system to start with. Adding another system on top of that is just asking for trouble in the implementation, and that’s without the weird (excuse me, I don’t mean to be offensive) political system which allows the country to be brought to the brink of collapse by political infighting, which is how it sounds from here. At least here, if we do have a government brought down, say, by a vote of non-confidence, we just have another election to sort out the matter. A quick election.
Cheryl
20 Oct 13 at 9:12 am
Total life expectancy is driven by numerous other factors other than simply access to health care, nevertheless, when I look at the Wikipedia link about life expectancy, I must note that the US is slotted in in the group tied at “33”.
Since my conservative critics seem to absolutely suck at math, I’ll make this easy for them and point out that that means 32 countries all have higher life expediencies than the U.S.
They all, every one, have universal health care.
No wonder JD didn’t use THAT chart. Must have some residual math sense after all.
And then there’s Robert, who’s phobia for numbers is only exceeded by his almost coprolaliac (the grammar police may correct me is that’s not correct) need to speak only in sarcasm.
But.
Yes, the I am quite aware of how the U.S.’s set up of tying healthcare to corporate employment got its start.
I’m also aware that for very many reasons it is in fact whites who have disproportionate access to corporate employment at corporations of sufficient size to offer health care.
Which does create a situation of a governmental massive unintended side effect of creating an underclass of non-white people with access to neither better employment nor health care.
Apparently Robert’s solution to this particular side effect of government policy, as it is one he benefits from, is to leave it alone. He’s got his and fuck everyone else. But then he always seems that way.
Just let me remind everyone that in the U.S. health care costs have been rising much faster than inflation even while the incomes of many of those white and still barely middle class people have been flat, well, ever since their hero Ronnie took office.
Which is to say that if something doesn’t work, that those white people are going to start losing access to health care in the U.S.
So pick your “unintended side effect”. Do nothing, live with the side effects of WWII and watch the whole system crash and burn. Or try to do something else. And note, the Rethugs who have been howling about the ACA have not put forward a single word of any other plan to keep the system from crashing and burning.
michaelwfisher@cox.net
20 Oct 13 at 10:25 am
Cheryl, on the weirdness; I dislike posting links, but you might take a look at this one:
http://www.washingtonpost.com/opinions/george-f-will-what-obama-and-the-tea-party-share/2013/10/18/c4243830-376f-11e3-ae46-e4248e75c8ea_story.html
The short answer is that we’re more Lockean than most modern governments. The executive is supposed to have a wide range of powers–but not the power of the purse. Spending the people’s money is something locally elected representatives with two year terms get to do–with the consent of the majority of the states’ representatives in the upper house. When the people and the states refuse to come to terms–or when the President vetoes the compromise–the system is SUPPOSED to not let anyone run the country by decree or spend the people’s money without their consent. Notice all the national defense didn’t miss a beat, Social Security checks continued to arrive and state and local governments went on keeping the streets safe and paved and educating the kids. A “government shutdown” still leaves a LOT of government functioning.
In a way, deadlocked government is the price we pay for not having a parliamentary system which can implement good or bad ideas very rapidly, and where a very small parliamentary party can hold a balance and hold everyone else to ransom. (Israel is, if you will, the opposite of America in that sense.)
But the even shorter answer is that this is what happens when we elect ideologues of opposite parties, and scarcely a decent negotiator in the lot. No representative democratic system will get you good results from that basis.
robert_piepenbrink
20 Oct 13 at 10:25 am
Oh. Michael, I missed that one. I am currently without health insurance, and have been since April. I’m also out of work. That means minor stuff is out of pocket, and if I get run over by a truck I’ll wind up on Medicaid.
I MAY get a new contract this fall, but my prospective employer can’t tell me whether it will include health insurance, because the company can’t tell whether their current plan meets HHS requirements or what such a plan might cost. And if the contract comes through after 15 November, I am (a) REQUIRED to go to the healthcare exchanges and (b) UNABLE to do so because the window will close before I know whether or not I will be required or what state I will be residing in. It took whole committees to come up with a plan like that. Very few people are that stupid individually.
If you stop inventing your facts as you go along, a whole new world opens up.
robert_piepenbrink
20 Oct 13 at 12:39 pm
Michael, your gratuitous bullshit ad hominem is getting tiresome.
Mique
20 Oct 13 at 7:29 pm