Senate Republicans are About to Challenge the Wrong Cabinet Nomination

I'm going to put on my objective policy analyst hat for this post, thereby pretending that Senate Republicans have the slightest interest in advancing the public interest rather than a nakedly partisan and ideological agenda. In this vein, I'd like to examine the announcement by Judiciary Committee Ranking Member Arlen Specter (R-PA) and others that plans are being made to oppose the confirmation of Attorney General-designate Eric Holder.

There is little doubt that Mr. Holder has the experience to handle the job of reforming the broken Justice Department. Out of law school, Holder served for twelve years in the Justice Department's Public Integrity Section. Later, as the US Attorney for DC he led the prosecution of Democratic Congressman Dan Rostenkowski on corruption charges. He was also the Deputy AG under Janet Reno for most of President Clinton's second term. On a more interesting note, he recently represented the NFL in private practice during its efforts to punish Michael Vick for leading a dogfighting ring.

The point of all this is, it seems like Holder's approach to the law is from the perspective of a prosecutor and jurist rather than that of a criminal defense lawyer or politician. His record would portend respect for the rule of law at a time when we desperately need an Attorney General devoted to restoring the integrity of the Justice Department.

So why would Republicans oppose him? Again, I am approaching this question from an objective policy analyst perspective, thus putting aside any cynical tendencies to say Republicans are deathly afraid that Holder will lead an effort to investigate the legality of certain actions (especially torture) ordered by the outgoing Bush Administration and defended by its congressional allies. So with that explanation ruled out, they must see him as lacking the integrity or demeanor to restore the reputation of the Justice Department. That would explain why Senator Specter and friends are concerned about Holder's alleged involvement in the Marc Rich pardon. But as the Washington Post article linked above says:

...more moderate Republicans say that the pardon issue alone will not be enough to jeopardize Holder's confirmation.

Indeed. Sure it looks slimy, but is that enough to try and block the guy? So what else are Holder's detractors concerned about? And seriously, after getting strongly behind the embarrassments Alberto (Abu Ghraib) Gonzales and Michael Mukasey (not to mention Justices Roberts and Alito) and claiming Democrats should give President Bush the benefit of the doubt on appointments because elections have consequences?! This just seems a little hypocritical and shortsighted to me.

Instead, Senate Republicans would be better served to look at the qualifications of the nominee for Treasury, Timothy Geithner. Mr. Geithner has been President of the New York Federal Reserve Bank for the past five years, and in that role has had an enormously important role in overseeing the regulation (or lack thereof) of Wall Street and more recently helping manage the $700 billion bailout. He is a protege of leading Clinton economists Larry Summers and Robert Rubin, two fervent Wall Street supporters and advocates of financial deregulation. In light of recent financial market crisis and the unpopular bailout package, perhaps it is worth asking a few questions about Geithner's handling of the $700 billion and how he would have done things differently from Secretary Paulson and the Bush Administration. While they're at it, it would be useful to find out if he has any ideas why our financial markets have crashed so dramatically and what he thinks can be done to prevent this mess from happening again in the future.

Not to say Geithner is necessarily going to continue the trend towards financial market deregulation and allow the kind of extraordinary speculative bubbles we have seen in recent years to persist. But the public deserves to know exactly how he feels about these issues of enormous import. And Senate Republicans as the loyal opposition are in a natural position to launch such an inquiry.

Blagojevich Blagojevich Blagojevich

Remember that scene from Being John Malkovich, where John Malkovich goes into his own portal and everyone looks like him, and all they say is "Malkovich Malkovich Malkovich Malkovich Malkovich"? I can't help but think that's not all that different from recently-arrested Illinois Gov. Rod Blagojevich's regular experience of the world.

Everyone in Illinois already knew that Blago is mind-numbingly corrupt. It's frankly a miracle he was re-elected in 2006, more of a testament to weakness in the IL GOP that his strengths as a politician. His approval rating then was around the low 40s; before he was arrested yesterday it was hovering in the 10-15% range. So it came as a surprise to precisely nobody that Blago had been under investigation by the feds for years now and knew about it, but just seemed to not care and went about his daily routine of being a huge jackass. Earlier this year, the state legislature was talking about impeaching him because on top of everything else he's done, he started doing the Bush signing statement thing and was basically either ignoring the substance of bills or inserting his own major legislation in an "amendatory veto". Like I said, he's a huge jackass.

Anyway, back to my original point. In the process of tracking down state budget cut documentation for work, I often have to visit state websites. I've noticed for some time that virtually every official state press release coming out of Illinois has "Governor Blagojevich" in the title. In light of recent events, I thought it'd be amusing to share a chronological listing of state releases. Mind you, this is not a pick and choose sample, but literally every article during a three-week period in November. And these are not Governor's releases, they are official Illinois news releases.

November 25, 2008
Governor Blagojevich Urges Illinoisans to Volunteer Time and Talents during the Holiday Season

November 25, 2008
Governor Blagojevich Approves Illinois Tollway Congestion Relief Green Lanes Plan

November 24, 2008
Governor and First Lady Blagojevich Launch Keep Our Kids Warm and Safe Campaign to Provide Winter Items for Needy Children

November 24, 2008
Governor Blagojevich’s Mortgage Fraud Task Force Moves to Protect Tenants from Eviction

November 23, 2008
Governor Blagojevich Reminds Illinoisans that Services are Still Available after Successful Workforce Outreach Days

November 23, 2008
Governor Blagojevich Urges Skilled Trades Workers to Apply for Illinois’ Home Weatherization Assistance Program

November 21, 2008
Blagojevich Administration Announces State of Illinois’ November “Veteran of the Month”

November 20, 2008
Governor Blagojevich Commends Illinois Tollway for Adopting $1.8 Billion Tomorrow’s Transportation Today

November 20, 2008
Statement from Governor Rod R. Blagojevich

November 20, 2008
Governor Blagojevich Restores Funding for Substance Abuse Addiction Treatment and other Critical Services

November 19, 2008
Governor Blagojevich to Sign International Declaration to Fight Climate Change

November 18, 2008
Governor Blagojevich to Sign International Agreement to Reduce Greenhouse Gas Emissions from Deforestation

November 18, 2008
Governor Blagojevich Announces Local Governments in Nine Counties Approved for Federal Assistance for September Flooding

November 18, 2008
Governor Blagojevich Announces Plan to Manage Fiscal Year 2009 Budget Deficit

November 17, 2008
Governor Blagojevich Launches Partnership with CareerBuilder.com to Further Assist Illinois Workers

November 17, 2008
Governor Blagojevich Launches Workforce Outreach Days to Connect Illinoisans with Services during Poor Economy

November 17, 2008
Governor Blagojevich Announces Click It or Ticket Enforcement Campaign this Thanksgiving Holiday

November 15, 2008
Governor Blagojevich Encourages Illinois Seniors to Apply for Illinois Cares Rx

November 14, 2008
Governor Blagojevich Proclaims World Diabetes Day in Illinois and Calls for a Stronger Focus on the Growing Diabetes Epidemic among Children

November 14, 2008
Governor Blagojevich Announces Schedule for Illinois Poverty Summit

November 13, 2008
Governor Blagojevich urges people to prepare for dangerous cold temperatures during Winter Storm Preparedness Week

November 13, 2008
Governor Blagojevich Announces Peoria County Approved for Federal Assistance Following September Flooding

November 13, 2008
Governor Blagojevich announces Landmark Lawsuit Settlement Empowering more People with Developmental Disabilities

November 12, 2008
Governor Blagojevich announces John Filan as the New Executive Director of the Illinois Finance Authority

November 12, 2008
Governor Blagojevich Announces Plans for State-of-the-Art Biofuels Production Facility in Northern Illinois

November 10, 2008
Governor Blagojevich to Co-host Governor Schwarzenegger’s Historic Global Climate Summit

November 10, 2008
Blagojevich Administration Offers Financial Assistance to Nurses Working in Veterans’ Homes

November 9, 2008
Governor Blagojevich Announces Nearly $200,000 in Research Grants to Study Alzheimer’s Disease

November 6, 2008
Governor Blagojevich Encourages Those Wanting to Find Birth Parents or Children to Sign Up for the Illinois Adoption Registry during Adoption Awareness Month

November 5, 2008
Governor Blagojevich Congratulates President-elect Obama and Discusses U.S. Senate Seat

November 3, 2008
Governor Blagojevich and Council of Economic Advisors Review Impact of National Slowdown on Illinois

A friendly reminder to the Pentagon...

War is hell.

Some 15,000 soldiers are heading home to this sprawling base after spending more than a year at war in Iraq and Afghanistan, and military health officials are bracing for a surge in brain injuries and psychological problems among those troops.

Facing prospects that one in five of the 101st Airborne Division soldiers will suffer from stress-related disorders, the base has nearly doubled its psychological health staff. Army leaders are hoping to use the base's experiences to assess the long-term impact of repeated deployments.

"I don't know what to expect. I don't think anybody knows," said Gen. Peter Chiarelli, vice chief of staff of the Army, as he flew back to Washington from a recent tour of the base's medical facilities. "That's why I want to see numbers from the 101st's third deployment."

Why is this happening?

Noting that some soldiers in the 101st Airborne units have been to war four or five times, Chiarelli said he is most worried the military will not be able to find enough health care providers to deal effectively with the troops needing assistance.

Many of the military bases are near small or remote communities that do not have access to the number of health professionals who might be needed as a great many soldiers return home.

More than 63,600 active duty Army soldiers have done three or more tours in Iraq or Afghanistan. That is a nearly 12 percent of the total number of soldiers who have deployed at least once. Roughly four in 10 soldiers who have gone to war have served more than one deployment — and that number is growing steadily

Finally, Army leaders are starting to get their heads out of the sand and deal with the horrible psychological and emotional trauma experienced by multiple-tour Iraq vets.

For the first time, Thomas said, every soldier returning home will have an individual meeting with a behavioral health specialist and then go through a second such session 90 days to 120 days later.

The second one is generally the time when indications of stress surface, after the initial euphoria of the homecoming wears off and sleeplessness, nightmares, and other symptoms show up.

"We're seeing a lot of soldiers with stress related issues," he said. "They're not bipolar or schizophrenic. But they're deploying three and four times and the stress is tremendous. They're having relationship issues, financial issues, marital problems — all stress related."

More than 3,000 of the 15,000 troops returning home, Logan estimated, probably will experience headaches, sleep disorders, irritability, memory loss, relationship strains or other symptoms linked to stress disorder.

And as if that wasn't bad enough:

Medical staff at Fort Campbell say they also worry that there will be a new surge of suicides — an escalating problem in recent years, largely related to the stresses of war.

While soldiers have been routinely deploying for 15-month tours, most Marines serve about seven months and airmen deploy for about four months, although some may serve for tours of six months or longer.

Late this past summer, Pentagon leaders ordered a change, saying any soldier who deployed in August or after would serve 12-month tours. Army leaders say they want to reduce that to nine months, but doing so will be difficult considering the strains of fighting two wars at once.

Logan said that some 85 percent of those soldiers with stress disorder symptoms will recover with the help of some treatment or medication. But the other 15 percent will require more intensive help.

Remember back in the runup to the war, when the neocon cheerleaders, toady TV pundits, Pentagon shills and the 101st Division of Fighting Keyboardists were smugly claiming an invasion of Iraq would pay for itself?

In addition to the myriad other reasons that claim was entirely ridiculous on its face, I'd be willing to bet a nickel that not a single one of these warmongers accounted for the potential PTSD-related mental health care as a potential cost.

Lest we take our eye off of Iraq with so much else going on, I feel it is necessary to ask the Pentagon to please take care of our troops, and not force them into repeated deployment until the point of mental breakdown. If we can't find new men and women willing to fight, it's time to end this war.

Fixing Health Care: Expanding Coverage or Controlling Costs?

I must admit I'm not an expert of any sort in the health care field. But I saw a very interesting panel discussion on Thursday at a work conference, about the challenges and expected priorities of the early Obama Administration, and one panelist named Chris Jennings talked in depth about what meaningful health care reform would look like. Apparently Mr. Jennings has been at the center of the national health care debate for a couple decades now and was a prime architect of the 1993 Clinton plan, so it can be assumed he is well attuned to the political realities of the situation and the potential pitfalls to avoid. His thoughts piqued my interest, so I figured I would share them here.

Here's the crux of his argument:

Health care reform is crucial to rebuilding the economy; without it America is operating at a major disadvantage in the global economy. The guaranteed free health care other countries provide is money employers in those countries don't have to pay for their workers.

The health care crisis has two major components: the massive amounts of uninsured and underinsured individuals unable to get quality care, and the pervasive skyrocketing costs.

Liberals usually focus exclusively on providing universal care while conservatives focus primarily on driving down costs. But it is nearly impossible to fix one problem without making significant headway on the other.

In other words, if we expand coverage to everyone without some mechanism to rein in the exploding cost of adequate care, American health care will face overwhelming financial strain and the system will implode before too long. Likewise, lowering overall costs through "market reforms" while millions of people remain uninsured will result in a massive reverse adverse selection problem - those that really do need quality coverage will be those least able to get it. This structure is also unsustainable in the medium-long run.

Makes sense intuitively. I've always figured an intrinsic advantage of government-provided health care is a much lower overhead cost. Insurance companies now spend something like 30% of their budgets on administrative and marketing costs, around half of that with bureaucratic mazes designed to keep people from getting care the company doesn't want to pay for and the other half telling you to ask your doctor rather suggestively about the LATEST COOL NEW DRUG!!!. Meanwhile, the overhead of Medicare is something like 3%. Between that and the promising potential of negotiating with Big Pharma for lower drug prices, It seems pretty obvious to me which is more economically efficient. Why would we not want a single-payer system based on that?

So.....does anyone who knows more than myself about health care policy want to react to this?

President Obama's Inheritance

No doubt, it feels good to be a progressive these days. Democrats have more control of the federal government than any time since just after the 1964 landslide elections. That was immediately followed by the enactment of Medicare and other key social safety net programs, so it is no surprise that many left-leaning advocates and engaged citizens are expecting big things from the upcoming Obama Administration.

Call me a downer if you want, but I'm not quite so thrilled about the prospects for immediate major advances. I'm certainly feeling an awful lot better walking by the White House these days, but that said, we are about to witness our nation's first black president attempt to maneuver an agenda through perhaps the most dire state of affairs this nation has seen since at least the Great Depression era. The global climate crisis, daunting economic inequality, the Iraq debacle and the threat of Islamic fundamentalism, unsustainable energy consumption, a health care system in absolute shambles. Oh yeah, and there's that whole financial/economic meltdown thing. And that doesn't even bother with a whole host of other important issues that aren't quite as imminently crucial.

We know one thing: governing with be anything but a cakewalk, even with significant Democratic majorities in congress. The constraints on enacting common-sense progressive legislation extend way beyond the impressive ability of Republicans to obstruct. We are plagued by a wide variety of obstacles of all shapes and sizes: a trillion-dollar structural budget deficit ("structural" means it won't go away on its own when the economy gets better), factionalism within the Democratic caucus, loss of credibility around the world, and a continued public aversion to large tax increases. And it's not like most people are aware of these formidable constraints; after all, didn't you hear about Lindsay Lohan's latest drunken escapade?

Really, I'm not trying to be a downer. I just think it's of the utmost importance that highly educated folks like us are realistic in our expectations for the President-elect's job performance. It will take a heroic effort on Mr. Obama's part to:

1. get the economy back on track and create quality jobs,
   
2. shepherd a meaningful climate change initiative through Congress,
   
3. shepherd meaningful health care reform, hopefully providing universal coverage, through Congress,
   
4. get us out of Iraq and restore our standing in the world,
   
5. squash the danger posed by Islamic terrorists and al-Qaeda,
   
6. and get the budget under control.

I'm not sure any president has ever accomplished this much in one term. From everything I've heard in people's expectations, both implicitly and explicitly, Obama will need to accomplish most or maybe even all of these things to be considered a successful president and be re-elected in 2012.

Good luck, Mr. President-elect. You'll need it.

The price of GM's continued existence

I was about to write a spirited rant about the blatant folly of bailing out disgustingly retrograde American car companies, but Lisa beat me to the punch. If you really want to know my thoughts on this, you can find them in a comment on Lisa's post.

But I do want to add one key point. If GM continues to exist and generally suck at making cars, it limits the abilities of more innovative startup companies to grow and gain market share. Companies making cars like the Aptera.


This beauty is actually ready for production, but auto industry regulations essentially written by GM lobbyists are making the producers jump through hoops just to get it on the road. Why does our government hate the car of the future?

Don't Bail Out Detroit!

For those who think American politics will be all rainbows and unicorns after Bush leaves, President-elect Barack Obama just sent a reminder that the Democrats have ridiculous constituencies to please, too. Although Congress passed $25 billion in favorable loans to Detroit's Big Three auto manufacturers in September, they're already begging for more. Today, Obama asked Bush to sign another $25 billion in loans before he leaves office.

Although some argue that these loans can give Ford, GM, and Chrysler capital needed to create cleaner cars, the question is why Honda, Toyota, and upstarts like Tesla Motors don't need similar favors. If we agree to live in a capitalist system, we have to agree to let failing companies fail. Period.

Note to the Democrats: If you are looking for a good policy that might save Detroit, think about fixing the health care system. Part of the problem is that the Big Three pay thousands more per car in health care and retirement costs than foreign companies. Then everybody wins.

Salutations - and elections recap/open thread

Hi fellow Hippos! I will be posting here quite a bit over the course of the year, so I thought I'd introduce myself. I go by "optimo" in blog land, but elsewhere you can call me Jeremy. I'm a first year MPP student and an Associate Editor for this year's Policy Perspectives.

So I am hoping we can rev up some lively discussion over here the course of the year and beyond. This is such an exciting time to be in Washington, having lived through an election that deserves a full chapter in the American history books and is yet to be fully completed.

There will be much time to talk about 2009 and the coming Obama presidency, but it feels right to start off with a recap of the election.

Obviously we know Obama won, and decisively so. He definitely has amassed 364 EVs and still could end up with 376 (Missouri and the single Omaha district remain too close to call). He outperformed John Kerry in just about every demographic group you can imagine. Check out the details, they're pretty striking. Obama won the 18-29 age group by an astounding 2-to-1 margin. Regionally, major gains were made in the coastal South, upper Midwest, Northeast and non-Mormon areas of the Mountain West. It's hard to see these gains fading away anytime soon if Democrats manage to deliver on at least some of their promises over the next few years.

In Congress, Republicans actually did a little better than expected. Although a few races in both chambers are still yet to be decided, they lost ground but managed to avoid a major landslide. As of now, the count stands at 22 seats flipping from R to D, 4 '06 D pickups flipping back to R, and eight still yet to be decided. If the eight remaining seats split 4-4, the final count will be 258-177.

The Senate saw at least six Democratic pickups in a very tough year for Republicans, while 3 races involving R incumbents remain too close to call. AK is waiting for all mail-in ballots to be counted, MN will go to a recount, and GA will go to a runoff election. If the D challenger wins in all three (which is very unlikely), then Democrats reach that supposedly magical 60 mark. Georgia would really be a shocker, and both sides will be throwing a ton of resources into the special December 2nd runoff election. My best guess for the final tally is 57-43: Franken wins in Minnesota and Lieberman bolts to the GOP. Again, both houses see non-negligible Dem majorities, but not large enough for the center-left governing coalition within the party to easily get legislation through.

The state level elections produced few surprises and was much more even. Democrats picked up the Missouri governorship which will impact policy there, but all other governor races stayed the same. Democrats picked up 5 state legislative chambers, including the NY Senate (as expected) for the first time in over a century, and Republicans surprisingly picked up both chambers in Tennessee along with 2 other bodies. New Hampshire now has the first majority-female legislative body in the country's history. Ballot initiatives were a very mixed bag. I won't bother with the details, but some nonpartisan review can be found here.

So, let's discuss. What specific thing are you most excited or upset about regarding the 2008 election results?

Green Culture Shock

After getting back to the States from almost eight months in Europe, I've experienced less culture shock that I expected, but it all tends to fit into a green theme. I miss, for example, not having to bring a sweatshirt and a blanket to movie theaters and classrooms, which are A/Ced down to the mid-60s here. I miss toilets with a splash of water in the bowl, rather than a family's daily water intake. I miss escalators that don't start until you get on them.

But most of all, I miss recycling. I miss being able to recycle almost EVERYTHING, and being able to buy everything recycled. (The "sustainable" notebooks in the GW Bookstore, for example, are a paltry 30% post-consumer.) I'm sure this isn't a typical feeling, but I've been watching my carbon footprint balloon over the past two weeks and felt so helpless to stop it.

Can someone point out where we're greener than Europe? Maybe that would help reduce my culture shock.

The Upside of Tax Opacity

Ok, so y'all have done your taxes, and you're probably thinking that perhaps an anarchist system wouldn't be so bad after all. Much of that has to do with the fact that you gotta pay money that you thought was yours, but it's also the fact that taxes are really complicated, and therefore doing taxes is a horrible experience.

Everyone rightly laments the complications in the tax code, but it's worth it to point out that there is a nice silver lining. Basically, a progressive tax system in theory creates distortions in the labor supply by creating a disincentive to work (although the magnitude of this effect is HOTLY disputed). But incentives and disincentives only cause behavior changes if individuals know about them. In this case, the worker needs to know how many cents on the next dollar they make will be taken. Deductions, credits, and anything else that contribute to a more opaque tax system prevents workers from discerning their marginal tax rate, and thus make it more difficult to decide how they should change their behavior in response to the tax. Most likely, cognitive limitations are, to a certain extent, currently causing people to ignore the disincentive to work, thus avoiding the distortionary effect of the tax. Conversely, making the tax system more transparent might then create more distortionary effects of the tax.

Just something to think about.

National Geographic Event "Human Footprint"-- RSVP today!

Sorry this is kinda last minute (RSVP due TODAY), but it looks like it should be a great event on preserving our planet (click on image to enlarge):

DNC

The question was never about authority. I argue:

My underlying point was about DNC threat credibility. The four states didn't break the rules, so therefore their intransigence does not threaten the DNC's credibility. Sure, you may argue that it's unfair, and that, as you say, "we might have to change the system" and mention the 4 region idea. Great idea. But who enforces it? If one state pulls a short straw and is scheduled to go in May, what entity will prevent them from moving their election up? Basically, any solution requires that the DNC enforce the rules of the solution, and enforcement requires punishment.

You can basically come down on one of two sides in this: either the DNC should have the power to issue credible threats (by having the power to enforce the rules if necessary), or they shouldn't.

If you argue that the DNC should not have the power to issue a credible threat to states, how can we possibly prevent the frontloading chaos in the next election?

Clinton campaign views on superdelegates

I can't believe I almost forgot this.

[Harold Ickes, Clinton campaign spokesman) confirmed that the Hillary campaign could still try to woo super-dels even if she lost the popular vote, with Michigan and Florida counted.

So let me get this straight: it's OK to get superdelegates to overrule the pledged delegates because she might still win the popular vote at the end of the day, but even if she doesn't, it's still OK to get superdelegates to overrule the pledged delegates. So why are we even arguing about pledged delegate vs. popular vote? Even the Clinton campaign now says that it doesn't matter.

Let's rehash, because this is totally underreported: Clinton is now saying that even if every single metric imaginable says that the primary voters prefer Obama to her, she will still attempt to get the party establishment to overturn those results. WOW.

Primaries cont.

OK, I think we've talked the "who is accountable for FL/MI's actions" thing to death. Just a few parting responses.

You're right, they didn't do their best to express their opinions. If they had, they would have sent letters, made phone calls, and otherwise harassed their elected leaders demanding why they would risk having their votes not count. And you're right, it's possible that it's because they didn't realize what was going on, which I would argue is the most generous interpretation of the situation. But so what? Who's fault was it that they didn't know what was going on? We have internet news sites that track the actions of your representatives down to the hour. We have newspapers that were reporting on it for months. Hell, I remember when Florida and Michigan were threatening to move their election up, and I don't even live there. Ignorance is an explanation but it doesn't excuse responsibility, and it's obvious that in this case the voters of those two states did not do their due diligence, only bothering to pay attention after it was too late.

That's also the most generous interpretation. I tend to think that they (policymakers and citizens included) did know would could happen and just decided to take the risk because they didn't think that the DNC had the balls to enforce the decision. But I also have an irrational dislike for Florida, so maybe my personal biases are intruding (Michigan's cool though).

But let's remember something: both the DNC and MI/FL could get their votes to count. MI/FL could just do a revote. They chose not to. Why is the Clinton campaign not blasting MI/FL for not ensuring that their citizens' votes would count? Because they never wanted a revote in the first place (see here and here for evidence). It's obvious why: they'd rather have this issue as a political football than actually get a real election in those two states, and it's a helluva lot easier to bash the national party (the Clinton wing of the party never liked Dean anyway) than it is to bash the very state policymakers that are your biggest supporters in MI/FL. It's sad that her campaign is playing politics with civil rights issues because it dilutes the validity of all legitimate claims of voter disenfranchisement, of which there still are plenty.

OK, done. Next topic, primary calendars.

We have a problem with the primary calendar. State faces a prisoner dilemma, when deciding to schedule their primary: they have an incentive to move their state up (defection), but that hurts everyone else. Because each state's dominant strategy is to move their state up, in the end they will all arrive at a suboptimal outcome, which is the following: campaigns will start years and years before the actual voting starts. Presidential candidates will declare for 2012 two years earlier, in 2010. Presidential and midterm campaigns will start to overlap. The perpetual campaign will be the multilayered perpetual campaign, with campaigns running for 2010 and 2012 at the same time. Time spent campaigning displaces time spent governing, and as a result the quality of policy will decrease.

The solution to a prisoner's dilemma is to create an independent entity that can rearrange the payoffs by punishing defection, thus making it more sense for states to follow the rules than defect and move their states up. That's what the DNC tried to do, and it was successful for 48 states (actually 44, because IA, NV, NH, and SC got what they wanted). But Michigan and Florida pushed their elections forward, and actually laughed in the face of the DNC while doing it. No, literally. Watch the video for yourself.

A teacher friend of mine once told me that when you get a new class, you have about a week to succeed in bringing order, which you do by establishing yourself as someone who lays out the rules and then enforces them. Of course, there are always a couple students who want to test out the rules and see if the teacher will actually follow through on the threats. If the teacher does not enforce the rules for those students, he or she will have lost the class for the rest of the year. It is that critical.

The DNC's power to solve the frontloading problem rests on the credibility of its threats. Like the rest of the class who watches to see how the teacher handles the unruly students, all the other states are watching to see if the DNC will enforce its rules. If it does not, it will be lord of the flies chaos, with each state trying to leapfrog all the others, and the DNC sitting on the sidelines, its credibility demolished, impotent to create order.

In this situation, we the voters, all the voters, suffer. My question is this: how would you solve this problem? If you argue that the DNC should not have the power to issue a credible threat to states, how can we possibly prevent the frontloading chaos in the next election?

Primary Pathos... just about done

1) I respond to this point in the most creative way possible: by using a Public Enemy song AND a Spiderman quote. Think it can't be done? Watch this:

If: power to the people
And: with great power comes great responsibility
Then: the people have responsibility

Ok, I'll add one thing. Yes, you personally may not be responsible for a decision that your representative might make, because hell, you're just one person, and while that letter you wrote might be strongly worded, it probably won't make it past the representative's Legislative Correspondent. But I still maintain that the people in aggregate assume responsibility for the actions of the politicians. In fact, not holding them responsible would seem weird. Do you really believe that Americans hold no responsibility for anything that our government does? Vietnam wasn't our fault, it was the Johnson's fault. The Iraq war wasn't our fault, it was Bush's fault. Tax cuts for the rich wasn't our fault, it was the GOP Congress's fault. Nothing is our fault!

Personally, I find that buck-passing to be disturbing. We the people, through the democratic mechanism of voting, have the power to make sure that our representatives actually represent us. If we fail in adequately exercising that power, we have no one to blame but ourselves.

2) Ok, that's just glib. I said "Wikipedia, et al", meaning that if I really wanted to look, I'm sure I could find a source or two that says that America practices a form of democracy. I mean, do you really doubt that we live in a democracy? If so, then join company with about a handful of political philosophy professors, but the rest of us are gonna go on living in what we call a democracy. Seriously, pointing out that we don't actually live in a democracy is like correcting someone when they incorrectly use the term "centrifugal force" - even if the correction is true, what's the point?

3) That is true, caucuses are confusing and overwhelming to a lot of people. I should know, I attended one in Iowa this year. But I also found that people tend to be much more informed. Part of that may be a selection bias; that is, caucuses attract only the most well-informed and engaged voters. But I think there's a reverse causation as well: caucuses make voters more informed than they otherwise would be. First off, unlike a primary, a caucus is a communal event, which of course comes with its own share of community pressures. Voters feel a need to be more informed because they will be expressing their political views in front of their neighbors, and so they want to be able to back them up. Second, the caucus isn't just where people vote - actual voter education goes on there as well. Neighbors talking to neighbors about who's better on the environment, who voted for the Iraq War, etc. And after the vote, members of the community were elected to act as delegates in the county convention. You don't get that kind of political participation in a primary.

I'm not saying that caucuses are better than primaries. But what they lose on turnout, I think they gain by bringing citizens to a higher level of political participation. Furthermore, I don't think that we should be answering these normative questions for the rest of the country. Both voting system has its benefits and drawbacks, and it's up to the states to decide which trade-offs they want to make.

You also said that we can't change the rules now. But using the popular vote as a measure would do just that! It is an unfair measure that is biased towards certain states and away from others. How can you say that we can't change the rules now, but then in the next sentence argue that we should use the popular vote to judge the winner of the primary?

By the way, I hope you're enjoying this as much as I am. Why no one else is chomping at the bit to jump into our little debate is beyond me.

Washington DC is a Baseball Town

Baseball has found a new home in Washington, DC, and it's 15 minutes from my apartment (by bike).

Tonight, the Washington Nationals kicked off their season against the Atlanta Braves winning 3-2 in the bottom of the 9th. Ryan Zimmerman won they game by hitting a solo home run over center field. Here's what the Post says:

Nationals Park had quite an opening. Ryan Zimmerman hit a tiebreaking homer off Peter Moylan with two outs in the ninth inning, and the Washington Nationals beat the Atlanta Braves 3-2 Sunday night in the first regular-season game at the $611 million stadium.

The brand spanking new stadium (that was built on schedule and within budget!) has a great view of the U.S. Capitol building. There were also the requisite fireworks, red carpet, U.S. President, and general hooplah. It was great. I highly recommend the kosher hot dogs.... very tasty.

Random question: Does anyone out there know why in the 9th inning people were turning their baseball hats inside out?

In Praise of the FDR Memorial

Given that it's cherry blossom season, more people than usual are probably milling around the FDR Memorial. It's by far my favorite monument/memorial. I have lots of good memories, from turning 18 (yes, that's where I was when the clock struck 12!) to sweet romantic dates to DC tours for friends and family. So I thought I'd note my 3 favorite FDR quotes from the memorial:

1) I have seen war. I have seen war on land and sea. I have seen blood running from the wounded...I have seen the dead in the mud. I have seen cities destroyed...I have seen children starving. I have seen the agony of mothers and wives. I hate war.

2) In these days of difficulty, we Americans everywhere must and shall choose the path of social justice...the path of faith, the path of hope, and the path of love toward our fellow man.

3) Freedom of speech
Freedom of worship
Freedom from want
Freedom from fear

Slow Start to the Season for the Policy Punishers

The Policy Punishers lost 0-5 today to a bunch of younger, faster, and fitter undergrads called the "The Sloths". Clearly misnomered, the Sloths were very not sloth-like. Two goals were scored against Eva and Matt in the first half. Three goals were scored against Eva in the second half.

Despite having more than 10 people registered for the team, only five people showed up forcing Kyle to recruit a good-natured freshman from a nearby treadmill. She was a really good sport and played excellent defense and offense for all 40 minutes. Thanks to Kyle's skillful recruiting, the Policy Punishers only had to play down for the first couple of minutes of the first half.

The final score doesn't reflect some of the outstanding efforts by the Policy Punishers. Steve used his excellent ball control skills to weave in and out of the Sloths leaving them paralyzed and helpless. Kyle showed that not all midwesterners are nice and played very aggressively. He even got called for roughing up his opponent. Matt had several fantastic shots on goal. And last but not least Tom ran himself ragged. He left the court promising that next time we are going to score.

I didn't do much on the field, but managed to talk quite a bit. It's an old habit from outdoor soccer where at least no one can hear you....

The Policy Punishers are the TSPPPA's four on four intramural soccer team. Games are 40 minutes long with a 5 minute half. The usual indoor soccer rules apply: keep the ball below the windows; goalies can use their hands inside the key; and, two women from each team must be on the court at all times.

Next game is Sunday April 6 @ 2:30.

Primary Pathos Plethora

C'mon, democracy, democratic republic? You might have been correct 230 years ago to draw a contrast between the two (Madison makes the distinction in Federalist #10), but nowdays the term democracy has been broadened to include more than just direct democracy, but also democratic republic (see Wikipedia, et al). The contemporary use is that democracy is the overall system of government, while democratic republic is the form of government (the other major form of democracy being direct democracy).

But who cares? The terminology is totally irrelevant to the topic at hand, because even if we didn't live in a democracy, we do subscribe to its democratic ideals. Are you really going to disagree that a fundamental principle of our system of government is the use of elections as a means of the people to keep the representatives accountable for their actions?

You also mention that party representatives aren't that accountable because most people don't pay attention to them... but they don't set elections - rather, it was the FL and MI legislatures who decided to break the rules and push the elections up early. So I guess I don't really understand your point there.

On your sidenoted question of delegate seating, it is actually not Dean nor the state reps who decide whether or not to seat FL and MI, it actually is Obama. DNC bylaws state that the DNC Rules Committee determines who is and is not eligible to be seated, and the rules committee is made up of a proportionate amount of representatives from each campaign. So if Obama has a majority of delegates, he will thus have a majority on the Rules Committee, and he can then decide whether or not to seat them. In this circumstance, Dean and the reps really don't have much of a say in the matter.

Ahh, the popular vote argument. It's enticing, but it's totally fallacious. Here's why: would you argue that the Redskins are a better team than the Nationals because they score more points per game? Of course not. They're two different games, and in football you always score more points. Likewise with primaries and caucuses: turnout is always higher in a primary than a caucus, so therefore the same percentage point margin of victory will thus translate into a higher popular vote margin for primaries than caucuses. This means that using the popular vote measure essentially favors primaries over caucuses, or rather favors the candidate that does better in primaries than caucuses. Is this fair? Hell no. Let's use an example. Both Minnesota and Missouri were given 88 delegates (72 pledged and 16 super). This year, 214,000 people turned out in the MN caucuses, which was nearly three times more than had ever turned out in the history of Minnesota's caucuses. But, because Missouri uses a primary instead of a caucus, they had 827,000 voters show up to vote. So while the current system in place gives MN and MO equal weight, using the popular vote measure would make MO count four times as much as MN. That would be like, the day after the general election, "Oh I'm sorry New York, but you didn't have quite the turnout that we thought you would have, so we're gonna give you ten less electoral votes to hand out to your favored candidate. Oh my, Georgia, what a turnout you had... we'll give you those ten electoral votes that New York no longer deserves. Well it looks like that changes who becomes president. Sorry Hillary/Obama, now McCain wins."

I'm sorry, but tying the state's electoral weight to its electoral method is just crazy, and doing it after a state has already voted is just wrong.

Three other problems: first, how would you count the caucus states that did not tally their popular vote? Not count them? Second, what about Texas? They had a primary and a caucus. You can't just count the primary and not the caucus, but you can't count both of them because then you're counting voters twice, which is unfair to every other state that had the lack of foresight to let voters vote twice. Third, what about open/closed primaries. More people vote in open primaries, but do we really want to favor them over closed primaries?

If only there was a way to take all of these different contests and give them a common denominator by which we can fairly compare the contests in equal terms. Wait! There is such a system, and luckily it's already in place. It's called the delegate system, and it's been the name of the game for the past four months now. If we want to change it, do it for 2012, but let's finish this election first. With delegates, just like it was supposed to be.

DC is the city of races... foot races that is

I'm glad to know I wasn't the only one up early this morning. Not that I came anywhere close to 4am. I was up at a much more reasonable hour this morning to cheer on my friend who was participating the National Marathon.

Lucky for me, cheering her on meant rolling out of bed and crossing the street.
The National Marathon course loops in and around Capitol Hill (also known for its politicians and green market). Here's a map (courtesy of the Washington Post):



If marathoning is your sport, you should start planning now to participate in the Marine Corps Marathon that happens in the fall. It's insanely popular. Or if you like shorter races, other events are the Cherry Blossom 10 Miler and the Army 10 Miler. For more information, the Washington Running Report has a good calendar.

Re: Primary Pathos

First off: yes, I am posting at 6am on a Saturday morning, and no, that does not make me a blogger extraordinaire. I had to drive a friend to the airport at 4am, and when I got back I decided to check Policy Hippo instead of going back to sleep. Now, I do plan on going back to sleep at some point this morning. But now is not the time for sleep. Now is the time... to blog.

My disagreement is twofold. First, I disagree that we can completely separate the citizens from the politicians who voted to move the primary. The fundamental principle of democracy is that politicians are held accountable to the citizens for the decisions that make. But that accountability goes both ways - the citizens are thus accountable for the decisions that their elected representatives make. If the representatives are not making good decisions, it's because the citizens aren't doing their job of keeping their representatives in check. Ultimately, good policy and good government arises from an informed and engaged electorate, a fact for which no amount of wonky GAO reports or management reform or multi-year budgeting can compensate. If the voters in FL and MI are complaining that their elected representatives aren't adequately representing their will, they have no one to blame but themselves.

My guess, however, is that the voters supported the early elections, even if it meant breaking the rules. It's a bit like us in 2008 blaming the invasion of Iraq on Bush. Sure, he pulled the trigger so to speak, but we let it happen. We supported it at the time, and hell, even if we didn't, the fact is is that we reelected the guy.

When I traveled around Europe, I, like many other American tourists, was given a hard time and often hassled about our inane and short-sighted foreign policy. Of course, I would tell my critic that it wasn't me, that I voted for Gore and Kerry, and that I campaigned against Bush in both elections. But that usually wasn't enough to get me off the hook, nor should it be. As an American, I bear responsibility for the actions and policies of my elected representatives. That is a fundamental principle of democracy, and, with all of FL and MI's blather about voting and representation, perhaps they should have cared as much about their role as citizens and voters when they put those policymakers in office. Remember: a democracy, if you can keep it.

My second point of disagreement was the main subject of my previous posts: that the voters were represented, and did have a say, because they altered the narrative, and thus the dynamic of the race.

Last point: the delegate race is not close, even if you include FL (I don't see how you could include MI given that Obama wasn't even on the ballot, and if they had a do-over he'd most likely win it anyway). Lemme give you an example of just how hard it would be for Hillary to pull ahead. Currently, Obama has about 170 more pledged delegates than Hillary. You count FL, and that deficit decreases to 130. At first blush, doesn't seem insurmountable at all. But consider the fact that Hillary's March 4th "blowout" netted her a grand total of... about five delegates. Obama then went on to net two delegates in WY and five in MS.

Now, Hillary is betting all her chips on PA, but not because it could save her, because nothing really can. After all, a 60% win in PA only nets her about 32 delegates, which still leaves her about 100 short of Obama. The reason she's putting it all on PA is that she's gotta move her chips in somewhere, and all the other states look even worse for her. North Carolina (115), the biggest state after PA (158), will probably go for Obama, as well as Oregon (52). But in order for her to catch up to him in pledged delegates, she's gotta run the board with 55-60% wins in all the remaining states, including NC and OR. That would be hard for any campaign, Obama's included, but let's also keep in mind that Hillary has only exceeded the 20 point margin twice: Arkansas and Oklahoma. Hell, she didn't even get 60% of the vote in New York!

Basically, if we start from the premise that the leader of the pledged delegate count should win, then, barring Obama being caught with a dead girl or live boy, there is no way that she can win. Even if FL is included. Hell, give her the 18 delegate margin in MI too. Doesn't matter.

This thing's over.

So now what happens? Well, Obama will be the nominee, and he'll then seat the FL and MI delegations because they no longer matter. Seriously, this whole FL and MI is a moot point, only brought up by the Hillary campaign because it creates the impression that it might actually matter. And if something that matters isn't resolved yet, then the race can't be over, can it?

See how well that works?

More on voter disenfranchisement

I know that I already commented on Lisa's post on FL and MI, but, I honestly can't help myself.
The argument is that FL and MI are disenfranchised because they won't be seated (not yet a foregone conclusion, by the way). As I stated in my previous post, they most likely did have an effect on the momentum of the campaign, which is usually a bigger aspect of the primary than delegate awarding.
But lets turn the tables around. In the '04 primary, CA voted on March 2nd. By that time, Kerry had won 18/20 primaries and was the de facto nominee. So did CA have an opportunity to make an impact on the election? Hell no they didn't. Neither did NJ, which voted June 8th, after every other state voted. In fact, really only the first 10 states mattered in the '04 primary - all subsequent states just ratified their decision, which was Kerry. Personally, I'd say that those 40 other states were more disenfranchised than FL and MI.

In Defense of American Democracy

My view of American democracy tends to be a little more favorable than Lisa's. Instead of going out on a full-throated rant on why our democracy kicks ass (checks and balances, baby!), I'd like to point to a few things in her post on which we part ways.

DC Representation
Contrary to popular belief, DC does have represenation in congress: her name is Eleanor Holmes-Norton, and she's a delegate. It's the same representation that Puerto Rico, the Virgin Islands, American Samoa, and Guam have. Is it full represenation? No. Norton cannot vote on the House floor.
I contend, however, that that does not matter. Why? Well, the House of Representatives has three power concentrations: the leadership, the committees, and the caucuses (Black, Hispanic, Republican Study Committee, Progressive, etc). Unlike the Senate, individual members can really only exert power over the legislative process through one of these institutions. And these are institutions to which she has full access. She can vote in committee, she is an influential member of the Black Caucus, and she has some good committee assignments: Homeland, Gov Reform, and Transportation and Infrastruction (the only committee which actually has more spending power as an authorizing committee than its coordinated appropriations subcommittee)
Furthermore, lets keep in mind that oftentimes what looks like full House consideration is really Committee on the Whole... where, of course, Norton has full voting rights.
In the House, the power to vote on the floor really isn't any power at all. Power is centralized in the House, and if you're just a lonely representative on the floor, you ain't got it.
Does that mean that Norton shouldn't get full voting rights? No, of course she should. It won't do much, if anything, for DC, but it's symbolic, and that really does mean something.
Nevertheless, DC does Congressional representation, and nearly at the level of every other state in the nation... at least in the House. The Senate is another matter.

"Broken" Delegate System?
Is the delegate system broken? Well, it depends on whether we define "broken" based on processes or outcomes. The process, certainly, isn't broken: the rules were set by the DNC and voted on by the states, and then Michigan and Florida's elected representatives decided to move their elections, thus breaking the rules, and knowing that their delegates would be stripped. Why would they do this? Well, keep in mind that there are two factors that determine who the nominee will be: delegates and momentum. Historically, the latter is more important - Kerry, for example, cleaned up the nomination well before he had reached the magic delegate number because he had the momentum. In fact, delegates haven't really played a major role in a primary since '72. See those "delegate counters" on all those news shows? Yeah, they're new. Networks didn't even really know how the delegate selection process worked until about three months ago.
MI and FL bet on the fact that this election would be no different from past elections: that the early states determined who got the momentum, and that by the time the later states voted, a candidate (hopefully propelled by MI and/or FL victories) would have broken away from the pack. Keep in mind that momentum is a media creation, so as long as the media pays attention to the MI and FL elections, it really didn't matter that their delegates wouldn't be seated. Once the candidate broke away from the pack, they'd seat the delegates anyway.
The bottom line is that the rules were fair. In fact, FL and MI must have thought that the rules were fair - why else would they have voted for them? Unfortunately, once the rules were in place, both states decided to break the rules in order to maximize your momentum-giving power at the cost of your delegate-giving power. This was a rational decision made by elected representatives of the voters. Doesn't sound like a broken system to me.
So what would be a broken process? Well, if the rules weren't enforced halfway through the primary election, or if the rules were changed to coddle two rouge states that decided to risk it all to have a bigger seat at the table. That'd certainly qualify it as a broken system.
Now, what if, by "broken", we are referring to the outcome rather than the process? Sure, it makes sense that if the outcome is that the voters are disenfranchised, then the system could be called broken. But were they? Is it true that the voters of MI and FL have had "no say" over who the nominee is? No. True, this race has been more about delegates than momentum, but that doesn't mean that momentum hasn't mattered. Ultimately, the media did pay attention to FL and MI, and Clinton's victories there undoubtedly gave her a momentum boost. Florida, in particular, mattered. For one, all the names were on the ballot, which at least made it appear to be a real election. Furthermore, it came between Obama's overwhelming (and demographic-shattering) victory in South Carolina and Super Duper Tuesday. It is entirely plausible that Florida's election blunted Obama's momentum coming out of SC and allowed Hillary to win the big states on Super Duper Tuesday, thus keeping her in the game.

Ok, I'm done. Sorry for picking on you Lisa, it's just that your post was at the top of the page, and, well, I'm too lazy to scroll down and see what others have written.

introductions!

Hi everyone! I'm ejew. Longtime reader, first time writer. Apparently, The Hippo can be bribed in exchange for blogging privileges.

Also, I apologize in advance for perhaps being a little, well, confrontational. It's what I do. And without further ado, I must go comment on Lisa's post.

Glad to be here.

Democracy in the U.S.

Last week I was in a seminar at the Friedrich-Ebert-Stiftung, a German think-tank closely allied with the Social Democratic party. The discussion leader, to break the ice, asked all 23 of us to introduce ourselves, say what country we're from, and rate democracy in our country and Germany on a scale of 1 to 10, 1 being perfect democracy and 10 being no democracy. What an eye-opening exercise.

The others in my group come primarily from Southern and Eastern Europe (Poland, Slovakia, Belarus, Macedonia, Kosovo, the Czech Republic, Ukraine, Hungary, Russia, etc.). For many, democracy is a relatively new development, and their annoyance with corruption and incompetence is tempered by excitement that things are moving in the right direction. It made me more bitter and angry at the failures of the U.S. system, which should serve as a model.

I mentioned only three failures:

1. The Electoral College, which gave Bush the presidency despite his popular-vote loss in 2000. (Of course, corruption, incompetence, and the Supreme Court added to the shame.)
2. My D.C. residence means I have no vote in Congress. No voting representative or senator. And this in the capital of the free world.
3. The current delegate system, crucial in such a close race for Democratic candidate this year, is broken, giving no say to the voters of Florida and Michigan, delegates not based on popular vote, and super-delegates completely without accountability.

I could've gone on, but my German isn't good enough to convey Jack Abramoff, gerrymandering, and the complacency of incumbents. At any rate, I think that we're not going to get the policies we want if we can't elect the politicians of our choice. Sorry to sound so snipy on Easter, but we've got a long way to go.

I gave the U.S. a 4. What do you give it?

War protesters and supporters descend on DC

The Washington Post reports that Iraq and Afghanistan war supporters and protesters are hosting a series of events in DC this weekend.

Groups supporting the conflicts in Iraq and Afghanistan, including Move America Forward, a Gathering of Eagles, and Free Republic, plan a rally at 11 a.m. today at the Washington Monument, followed by a 1 p.m. march along Constitution
Avenue.

Antiwar groups plan an extensive series of events, including marches, protests and blockades, across the city Wednesday to mark the fifth anniversary of the start of the war in Iraq.

The protesters, headed by the umbrella group United For Peace and Justice, plan, among other things, a morning demonstration at the Internal Revenue Service at 12th Street and Constitution Avenue NW, disruptions along K Street NW and a 10 a.m. march on the Mall.

They plan roving activities throughout the day, as well as a procession from Arlington Cemetery to Washington, and demonstrations at the White House and the Department of Veterans Affairs.

Dueling demonstrations are pretty common around here, but one thing strikes me as a bit different. Anyone know why the peaceniks will be demonstrating at the IRS?

The Post also has an interesting article on an event where war veterans shared their experiences. Here's the link: http://www.washingtonpost.com/wp-dyn/content/article/2008/03/14/AR2008031403887.html?nav=hcmodule. To see a live webcast of the Iraq War Veterans Against the War event go to: http://ivaw.org/ws_live.html.

Panel Series on Women's Studies & Policy Topics

The public policy and women's studies program, in association with the WSTU Graduate Student Association, has put together a panel series discussing contemporary policy problems involving or affecting women. On April 2, the panel will target international policy and related women's issues, and will include speakers Elizabeth Abi-Mershed and Mercedes Kremenetzky from the Organization of American States.

The Organization of American States (OAS) promotes collaboration among member nations within the Western Hemisphere to strengthen cooperation on democratic values and to define and defend common interests by debating major issues of concern to the region and the global community as a whole. The OAS lists its key concerns as strengthening democracy, promoting human rights, and confronting poverty, terrorism, illegal drugs, and corruption. Made up of 35 member states, the organization seeks to defend mandates established by the body and carry them out at the Summits of the Americas.

Elizabeth Abi-Mershed and Mercedes Kremenetzky will speak about their experience at OAS and will discuss particularly how the issues they confront in their work affect women. The April 2 event will take place at 7:15 p.m in Room 211, 1957 E Street.

Log onto http://www.oas.org/ for more information about the organization, and http://www.summit-americas.org/ for information concerning the Summits of the Americas.

Networking Event with DC Health Policy Groups on Thursday

In conjunction with the Roosevelt Institution, students of GW's Trachtenberg School of Public Policy and Public Administration (TSPPPA), and the School of Public Health and Health Services (SPHHS) have organized a networking event for students, alumni, and employers.

The following organizations have indicated that they are coming to the networking reception to meet students and recruit for open positions: Altarum Institute, AcademyHealth, Marwood Group, White Ribbon Alliance, Center for Economic and Policy Research, Avalere Health, Kaiser Family Foundation, The Center for Health and Gender Equity (CHANGE), Congressional Budget Office, National Academy of Social Insurance, National Research Center for Women and Families, Medicare Rights Center, The Population Institute, Public-Works, Pediatrics AIDS/HIV Care, Inc., Roosevelt Institution, American Public Health Association--Student Assembly, and Association of American Medical Colleges.

The reception is free and open to all GWU students (and Roosevelt Rx Health Policy conference attendees).

The reception will be held at the Marvin Center's Third Floor Terrace, 7pm - 9pm. No RSVP required. Free light refreshments.

Health care vouchers to cure our health care woes

Earlier today GWU's Department of Philosophy held its annual Elton Lecture featuring Dr. Ezekiel Emanuel, an oncologist and Chair of the Department of Bioethics at the National Institutes of Health.

In his lecture, Dr. Emanuel presented his analysis of what goals should we want an
ideal health care system to achieve? Which health care reform best realizes those goals?

Dr. Emanuel identified seven goals of reform: cover everyone, control costs, provide integrated high quality care, choice for consumers, fair financing mechanisms, medical malpractice reform, and a stronger economy. He then showed quite convincingly that our current health care system falls quite short of these goals. Some of the highlights of our system failings include the 47 million uninsured, fragmented care system (e.g., the typical Medicare patient sees on average seven different physicians including five specialists), and subpar medical care (e.g., a RAND study in NEJM showed that people receive 55 percent of recommended care).

The Guaranteed Healthcare Access plan is Dr. Emanuel's prescription for our ailing health care non-system. He argues that his plan both reforms the financing and delivery side of health care creating a more equitable and sustainable system. Under the Guaranteed Healthcare Access plan all Americans would receive a health care voucher, fully funded with a 10 percent Value Added Tax (yes, VAT would be a new sales tax), to sign up for a private health insurance plan. The health insurance plans would offer a standard set of benefits equivalent to the Blue Cross Blue Shield PPO plan in the Federal Employee Health Benefits Program. Those who wish additional insurance protections could purchase supplemental policies with their own after-tax dollars.

The overseerers of this sytem would be a Health Care Board (modeled on the Federal Reserve Board) that would determine the benefit package, oversee regional insurance exchanges, and regulate health care plans.

The final two major pieces of this plan are an Institute for Health Technology Assessment and Center for Dispute Resolution. These entities protect beneficiaries; eliminate the need for medical malpractice insurance; and compare the effectiveness of health care services.

For those interested in learning more about this plan, Dr. Emanuel recommends http://www.fresh-thinking.org/ and http://www.healthcarevouchers.org/.

Accounting Rules Force States to Confront Hard Choices

Massachusetts Deputy Comptroller Eric Berman visited Professor Joyce's Public Budgeting and Finance class earlier this week. Mr. Berman focused his remarks on an a previously obscure (to me at least) accounting standard that is forcing states and local government to confront the cost of retiree health care and other post-employment benefits in a big way.

The accounting standard calls for states to start paying for retiree benefits as they are accrued (similar to how you accrue vacation time) instead of as benefits are paid (i.e., when you are 65 and sign up for retiree health insurance). The crux of the problem for states and local governments is that they have been paying for their public employees' retiree benefits out of general revenues on a yearly basis. But now, under these new rules, they have to pay not only for the current cohort of retirees, but also set aside money for current employees who are accruing retiree benefits while they are working.

Faced with a bigger budget item in what's become tough financial times, states and local governments are feeling the pressure. Mr. Berman discussed a a number of the policy alternatives some governments are considering in dealing with the crisis, including:

1. Issue bonds;
2. Establish an irrevocable trust;
3. Sell of state owned assets;
4. Use tobacco money; and,
   
5. Reduce retiree benefits and/or shift costs onto the retirees.

In discussing the merits of alternative 5, Mr. Berman argued that increasing copayments for doctor visits could have beneficial effects beyond shifting costs from the state to the retiree--it would force consumers to confront the cost of health care such that it would lead to a more equitable market place.

Reflecting the pressures of uncontrollable increases in health care costs, Mr. Berman's policy alternatives make some sense--if you are thinking in the short-term about the state's coffers--not if you are trying to help people stay healthy or protect their limited income from costly medical procedures.

Increasing the price tag for state retirees (or any population with a fixed and limited amount of resources) to take advantage in a service will decrease demand for that service. There are a number of studies on this point, one most recently about how copayments for mammograms are a deterrent which may then lead to more incidents of breast cancer and harder to treat breast cancer. (Read: Higher hospitalization costs for the state later and unnecessary deaths)

From an economic point of view, Amitabh Chandra, Jonathan Gruber and Robin McKnight have a paper on "Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly," which states in the abstract:

Patient cost-sharing for primary care and prescription drugs is designed to reduce the prevalence of moral hazard in utilization. Yet the success of this strategy depends on two factors: the elasticity of demand for those medical goods, and the risk of downstream hospitalizations by reducing access to beneficial health care. Amazingly, we know little about either of these factors for the elderly, the most intensive consumers of health care in our country. We remedy both of these deficiencies by studying a policy change that raised patient cost-sharing for retired public employees in California. We find that physician office visits and prescription drug utilization are very price sensitive; while direct comparison is difficult, the price sensitivity appears to greatly exceed that of the famous RAND Health Insurance Experiment (HIE). Moreover, unlike the HIE, we find large "offset" effects in terms of increased hospital utilization in response to the combination of higher copayments for physicians and prescription drugs. These offset effects are concentrated in patients for whom medical care is presumably efficacious: those with a chronic disease. Finally, we find that the savings from increased cost-sharing accrue mostly to the supplemental insurer, while the costs of increased hospitalization accrue mostly to Medicare; thus, there is a fiscal externality associated with cost-sharing increases by supplemental insurers. Our findings suggest that optimal insurance should be tied to underlying health status, with chronically ill patients facing lower cost-sharing.

Chandra et al. are essentially saying that when California increased copayments for state retirees, they saved a bunch of money for the state, but they lowered health outcomes for their population (more hospitalizations) and shifted costs from the state to Medicare, a federal program paid for with tax dollars. Which is similar to shifting your costs from your left pocket to your right pocket, to borrow Mr. Berman's turn of phrase.

Raising copayments and reducing benefits alone will not solve the problem of uncontrollable costs in a particular state or for the country. In order to control medical inflation we will need to cut waste in the system (i.e., move from paperless records to electronic records), reduce unnecessary medical errors and services, and encourage patients to take responsibility for their health.

I don't mean to say that these three policy alternatives will solve the evolving fiscal crisis at the state level. I don't think they will, but I do think they will go much further to control costs than reducing benefits and increasing copayments. Ultimately, health care is a national economic issue that will need to be dealt with by the federal government through national reform. Which is what, as the most recent GAO paper on state and local retiree health care costs notes, many states have been waiting for.

Best time in DC: Cherry Blossoms

The Cherry Blossoms are coming! The Cherry Blossoms are coming!



According to Robert DeFeo, the chief horticulturist for the National Park Service, the cherry blossoms will be at their best from March 27 to April 3.

The Washington Post reports:

The annual Cherry Blossom Festival runs from March 29 to April 13. In addition to the festival's highlights -- the kite festival on the Mall, fireworks over the Southwest Waterfront, a parade along Constitution Avenue on the final weekend -- there are some interesting new initiatives this year. In an attempt to alleviate the congestion around the Tidal Basin, the Park Service is partnering with Tourmobile to offer satellite parking at Hains Point. Visitors will be able to park at a number of free lots on the peninsula and take free shuttle buses up to the Jefferson Memorial. (Click for a (PDF) map.) This service will be in operation every day between 10 a.m. to 7 p.m.

My favorite part of the Cherry Blossoms season is riding my bike around Hains Point under a blanket of pink pedals. It's really quite amazing. My least favorite thing is playing dodgems with all the tourists who go down to basin and don't look both ways....

A brief history of the Cherry Blossom festival:

The National Cherry Blossom Festival annually commemorates the 1912 gift to the city of Washington of 3,000 cherry trees from Mayor Yukio Ozaki of Tokyo to enhance the growing friendship between the United States and Japan....

Three thousand eight hundred more trees were accepted in 1965 by First Lady Lady Bird Johnson. In 1981 the cycle of giving came full circle. Japanese horticulturalists came to take cuttings from our trees to replace Yoshino cherry trees in Japan which had been destroyed in a flood. With this return gift, the trees again fulfilled their roles as a symbol and agent of friendship. The most recent event in this cycle occurred in the fall of 1999. It involved the formal planting in the Tidal Basin of a new generation of cuttings from a famous Japanese cherry tree in Gifu province reputed to be over 1500 years old.

On getting things done

It's amazing to me that Congress was designed by the framers to be a slow and deliberative body. I've been working as a fellow there for the last two months and my day is anything but slow and deliberative. In fact, it's a bit of a workout.

I feel like I'm constantly running from a 10am meeting on one topic to a 12-2 briefing on another, then to a 2pm meeting on something else. And in between, I'm supposed to have read something, answered emails, made phone calls, and tried to think of intelligent questions to ask in the next meeting.

Or maybe this is the point: The members of Congress and their staff are so caught up with all the activity that no one can really sit down to think things through.