Coming and going

Two Fiorina voters, both mad about ACA: one fears that it will cut Medicare, the other fears that it won’t.

I just had dinner with two people – one an old and trusted friend with a sophisticated knowledge of public policy, one a relative stranger with limited information – both of whom plan to vote for Carly Fiorina over Barbara Boxer this fall. For each of them, the Access to Care Act is an important reason. Their concerns were opposite; the stranger loves Medicare and fears that ACA will cut into Medicare spending, the friend has caught Peterson-itis and is convinced that Medicare is going to eat the GDP, and hates ACA for not cutting Medicare enough.

Similarly, the stranger thinks that extending the Social Security retirement age would be a crime, while the friend regards it as an obvious response to increased longevity.

The fact that they were voting for Fionina for opposite reasons didn’t bother either of them; the stranger has decided that all incumbents ought to replaced, and indeed offered John Boehner’s proposal to raise the retirement age as a reason to vote against Boxer. (All this while railing against “socialism.”)

Anecdote isn’t data, but the hint here is that the Repubilican strategy of obstruction plus obfuscation is, so far, working pretty well.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

26 thoughts on “Coming and going”

  1. Yeah, but just look at all the good things Obama has done since he became President! And it's gonna go over real well when he signs a bill that requires a man or woman who started his or her working life at age 18 as a miner/plumber/carpenter/iron worker/roughneck/roofer/house painter/mechanic that in only 52 years you can retire and collect your full Social Security benefits!

  2. Mark,

    All fears about government programs "eating" the GDP never seem to consider military spending, somehow it's off the table even for discussions. I recently got a mailing from the American Friends Committee and their estimate is we are spending almost $2,000,000 a MINUTE on "defense" items, either directly or indirectly, or about 70% of all federal spending. During the health care food fight, one of the ongoing opposition points was that it would add an additonal $100 Billion to the federal budget over the next 10 years. About this same time, I came across a short article that said the F-35, a fighter designed years ago to fight the Soviet Air Force over the plains of Europe, was still in the defense budget, even though Secretary Gates and President Obama had tried to kill it. This project was projected to cost about $35 Billion, or about a third of the projected additional cost of the health care reform. That's ONE program that could help significantly in covering a nation-wide health care extension. President Eisenhower was right about the "Military-Industrial Complex," and I fear that we're "defending" ourselves into financial, moral, political, and military bankruptcy.

  3. I can't understand one-issue voters like your two dinner companions. Given the filibuster rule, can there be any basis other than party to choose a senator?

  4. Fascinating. I can see this happening because while they both professed to care greatly about the ACA, it was really just a sort of partisan bludgeon: the opposition to Boxer stems more from a larger disgust with what she represents on many levels. So the obstructionist strategy creates a scenario in which everything the Democrats do is terrible and almost fascist ("ram it down our throats"). So the good in even something as conservative as the ACA – similar to historical Republican proposals – is denied out of hand, and fodder for further political anger.

    The alternative would have been to work out a bi-partisan agreement, and been more honest about elements of legislation that their ideology is actually comfortable with ("government keeping its hands off medicare"). But that would have cost political capital. Republicans would have had to tone down their rhetoric considerably, and admit that they too believe in *some* government, *some* of the time. Of course, the right-wing media-fueled tea party has largely tied them into this sort of craziness, but at some point you need to have principles.

  5. an old and trusted friend with a sophisticated knowledge of public policy,

    Maybe a sophisticated knowledge of public policy, but utterly naive about the politics necessary to implement good public policy.

  6. sophisticated knowledge of public policy

    Not sophisticated enough to understand that $1.50 of every dollar saved on entitlements will be paid out in tax cuts to the top 1%.

  7. Your tolerance for stupidity (or banal evil like Volokh) of people you are friendly with amazes me.

  8. Mark, you're not being entirely fair. The Republican strategy of obstruction plus obfuscation would not be nearly as effective if it was not parallelled by the Democratic strategy of accommodation plus obfuscation (see, for example, the pending "reform" of the financial sector).

    Also, given that near universal coverage was the major accomplishment of the health insurance reform legislation, why isn't the new law called the Comprehensive Access to Care Act?

  9. It's clear that neither one of these people have a clue what they're talking about and have made their decisions based on something else entirely, then created rationalizations. That's why they were not bothered to discover that someone with diametrically opposed ideas supports the same candidate – something that should create some emotional concern if you really believe what you're saying, but is utterly unimportant if you're spouting bullshit. Are your dinner companions both men? Boxer is 69 while Fiorina is 55 – I suspect that your companions are reluctant to vote for an old woman.

  10. The very idea of voting Republican on policy grounds baffles me. The only discernible policies are 1)war against somebody and 2)tax cuts for the rich. There just isn't a Republican policy on Medicare (or climate change or the recession or the deficit or …) to vote for. They might axe Medicare, as in Ryan's plan, or boost it, like GW Bush, depending on how their gonads feel at the time.

  11. James Wimberley, let me try to help you out of your bafflement. I hoped that the ACA would fail because I thought/think it a huge Rube Goldberg apparatus with lots of built in disincentives to making care cheaper and making providers compete against each other in meaningful ways. There are too many little crap buyouts to get this or that group on board – for pharma, for the medical oxygen people, etc. And I think, now that it's in place, it will be very difficult to make changes. I'm a big believer in path dependence, and I think the path on which it has set us is non-optimal. So, if I could blow it up and try again, I would. A Fiorina victory would make that more likely, so if I were a California voter I would vote for her.

    Now, you likely (certainly) don't agree with me, but you can't claim that this isn't a policy basis for voting Reep.

  12. Dave Schutz,

    What a bullsh** argument without any merit. Repeal of ACA isn't in the cards even with a Fiorina victory so now you want to minimize the damage you perceive that will occur. The only way to do that is to increase the likelihood that gridlock does not continue in the US COngress. A Fiorina victory increase the amount of gridlock in 2 ways by moving Congress to a more evenly divided distribution AND by rewarding obstuctionism.

  13. RE: dave schultz's comment: "There are too many little crap buyouts to get this or that group on board – for pharma, for the medical oxygen people, etc. And I think, now that it’s in place, it will be very difficult to make changes. I’m a big believer in path dependence, and I think the path on which it has set us is non-optimal. So, if I could blow it up and try again, I would. A Fiorina victory would make that more likely…."

    It seems to me that:

    (1) If blowing it up actually would ensure a better chance at a more coherent, cost control centered, and comprehensive set of reforms then I can see the value in considering such a course; but, I have no confidence that such an outcome is even remotely likely.

    (2) As with anon, I see a Fiorina victory leading only to blowing up the ACA with an outcome worse than the pre ACA policy environment.

    So, flawed though ACA may be, it is better than alternative likely policy alternatives. Lets go with ACA and fight for cost controls and other enhancements in future legislative cycles — large bills regularly come up for reauthorization or other amendment opportunities.

  14. Dave: where's the path dependence on Medicare, which was the gravamen for Mark's dinner guests? The only structural change ACA made there was the cost control commmission, and what's wrong with that pathwise?

    I can see that for the working-age population, the dropping of the public option closes off a German path to a mixed public/private system. But it leaves open a Swiss or Dutch one to a tightly regulated private insurance model: surely OK.

    Your scenario requires that repealing or crippling ACA will eventually lead to a fresh start on your preferred path. But if the American political system is capable of such a fresh start (against current evidence), then why isn't it capable of the lesser tweaks needed to set ACA on the same path? For instance, reintroducing the public option, or a serious squeeze on drug and hospital prices.

    The French term for your line is la politique du pire. It has a terrible track record (see: German Communists in 1933).

  15. Voting Fiorina to get a better health care situation is a lot more 'Rube Goldberg' than anything enacted into law. Even waving away all the magical thinking (not restricted to California, or course) involved.

  16. Ah…

    The summer of our discontent…

    Have you ever lived in a more unhappy America?

    I haven't. Seems everyone has an itch to bitch…

    It all started when the teabaggers started showing up at townhalls with tommy-guns.

    Wasn't that cute? Few cried foul. No one wanted to upset the pro-gun zealots…

    Even fewer cried foul when teabaggers shouted down a woman in a wheelchair with diseases…

    Wasn't that a 24-carat stone gas?

    Cute. Very cute.

    Just a couple of angry teabagging ole boys…

    With legitimate concerns…

    Who want their America back…

    Got a bitch to itch? Show up somewhere with a misspelled sign and a gun and scream socialism…

    Never mind that the rich are getting richer and the poor poorer. Socialism!

    Shout it loud like you got teabags for brains…

    They'll put you on teevee and give you a chance to tell it to the world…

    They might even let you bring your gun…

    What we have here is not a failure to communicate…

    Rather what we have is:

    The legitimization and media-ization of every pucker-faced dolt with an asshole, a gun, and a bad case of pruritus…

    Call it: A devolution into a repugnocracy…

    Everyone in America is now an asshole with a lot of unhappy opinions…

    And always always always always…

    It about me me me me…

    About how I've been wronged somehow…

    About how I didn't get the health care bill I wanted…

    About how I didn't get my taxcuts for the rich…

    About how BP or the Government is to blame for the spill…

    Me first cry babies with dirty nappies…

    Tomorrow is the fourth of July…

    To celebrate it in our summer of discontent…

    It would be befitting if:

    Everyone put on a red white and blue diaper…

    And ww walked around sloshing in our feces all day…

    The bombs bursting in our underwear…

    Bitching and itching about how unhappy we are…

    Until the fireworks…

    That will surely disappoint us as well…

    Go off…

  17. How anyone can vote for a demonstrated incompetent like Fiorina is a mystery. Here's a simple ad idea: When HP shareholders entrusted their money to Carly Fiorina for six years they lost 60 cents of every dollar. Ready to trust her with a Senate seat for six years?

  18. Not to mention the fact that she perjured herself in the lawsuit Hewlett brought against the Compaq merger.

  19. Fiorina got good health care for her situation, so it makes sense to vote for her so we can all get that kind of coverage.

  20. Extending the retirement age is a TERRIBLE idea, but quite in keeping with the conservatives' belief that you should work the poor until they drop. The people who like this idea work indoors at office jobs that involve no heavy lifting. If they would talk to other workers—agricultural workers, workers on the factory floor, particularly in heavy industry, construction workers, and so on—they might find that working to age 70 is both unattractive and infeasible. And even some office workers (various types of engineers, for example) are subject to frequent layoffs. Looking for a new job at age 65 is going to be a challenge. I was laid off (company purchase) on my 62nd birthday, and after 4 months of intensive job hunt with not a single interview, I packed it in and retired—because Social Security was available, I was able to do that. Without it, I suppose I could have spent the next several years trying to get hired.

  21. Narcissism of Small Differences?

    Voting for Democrats is not very effective, is it? Why shouldn't we just vote at random?

    The Democrats have all sorts of excuses for delivering unchanged, Republican policy.

    Have the Republican Wars ended? Did Guantanamo close? Has torture ended? Is Social Security safe? Have Unions been strenthened? Has the unemployment rate been kept down? Were the banks discipline and reformed? Is anyone on BP about cleaning up their mess in the Gulf? Did the Democrats enact single-payer health insurance?

    I could go on, and on. The Democrats deliver the same, lousy, pro-corporate-business policy, only they have to make more excuses. At least, the Republicans deliver fascism on a stick, without insisting that they feel anyone's pain. The country deserves Carly Fiorina.

  22. Somehow I am not worried for Barbara Boxer. I think she is one of the finest public servants, and people know she is on regular folks' side, notwithstanding the overwhelming media attacks on her year after year. Fiorina comes off as a phony, and her gaffe was one that exposed her phoniness about people's appearances. The low information voter votes on who they "like," and Fiorina does not pass the "like" factor. There are also a number of "movement" conservatives that smell Fiorina as a phony, and will sit on their hands.

    I know I could be wrong, but I think it is important to watch for the above scenario, too.

    As someone who is highly disappointed in Obama, I remain a major fan of Barbara Boxer. She is one of the great ones who stands for people in the Senate.

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