We are all familiar with the old saw, "If it ain't broke, don't fix it."
As we watch our foreign and domestic polices flounder, I have begin to wonder about the definition of the word "broke", primarily with both sides of the aisle claiming virtually everything is indeed broken! If such is the case, I'm still waiting for someone to define exactly what "unbroke" looks like.
So, sitting on the front veranda this AM, enjoying a cup of steaming joe, a cigar and the sun rising over the blue Aegean, my mind wandered back to grad school, and two of my premier public policy profs, Floyd Durham (Economics) and Barry Epstein (Program Evalustion). Both of them had their act together.
Of the many approaches to social program evaluation, two are ever so intuitively attractive, yet really bankrupt. They are called "The Charity Model" and "The Pork Barrel Model" of program evaluation.
The "Charity Model" is pretty straight forward. It simply looks to see if a "need" exists, if the program in some way addresses the "need", if the actors in the program are sincere and diligent in addressing the need and if no one is seriously and involuntarily inconvenienced by the program. If those four criteria receive a "Yes", then that's all that is needed. Sort of like Ron Paul's idea of the community rising up to voluntarily see to the health care needs of the needy, rather than any "government program".
The "Pork Barrel Model" is equally straight forward. If the constituency receiving the benefits is satisfied, and no one is seriously and involuntarily inconvenienced by the program, that is also a sign of a successful program. Take, for example, "progressives" turning a blind eye to sub-prime mortgage abuses because it was getting more Americans into homes and millions of borrowers and lenders seemed to be happy - for a while.
Of course, neither model looks at inputs versus outcomes or "cost/benefit ratios" as it is commonly called. Further, neither model addresses whether or not all of the potential "needy" population is being served, if the number of "needy" is reduced or even if the "need" is valid as defined. Nor is there any evaluation of long term consequences. It's just a subjective, close cropped snapshot.
Both of these approaches fuel what I would call the "Fat, Dumb and Happy" model of society. In doing some searches on the web to brush up on program eval methodology, I found a paper from 1984 with the ever so apt title "Evaluating Programs the Whole World Already Calls Wonderful". While the content of the paper goes far beyond what I offer here, the title does parallel my "Fat, Dumb and Happy" issue. In short, just because no one is calling for something to be fixed, that doesn't mean it isn't, in many ways broken.
Back to the two examples given above. Ron Paul's "Charity Model" does indeed show that communities and institutions have, on occasion, risen to the task of caring for the some of needy in health care, and that can seem to meet the "Whole World Already Calls Wonderful" test, and can make selected people feel good about themselves. What it fails to address is the question of whether the general population of needy receives health care every time it is needed, no less routine or preventative care. All he is demonstrating is that some sincere people, without seriously inconveniencing others, provide some care to some needy. Of course, this approach has come crashing down on some 50 million or more uninsured Americans who now are effectively outside the "system" and cannot make life decisions based on an unpredictable and random "charity model".
As to the sub-prime fiasco, well, a lot of people were made happy in the short run. Both borrowers and investors. From a "Pork Barrel" view, all was well, for a while. Of course, since it met, for a time, the "Whole World Already Calls Wonderful" principle, no further thought was needed. However, once "reality" set in, probably more Americans lost their homes than new owners were created.
In foreign policy, there is the Bush invasion of Iraq, which was carefully crafted to avoid serious inconvenience for most Americans, and bolstered by "sincerity" in the justifications ("Charity Model"). And, of course, lots of "Pork Barrel" for the defense industry. Best of both worlds. And, a total fiasco, domestically and for Iraq.
How can we, as a society attempt to operate in the long run when our policies and programs are subjected to "evaluation" techniques so short sighted, deficient and totally debunked decades ago? Or, are we not only "Fat, Dumb and Happy", but intellectually lazy as well? In fact, wasn't one of the alleged handicaps of GWB identified as being "intellectually incurious"? And a fresh supply of darlings of the Far Right (Palin, Bachman, Perry, Cain) exhibit this same intellectual laziness, and Progressives have counterparts as well. They simply mirror society.
Think about these two models of "evaluation, and I'm sure you can add dozens of other policy decisions that are made using these simplistic measurements.
WASF
Little article in this month's "Vanity Fair" that talks about just this kind of thing, Al.
ReplyDelete(http://www.vanityfair.com/business/features/2011/11/michael-lewis-201111)
Here's two quotes I thought were germane:
"But when you look below the surface, he adds, the system is actually very good at giving Californians what they want. “What all the polls show,” says Paul, “is that people want services and not to pay for them. And that’s exactly what they have now got.” As much as they claimed to despise their government, the citizens of California shared its defining trait: a need for debt. The average Californian, in 2011, had debts of $78,000 against an income of $43,000. The behavior was unsustainable, but, in its way, for the people, it works brilliantly. For their leaders, even in the short term, it works less well. They ride into office on great false hopes and quickly discover they can do nothing to justify those hopes."
And this:
"In academic papers and a popular book, American Mania, Whybrow argues, in effect, that human beings are neurologically ill-designed to be modern Americans. The human brain evolved over hundreds of thousands of years in an environment defined by scarcity. It was not designed, at least originally, for an environment of extreme abundance. “Human beings are wandering around with brains that are fabulously limited,” he says cheerfully. “We’ve got the core of the average lizard.” Wrapped around this reptilian core, he explains, is a mammalian layer (associated with maternal concern and social interaction), and around that is wrapped a third layer, which enables feats of memory and the capacity for abstract thought. “The only problem,” he says, “is our passions are still driven by the lizard core. We are set up to acquire as much as we can of things we perceive as scarce, particularly sex, safety, and food.” Even a person on a diet who sensibly avoids coming face-to-face with a piece of chocolate cake will find it hard to control himself if the chocolate cake somehow finds him. Every pastry chef in America understands this, and now neuroscience does, too. “When faced with abundance, the brain’s ancient reward pathways are difficult to suppress,” says Whybrow. “In that moment the value of eating the chocolate cake exceeds the value of the diet. We cannot think down the road when we are faced with the chocolate cake.”
Chief-
ReplyDeleteConsidering that household debt exceeds the national debt by a considerable amount, isn't it really a false abundance? Unsecured student loans alone just passed the $1 Trillion mark.
The advantage of the charity model is that it favors action over analysis. If kept relatively small, there is the possibility of having many "charity type" interventions which the winds of chance might randomly cover much of the "need".
ReplyDeleteA more rational and structured evaluation, however, might be able to define, organize and serve the "need" in a much more coherent manner.
On the other hand, if the analysis is flawed because of some ignorance or ideological bias on the part of the analyzer, you might end up with a complete miss and everything would be wasted.
Presumably, you would want some sort of cyclic evaluation system where you reinforce success and starve failure (however you define success and failure)
Al: I think the problem is that most of us can't tell where the end of the gravy train is; as long as we have checks, we can't be broke, right?
ReplyDeleteBut if the question is "helping the needy", I'd argue that, as in the case of Christianity, it's not that it hasn't been tried and found wanting but found difficult and never tried.
The bottom line is that prior to the social programs created between 1932 and 1972 the "poverty" level in the U.S. (regardless of how you define(d) it was always somewhere around 25-28% and probably actually much higher if you counted in the "rural poor" who were pretty much invisible to the census takers because while they were poor as dirt could always feed themselves. Among old people that number was WAY higher.
And this was an America where families often lived together in multigenerational homes, so Grandma and Grandpa, even though they were flat broke, were fed and housed in their decrepitude in return for (probably) some half-assed grandchild care if that.
Since the Fifties the U.S. poverty level has seldom gone above 10-11% until the Lesser Depression. So those programs DID work...and in most cases, for a fair bit less than we spent on, say, upgrading the Polaris to the Polaris II.
And let's not forget that this "charity" has never been what you'd call lavish. Whether from government or from private sources, we've never really worried much about the big-picture problems that keep people, often many generations of people, in the same poverty rut.
I think the thing to look at here isn't the U.S. as a snapshot but the bigger historical picture. For most of history if you got old, or sick, or injured, or wiped out in economic collapse, you were just plain shit out of luck. If you could you begged, or stole, if you couldn't you died. For most of human history the lot of the "unlucky" has been pretty effing miserable.
Our Western liberal democratic society is an aberration in that we have actually tried in our haphazard, inefficient, ridiculous ways, to "do something" about this. No argument that the ways we've done it have been pretty awkward. But we've at least tried - which is more than most societies have throughout most of human existence...
Ael-
ReplyDeleteNothing wrong with a "charity model" of evaluation for a philanthropic organization. They can define their constituency and scope of services as they choose. However when applied to public policy, it falls far short of the mark. Consider fire protection. No matter how sincere the firefighters may be, and no matter how proficient they are at addressing a given fire, if the department is too small to respond to the general fire patterns of a given city, is the program "successful"? One has to see that there is a difference between simply providing "good" versus providing for the general welfare.
Al-
ReplyDeleteI hadn't thought about it before, but the sub-prime crisis is/was different than either of the two types you describe . . . the scope was international, not just confined to national policy/effect. Wall Street's essentially scammed and looted the world . . . ?
seydlitz-
ReplyDeleteAs to the sub-prime fiasco, I heard it described as "The Perfect Storm" in that it was a confluence of a variety of objectives being inappropriately met, for "caring for the needy", via increased home "ownership" to unmitigated greed, all moving at a pretty rapid rate, without any close inspection or foresight.
Chief-
Yes, from 32 to 72, we did a pretty good job with social programs, but then many folks were talked into feeling that they were being inconvenienced, and they began to balk. The issue with health care in the US isn't just that it's expensive, it's that many, many people do not have access to basic care. That has resulted in a significant "culture" that sees routine and preventative health services as something alien. You only see a provider when something meets the criteria for emergency room level attention. Hell, back in the late 70's, I had a physician friend who did volunteer work at a ghetto clinic. He was told to use injectables whenever possible versus prescribing an oral med. Not because the clinic made money on the injections, but because the population served had no notion of taking meds for 10 days or so. It was more likely they would come back for the next injection than take meds. Not guaranteed, just more likely. Here, where access is 100% due to national health care, it's not an issue. Health care is part of every day life. Even for a cold.
Yes, we should look at the historical US, but snapshots are so much simpler. I remember my Constitutional Law prof addressing "Legislative history and legislative intent" as key elements in judicial review of a piece of legislation. Hell, ask you neighbor about the history and intent of Social Security, for example, and odds are he will just say it's a "Ponzi Scheme"! Want to know what someone thinks, find out who last spoke to them.
WRT debt and assets, it's not really so much a set piece of so much debt vs. so much assets, which you see in bankruptcy notices. It's also the stability, reliability and honesty of the creditor/lender vs. the same of the borrower. One cannot honestly talk about the one without talking about the other.
ReplyDeleteWhen we first bought a house in 1989, I had stable employment with decent income ( education, though my field within that historically isn't stable, Latin/Greek with no other qualification ), our debt to income comparison was shocking. But that was a snapshot of the situation, without the factor of time brought in.
So that can be misleading to only talk about debt. The US has tremendous debt and annual deficits, but with intelligent leadership and decent fair progressive taxation, it really should not be a tremendously difficult problem to overcome.
But we don't have such political and financial leadership.
So we're in a fix.
bb
In general, I don't believe in one-size-fits-all solutions. I think diversity is a good thing and so I think we need both models and it would be a mistake to entirely rely on one or the other.
ReplyDeleteAnd this was an America where families often lived together in multigenerational homes, so Grandma and Grandpa, even though they were flat broke, were fed and housed in their decrepitude in return for (probably) some half-assed grandchild care if that.
I think we've lost something there. Now the elderly who can't care for themselves are put in overcrowded nursing homes, living their last days, months or years dependent on overworked staff in mostly unpleasant conditions, billable to Medicare for tens-of-thousands of dollars. So, while I think it's necessary for government to provide funding for this, it's far from ideal. The medicare-funded long-term care nursing homes I've seen are all really bad except for the ones run by Catholics.
is that people want services and not to pay for them.
ReplyDeleteI think that's a central problem. I think people tend to be this way naturally, but it's gotten really bad over the last few decades. Most of that is, IMO, a result of the boomers who, as a cohort, exhibit this tendency more than previous generations:
Whether or not the popular characterization of the Boomers as self-interested is correct, this survey suggests that, politically, Boomers of all orientations are now and will continue to engage in politics on their terms, and with clear self-interest in mind.
The best illustration of this is the manner in which Boomers regard entitlements and obligations. In the survey, Boomers are more likely to name more “definite responsibilities” of government, yet they are less likely to believe that they owe the country certain obligations, including military service, paying taxes, and paying attention to political issues. The sense of obligation increases among the Silents and is highest among the GIs.
The boomers are still driving the bus - they remain the most potent political force and our current crop of politicians are mostly boomers themselves. Our President thinks it's necessary to use euphemisms like "spending reductions in the tax code" for tax increases. I'm not sure what can be done, honestly. All I know is that there's going to a be a helluva bill laid at the doorstep of future generations.
The way this discussion here is going reminds me of the little parable Jesus presented in Matthew 21:
ReplyDelete28 “What do you think? There was a man who had two sons. He went to the first and said, ‘Son, go and work today in the vineyard.’
29 “‘I will not,’ he answered, but later he changed his mind and went.
30 “Then the father went to the other son and said the same thing. He answered, ‘I will, sir,’ but he did not go.
31 “Which of the two did what his father wanted?”
The first,” they answered.
Jesus said to them, “Truly I tell you, the tax collectors and the prostitutes are entering the kingdom of God ahead of you.
32 For John came to you to show you the way of righteousness, and you did not believe him, but the tax collectors and the prostitutes did. And even after you saw this, you did not repent and believe him.
In our society, we have a Conservative, Family Values, mostly Christian group that claims to support the things Jesus taught, but don't want to construct a society that provides at least basic health care for all, social justice, fairness and opportunity for all.
OTOH, is the generally atheistic, secular, "Flying Spaghetti Monster", or very liberal denominational group who advocates and promotes such as the first group does not.
So, who's doing the Will of the Father?
Now granted, I'm using a broad brush here, and there are certainly theological questions about my comparison of the political with the Biblical, but the operative word here is "work".
But . . . which group will be playing the part of "goat" and which group will be playing the part of "sheep" at Judgement Day?
Now this leads up to my next point, abortion.
IIRC, we may have discussed the case of Terry Schiavo back in the Intel days, but this issue of abortion is back, WRT to Planned ParentHood and accompanying questions about healthcare for women.
( Also, as an aside, I'm able to log into my Google account here to access all the goodies here, but I cannot post comments under my Google account. I can post under "name" profile. Can the PTB fix or advise? )
bb
Yes, from 32 to 72, we did a pretty good job with social programs, but then many folks were talked into feeling that they were being inconvenienced, and they began to balk. The issue with health care in the US isn't just that it's expensive, it's that many, many people do not have access to basic care.
ReplyDeleteThis is, in part, circular though. The reason people don't have access to basic care is because it's so expensive and so most people can't pay for it without insurance. In the 50's and 60's basic care was cheap and so it was relatively easy to pay out of pocket. Social programs were able to spend a lot less per capita because everything was cheaper. They also covered a lot less than they do now.
There's also the fact that dealing with the medical system is unpleasant and so people will skip basic care because it's a hassle. I know I dread having to go into the doctors and the ER even more. And I end up at the ER quite often (three kids) because I can't get an timely appointment and urgent-care facilities are practically nonexistent. The ER is the only game in town.
As I noted above, I don't believe we as a group over the years dicussed the issue of abortion. I was rather leary of making this a site post, but since Al has opened the door WRT health care.
ReplyDeleteThe reason I'm bringing it up is because of the broader issue of how much should society or its official organization, the federal and state and local governments, be involved in the relationship between doctor and patient. I'm excluding religious organizations, because that's a matter of choice; with government, there is no choice, unless one decides to leave the territory so governed.
My religious affiliation is Orthodox Christian. Dr. George Tiller was murdered in his Lutheran church which is right next door east to my Cathedral. The Dr. conducted his practice not more than an hour's drive away from me.
It does not cover all issues, for instance incest or the case of a female able to conceive but which situation may be physically damaging to her body or life, but here is my church's thoughts on abortion
http://www.antiochian.org/1178
In general, I agree with it, though I do not know who the author is or if her statement has been certified by an appropriate church official. But it is on the church's website.
WRT birth control
http://www.roca.org/OA/155-156/155h.htm
I am familiar with the author, but he does say what is to me an odd thing
As a priest, I must say to any couple that approaches me for marriage that, if they are not prepared and willing to conceive and bear a child, without interfering with the will of God by means of artificial birth control, then they are not ready to be married. If they are not prepared to accept the natural and blessed fruit of their union - that is, a child - then it is clear that their primary purpose in marrying is to have legalized fornication.
So if I married ( or want to marry ) a woman that I had known was incapable of conceiving, that makes me a fornicator? And if we had no intent or capability of adoption?
My view is let the "heathen" do as they wish, but if one is inside a group that has a set of values on this topic one should follow them.
I support Roe vs. Wade, because I believe that even for Orthodox Christians, abortion may be necessary and unavoidable. In the case of rape, it seems very unreasonable to me to force a female to endure 9 continuous months of reminder of the violence that was committed against her.
What has inspired me to comment upon this topic is the new political attacks against Birth Control, which has lain dormant for the most part, although there was a while ago the brouhaha over making pharmacists who oppose dispensing abortifacients do that.
And in general, the use of violence by members of the anti-abortion groups in promoting their cause and the defunding of Planned ParentHood by conservative state governments.
Read this
http://tbogg.firedoglake.com/2011/10/19/rita-diller-hates-healthy-women-contraception-children/
bb
Andy: I love the notion of the Waltons, too, but I think that it's instructive to note that when they could, many Americans grabbed a hat rather than stay on the family farm and live in the big house with the two generations above and below them.
ReplyDeleteWe like to think of our rural past as a sort of bucolic paradise, but in a lot of cases talk about your "lives of quiet desperation"...
I've heard friends called the "family that you choose for yourself" - so perhaps family might be called "the people that you often wouldn't choose for friends if you had the choice". In the parts of the world where Grandma and Grandpa AREN'T housed in soulless and overcrowded nursing homes they are often housed in overcrowded family homes; resented by the children, ignored or abused by the grandchildren, treated as excess mouths by everyone.
Obviously sometimes they're beloved elders - that's always been the case - but a lot of times...not.
Ideally the old folks will have enough on hand to remain independent into senescense, with a little help from the kids and grandkids; that was the idea of Social Security. I can tell you that without SS I'd probably have my in-laws living with me, and within a year my father-in-law and I would be throwin' down. He and I are just that kind of people...
So, as you say - there really isn't a "one size fits all" here.
"...it is clear that their primary purpose in marrying is to have legalized fornication"
ReplyDeleteUmmm...duh.
One thing I love about heirophants, regardless of their stripe, is their obsession with what humans do with their sexual bits. Despite the fact that people were fornicating - probably quite ardently and often, if modern humanity is any guide - long before religion got around to getting all squwicky about it the average prelate seems to feel that there is still something dirty about the entire business.
Bottom line; "marriage" in the monogamous, Western het. sense is the best that the various churches can do. It confines human lechery - a drive that has toppled empires and wasted fortunes - into a nice little domestic scene. If I was a priest I'd be happy to stop there. Your man should really reflect; how man men and women are made of true celebate cloth? How many sprogs do you want them to pop out, given that we have no natural population control other than other humans, padre?
You should be on your knees thanking your God that the horny rascals DO want to keep their fornication in the marriage bed, kiddos or no kiddos. Because you have no real hope for confining that genie to the bottle otherwise...
"It confines human lechery - a drive that has toppled empires and wasted fortunes - into a nice little domestic scene. If I was a priest I'd be happy to stop there. Your man should really reflect; how man men and women are made of true celebate cloth?"
ReplyDeleteThe religious would say "lechery" is a sin, our fallen nature's expression of sex. And it's not just sexual matters that fell empires and cause general mayhem, it's our fallen nature that has ruined us all.
And why abortion exists.
You're up where the state is killing old people by the hundreds, with their assisted suicide?
So, what abort abortion, the 50-cent solution, eh?
And what's wrong with me?
bb
I'm not getting your point on abortion BB.
ReplyDeleteThe general tenor of aviator's post is the evaluation of gov't programs WRT to need and effectiveness.
ReplyDeleteIYO, is abortion a necessary and needed component of women's health? It's very much in the news as well as birth control. Several states have or are on the point of having laws that establish "personhood" as including human embryos.
And several states, including mine, have or are about to have laws that defund Planned ParentHood. Is this a good move, IYO?
I think I've clearly written my thoughts on abortion above and I've provided a link for further discussion.
bb
Basil-
ReplyDeleteThe link on marriage is from the far right wing of Orthodox Christianity that has broken communion with the vast majority of the Church. I think the actual Orthodox consensus on birth control is in the rubric of the Marriage Ceremony (see Hapgood) where the petition made is "That they may have as many children as is expedient".
Andy: In general, I don't believe in one-size-fits-all solutions. I think diversity is a good thing and so I think we need both models and it would be a mistake to entirely rely on one or the other.
If you are talking about the two models of policy evaluation, both are bankrupt. Read the descriptions carefully. Neither addresses effectiveness or efficiency. Our system of medical care by "health insurance" is an example of "pork barrel" evaluation. The constituency (the insured) were generally pleased over the years, but costs were escalating so rapidly that more and more of the population were priced out of the "constituency". However, insurance decisions are made concerning the insured, not the uninsured. Thus, from a public policy standpoint, what to do about the 50 million uninsured that are not part of the insurance driven system? Nothing, under the "pork barrel" method of eval. They are not "constituents". That is how we got to where we are today. Since the insured "constituents" were fat, dumb and happy with the rising costs, diluted by someone else picking up their insurance tab (employer, for example) access became less and less affordable for the non-constituent. There has never been a serious debate on how to provide affordable access to the general population. Rather, we have been trying to tweak the very monster that has driven costs through the roof, and access down the drain - for profit insurance providers by the hundreds.
I think you're getting close to the heart of this, Al, when you say "...(t)here has never been a serious debate on how to provide affordable access to the general population".
ReplyDeleteWhen you think about it, there are a lot of things that we've never had a "serious debate" about. Military spending. Corporate personhood. Economic "justice" versus economic profit. Abortion.
On almost all of the important big-picture subjects as well as most of the goofy little stuff we tend to retreat to our comfort zones. We have often simplified issues into tidy packages that fit our prejudices, and when confronted with them simply vomit up those pre-digested bits of opinion like a puffin feeding its young.
I think the only real difference in the past 30 years is that on one side there's an almost complete lack of vitality and imagination. The bulk of the Democratic Party is completely barren, coasting along on "what we usta do". The only real ideas are coming from the "Left" (which, in most industrial nations of the West is referred to as the center-left or "social democrats") and are untouchable to the huge majority of the governing classes, the media, and, therefore, the mushy American middle.
Sadly, the Right is now just a complete disaster; driven by its loonies, unhinged, fanatical, nearly feudalist in it's determination to unravel the 20th Century. It's only contribution to the "debate" is a nonending stream of nonsensical talking points. It's fucking hopeless.
The sociologist Whybrow I quoted in the first comment had a conclusion in the referenced article. He said that the reptile-brain malfunction was so severe that he felt that it was unlikely that we could "think" our way out; that were were just locked into this circular cycle of greed and self-destruction, and his thought was that there were two ways it ended.
One was that we just crashed and burned; that our society just augers in and collapses. He had no idea what that would look like, other than it would be...Bad.
The other was, I think, the obligatory "hopeful note" that supposed that people could begin working outside the existing structures to renew the U.S. and the West socially and politically. He was quite vague about how this would happen, however, and it sounded to me more like a Pollyanna sort of wishful thinking designed to send the reader away with a bit more upbeat attitude than you'd get from actually reading the article...
To me, it's become fruitless to attempt to discuss these types of things in the U.S. That's because even the simplest matters have turned out to be way over the heads of most Americans. The U.S. is hands-down the worst educated nation in the so-called First World. Not in numbers of HS diplomas or college degrees, but in numbers of people who apparently slept through the educational experience or who disregard whatever someone tried to teach them in favor of voodoo, mysticism and internal feelings/prejudices. It's no coincidence that the U.S. is also the self-stated "most religious nation" in the First World.
ReplyDeleteCheck all of the indices for advanced nations and you will see the U.S. steadily dropping. At the rate we're going, Russia is not safe with its current #1 ranking as nation that regressed the most at the end of the 20th and beginning of the 21st century. I think just about everybody posting here is getting up there in age. We're lucky because we'll likely get out in time. Our kids and grand kids are another story.
The only difference between the U.S. and many of those nations our politicians call "failed" is size and more than enough belligerence to employ a large military at the drop of a hat. No one respects the U.S.; everyone fears it. We are a crazed society, drunk on religious fervor, prejudice and the insane belief that rich people are somehow worthy of emulation.
Sure, be charitable. That will make up for a failed government. IMO, the odds of a nuclear explosion somewhere in the world are trending upward and we don't have a government capable of doing anything about it.
Here's an example of the sort of thing I'm talking about; this is from Greenwald discussing the "secret drone war" on people we (our government, that is) says are evil bad men (in this case, Al-Awlaki's sixteen-year-old kid:
ReplyDelete"Every now and then it’s worth pausing to reflect on how often we talk about the killing of people by the U.S. Literally, the U.S. government is just continuously killing people in multiple countries around the world. Who else does that? Nobody — certainly nowhere near on this scale. The U.S. President expressly claims the power to target anyone he wants, anywhere in the world, for death, including his own citizens; he does it in total secrecy and with no oversight; and this power is not just asserted but routinely exercised. The U.S., over and over, eradicates people’s lives by the dozens from the sky, with bombs, with checkpoint shootings, with night raids — in far more places and far more frequently than any other nation or group on the planet. Those are just facts.
What’s most striking about this is how little effort is needed to induce America’s political and media elites to acquiesce to it." (And, I should add, the American public) "The government need do nothing more than utter empty nationalistic phrases such as “we’re at war” and “Terrorist!” and this unparalleled, endless state violence all becomes instantly justified. Yesterday, Yemen expert Gregory Johnsen wrote about the Awlaki killings: “Many Yemenis can understand (if disagree) killing the father, few can understand killing the son,”
I can't, either. Sending a million-dollar strike (when you add up the cost of the hardware, the pax, the intel needed to target this kid, the diplomatic and political costs) to starch a teenager?
WTF?
We just went through our annual orgy of fury, grieving, chest-beating, and bloody-shirt waving over a single attack ten years ago. And yet where is the "debate" over what our government is doing - not just doing, but doing in utter secrecy, a well so deep and in the words of my own Senator, so bizarre that "we would be shocked" to find out exactly what our government considers justifiable under the AUMF and the PATRIOT Act.
Just listen to the unrest amongst the citizenry!
(sound of crickets chirping)
It just seems that wherever you look there's one more example of some sort of utter fuckupitude from the American public. IT's in our electoral habits, it's in our public discourse, it's in our personal lives...
What the FUCK is wrong with us?
Al,
ReplyDeleteHave you ever stopped to consider that even if it ain't broke this does not imply that it's working.
ie -a dull chain saw.
jim
Chief,
ReplyDeleteI love the notion of the Waltons, too, but I think that it's instructive to note that when they could, many Americans grabbed a hat rather than stay on the family farm and live in the big house with the two generations above and below them.
That's true, but traveling around the world I've noticed that most other cultures are more family-oriented than we are in the US. There are definitely downsides to closer family ties, but there are a lot of upsides too.
Al,
If you are talking about the two models of policy evaluation, both are bankrupt. Read the descriptions carefully.
I probably missed something - I was talking about public vs private.
There has never been a serious debate on how to provide affordable access to the general population.
I think there has been a bit of serious debate - the main problem is that there is no consensus. There isn't even consensus on what it is exactly that makes our system so terrible or expensive. It's hard to look at solutions when we can't agree on how to define the problem.
Publius,
That's because even the simplest matters have turned out to be way over the heads of most Americans.
I give the American people a little bit more credit. It's hard, frankly, to cut through the bullshit to find a nugget of truth. I've spent quite a bit of time researching various health care and tax issues yet these and other things are so opague that it's hard to know what the truth is. It's easier for busy people trying to get by to adopt the views of elites - unfortunately the elite views are pretty much bankrupt.
BB,
ReplyDeleteSorry, I don't discuss abortion on the internet. It never turns out well.
Andy-
ReplyDeleteI think that in the main, the debate, if one wishes to call it that, has been how to make insurance available. It has never really focused on or addressed universal access, or what the standards of health care delivery should be. Simple on methods of funding payments of an industry of independent operators. There is no "health care system" that delivers a given level of access. That's what I am talking about.
Our island has a National Health Care Health Center. It is staffed to provide emergency room and routine care, along with 8 beds for stabilizing urgent and critical care patients, a radiology dept, microbiology lab and the like. critical care patients are stabilized, then evacuated to the appropriate next level, by air or boat, with excellent outcomes. General health here is good, life expectancy is higher than the US. Visiting specialists are available on a scheduled basis, and in several specialties, private practice physicians practice on the island at very modest cost. All levels of care, from the common cold on up are available at no cost other than certain supplies and meals for inpatient. Our Ministry of Health coordinates all health care provision to ensure access, as well as standards of care for everyone, to include tourists. Is there anything close to that even being openly dreamed about in the US? Our public policy focus is simply on methods for paying providers.
Andy, it seems that you are right again, no one's biting on that bit of bait.
ReplyDeletebb
Publius-
ReplyDelete"IMO, the odds of a nuclear explosion somewhere in the world are trending upward and we don't have a government capable of doing anything about it"
You've been following the Iran stuff too, haven't you? . . .
--
As to the topic of this thread . . . we're in new waters now. We've pretty much trashed our economic model that we had everyone following, so what now? We've, or rather Wall Street's lost all credibility, so nobody's really buying the scams anymore so . . .
Get out the drones and pretend that it's all about the "war on terror"?
Andy: Yes, yes, yes. But I think the crucial difference is that those other societies DO have stronger family ties-and-traditions than we do. IMO a lot of U.S. "family" mores and manners are somewhere between dysfunctional and toxic. I often wonder if that has something to do with the way we've physically designed our country, with everyone physically separated and almost forcibly distant?
ReplyDeleteI'd go broke if I had a nickel for everyone I know whose family a) is emotionally close and b) physically close. Most of the U.S. seems to live in a very disconnected world.
I agree wholeheartedly that the older system is "better" - when it works - at taking care of the old folks. But I'm skeptical if anything beyond several generations of economic hardship will force Americans into the pre-war family dynamic again...
Continuing on health care, simply as an example of policy analysis and objectives gone wrong:
ReplyDeleteWalmart's Cuts To Health Care For Part-Time Workers Mirror Larger Trend
Under the plan, new hires who work under 24 hours a week on average will not be eligible for company health coverage, while premiums for some existing plans may go up as much as 40 percent, along with other benefit reductions, The New York Times reported. Additionally, spouses of new hires who work less than 33 hours a week will no longer be covered.
"The current health care system is unsustainable for everyone and, like other businesses, we've had to make choices we wish we didn't have to make," said Walmart spokesman Greg Rossiter. "Our country needs to find a way to reduce the cost of health care, particularly in this economy."
How, in any stretch of the imagination, can health care be called a "public policy" issue, when people look to employers to provide solutions, and employers look to "our country" for cost containment? And, is WalMart concerned about universal access, or just getting the price of insurance to fit within its P&L for its own employees?
Who is the "constituency"? What are the desired outcomes?
Al,
ReplyDeleteThe fed has a PPT policy similar to walmarts, designed to deny bennies.
jim
jim-
ReplyDeleteWhat I am getting at is that we, as a country, or society, do not have a policy addressing our goals for access. Do we want universal access to all levels of health care? All the discourse is about paying. We are in the high cost mess we are in primarily because of the disjointed programs, most of which were private sector, to pay whatever the medical industry demanded. And it was done by shifting the actual costs to the customers of the employers, until the P&L couldn't sustain it. Government or public policy does not set or provide the standard of access. The "market" does, and right now 50 million Americans are priced out of the market, a couple of hundred thousand more, with "insurance" have gone bankrupt as a result of medical bills, and the trendline continues in the same direction - higher and higher costs and less and less access.
Now, if a bank is going to fail, public policy has a safety net. When Wall Street almost went under, public policy bailed them out. We have the ability to cater to some powerful limited constituencies, but not the balls to take on a huge industry health care and insurers) to provide for the general well being.
And health care is just one arena where were are adrift.
Al,
ReplyDeleteIn a capitalist society there must be a winner when there's a loser. And visa versa.
Did we bail out Packard?
If any enterprise to include gov't can't cut the muster then it should die. IMO the reason the USSR failed is because nothing was allowed to fail.
jim
jim-
ReplyDeleteAre there any such ideas as social services in a capitalist society? Are there any social services that should be allowed to fail? Like roads, police, fire protection? The health care industry is very profitable, yet it is currently failing 50 million people, and the number will only grow. Are there any social services that should address the common good - as in a universal sense? Suppose fire fighting service was done on a "for those who can or choose to afford" basis. Would it bother you if the houses on both sides of yours did not subscribe to fire fighting service? How about if they decided not to connect to the private sewer service, and simply had nice open cess pools?
Social services are not alien to capitalist society. They are the services society deems too essential to make park of the voluntary market, but join together, through government, to provide.
jim-
ReplyDeleteAre societies capitalist or socialist, or are political/economic systems what we are talking about? Does socialism rule out all private enterprise? Does capitalism rule out all social programs?
In the simplest of terms, The USSR failed because it's monolithic economy was based totally on "creative accounting", and the limits of that fraud were reached. The US financial industry failed because it engaged in "creative accounting", and the limits of that fraud were reached. The difference between the two countries was just that the US private sector had a separate government sector to bail it out by creating taxpayer debt. The USSR simply didn't have a backup to turn to that could create more debt.
Thank you for your interesting and informative blog. I have enjoyed reading it and appreciate the work you have put into it. Here is some relevant information for you to review .
ReplyDeleteKids Tactical Vests