Lefty Parent » health care reform

Winner Take All Governance?

Cooper Zale — Sat, 08 Jan 2011 18:54:20 +0000

I read the title of the on-line CNN piece, “Democrats dismiss GOP health care repeal push”, and had to groan. Here we go again! A fresh new year, but the same old same old in terms of “us and them” thinking in our national governance. As a Unitarian-Universalist, a hardcore egalitarian and a “governance nerd”, it struck me that though I’m used to this kind of rhetoric from our Congressional reps, from the point of view of effective legislating, it is really quite dysfunctional and corrosive to the process.

Washington (CNN) — Top Democrats are dismissing Republicans’ plans to ram a repeal of President Barack Obama’s health care overhaul through the House of Representatives in the opening days of the new Congress, portraying the move as little more than a hollow nod to the GOP’s conservative base.

From my thinking, this kind of framing of the situation is all about power politics rather than egalitarian governance, and also all about a spectator sport with victors and vanquished rather than a meeting of the minds between peers towards compromise and solutions. Everything seems to be done in terms of jockeying for more Congressional seats for your team in the next election and towards the big prize of winning the Presidency for the next four years. Compromise is for wusses, and it might turn off your partisan supporters and give a shred of an advantage to the other side.

Given that I am biased as a lifelong progressive and voting Democrat, I feel like the Congressional Republicans made a political calculation after Obama won the 2008 election that if they opposed everything his administration tried to do (even compromises that reflected their ideas) that they would be better positioned for the 2010 election and to defeat him in 2012. It seems that part of that calculation was trying at every turn to accuse Obama of being a “socialist” (certainly that was the main Fox News talking point), particularly in his attempt to resolve the financial crisis, save General Motors, and pump money into the moribund US economy. That seemed disingenuous since I don’t think Bush or even McCain (if elected) would have done anything that much differently. It seemed like a simple calculation that they could make that label stick with and motivate their conservative base to action, the better to win the next contests in two and four years.

That said, progressives and their MSNBC spokespeople had previously seemed to do their best to paint a fascist face on the Bush/Cheney administration, given the unique challenges of the World Trade Center bombing in 2001 and subsequent terror campaigns. I think I was guilty of that at times myself, and looking back now see it as going against the Golden Rule and sewing negative seeds only to reap them when the pendulum swung the other direction.

It seems to have become the standard national legislative/political script for both sides. As soon as the other side grabs the majority, immediately start trashing them including questioning their intentions. “Preemptive war” of sorts.

Pragmatically, if you are going to have an effective governing body, you don’t start the meeting by accusing the other side of being disingenuous. An effective egalitarian governance process depends on establishing shared values and goals, even if there is strong disagreement on how to get their. I think there is actually a fair amount of agreement between Democrats and Republicans in Washington, at least on values and goals, but that is trumped by the political fear that the first side that “flinches” (compromises) will lose the ardor of their base.

In contrast to the highly inaccurate accusations of being hyper-partisan, President Obama sounded like the lone egalitarian statesman in the mix…

“I think that there’s going to be politics, that’s what happens in Washington,” Obama told reporters aboard Air Force One after wrapping up his Hawaiian vacation late Monday night. The Republicans “are going to play to their base for a certain period of time. But I’m pretty confident that they’re going to recognize that our job is to govern and make sure that we are delivering jobs for the American people.”

Obama here is guilty of putting himself in his adversaries’ shoes and acknowledging their position, a hallmark of facilitating effective egalitarian governance. Contrast Obama’s statement with the clips in the story from Congressional Democrats.

Connecticut Rep. Rosa DeLauro, addressing reporters at a news conference with other House Democratic leaders Tuesday, called the GOP move “disingenuous” and “nothing but political theater”… “It is a Kabuki dance,” she said. “The fact of the matter is we’re not going to repeal health care. It is not going to happen.”

DeLauro could not be accused of trying to acknowledge any good intentions in her opposition. And even more so her caucus leader…

Outgoing House Speaker Nancy Pelosi, D-California, cited projections from the nonpartisan Congressional Budget Office noting that the Democrats’ overhaul will lower the federal deficit over the long term. As a result, she argued, a GOP-led health care reform repeal would “do very serious violence to the national debt” — undermining a central Republican pledge.

Pelosi’s preemptive strike is to say the other side will “do very serious violence”, and not just “lead to a significant increase” in the national debt. More extreme framing!

Why can’t we even acknowledge that the people on the other side of an issue can be genuine and principled in their opposition, even if we think they have it wrong? Do our opponents need to always be vilified in order to increase support for our position?

The GOP caucus number two (at least through his spokesperson) can’t be accused of putting himself in his opponents shoes either…

“Obamacare is a job killer for businesses small and large, and the top priority for House Republicans is going to be to cut spending and grow the economy and jobs,” said Brad Dayspring, spokesman for incoming House Majority Leader Eric Cantor, R-Virginia… “Further, Obamacare failed to lower costs as the president promised that it would, and does not allow people to keep the care they currently have if they like it.”

That last quote could be written off as clueless for someone that did not understand implementation of major new public policy, but coming from GOP leader Cantor’s office it seems patently disingenuous. The provisions of health care reform have barely begun to be implemented. Its like accusing FDR of not winning World War II yet… in say October 1942, when American forces have barely begun to engage the Axis. This seems like a calculated effort to mislead people.

It also looks like all the Republican hyper-partisans are carefully disciplined to call the health care reform legislation “Obamacare”, trying to take full political advantage of a compromise bill that made neither set of partisans very happy, focused on the 2012 election rather than governance in the meantime. (It might more accurately be called “Baucus-Grassleycare”, since that would reflect the two people whose ideas are prominent in the provisions, but that would not help with the pre-2012 artillery barrage.)

Well I could go on and on, but back to the point. The reality here is that almost everyone (except Obama it seems) is framing the legislative crafting of health care reform as a winner-take-all contest between two angry combatants both claiming principle on their side and lack of the same on the other. That’s apparently what attracts eyeballs and sells ads on cable news.

But I think that the ethical base of our egalitarian republic takes a hit with each salvo from either side, and more and more politically unsophisticated US citizens may be drawn to a Tea Party type stance of “a pox on both your houses”, and that the best government is an emasculated one.

Lefty Parent 2010 Year in Review

Cooper Zale — Wed, 29 Dec 2010 20:58:50 +0000

As I continue to try and broaden my writing skills I occasionally try my hand at a different sort of content than my typical essay featuring a personal experience that I link to what I see as a broader trend, straight out rant, or a wrestling with ideas I’ve encountered in a book or article I read. Like recently I did a piece trying to capture the zeitgeist of the moment in US education as reflected in a selection of recent articles in Education Week magazine and the Public Education Network weekly e-blast (which was a challenge and tons of work and something I’d do again but not all the time).

Today I’m going to try my hand at another genre of short essay, the end-of-year year-in-review type piece, calling out some highlights or trends from the year past. Given that, I won’t even attempt to be comprehensive, other than scoping my piece on the items from 2010 that I’ll be curious to see play out going forward in 2011 and beyond. Here goes… wish me luck!

The first is health care (or really health insurance) reform. This topic is particularly poignant for me due to my emergency neurosurgery in February (for a subdural hematoma) which, if I had not had health insurance coverage (mine with Kaiser Permanente), probably would have saddled us with enough medical bills to put us in a very deep financial hole.

Though a majority of the country (left and right) criticized the compromise legislation hashed out by Congressional Democrats, my hat goes off to them and to the Obama administration for actually taking an initial huge step towards universal coverage. Unlike the Clinton administration plan in 1994, this plan had the majority of the health insurance industry on board at least to some degree. Yes I would prefer a “public option” or even single payer, but given that we have a mostly for-profit health care financing industry, I thought this was a stunning step forward in a more egalitarian direction toward universal health care as part of our shared “commons”.

Given that there are an array of obstacles and countervailing forces ahead that could dismantle the effort, it is stunning that the insurance industry, which has fought federal regulation for decades, finally agreed to a significant regulatory guidance from Washington in exchange for mandates that everyone buy coverage (or receive it via Medicaid). Whether you think that’s a good thing or not, it is certainly a milestone in the history of the industry.

And whether this hybrid “free market with mandates” solution in its current form will actually work to control costs and move us to near universal coverage, I am highly doubtful. But my hope is that it has created enough momentum, enough expectation, that there is no going back, no stopping this train that has left the station. Hopefully where the legislation fails to deliver, that momentum will force fixing rather than derailing the locomotive.

The second is our slow economic recovery, particularly the slow jobs recovery, which I am hoping is a blessing in disguise going forward. Yes many people still without jobs are suffering mightily, but I believe a quick return to the more robust employment during our country’s “shop ’til you drop” hyper-consumerism would be a step backward. I hope that continuing flat job growth will instead catalyze new outside-the-box economic thinking in the worlds of consumption and work.

I am hoping that a “small is beautiful” ethos will take hold, and people will look at how they can lead their lives more simply, and really analyze spending their precious time and money more effectively. It seems like a significant amount of our spending in the past has been compensatory. We buy expensive cars, gadgets, vacations, etc. to compensate perhaps for unsatisfactory, stressful work environments that we endure to earn that extra money for those compensatory purchases… a vicious cycle.

I’m also thinking about the possible logic of a transition from the conventional forty-hour to say a thirty-six-hour work week, with a commensurate ten percent reduction in pay. I believe a lot of people that work in stores, restaurants, etc. already are being limited by employers to less than forty hours per week. But particularly for higher wage “knowledge workers” and other “apparatchiks”, it seems at least simplistically, that the shorter work week and pay cut would perhaps open up ten percent more jobs in this higher paying category of work. Being in that category myself, I would take that trade-off even though it would be a big challenge to our budget.

Finally, the continuing sluggish economy with its significant impact on government spending, particularly the big-ticket item of public education, could catalyze a rethinking of our increasingly expensive top-down, bureaucratic school system in favor of something simpler, featuring the basic triad between student, parent and teacher.

On that note, the third is the growing challenge to the conventional wisdom of the “Education-Industrial Complex” represented by the popularly provocative documentaries “Waiting for Superman” and “Race to Nowhere”, and by a one-off local insurrection in Compton California where parents petitioned to oust the staff of their neighborhood public school in favor of an outside charter group. I’m hoping that we are seeing here a growing movement to challenge conventional educational wisdom, perhaps something akin to what my friend Ron Miller calls out in his book, The Self-Organizing Revolution. Says his book’s promo blurb…

The Self-Organizing Revolution explores the transition from the modern institution of mass schooling to a postmodern network of diverse learning options available to all young people. Miller wrestles with the philosophical, moral, and political questions that arise with the radical proposition that public schooling as we know it has become obsolete. He cautions against simplistic models of privatization and lays out an egalitarian, democratic, socially responsible program of decentralized education.

I’m hoping there is synergy here with the sluggish economy and likely continuing cuts in public education spending. As the Soviet Union learned, a huge hierarchical bureaucracy featuring top-down control and little “ownership” by the people at the bottom is debilitatingly expensive to maintain. I think our state public school systems are comparable pyramids of ineffective spending above the level of students, teachers and parents in the school “trenches”. As the control model begins to unravel due to lack of funding, I’m hoping we will see more insurrections from parents, teachers, and even students, to tear down “the wall” between bureaucratic practice and real learning.

Fourth (and last for this piece) is the playing out of the “Tea Party rebellion” in our political process. I think the election of these populist fiscally-conservative contrarians is just act one of a perhaps five-act play, the catalyst for more to come in the 2012 election, when the stakes will be ratcheted very high on all sides. Between now and that election, the growing American dichotomy between governance and gaining political advantage will be highlighted in stark relief.

The compelling political drama may well be how the Republicans try to find a Presidential candidate with sufficient gravitas from perhaps a weak field of Fox News commentators, little-known governors, and junior senators. All this while the person with the most buzz and eyeballs, Sarah Palin, may well just comment and grant favor lucratively from the sidelines. Obama vs Rubio in 2012 anybody? A former junior senator vs a current one?

Will the energized Tea Party constituency (the conservative side of the “part of the problem or part of the solution” baby-boomers) drag the GOP back to a focus on fiscal conservatism from their thirty-year romance with religious, racial and social conservatives? Has the ideological realignment of American political parties, set in motion by Lyndon Johnson and the Civil Rights Act of 1964 finally played itself out?

But in the context of all that classic American political theater, how will major issues of governance, including implementation of health care reform, move forward? Will we have government agencies charged with implementing the new policy while the funding to do so is blocked by reform opponents? At the state level, will we have a patchwork quilt of efforts toward universal coverage moving forward in “blue” states while languishing in “red” ones? And when the Supreme Court ruling comes down on the mandate to purchase health insurance, how will that impact the mix?

Certainly a lot for a “news junkie” to look forward to in the year ahead. But beyond that spectator sport, a hope that there will emerge some new possibilities for all of us to take more control of our own lives and our institutions (including education) in an effort to “right size” things toward more simplicity, efficacy and sustainability.

Shopped ’til we Dropped

Cooper Zale — Thu, 04 Nov 2010 18:42:38 +0000

I can’t say I was one of those prescient people who saw the Great Recession coming, but I will tell you that ever since the 1980s, whenever I walked into a mall or shared the freeway with a zillion other cars with just a driver in them (and no passengers), I felt like our culture (at least the urban version in Los Angeles) was profoundly out of balance. It seemed like in the mall ninety percent of the money being spent was for stuff that the buyers did not really need, and on the freeway the same percentage of the gasoline being consumed was beyond what was needed to move all these people from their points A to points B. We were like addicts trying to maintain a high, taking yet another dose at the expense of our health, ever pushing back and even attempting to deny any day of reckoning.

My partner Sally and I bought a house, just before the millennium began, that doubled in price in seven years. We borrowed much of that equity and plowed it into business investments that went south with the rest of the economy. This to say that we got caught up in the whole thing like many others, and so are not about to cast any stones.

I hear some commentators and economists speculating on how long it will take to get back to where we were before the recession, particularly for home prices to recover to those stratospheric 2007 levels. But were those home prices ever realistic, and could anything short of another craze and resulting bubble get prices their again in the near future? Not sure that would be a good thing. And do we really want to go back to an economy that depended on “shop ’til you drop” to have full employment? Well I have a job and so do both of my young adult kids at the moment (knock on wood), so maybe I’m not the one to best answer that question.

So with the 2010 national election now behind us and more conservative (even libertarian) governance ideas in ascension (for the present at least), and the U.S. still mired in a slow recovery that some say could sputter back to a new recession, I keep thinking that 2008 was a helluva time for Obama and the Democrats to grab the political reins. Of course who knows where we’d be if they hadn’t, but I just wish George Bush could have been President long enough to be responsible for all that crude spilling into the Gulf of Mexico from his favorite industry, and have to be fully culpable for the financial (and not to mention human fiasco) that was the Iraq war.

Instead of that scenario, we have had the Democrats at the helm while a significant percentage of the electorate is indulging themselves in reenacting that iconic scene from the movie “Network”, where people go to their windows and scream, “I’m mad as hell and I’m not going to take it anymore”, egged on of course by the bulk of the Republicans in congress and the full array of the Fox commentators.

I keep wondering if, from the moment Obama was elected, if the congressional Republicans had any intention of being anything but completely obstructionist. I think about the U.S. Back in 1860, when Lincoln’s election as a “radical Republican” led to the almost immediate secession of the soon to be Confederate states from the Union.

Anyway… as I have said before, I am guilty of being an optimist. As such, I seem to be one of a minority of political progressives that thinks Obama and the Congressional majority did a good job crafting a compromise health care reform bill, to finally create a path forward for the county to move toward universal health care, in such a way to accommodate our crazy for-profit medical industry. In my mind, just the fact that the Federal government is finally getting into the business of regulating the insurance industry is a great step forward. Certainly there is much “sausage making” to come, but after half a century of trying, the U.S. is finally at least starting to build some sort of consensus (still shaky, and soon to be tested post 2010 election) for health care as a universal right.

I hold out hope that the silver lining here is if we can get to some sort of near universal health care coverage by 2014 (assuming Obama can get reelected) then continuing health care inflation by our mostly for-profit system will put pressure toward moving to a single payer system to get costs under control. That may be the way it will work.

When I suggested this to a good friend the other day in an email, he replied…

I certainly hope you’re right, but delivery of affordable health care is not a stand alone problem. it is part of a witch’s brew of a toxic economy, a sick housing market, high unemployment and a continuing loss of better paying jobs. If matters do not improve in the next couple of years providing access to medical care may be even less possible than it is now.

I hear his concern and I have it too. But what I am hoping is we are going through a painful adjustment to a “new normal” that is less materialistic, less “shop ’til you drop”, and more focused on a real, rather than what seemed like a more fabricated quality of living.

So for a while the metaphorical addict (our country) will have to go through a “detox” process as the toxins are expelled from our system and we eventually recover to a healthier base state not so reliant on artificial stimulants and other metaphorical “medication”. From my point of view the housing market was “on drugs” for years prior to its crash in 2007-2008, I don’t think that either the big run-or or crash was healthy.

Once we recover from this metaphorical “substance abuse”, I think we have a chance for a healthier housing market that is more realistic and less speculative. As to employment, we will have to acknowledge that the jobs that supported “shop ’til you drop” probably won’t return and we have to sort out how maybe we can all live more frugally, rather than endlessly trying to work more, in an endless pursuit of more money. Again, perhaps easy for me to say, I have a good-paying job at the moment.

I see the whole halting, still shaky, and long-sought move towards universal health care emblematic of perhaps a new beginning of moving from “us and them” thinking to more of a frame of “all us”, and an acknowledgment that we are all in this ongoing experiment we call the United States of America together. If we can move to taking access to affordable health care off the table somehow, I think it can simplify all our lives and help us really unlock the entrepreneurial spirit of our country, which could eventually lead to a renaissance of simple pragmatism and “rightsizing”.

That’s my optimistic spin and the dream I hold on to!

Healthcare Reform, Democracy & Schools

Cooper Zale — Sat, 03 Oct 2009 22:03:43 +0000

I am concerned about the unfolding process of working out changes to our healthcare system, and particularly how it is being covered in the media as a contest with winners and losers rather than an exercise in compromise to find a working consensus. I think the framing of the debate in the coverage reflects a conventional wisdom that our political and legislative process is more akin to a spectator sport (where our political elite are alone on the playing field) rather than a societal effort to mitigate conflicting interests and find a compromise that can begin to improve the healthcare context for all of us. I for one, put a lot of blame on our education system.

My personal preference would be to treat healthcare basically as a public utility and adopt a single-payer system like they have in Canada, which I think would unleash the currently tamped-down entrepreneurial spirit in our country and liberate a great deal of pent up creative energy that could be directed toward starting more small businesses and reinvigorating our economy. Short of single-payer, some sort of government-run “public option” would be a step in that direction, and I imagine that fact is why so many conservatives and others vested in our for-profit medical establishment are fighting so fiercely against any sort of additional “toe in the door” alongside Medicare, the VA, and Medicaid.

That said, I have a sophisticated enough understanding of democratic process, including consensus building and vote counting, to understand that, at least at this point in time, there is not the consensus in this country to adopt a single-payer system. Furthermore, I also understand that though there is a majority in the country and in the U.S. House for some sort of a government-run “public option”, there do not seem to be the 60 votes in the Senate to pass it outright. I have to acknowledge that at this point in our country’s history the business of America is still business, and the existing for-profit health care industry is a powerful political player, particularly as reflected in the U.S. Senate with its bias towards smaller population states with more conservative, rural constituencies.

So I could wave my “Power to the People” flag, hurl a few choice epithets at Rush Limbaugh and Glenn Beck, pick up my cards and go home, but that would not be in the spirit of the admitted “sausage making” that goes into building a “consensus of the possible” which is at the root of any real democratic process.

I am concerned that building a workable compromise solution is being made way more difficult by the news media, particularly conservative and liberal pundits, who are framing this effort to craft healthcare reform (or maybe more accurately health insurance reform) as a contest between Obama and conservatives, where one side or the other will be victorious and the other vanquished. Since the media is commercially motivated, presumably most people out there buy into this spectator sport and are rooting for one side or the other rather than focusing their hopes (and the reflection of their hopes in town hall meetings and other communications with their legislators) on improving the health care system in our country by coming to some sort of “consensus of the possible”.

There is a lot at stake, including ending what I consider the unethical practice of denying people coverage because of preexisting conditions. Short of guaranteeing every one of us adequate healthcare coverage, we should at least offer every American affordable health insurance, even if it takes mandating that all of us purchase that coverage. The latter is admittedly a backhanded way of doing it, which will be a boon for the insurance and healthcare industry. But so be it, since most of us Americans seem to want to live in a society awash with consumer goods, and we buy the products that big business provides, giving them the profits to allow them to have so much political clout in the legislative process.

One way or another we need to take some sort of a step to a more humane and rational healthcare system that is a source strength rather than stress in our collective and individual lives. But I am concerned that we lack the political sophistication to do so, and are instead caught up in a very passive, unsophisticated rooting for one side to “triumph” over the other. And if one way or the other there is a compromise, rather than all of us breathing a sign of relief and acknowledging each other for working something out, every effort will probably be made to frame it as win for somebody and a crushing defeat for someone else.

So how has a country founded on perhaps the most advanced political thinking and sophistication at the time of its founding become so much the opposite? There is the list of the usual culprits, depending generally on what side of the political spectrum you inhabit. Conservatives might say it is big-brother big government usurping individual liberty and leading to alienation with the political process, while people on the liberal side might say it is big business control over politics leading to a similar alienation.

I have my own culprit to add to the list, the American education system. In a country that needs to rely on political sophistication to work through difficult challenges like healthcare reform, we have a population that has mostly grown up in schools, whether public or private, that do not give kids the opportunity to have a meaningful stake in the governance of this institution where they spend so much of their young lives. The average American adult has never had the experience of hashing out a difficult compromise using the pragmatic tools of democratic process, and therefore I think has no appreciation for the discipline and nuances of that process.

School instead is all about students respecting, mostly unchallenged, the authority of the teachers and administrators and watching from the sidelines while those same authorities make and enforce all the rules. The student’s role in the governance process is nada, just do what you’re told and hopefully be favorably evaluated by your teachers.

Generation after generation of Americans has grown up with no ownership stake in the primary institution they have participated in during their formative years. Educators often defend this pecking order by saying they are just preparing kids to participate in a work world where they will have to follow the orders of their future employers, and do whatever boring work (like the boring work at school) that is on their plate in the work world. Given all this, no wonder we have a politically unsophisticated population that views politics as a sport with winners and losers.

So I say its time that we face this fact and begin to profoundly change the governance structure of our schools to include all school stakeholders (particularly our youth) in its governance process. Education is not just about what you are learning, the curriculum, though most people (including most politicians, educrats and voters) seem to fixate on that. Education is also about methodology and governance.

Methodology, or in “ed-speak” pedagogy, is about how we learn. Most people (including most politicians, educrats and voters) seem not to understand that the pedagogical basis of most schools is instruction, which is only one of a number of different learning methodologies.

And finally, education like any other institution is about governance, and it seems that practically no one is thinking about that. Like anything else, practice makes perfect, and the bulk of us are failing to realize that generation after generation of American kids are getting no practice in governance during their youth. Instead they are getting intense training in being compliant worker-bees at the bottom of the pecking order, who can get only vicarious satisfaction when their “team” goes out and hopefully crushes their opponents on the gridiron.