The Summit.

What a fun way to spend a day at work! Anyway, just 2 moments to point out now that the transcript is available:

1. In response to the argument that the government should not be regulating minimum insurance standards because .. the government shouldn't be regulating things, period:

THE PRESIDENT: We could set up a system where food was probably cheaper than it is right now if we just eliminated meat inspectors and we eliminated any regulations in terms of how food is distributed and how it's stored. I'll bet in terms of drug prices, we would definitely reduce prescription drug prices if we didn't have a drug administration that makes sure that we test the drugs so that they don't kill us.

But we don't do that. We make some decisions to protect consumers in every aspect of our lives. And we have bipartisan support for doing it, because what we don't want is a situation in which suddenly people think they're getting one thing and they're getting something else -- they're harmed by a product.

2. And a funny moment:

THE PRESIDENT: Let me just make this point, John, because we're not campaigning anymore. The election is over.

SENATOR McCAIN: I'm reminded of that every day.

On a related note, this is a great piece by Ezra Klein about the "philosophical" differences between the two parties that people kept bringing up.

...just as many people discover religion in the face of tragedy, the GOP appears to have discovered philosophy in the face of a Democratic majority.

Anniversary.

It was exactly a year ago when I went to La Guardia to pick up Olive. She turned out to be the sweetest thing and I never stop being amused by the simplest things she does. Like this morning when she jumped up on the bed, licked my face and decided to lay down on my face, of all the places. Here's to our first year together, my little beast.

The Weird Idiocy of the Filibuster in the Senate.

The Senate just passed the $15b jobs bill, with 70 yeas and 28 nays.

Now, the extremely weird thing is that the cloture vote (ie, ending debate on the bill to allow for the actual vote on the merits of the bill, ie breaking the filibuster) was 62 to 30.

In other words: on Monday night, there were 8 people who didn't even want to allow a vote on the bill who by Wednesday morning voted in favor of the bill.

Huh??

Edge.

Having grown up in one country and lived all of my adult life in another, yet not really identifying with or feeling fully at home in either, I appreciated Tony Judt's essay on the New York Review of Books blog.

Speaking of which, his recent collection of memoirs in the last 3 issues of NYRB is well worth purchasing the online subscription. But in case you're hesitating, here's the first one from the series, which can be accessed for free.

Hear That, McCain?

On CNN's Situation Room, Wolf Blitzer asks NATO military chairman about gays in the military:

BLITZER: Let's talk about gays serving openly in the military. It's a big debate here in the United States as you well know, right now. Most of the NATO allies, including in Italy, allow gays to serve openly in the military. How is that working out in the NATO alliance?

DI PAOLA: I think it's working out quite well. In the end, fundamentally, the issue here is the sexual orientation is not an issue insofar as you being a soldier or whatever you would be in the environment you are working for, that is not a problem. Sexual orientation is a personal matter, not a matter for state policy.

BLITZER: So it hasn't undermined unit cohesion, combat readiness?

DI PAOLA: Absolutely not. If there is misconduct, applied to a gay or non-gay, that would be treated as misconduct. So your sexual orientation does not have to influence the environment in which you work.

BLITZER: When NATO troops, whether from Canada, Britain, or Germany, or France or Italy, serve in Afghanistan, for example, with U.S. combat troops and there are gays serving side by side, have you seen one example of an incident that has undermined the ability to fight?

DI PAOLA: I have not seen it. I am not aware of it. Of course, I don't know all the cases that might have happened. But I'm not aware of any cases of any relevance.

SO, for someone to argue against gays in the military, they not only have to explain why the US military is different in this respect from almost every other military in NATO, but also why it is a problem for gays to serve in the US military when US troops routinely serve along side with gays from other countries during NATO missions. I guess the only possible answer would be that American gays are somehow lesser or more problematic when serving openly than foreign gays, and I am dying to see someone explain that.

Editor-At-Home.

All I have to say about Krugman's profile in the New Yorker is that when I become a big time columnist/writer/academic, I hope Daniel will be my at-home editor. Because that's really neat.

Tufts, Blonde.

Reality imitates fiction - it's just a little sad when it choses to imitate Legally Blonde .. the timeless classic featuring Reese Witherspoon who gets into Harvard Law thanks to a video in lieu of an application essay.

That was my first thought when I read about Tufts encouraging college applicants to make YouTubes of themselves. But I'll let the admission dean explain the brilliant idea in his own words:

Lee Coffin, the dean of undergraduate admissions, said the idea came to him last spring, when watching a YouTube video someone had sent him. “I thought, ‘If this kid applied to Tufts, I’d admit him in a minute, without anything else,’ ” Mr. Coffin said.

Really? Great.

Truth With An Error Range.

A recent article by Megan McArdle cause a mini storm in the health blogging circles. Moved by the assertion made by Ezra Klein back in the fall that Joe Lieberman was willing to cause the deaths of hundred of thousands of people by threatening to block reform, McArdles goes on to examine the link between mortality and health insurance and after finding various reasons to ignore or disqualify various studies on the issue, she concludes that while there might be some effect, it's hard to tell how big it is and because it's hard to measure exactly how big it is, it's probably too small to matter.

Needless to say, McArdle has been attacked from all sides (actually, mostly from the left) for this article and it's easy to see why. While her article doesn't insist that health insurance is irrelevant and she does say "even if we did agree that insurance rarely confers significant health benefits, that would not necessarily undermine the case for a national health-care program" by launching a pedantic attack on a statistic, she helped to undermine what many would consider a "logical" case for expanding health coverage to everyone.

There are two reasons why I find this whole debate incredibly annoying and offensive.

First of all, by making a reasonable case that the effect of health insurance on mortality are hard to determine precisely she then goes on to argue that we can't say how large it is. If one study says 50, another study says 200, it could probably as well be 0, seems to be the argument. The truly annoying thing about this argument is that from everything McArdle says, she doesn't seem to actually believe that there is no relationship, but she is suggesting that it might be small and either way no one can claim with any certainty what exactly it is.

I guess McArdle deserves credit for correctly identifying a problem with the studies of this sort - they aren't perfect and they aren't precise. However, does it mean they are thus entirely irrelevant? That's what she seems to be suggesting in her concluding paragraph: "we should have had a better handle on the case for expanded coverage—and, more important, the evidence behind it—before we embarked on a year-long debate that divided our house against itself." Translation: why didn't you pro-reform morons get your facts straight before wasting everyone's time with this non sense for a whole year?

Therein lies the insane contradiction of what McArdle is saying: on the one hand, she discredits the assertion that expanding health insurance saves lives by showing how evidence is hard to attain; on the other hand, she says we need better evidence to show exactly how many lives were saved by health insurance. Unless we have an exact measurement, it's useless; if it pretends to be exact and precise it's probably wrong.

McArdle's sophistry is equivalent to asking a man on a boat in the middle of an ocean how deep the water underneath is. The man clearly sees that the water is very deep but he has no good way to measure it until he realizes that he can tie a heavy rock to one end of a thread, drop it in the ocean and measure the length of the thread until the rock hits the bottom. Of course the bottom of the ocean is uneven, so multiple measurements will result in different results. Faced with this imperfect technique and variation in results, McArdle would probably say that we can't conclude that the ocean is very deep. Even though it is intuitive and obvious to all the rest of us that the ocean is very deep, because one can't measure exactly how deep, she would suggest there's some likelihood it's shallow, and maybe we're all just imagining the ocean in the first place. In the case of health care, McArdle's logic would suggest that because we can't exactly measure the link between insurance and health outcomes, we shouldn't be so obsessed with providing insurance to everyone. In the case of our man on a boat, McArdle would probably send the man without an oxygen tank to find something on the bottom of the ocean because he can't prove exactly how deep it is. Despite the preponderance of logic, common sense, intuition and countless anecdotes of people who lose their lives because they can't get the care they need, McArdle is totally unmoved and declares the deep ocean of the problems that uninsured have a mere mirage.

The other reason why this debate is incredibly annoying is because it's entirely besides the point. Yes, it would be great if we could say with total certainty how many people die each year because of lack of insurance and it would be awesome if we could therefore accuse someone blocking reform of killing hundreds of thousands of people. But even in the absence of that, the case for reform is no weaker. In fact, disproving (or undermining) any one "estimate" does not change the fact that the system is incredibly broken and unfair. And while it might be fun to play around with statistics to make a case one way or the other, the truth has an error range and no estimate or projection can be relied upon with absolute certainty. Ultimately, this debate is about values and trade-offs and I wish those hiding behind pseudo-statistical analysis would debate it as such.

What Now?

New article for Zahraničná politika. Other articles here.

What Now?

On January 19th, 2010, the good people of Massachusetts were voting to elect a US Senator to replace the deceased Ted Kennedy, a Democrat who held the seat since 1962. Ever since the Republican candidate Scott Brown was announced the winner of that election, the Democrats have been in a crisis that is threatening to completely dismantle the young Obama administration.

First some background is due. Prior to this election, the Democrats (in combination with the independent Joe Lieberman) held 60 seats in the Senate, and the Republicans held 40. Because a Republican won the seat, the Democrats lost their 60-vote majority. Now, in most legislative bodies, a 59% majority is still a perfectly good majority to pass a bill. Not so in the US Senate, where the rules require that in order to take a vote on a bill, the debate has to be formally brought to conclusion by 60 or more votes. Therefore, losing the 60th seat amounted to losing the ability to pass anything in the Senate. While Democrats technically still have a majority of seats in the Senate, what matters more is the other 41 seats occupied by Senators that represent 37% of the US population, who can bring the Senate to a halt any time they wish. If you thought that the US was a representative democracy, you might want to rethink that.

There is no area that illustrates better the effects this has had on American politics than healthcare. Prior to the special election, before the Democrats lost their 60th seat in the Senate, both the House of Representatives and the Senate passed their version of reform. Like they would with any other bill, after passing their respective versions, the representatives of the two bodies started negotiating a compromise bill that could be put to vote and passed in both chambers of Congress, thus finally enacting health reform, after nearly a year of hearings, negotiations and compromises - and a century of failed attempts. Indeed, when the President set the date for his first State of the Union speech for January 27th, 2010, it was commonly expected that he will list health reform as one of his first year accomplishments.

The situation changed dramatically on January 19th when a Republican won the Massachusetts senate seat. The implications of this loss quickly reverberated throughout DC. On a practical level, the loss of the 60 vote supermajority meant that the standard route that everyone envisioned prior to the election - passing a compromise bill in both chambers - was no longer a viable option, since the Democrats were now one vote short of the necessary supermajority in the Senate. As a result, the only option to still pass reform was for the House to simply adopt the bill already passed by the Senate prior to the special election. (Remember, as long as both chambers of US Congress pass the same legislation, it becomes law.) With a Democratic majority in the House and a simple majority required to pass a measure, one might think that concluding this saga would be a breeze.

However, what happened in Massachusetts had a much more profound impact than simply losing a seat in the Senate. With a solidly Democratic state like Massachusetts suddenly voting Republican, the narrative that quickly developed in the media was that the election in Massachusetts was basically a litmus test for Obama, his administration and the Democrats at large. The failure of a Democrat to secure the seat despite hugely favorable position in the polls just a few weeks prior to the election was being interpreted by many as a sign of meaningful dissatisfaction in the electorate. Even more specifically to healthcare, many commentators insisted that popular opposition to the current reform effort occurring in the Congress was behind the downfall of the Democratic candidate. Whether or not these theories have any truth to them, it is understandable that all Democrats in the Congress must have asked themselves what this means for them and their prospects during the midterm elections in November. After the loss in Massachusetts, which no one saw coming, are they risking their reelection by voting for the health bill? Something along these lines must have been happening, because by January 21st, the speaker of the House Nancy Pelosi declared that she doesn't have the votes to pass the Senate bill.

This chain of events clearly had an effect on Obama's State of the Union speech. Instead of taking a victory lap for passing health reform, Obama felt it necessary to urge the legislators: "Do not walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people." Certainly, these are not words of someone confident in the imminent passage of the bill; on the other hand, some optimists in the pro-reform crowd might have rejoiced: he still cares about reform, despite what happened in Massachusetts! Clearly, Obama did not drop the issue entirely; however, the fact that he spent barely 5 minutes in the second half of his 69 minute speech on something that he and the Congress spent a whole year deliberating would suggest that he would rather not risk being remembered as the president who went down in flames in his first term due to his aggressive insistence on health reform. Instead, Obama used the speech to outline new priorities - the economy, financial sector reform, and the deficit.

At this point, many have written off health reform as dead. The irony of the situation is that not many envisioned the process getting this close - and its path certainly was not easy. After the August recess and a wave of attacks from all sides this column all but predicted its failure. Which is why after passing through both chambers of the Congress, it seemed all but inevitable and very few could see what would stop its momentum - until that fatal election in Massachusetts.
So what does this all mean for Obama, the administration and Democrats generally? On the one hand, it is hard to make a bulletproof argument that the Democrats should keep on marching fearlessly without a second thought about public preferences - an arrogance that was the staple of the last two administrations. On the other hand, it is not exactly obvious that letting health reform fail will save them from the anger that is brewing in the American public and that was at least part of the reason for the Democratic loss in Massachusetts. Yes, health reform has become less popular - a quick look at the polls can prove that (http://www.pollster.com/polls/us/healthplan.php). Still, will simply reversing course on health care be the saving grace for the Democrats? Unlikely. A recent survey by Public Policy Polling shows that the Democrats' chances at the midterms are not necessary better if reform fails - in fact, fewer people are likely to vote Democrat if reform fails. It seems that whatever damage health care is doing to the Democrats has already been done and retreating from it now can only do more damage. As Jonathan Cohn at the New Republic pointed out, letting reform die would have a threefold effect: first, it will discredit the party in the eyes of those who supported the effort - their base; second, it won't prevent the Republicans from campaigning against them as supporters of reform (they voted for it once before!) - and flip-floppers (they keep changing their minds!), and third, it will rob them of the chance to point to one big accomplishment. The last piece is the most critical one, not only in a symbolic sense (passing bills means "getting things done") but also in a practical sense, that is, there were enough concrete positive measures that would become effective immediately and be perceive positively. And so, even if the public is now riled up against reform, once they started experiencing its early benefits, they would quite possibly appreciate it.

Thinking about the current situation more broadly, if the result of the special election is the failure of health care, I deeply worry about the next 3 years and the ability of this administration to do anything at a time when crucial reforms are desperately needed in America. For if this one road block has the power to create such paralysis among the Democrats that they are not able to take the roads that are still widely open to them to deliver on a key domestic priority, what are their chances to tackle their next agenda items that are just as important yet controversial, like the economy, financial sector reform, climate change? And more importantly, if they fail on this one occasion, why should they deserve to even have the chance to try? After all, how can the country and indeed the whole world face the challenges of the post-Great Recession era with an impotent US government? My message is simple: wake up, Democrats, or die.