Obamacare

6
Oct

Hurricane Donald

In the past month, I’ve written a trifecta of articles on a diverse set of issues in the news – the cultural divide within the country, international relations, Puerto Rico’s needs.  But they all have one thing in common: the destructive nature of Donald Trump.  Here are the highlights – but first a reminder:

 

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Let’s start with Puerto Rico, which I wrote about this week in US News & World Report.  I’ve spent a lot of time in Puerto Rico in the last several years, working on the Commonwealth’s fiscal situation and economy.  Puerto Rico offers – as did New Orleans, in the wake of Hurricane Katrina – an unusual opportunity for creative solutions, some of which I discuss in this article.

These will require resources.  Yet Trump uttered “jaw-dropping comments in Puerto Rico itself” like, “It’s a great trip. Your weather is second to none,” while complaining that “You’ve thrown our budget a little out of whack.”  The headline on the piece, Trump’s Past, Puerto Rico’s Future, doesn’t quite lay on the irony as thickly as I’d intended, but here’s the main argument:

How did Trump recover from the unmitigated disaster of his own financial choices? By declaring bankruptcy, refusing to pay his bills and restructuring in ways that left him an income and everyone else with the debts. Instead of railing against the Puerto Ricans for their failure to pull themselves up by their own bootstraps, in this instance Trump for once actually could profitably offer his preferred example for everything: himself.

… Puerto Rico needs a fresh chance to restructure operations, escape its debt, obtain massive new infusions of cash, and rebrand itself as a leader. And it needs all the rest of us to be complicit in that. Just as Donald Trump did.

This begins to get at the point that Trump’s personal brand of dysfunctionality both epitomizes and drives virtually all the spiraling challenges facing the country today. The State of Nation-States is a somewhat academic piece tackling “a point Trump made in passing” in his speech to the United Nations: “that, as he put it, ‘the nation-state remains the best vehicle for elevating the human condition.’”  This proposition is debatable because the original impetus for the nation-state “was to reduce violence at the international level … while giving nation-states explicit and unlimited control over violence within their borders – not simply policing against violence but wielding it against their own citizens however they see fit.”  Until a year or so ago, most Americans and Europeans would have agreed with “circumscrib[ing] the rights of nations to do whatever they want to the peoples within their borders” – i.e., “human rights” – but global changes are making many more sympathetic to authoritarian regimes.

The new virtual economy leapfrogs borders and generates changes that are leaving many behind economically and undermining aspects of their lives that they until now have taken for granted. For those less globally connected, the threats – physical, cultural, religious and economic (as well as cosmopolites who don’t seem to mind all those) – all seem associated with territoriality. The traditional nation-state therefore appears to be their bulwark, forging an odd, new coalition between traditionalists in cutting-edge economies and repressive states with extractive economies – personified in the rise of Donald Trump.

That takes me to the piece I grappled with for weeks and rewrote multiple times in the wake of the violence in Charlottesville and Trump’s kulturkampf reaction to it – The Rise of Zero-Sum Politics – which concluded:

For all the Hitler comparisons, Trump is really more reminiscent of Mao: Besides seething resentment and authoritarianism, Mao’s most notable personality trait was a constant need to throw everything around him into chaos. Having fractured the Republican Party into its constituent parts and driven a wedge between them, Trump, with his unerring sense for disruption, now has embraced the opposition.

I ended with a perhaps implausible prediction:  Eventually, “Trump will endorse some form of single-payer health care plan” – not because he supports the idea (he obviously has no clue on health policy), but rather because “it would wipe Obamacare off the books” and “rupture the Democrats as badly as he has already his own party.”  We’ll see if I’m right.

As usual, I welcome your comments below!

 

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19
Jul

Hinges of History

As you know, for the past several years, I’ve been writing about the challenges of illiberal and antidemocratic forces, rising alienation of the failing middle class, and technological changes making governance and social cohesion increasingly difficult. I’m starting to shift more toward trying to sketch out solutions, and actually creating new initiatives that, in their own small ways, may – in the words of an old colleague, Bill Drayton – make a “scratch on history.”

The next few updates will be unveiling the new platforms and initiatives I’ve been working on that I hope will help make more of a contribution. In this update, I want to start with several articles I’ve written recently that begin to spell out the framework for those efforts.

In a prior update, I mentioned my recent trip to Brussels, where I visited both the battlefield of Waterloo and the headquarters of the European Commission. In A Modern Waterloo, I described how a high-ranking Euro bureaucrat responded to my questions about the opposition to European (and, more generally, global) integration with the retort, “It doesn’t matter.” Similarly, “the great and good of Europe could congratulate themselves after Waterloo that the revolt of the lower orders, well, it didn’t matter”:

Those who believed that Waterloo meant they could now get back to ruling subject populations as they had for the previous half-millennium were therefore soon to be sorely disappointed…. The democratizing aspirations of the deplorables so feared by the aristocracy ultimately proved to be not only on the right side of history but also right.

That we’re at the end of another similar fin de siècle is evident even in such seemingly-quotidian issues as the never-ending health care struggle, which, I argued in Life after Obamacare, is really the last battle of the last century and the politics of the welfare state: “[I]n today’s polarized either/or environment, both parties are locked … in a duel to the death between a pre-20th Century vision of a market unpoliced by government and a mid-20th Century vision of government supplanting the market.” Other alternatives will soon overtake both positions “that better reflect the direction the world is headed – one of weakened states where other entities, including businesses, provide more and more of what used to be thought of as government services.”

Is there hope of resolution in this increasingly polarized society? Yes, but perhaps in diversity more than consensus – if we can learn to live with that. In an Independence Day riff on a Harvard Business Review study (of all things), I spent some time musing on How environmental factors affect our politics. The study discussed in the HBR found that people in more densely-populated areas tend to be more “future-oriented,” which leads to all sorts of behavioral and attitudinal differences:

Environmental factors – like community size and density – not surprisingly affect the strategies organisms (like, say, people) adopt … for every other aspect of dealing with their interactions with others. This includes fundamental questions about how to structure those dealings – centralized or decentralized, coercion by law or through social ostracism – and issues that flow from these such as taxes versus charity…, attitudes toward crime and terrorism, receptivity to immigration and trade, regulation of business activities or firearms, in short virtually everything.… Which may mean that, if we are to remain United States, and celebrate many more holidays of shared nationhood and shared values together, we will need to learn better to accept that the other side may be coming from a different place on major issues not because these other Americans are evil or irrational, but simply, well, coming from a different place.

And that brings me to my piece this week in US News: A Better Future for Democrats: We need to start recognizing both the challenges and the opportunities that an increasingly centripetal world poses to modern ideologies. “The left needs to reconceptualize what ‘government’ – or, more specifically, liberalism – might look like in a post-industrial, post-mass-produced world. The ability to individually customize mass-produced items is the hallmark of the New Economy.”

The challenge for progressivism and liberalism today is not how it can compete with the revival of anti-liberal ideologies of the 1930s with a similarly retro agenda from the ’30s – it is how to further progressive aims like meaningful opportunity, economic security and constraint of the powerful in a world where the traditional enforcement mechanisms of collective action to achieve these aims are increasingly undermined by emerging technologies.

The same technologies that give rise to the challenges also offer solutions. I’ll be discussing possible solutions – and the initiatives I’m launching – in future updates over the next month.

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21
Mar

The Policy Debate We Need

A project at Harvard’s Kennedy School of Government, under the direction of noted public-sector leader Stephen Goldsmith, has compiled what it regards as the 30 best reports on “Operational Excellence in Government” – and my firm, Public Works, is the author or co-author of three of these. Harvard cited our government-wide efficiency and management work in Iowa, Colorado, and Louisiana. This confirms what we’ve always said: Although we’re a small firm, we can match our record in this area against any of the largest consultancies in the world.

Meanwhile, in Washington the Trump Administration has unveiled plans to down-size government in a manner very different from how we pursue our efficiency and streamlining work. It’s the difference between hiring a surgeon to cure your ills – or a guy with a chain saw and hockey mask.

I wrote about this larger “hollowing out” of government at which the Trump Administration aims in The Hollow Men in U.S. News & World Report:

The Americas Bannon and Trump envision are depressing, but not totalitarian: One is illiberal but not necessarily authoritarian, the other authoritarian but not necessarily illiberal. Both lead to a society embodying not so much the banality of evil as the evil of banality. And where they overlap is not the creation of a fascist state, but rather the opposite: The hollowing out of the state as a viable institution. And, in that, they represent not a radical departure from the modern trajectory of the U.S. (and most other countries today) but an acceleration of it.

“All of this should be concerning,” I concluded, “but, while liberals have been warning not to ‘normalize’ Trump for the last year, the mistake is to ‘abnormalize’ him.” I elaborated on this theme in my next piece, Parallel Universe of Trump-World: “Right now, the opposition is focused on furious assaults against the very tar babies that keep Trump’s supporters in his column; such attacks will do nothing to weaken his grip on his alternative universe,” I argued.

I simply don’t agree that becoming your enemy is how to defeat him – a sentiment liberals argued vehemently in opposition to Bush-era depredations of civil liberties in the “War on Terror” but now deride as comic-book morality in the Age of Trump. How quickly our values have collapsed into not opposition, but conformance, to Trump’s.

So how should we respond to the pathologies of the Trump Administration? By focusing on policy, of course:

The real question is, What will create economic growth for the huge numbers of Americans being left behind? What will salvage the communities of an alternative universe being ground under by the advance of what is, to them, an alien culture and destructive economy?…

You really want to save truth, justice and the American Way? Stop seeing every Trump outrage as a cause for, well, outrage: Stop “ab-normalizing” him. Embrace the pathetic reality: He is a politician like any other, to be judged by his vacuous policies that fail even his supporters. Offer real policy alternatives that will protect the families of those who wrongly believe he is their hope. Start doing that, reality will take care of itself.

And that takes us to this week’s policy-oriented post – on the appallingly bad, long-awaited Republican alternative to Obamacare:

[T]he Republican health care bill concerns itself mainly with stripping millions of their coverage, recreating those halcyon health care days of the Bush years for most, and providing massive subsidies to – get this – the wealthiest. That ultimately makes plain the real Republican philosophy of government.

There are three basic conceptions of government’s role in human affairs. Some believe it is properly a force for collective good. Rightly or wrongly, that’s the vision liberals propound today.

Others believe – and this is, of course, a deep strand in American political thought – that while government might indeed be used for good as well as ill, in practice it tends to reflect what Francis Fukayama has called the “stationary bandit” theory of the state: It is a coercive force for extraction and exploitation of the many by the few, and thus to be constrained wherever possible. And then there are those who do the extraction and exploitation and recognize government as the best institution for achieving that.

Republicans love to talk like they fall into the second category. The chief virtue of this health care bill is that it makes transparent that they actually comprise the third.

You can read the whole analysis, The GOP’s Health Care Shock, here.

Easy links in this update:

30 best reports on “Operational Excellence in Government

U.S. News & World Report: The Hollow Men and Parallel Universe of Trump-World

The GOP’s Health Care Shock

As always, I welcome your comments below!

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2
Nov

Obamacare: Great Public Policy, Lousy Name

Everything you need to know about the Obamacare debate:  The problem isn’t the “care” – it’s the “Obama.”

Polls show overwhelming support for virtually every component of the Act – prohibiting insurers from refusing to cover people with pre-existing conditions, allowing young Americans of working age to continue on their parents’ insurance, requiring all businesses with more than 50 employees to provide health coverage for their workers – except the (in) famous “individual mandate.

Read the full story in Aspenia Online.

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