Monthly Archives: October 2017

Design Defect?

In the short time it has existed, Vox has proved to be one of the smartest sources on the internet; its “explains the news” feature, credible reporting and excellent writing have made it a “must go to” for many of us.

Recently, the site had a political science meditation by Lee Drutman, titled “Yes, the Republican Party has become pathological. But why?”

The article began by quoting an often-cited paragraph from Mann and Ornstein:

In Thomas E. Mann and Norman J. Ornstein’s now-classic and still-true description of the party, “The GOP has become an insurgent outlier in American politics. It is ideologically extreme; scornful of compromise; unmoved by conventional understanding of facts, evidence and science; and dismissive of the legitimacy of its political opposition.”

Drutman doesn’t quarrel with this observation, but says that the pressing question is why did the GOP go insane? And unlike those who pin the problem on flawed leadership, or the Christian Right, or even the racism that has become embarrassingly obvious, he argues that the opportunities and incentives that are built into the system are “design defects,” that have caused the astonishing dysfunction we now see.

My argument is that the modern Republican Party is a direct result of the design flaws of the American political system — our winner-take-all single-member electoral districts, our reliance on private money to finance elections, and our increasingly presidentialist system of government. You simply can’t understand the GOP’s pathologies without understanding the larger political system in which it operates.

Drutman’s argument begins with America’s  two-party system. When voters are given only two choices, the key to victory is being less unappealing than those other guys. “Such is the twisted logic of negative partisanship.”

Drutman dismisses the widespread belief that American politics are ideological; that may be true for the so-called “elites” who are perhaps 10-15% of the voting public, but it doesn’t hold true for the average voter. Instead, voters look to their political parties to decide what policies they embrace, and they choose their party affiliation by deciding which “tribe,” is composed of people “most like me.”

At heart, when we vote, we ask the question: “Who represents people like me?” We support candidates who we think share our values. And here, party is a very strong cue…

Certainly we shouldn’t overstate the level of blind partisanship. But one of the most remarkable and consistent political science findings is how little voters really think for themselves. This is why many previously moderate Republicans didn’t leave the party as it moved rightward — they just became less moderate. Their ideology was far more flexible than their partisanship, because it was less deeply rooted.

All well and good–but if it is the system that has produced today’s cult-like GOP, why haven’t the Democrats similarly gone off the rails? Drutman quotes Jonathan Chait:

The] Democratic Party is racially and economically heterogeneous. Even if he had wanted to take vengeance upon white America for its sins, Obama had far too many white supporters to make such a course of action remotely practical. (A majority of Obama’s voters were white, in fact.) On economic issues, the Democratic Party relies on support and input from business and labor alike.

… There is little such balance to be found in the Republican Party. Republicans concerned about their party’s future may blanch at Trump’s pardoning of the sadistic racist Joe Arpaio or his gleeful unleashing of law enforcement. In the short term, however, they have bottomed out on their minority support and proven able to win national power regardless, by using racial wedge issues to pry away blue-collar whites.

But what about Drutman’s assertion that America’s political design has incentivized the GOP’s troubling behaviors?

One factor is that the past three decades have been a very unusual period in American politics, in which national elections have all been quite competitive, with the balance of partisan control of institutions hanging in the balance. Because American institutions are majoritarian, and because the president has considerable power, a small number of votes can mean the balance between two very different outcomes. When the stakes are this high, the political incentives push hard on gaining every little advantage.

Drutman points to gerrymandering and the single-member plurality-winner district  design feature that makes gerrymandering possible. And at the end of his essay, he comes back to the (considerable) drawbacks of a two-party system.

It’s long, but the entire thing is well worth reading.

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The Public Good

Americans need to reclaim the concept of the public good, and nowhere is that more important than in health policy.

Law Professor Fran Quigley has a new book coming out that examines the interface–or more accurately, the lack of an interface–between Big Pharma, Congress and the common good. Quartz recently published a review of the book, and began by referring to the infamous “Pharma Bro,” Martin Shkreli, who purchased a life-saving drug that had been on the market for some time, and jacked up the price astronomically–because he could.

Shkreli is not an outlier, according to Indiana University law professor Fran Quigley’s new book Prescription for the People. The pharmaceutical industry jacks up prices on life-saving drugs to extort windfall profits from desperate patients as a matter of course. That’s an immoral way to treat medicine, Quigley argues. The solution? Stop treating medicine as private property—and start treating it as a public good, like education or infrastructure.

It’s one thing to allow private companies and markets to set prices for items like big-screen TVs or cars, Quigley explains via email. In those cases, “purchasers can compare prices and walk away from the transaction if they wish.” But a patient with cancer or a child diagnosed with Type II diabetes can’t just walk away. “That kind of choice is not present when the good in question is life-or-death and there are no options for comparison shopping,” he writes.

 One of the great virtues of Quigley’s book is its explanation of the major role government plays in drug research. Big Pharma has long justified high prices by citing the costs of R & D; as Quigley points out, much of that research is funded with our tax dollars–but drug companies, not taxpayers, enjoy the return on that investment.

Furthermore, drug companies don’t actually funnel the bulk of their profits into research and development. Case in point: Reuters has reported that Pfizer made $45.7 billion in revenue in 2014, of which it spent $14.1 billion on sales and marketing and $8.4 billion on research.

The book details the various ways in which drug companies’ concern for the bottom line takes precedence over concern for the public’s health, and it goes into considerable detail about the perverse public policies that have facilitated those companies’ profitability.

The genesis of those favorable policies? Follow the money.

How did we get to this point? “In the last 40 years, the pharmaceutical industry has deployed billions of dollars of lobbying and political campaign contributions” to change laws to their benefit, Quigley says. One of their most remarkable successes was the 1980 Bayh-Dole Act, which allowed corporations to patent publicly-funded research. This means that pharmaceutical corporations essentially receive monopolies to sell government-created products, “truly one of the most bullet-proof business models in modern history,” Quigley says.

Quigley also takes aim at current patent practices.

The US should even consider ending medicine patents altogether, Quigley argues. “The patent system fails miserably in making medicines available to those who need them,” he says. Studies show that 70% of newly marketed drugs make no therapeutic advances on existing medicines; they are “me-too” drugs that try to carve out a portion of already existing markets for things like cholesterol medication, without bringing any improvements to the table. Furthermore, patents prevent competitors from building on previous research. Expanding grants for patent-free, open-source research would focus medical research on innovation, and make research findings available to everyone immediately, Quigley argues.

Quigley is not the only observer who faults the current patent system; economist Dean Baker goes considerably farther:

Are corporate patent and copyright monopolies a form of government-licensed private taxation? Dean Baker of CEPR thinks so: “Government-granted patent and copyright monopolies are actually much more important in determining future flows of income than debt. In the case of prescription drugs alone, patent and related protections raise the price of drugs by close to $370 billion a year over the free market price, a bit less than 2.0 percent of GDP. This is considerably larger than the current interest burden of the debt, which is approximately 1.6 percent of GDP, net of money refunded from the Federal Reserve Board to the Treasury. These monopolies are effectively like privately collected taxes.”

The book is Prescription for the People.

I know Fran Quigley, I know both his passion and his meticulous attention to fact and evidence. He’s a clear writer and a clear thinker. You should buy the book.

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