Public Policy and Governance – Page 102

The People’s Business

The polarization that characterizes American politics these days begins with very different world-views–and very different beliefs about what government is and what it is for. Those differences used to exist within a “big tent” Republican Party, back when there were still a lot of perfectly sane Republicans. (I still remember those times; I told you I’m old…)

I still remember the telling difference between the rhetoric employed by Mayor Stephen Goldsmith, who liked to refer to citizens as “customers” of government, and the Hudnut Administration that preceded Goldsmith’s. I served in the Hudnut Administration, and although we didn’t borrow from business terminology, I think it’s fair to say that we considered citizens to be shareholders, not customers.

We understood that citizens are the owners of the government enterprise.

So far, the Biden Administration has taken steps to do the people’s business, to reflect a belief that government should actively pursue the public good as reflected in the desires of a majority of its citizen-owners. As Heather Cox Richardson recently noted, Biden has refused to engage with the craziness and has instead acted on matters ordinary people care about.

Biden is using executive orders to undercut the partisanship that has ground Congress to a halt for the past several years. While Biden’s predecessor tended to use executive actions to implement quite unpopular policies, Biden is using them to implement policies that most Americans actually like but which could never make it through Congress, where Republicans hold power disproportionate to their actual popularity.

According to a roundup by polling site FiveThirtyEight, Biden’s executive actions cover issues that people want to see addressed. Eighty-three percent of Americans—including 64% of Republicans—support a prohibition on workplace discrimination over sexual identification, 77% (including 52% of Republicans) want the government to focus on racial equity, 75% want the government to require masks on federal property, and 68% like the continued suspension of federal student loan repayments. A majority of Americans also favor rejoining the World Health Organization and the Paris climate accords, and so on.

There is, of course, a limit to what can be accomplished by Executive Order. Biden has thus far shown an admirable intent to “stay in his lane”–to restrict his actions to those that can be defended as appropriate to the Executive Branch. But doing the people’s business–fulfilling the numerous needs and demands of government’s “owners”–will require action by Congress.

Congress, unfortunately, is massively dysfunctional.

The current debate in Congress about the filibuster illustrates that today’s partisan divide is between those who believe government is obliged to do the people’s business–to carry out the wishes of the owners of the enterprise– and those who quite clearly believe that their role is to prevent that business from being conducted (unless, of course, the business at hand involves a tax cut that will benefit their donors.)

The nation’s Founders contemplated a Congress that would engage in negotiation and compromise, and would then proceed to pass measures by a simple majority vote–not a super-majority. Today, thanks to the evolution of the filibuster over the years, it takes sixty votes to pass anything, no matter how innocuous.

Of course, the Founders also believed that the people we would elect to Congress would be “the best and brightest”–public-spirited, educated and reasonable men (yes, I know…) who would take their legislative responsibilities seriously. I wonder what they’d think of the gun-toting, conspiracy-believing wackos who are currently walking the halls of the Capitol and warning about fires started by Jewish space-lasers …

Not to get overly partisan here, but those lunatics are all Republicans…..and they have no concept of–or ability to do– “the people’s business.”

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Health Costs And Benefits

Americans have been arguing over health care (actually, health insurance) for my entire life–and as I frequently mention, I’m old. Every time the federal government has extended access to health insurance, conservative politicians have insisted that America cannot afford it.

“Medicare for All” proposals invariably meet with outrage–and disinformation. In addition to insistence that universal health care would bankrupt the country, opponents used to warn that extending access would ruin what they say is the “best medical care in the world.”

That claim that “we’re number one” has diminished considerably, as more people have recognized that we’re actually number thirty-seven or thirty-eight, and that the only people who receive the “best” medical care are people who have lots of money. But Republicans have continued to insist that America just can’t afford universal coverage.

Which brings me to a very interesting report in The Hill, titled “22 Studies Agree: Medicare for All Saves Money.”

The evidence abounds: A “Medicare for All” single-payer system would guarantee comprehensive coverage to everyone in America and save money.

Christopher Cai and colleagues at three University of California campuses examined 22 studies on the projected cost impact for single-payer health insurance in the United States and reported their findings in a recent paper in PLOS Medicine. Every single study predicted that it would yield net savings over several years. In fact, it’s the only way to rein in health care spending significantly in the U.S.

All of the studies, regardless of ideological orientation, showed that long-term cost savings were likely. Even the Mercatus Center, a right-wing think tank, recently found about $2 trillion in net savings over 10 years from a single-payer Medicare for All system. Most importantly, everyone in America would have high-quality health care coverage.

The studies found that Medicare for All would eliminate three-quarters of the estimated $812 billion the U.S. now spends on health care administration. Administrative costs in the United States are so high because insurance companies–and there are hundreds, if not thousands of them– individually negotiate benefit rules and rates with thousands of hospitals and doctors. They also require different billing procedures , use different forms and have different rules for submitting claims.

The studies estimate that savings from Medicare for All would be about $600 billion per year. And that’s not including savings on prescription drugs, estimated to be another $200 or $300 billion a year if we paid about the same price as other wealthy countries pay for their drugs.

Even more savings are possible in a Medicare for All system because, like every other wealthy country, we would have a uniform electronic health records system. Such a system generates additional savings because system problems would be easier to detect and correct. A uniform claims data system helps reduce health care spending for fraudulent services. In 2018, total U.S. health care costs were $3.6 trillion, representing 17.7 percent of GDP.

The “cherry on top” of these calculations? Savings were calculated assuming the elimination of deductibles and out-of-pocket expenses.

The article also pointed to something that is not widely understood: government already pays approximately two-thirds of all American health care costs. A few years ago, when I participated in a multi-disciplinary study, the calculation was that some seventy percent of all health costs were being paid for by some unit of government– not just via Medicare and Medicaid, but also through the VA, CDC awards of research dollars, federal, state and local health care programs, coverage for government employees (including thousands of employees of public schools and universities), and ACA tax subsidies for private insurance.

A more expansive and accurate cost/benefit analysis would also include things like the decline in bankruptcies–some 50% of personal bankruptcies are due to medical costs not covered by insurance.–and evidence that crime and other forms of social discord decline sharply when social safety nets improve.

Here’s my question: if Medicare for All improves health care and costs less, what is the real reason so many Republicans oppose it?

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It Isn’t Just Media Literacy

Americans today face some unprecedented challenges–and as I have repeatedly noted, our information environment makes those challenges far more difficult to meet.

The Internet, which has brought us undeniable benefits and conveniences, also allows us to occupy “filter bubbles”—to inhabit different realities. One result has been a dramatic loss of trust, as even people of good will, inundated with misinformation, spin, and propaganda, don’t know what to believe, or how to determine which sources are credible.

Fact-checking sites are helpful, but they only help those who seek them out. The average American scrolling through her Facebook feed during a lunch break is unlikely to stop and check the veracity of most of what her friends have posted.

There is general agreement that Americans need to develop media literacy and policy tools to discourage the transmittal of propaganda. But before we can teach media literacy in our schools or consider policy interventions to address propaganda, we need to consider what media literacy requires, and what the First Amendment forbids.

Think about that fictional person scrolling through her Facebook or Twitter feed. She comes across a post berating her Congressman for failing to block the zoning of a liquor store in her neighborhood. If our person is civically literate—if she understands federalism and separation of powers– she knows that her Congressman has no authority in such matters, and that the argument is bogus.

In other words, basic knowledge of how government works is a critical component of media literacy.

It isn’t just civic knowledge, of course. People who lack a basic understanding of the difference between a scientific theory and the way we use the term “theory” in casual conversation are much more likely to dismiss evolution and climate change as “just theories,” and to be taken in by efforts to discredit both.

To be blunt about it, people fortified with basic civic and scientific knowledge are far more likely to recognize disinformation when they encounter it. That knowledge is just as important as information on how to detect “deep fakes” and similar counterfeits.

There are also policy steps we can take to diminish the power of propaganda without doing violence to the First Amendment. The Brookings Institution has suggested establishment of a “public trust” to provide analysis and generate policy proposals that would defend democracy “against the constant stream of disinformation and the illiberal forces at work disseminating it.”

In too many of the discussions of social media and media literacy, we overlook the fact that disinformation isn’t encountered only online. Cable news has long been a culprit. (One study found that Americans who got their news exclusively from Fox knew less about current events than people who didn’t follow news at all.) Any effort to reduce the flow of propaganda must include measures aimed at cable television as well as online media.

Many proposals that are aimed at online disinformation address the social media protections offered by Section 230 of the Communications Decency Act. I reviewed them here.

Bottom line: we can walk and chew gum at the same time.

If and when we get serious about media literacy, we need to do two things. We need to ensure that America’s classrooms have the resources—curricular and financial—to teach civic, scientific and media literacy. (Critical thinking and logic would also be very helpful…) And policymakers must devise regulations that will deter propaganda without eviscerating the First Amendment. Such regulations are unlikely to totally erase the problem, but well-considered tweaks can certainly reduce it.

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HR 1

HR 1 was the first bill passed by the House of Representatives after the Democrats won control in 2018, and it languished, of course, in Mitch McConnell’s “do-nothing-good” Senate. The question now is whether– with Democrats razor-thin control of that body–it can be passed.

Because passage is truly essential if we are to recover basically democratic governance.

There have been a number of articles and editorials about HR 1, but I particularly agreed with the headline on the subject from Esquire:“If We Don’t Pass HR 1, We Are F**ked As A Nation.”

The headline came from a quote by Josh Silver, who works for Represent.Us, a nonpartisan nonprofit dedicated to ending political corruption, extremism, and gridlock. The organization has promoted model legislation very similar to HR I since 2012. Silver believes that, should we fail to pass these reforms, America will continue what he calls “our decline into authoritarianism.”

“It is these problems that the bill addresses that are the root cause of the extremism and polarization that gave rise to Trump and the new sort of anti-representative form of government that the Republican Party has chosen to embrace. And I’m saying that as a truly nonpartisan guy.”

So–what would this measure accomplish?

Title one of the bill is John Lewis’s Voter Empowerment Act. Lewis introduced it–and saw it die–in five congresses in a row. It would make voting and access to the ballot box easier and more convenient by creating automatic voter registration across the country, and expanding early and absentee voting. It would also restore voting rights for felons, streamline the vote-by-mail process, and prohibit various voter-suppression tactics currently in vogue. It would also beef up election security– promoting the use of paper ballots and strengthening oversight of election-system vendors. (It also evidently backs a grant of statehood for Washington, D.C., although not directly.)

In my favorite part of the bill, HR 1 would take on gerrymandering. It would require states to use independent commissions subject to strong conflict-of-interest rules. District maps would be approved differently, and would be more easily challenged if they are partisan and/or unrepresentative.

Another part of the bill–called the Disclose Act– would address “dark money” in politics.

The bill would institute an “Honest Ads” policy, where disclosure requirements for online political advertisements are expanded and strengthened. It would put in place a “Right to Know” policy where corporations would have to make shareholders aware of their specific political activity. It would root out participation of foreign nationals in fundraising—a foreign money ban. It would, per the name, beef up disclosure requirements for organizations engaging in political spending, including by reinforcing the Internal Revenue Service’s powers and prerogative to investigate misuse of charities to hide the source of political money.

The bill also addresses fundraising for Inaugurations, which has previously been a way for wealthy donors to curry favor with incoming administrations.

And finally, HR 1 deals with lobbying. It closes what has recently been called “the Michael Cohen exception,” where people who don’t lobby directly aren’t covered by some of the registration requirements, and it gives real enforcement power to the Office of Government Ethics. The bill bolsters ethics law in general: it requires presidents to release their tax returns, expands conflict-of-interest policy and divestment requirements, and attempts to slow the “revolving door” through which members of Congress and their staff have moved between government and the private sector, influence peddling while lobbying or serving on corporate boards.

There are other provisions, but this overview gets at the major elements. Every citizen who has railed against vote suppression, despaired of getting rid of gerrymandering, and cursed the outsized influence of big money in politics should lobby their Senators for its passage.

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Trust Me

One of the approximately ten zillion critical tasks facing President Biden is the need to restore Americans’ trust in the integrity of their government. Biden is well-equipped to begin that restoration–he is a thoroughly decent and trustworthy man–but it won’t be easy.

Time Magazine recently began an article with some very concerning data:

After an unprecedented year of global pain, loss and uncertainty, a new report finds that 2020 marked “an epidemic of misinformation and widespread mistrust of societal institutions and leaders around the world.”

The 2021 Edelman Trust Barometer, a study published annually by global communications firm Edelman, unveiled its findings on Wednesday after conducting more than 33,000 online surveys in 28 countries between October and November 2020. The firm found that public trust had eroded even further in social institutions—which Edelman defines as government, business, non-governmental organizations (NGOs) and media—from 2019 due to the COVID-19 pandemic, global outcry against racial injustice and growing mistrust of what political leaders say and journalists report.

The research found that most people trust businesses– especially their own employers– over government and media. Trust in journalists is split along party lines. Among the consequences of this pervasive distrust is a particularly worrisome one: only 1 in 3 people are “ready to take the [COVID-19] vaccine as soon as possible.”

Social trust is an essential and irreplaceable basis of a democratic society. Social capital–the bonding and bridging connections to others that make a society work–is defined as a combination of trust and reciprocity.

Social scientists warn that erosion of interpersonal trust has very negative implications for democratic self-government. When I was researching my 2009 book Distrust, American Style, that erosion was already visible. Some scholars suggested that the country’s growing diversity had led to a loss of the cohesion achievable in more homogeneous societies; my research suggested a different culprit. I became absolutely convinced that generalized social trust requires reliably trustworthy social and governing institutions.

In other words, fish rot from the head.

As I argued in that book, the nature of the trust we need is justifiable confidence in the integrity of government and civil society writ large. That confidence was being steadily undermined–not just by what seemed to be daily scandals in business (Enron, Worldcom, et al), sports (doping, dog fighting), religion (revelations about the Catholic Church’s inadequate response to child molestation), and the George W. Bush government (duplicities which seem almost innocent in contrast to the past four years)–but especially by the Internet.

Suddenly, Americans were marinating in information. Publicity about each scandal and details about a seemingly pervasive lack of trustworthiness was impossible to avoid.

It has gotten considerably worse since 2009. Now we are swimming in a vast sea of information, disinformation, propaganda and conspiracy theories–and as a consequence, trust has continued its sharp decline.

The problem is, without widespread social trust, societies are impossible to maintain.

Think about our daily lives: we deposit our paychecks and trust that the amount will be reflected on our next bank statement. We put a deposit down with the local electric utility and trust that service will be forthcoming. We call the fire department and anticipate their speedy arrival. We drop our clothing off at the cleaners and trust it will be there, cleaned, to pick up. We buy goods online and trust they’ll arrive. We buy meat at the grocery and trust that it has been inspected and is fit to eat. We board an airplane and trust that it has passed a safety inspection and will travel in its assigned air lane..

I could go on and on, but you get the picture. And that picture is much broader–and social trust much more critical– than most of us realize.

An article in The Week had a relevant factoid: evidently, Twitter’s permanent ban of Trump has already made a huge difference. “One research firm found the amount of misinformation online dropped 73 percent in the week after the president and 70,000 QAnon aficionados were shut down by the platform.”

So–the solution to our trust deficit is obvious and simple (cough, cough); we just have to make government visibly trustworthy again, enforce regulations on the businesses and other institutions that are flouting rules with impunity, and figure out how to get online platforms to disallow misinformation and propaganda, without doing violence to the First Amendment.

Piece of cake!

I think I’m going to go pour myself a very stiff drink….

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