Public Policy and Governance – Page 290

Politics Trumps Both Compassion and Common Sense

Apparently, common sense is fairly uncommon, and compassion is just a word in the dictionary.

The Dallas News recently reported that Texas’ refusal to expand Medicaid and participate in the Affordable Care Act (aka “Obamacare”) will cause individual health insurance premiums to rise a whopping 9.3%.

The Texas Observer reports that Texas will not only leave 100 billion dollars “on the table,” but the decision will cause a raise in local property taxes. (The burden of emergency medical care generally falls on property taxpayers in Texas–just as it does in Indiana. When people take Mike Pence’s advice and get their “access to care” through the Emergency Room, property taxpayers pay for that unnecessarily-expensive care. )

Fiscal stupidity is one thing. Essentially telling poor people to f**k off is another.

Nearly 7 million adults ages 19 to 64 would qualify for Medicaid in the 25 states that have not voted to expand it, according to an Urban Institute report. Those 7 million people won’t get Medicaid and they won’t get federal help to buy health insurance.

The refusal to expand Medicaid won’t “defund” the Affordable Care Act, or change any of its provisions. The only “message” it will send to Washington is “we’ll show you–we’ll hurt ourselves!”

The bottom line: Rick Perry, Mike Pence and other Republican governors care more about obstructing Obama than about the health of their economies or their citizens.

That’s politics these days. And it’s not only stupid, it’s despicable.

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Excuse Me While I Hit Myself Repeatedly with a Hammer….

A recent post at Maddowblog began with the following observation:

Since so much of the public has no idea what the debt ceiling is, what default is, what bond markets are, or what the full faith and credit of the United States means, polling on the subject just doesn’t tell us much.

The post went on to describe a different sort of poll that proved the point; it asked about the debt ceiling, but phrased the same question two different ways. When asked simply whether Congress should raise the debt ceiling, respondents were pretty evenly split. The second version asked whether Congress should prevent the government from borrowing money in order to pay its debts; 73% of those responding to the question when it was posed that way said such a step would seriously harm the economy, and opposed it. Only 22% approved.

The American people aren’t stupid. When the question is asked using language citizens understand, they resoundingly offer the right answer. The lesson of this–and multiple other examples–is twofold: (1) the public is generally unfamiliar with the language of its own government, with many equating “raising the debt ceiling” with incurring new debt; and (2) polls that politicians reference to “prove” that the American public is on their side of an issue tend to be worthless and/or deceptive.

Thanks to their own extremism and lack of elementary economic knowledge, the Tea Party zealots who have captured one of America’s major parties and the House of Representatives are poised to do substantial damage to the people they have been elected to represent.

Pundits from both Left and Right (even Karl Rove!) predict that the government crisis they are determined to precipitate will create a backlash that can only hurt the GOP, but those warnings are falling on deaf ears. As a friend of mine used to say, you can’t reason someone out of a position they didn’t reason themselves into.

The broad, sane middle of the American public will need to batten down the hatches and prepare for a totally unnecessary period of fiscal and economic misery–brought to us by people motivated by one and only one “principle”–ensuring that thirty million Americans currently without health insurance don’t get access to healthcare.

And to make sure they don’t, they’re willing to plunge the country into another recession.

Excuse me while I go hit myself some more with that hammer….

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Telling It Like It Is

John Green explains American healthcare .

The most mind-blowing statistic is one I didn’t previously know: The American government already spends more on healthcare per capita than the U.K., Australia and other countries with “free” systems. Think about that.

Then watch this!!

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The Root of the Problem

Paul Volcker is a longtime, widely respected public servant. Most of us know of him through his service as head of the Federal Reserve, but his interest in good government is wider than fiscal policy. That interest has led him to create a new organization–the Volcker Alliance. This new initiative has grown out of what is described as Volcker’s deep concern about public mistrust of government, partisan polarization, and the low level of status/prestige associated with career public service in the United States.

I share his concerns. And I hope that the Volcker Alliance will focus upon the roots of the problem.

Any reader of this blog can probably guess what my analysis of our current situation is. I am absolutely convinced that public administration practice–the daily decisions of the elected and appointed people who run government at all levels– take place in a culture that has been shaped by American constitutional, legal, and political values. Public decisions and actions must be seen as consistent with those values in order for citizens to trust them.

One of the reasons I am so concerned (okay, maybe obsessed) about civic literacy is that I firmly believe the electorate must be sufficiently knowledgable about our national principles/values to make accurate judgments about their elected officials’ compliance with them.

Our constitutional values create the framework for moral decision-making in the public sector. Public confidence that policymakers are guided by them is an essential element of perceived legitimacy–and the electorate’s belief in the legitimacy of governing institutions is a precondition to the ability of public managers to govern at all.

I teach at a school of public affairs, so I obviously believe in that it is important for our public administrators to have the requisite skills to implement chosen policies. But even the most able technocrat can’t function properly without legitimacy: public acceptance of his role and his right to exercise authority.

If I am correct about that (and there is a good deal of scholarship suggesting that I am) then the widespread belief that public officials are just beneficiaries of political gamesmanship–gerrymandering, vote suppression, etc.–is corrosive of the public’s confidence and undermines the public manager’s ability to do her job.

Let me suggest a somewhat weird analogy.

In Florence, Italy, in one of that city’s many museums, there is a famous marble statue of two men wrestling. One of them has his hands around the testicles of the other, and ever since we first saw it, my husband has always referred to it as the ”fight fair, dammit” statue.

A functioning democracy depends on the citizenry’s confidence that the “fight” was fair. The idea is that we contend in the public arena for the support of the voters; we make our respective cases, our voices are heard and our arguments considered, and citizens choose whom they prefer in a fair election, after which, we come together and work with the people the voters freely chose.

If the election wasn’t fair–if boatloads of special-interest money drowned out the voices of certain candidates, if one party or the other abused the redistricting process, or gamed the system to dissuade some constituencies from voting–the winners cannot expect the losers to cheerfully abide by the results. People who use these tactics may win elections, but they lose legitimacy and the public trust.

If we want to restore public trust in our government, we need to fight fair, dammit.

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What Is WRONG With These People? Rerun Edition

The Atlanta Journal-Constitution recently ran a story that left me banging my head on my desk.

“Let me tell you what we’re doing (about ObamaCare),” Georgia Insurance Commissioner Ralph Hudgens bragged to a crowd of fellow Republicans in Floyd County earlier this month: “Everything in our power to be an obstructionist.”

After pausing to let applause roll over him, a grinning Hudgens went on to give an example of that obstructionist behavior, this one involving so-called “navigators” who are being hired to guide customers through the process of buying health insurance on marketplaces, or exchanges, set up under the federal program.

“We have passed a law that says that a navigator, which is a position in that exchange, has to be licensed by our Department of Insurance,” Hudgens said. “The ObamaCare law says that we cannot require them to be an insurance agent, so we said fine, we’ll just require them to be a licensed navigator. So we’re going to make up the test, and basically you take the insurance agent test, you erase the name, you write ‘navigator test’ on it.”

As the article points out, Georgia is not the only state where Republicans are in charge and are doing everything in their power to insure that people don’t get healthcare.

Think about that. No matter what your policy differences with the President, no matter what concerns you might have about the ACA’s approach, what sort of human being deliberately–indeed, gleefully–takes steps to insure that other people will continue to suffer?

How much do you have to hate the President that you are willing to let thousands of people go bankrupt and/or die if that’s what it takes to deny him a policy victory?

The Atlanta reporter asked the obvious questions:

Why would you take pride in making it harder for Georgians with pre-existing conditions to get the insurance coverage that had previously been denied to them, and that might save them from potential bankruptcy or even death? Why would you block the federal government from offering Medicaid coverage to more than 600,000 lower-income Georgia citizens, coverage that would allow them to compensate hospitals and doctors now forced to treat them for free? Why refuse to educate uninsured Georgians on the fact that they will soon be eligible for subsidies to help them pay for health insurance, as other states are doing?

I’d ask how low these people can go, but I’m afraid I’ll find out.

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