Politics & Culture, Writing, Editing & Journalism

News Roundup

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Several interesting news items —

  • Apparently, the human brain is hardwired to multitask two items, but only two items, simultaneously.  Anything more, and we lose the ability to track the risk/reward matrix for all tasks concurrently — or we reduce choices until a binary pair remains.  Perhaps one day, the business world will internalize the wisdom of this and will create systems that reduce multitasking stress among employees.
  • David Sirota, in a media-criticism piece in Salon published April 16, suggests that the state of journalism as a profession is on the downswing. He suggests that journalists who are struggling for access, either to their sources for lucrative book rights, or to subjects for potential subsequent employment, are causing significant damage to the industry: “Are many of today’s opportunity maximizers destroying journalism? Clearly, yes — and unless the media sachems institute some basic ethics rules, the parasites within their ranks could end up making sure there’s no journalism industry left to save.”
  • On the “power of the purse” front:  President Obama has ordered HHS Secretary Kathleen Sebilius to direct hospitals that receive reimbursement from Medicaid and Medicare to implement policies that allow same-sex partners to visit patients or to make decisions on their behalf. This seems like a gross overreach of federal authority, and one that Congress should consider revisiting. Legislating via executive directive may be convenient but it hardly comports with the principle of representative democracy.
  • Former Michigan governor John Engler, who was term-limited out of office in 2003 after three four-year terms, has purchased property in Michigan; after leaving office, he moved to Virginia to take over the National Manufacturers Association. Although confidants doubt he will seek further elective office, the 61-year-old could be an interesting candidate to take on Debbie Stabenow in 2012.
  • A Kalamazoo-based wrecker service, T&J Towing, is suing a Western Michigan University student for starting a “Kalamazoo Residents Against T&J Towing” group on Facebook. The company is suing for $750,000 and requesting a cease-and-desist order, and the suit apparently includes Facebook. Reaction in the community was swift; there are more than 8,000 members of the Facebook group.  T&J is accused of towing cars inappropriately. Commentators in the social-media space are sharing T&J horror stories. As a former WMU student, this humble blogger is acquainted with T&J and has little grounds to doubt the horror stories.
  • For the first time in 101 years, General Motors has dropped out of the top 10 of the Fortune 500 list. A tragedy, entirely avoidable. A few weeks ago, I was part of an interview process for a project manager who hailed from GM; he recounts how frequent and even normal it was for manager to scream at subordinates, throw things in the office and make vulgar threats. A change of culture at that venerable automaker is an absolute prerequisite to future success.
  • Kent County, citing financial constraints, is refusing to enforce a new state-wide ban on smoking; the county’s health department will not enforce the ban at any establishment that does not serve food or drinks, including Laundromats and hair salons. The state will have to manage enforcement in those facilities. Of course, perhaps instead of limited enforcement, it makes sense to move to no enforcement.
  • Paul Keep, the editor of The Grand Rapids Press, has seen fit to write a column praising his newspaper for making a difference. Claiming that the printed newspaper and MLive.com (a state-wide aggregation of local newspapers) reach 81 percent of adults in any given week, Keep believes his paper is performing a valuable public service.  And perhaps it is.  Yet I cannot help but notice that as senior, seasoned writers are disappearing from the staff roster, the quality of writing has declined substantially.  Circulating more of a second-tier product may not be the best thing to crow about; it works for Wal-Mart but is less effective, perhaps, for a newspaper.
  • Speaking of local media, behold the power of self-selection. A new opinion column at The Rapidian (by its publisher, no less) amounts to a plea for engagement. Suggested story topics: Road delays, opinions on healthcare, eating organically, top parks for kite-flying.  Yes, really.  As a “new reporter” who receives weekly story  ideas, I can say that the arts and “sustainability” are frequent subjects.  All of which prompts the question: Is The Rapidian attempting to be a hyperlocal source of community news, or a hyperlocal source of progressive-left news?  The first page includes stories on organic farming and a positive review of the anti-corporate manifesto Food Inc.  I don’t see much by way of hard news or center-right commentary. This prompts the question of whether the experiment in local journalism will merely become an echo chamber.
  • I feel her pain, but this is ridiculous: Juanita Westaby, a self-appointed flagellant of the Catholic Church, “apologizes” for the Church’s sins even as she confesses that she is considering abandoning the Church. Her column contains the admonition, “Remember the mission.” If only she would, and if only the The Grand Rapids Press had the good grace to avoid elevating holier-than-thou laity to speak on behalf of the Church Universal.
  • An upbeat note … a prominent Pakistani cleric has declared a jihad on terrorism.  Yes.  It seems that some Islamic religious authorities are beginning to struggle against radical Islamism. This is a good thing, and we can all pray to the God of Abraham that their work meets with success.

All for now.

Politics & Culture

Thoughts on the “With What” Part of “Repeal and Replace”

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Diagnosis: Miserable Failure.

Yuval Levin’s analysis of Obamacare is a cogent but brief summary of the problems arising out of the newly passed Patient Protection and Affordable Care Act. His review is merely one of thousands, from both sides of the political spectrum, that tears apart the new law.

Concerns about Obamacare are as substantial as they are plentiful:

  • The new law does very little to reduce costs — indeed, it is likely to increase them substantially in the long run, because of the “trick” in delaying the provision of benefits against the immediate collection of tax revenues in order to bring in a 10-year cost of less than $1 trillion.
  • The expected revenues (e.g., Medicare cuts and the long-delayed tax on “Cadillac plans”) are almost surely not going to be imposed because of a lack of Congressional fortitude, which will add to significantly higher long-term federal deficits and unsustainable growth in state liabilities for Medicare and Medicaid recipients.
  • The law is internally incoherent: It was designed to accommodate a public option, which was later stripped, but the context of the law does not adequately reflect the removal of the public option.
  • The most serious barriers to public access to health care are not addressed.
  • The law creates perverse incentives to dump employees from company benefit plans into private exchanges, but the exchanges are unlikely to materialize as intended because it would be financial suicide for an insurance company to enter the private market under the current Obamacare regulations.

Conservative activists are pushing the “repeal and replace” mantra. Whether this goal is politically feasible is too early to tell — realistically, repeal cannot happen until after 2012, assuming Obama doesn’t win a second term. In terms of public discourse, three years is an eternity.  Some options, like refusing to fund the development of Obamacare if the GOP takes the House this fall, are on the table, but any opposition strategy could backfire horribly. Only a crystal ball will show whether the public’s zeal for repeal will survive the test of time.

That said, the question remains of what the “replace” part of “repeal and replace” might look like.  Some conservatives have offered incremental reform options that are essentially tweaks to the current system. Although there is a degree of prudence to this, there is also a danger — the current system’s whole approach is methodologically flawed.  Employer-paid comprehensive health insurance is simply a dead end, and propping up the system’s inevitable collapse seems dangerously short-sighted.

So if I could blow up the system and impose a new health-care industry by fiat, it would look like this:

  1. Employers would get out of the health-insurance business altogether. There is absolutely no reason that my boss needs to help me pay for a doctor’s visit.  Employer-provided insurance is a relic of World War II, when business first offered benefits packages as a way of getting around Roosevelt’s wage and price controls. Although the people tended to like these benefits, as a matter of pure reason, there is no justification for keeping employers in the middle of a person’s relationship with their doctors.  None whatsoever.  And freeing individuals from the perceived need to stay in a job with benefits may improve employee portability and risk-taking and encourage entrepreneurship.
  2. Routine well-care and ordinary medical expenses are solely the responsibility of individual citizens. We sometimes forget that insurance is a risk-adjusted method for protecting a person against possible loss. In a health context, however, we use insurance to handle things that have very little to do with risk mitigation, a practice that is borderline irrational and shifts the financial burden from those who are high-cost consumers of health services to those who are low-cost consumers (after all, you pay the same premium as your coworker even if your annual insurance billings total $100 and hers totals $15,000). In a perfect world, people will attend to their routine medical needs just like they attend to things like hygiene and clothing and auto repairs, none of which require an employer or governmental subsidy — and if they don’t, then this reflects a disordered prioritization of expenses by the consumer and not a systemic problem requiring an expensive public fix. Especially if we impose meaningful tort reform, to limit malpractice claims to situations that a team of physician advocates (instead of a lay jury) agree rises to the level of gross malpractice, the cost of services like annual physicals, immunizations, and diagnostic radiology will plummet and be affordable across the board.  To assist with individual cost management, a person could open a health savings account, accessed at the point of service by a debit card, funded with pre-tax voluntary contributions from payroll, so that even routine care doesn’t require a direct out-of-pocket cash outlay. Side note:  To those who are concerned about costs … what about costs for people who overpay?  In the last five years, I have paid more than $8,000 in insurance premiums while collecting less than $3,000 in total benefits.  Economically, it would have been significantly cheaper for me to forego insurance and pay for everything out-of-pocket, but if all the healthy and self-reliant did that, then those seeking insurance under the current system would have astronomically high premiums.  Hence the need for Obamacare’s “individual mandate” — it shifts costs to people like me, from people who go to the doctor every time they get a sniffle.  How, exactly, does forcing the healthy to subsidize the unhealthy pass social-justice muster? Under what ethical paradigm does forcible charity become an intrinsic public good?
  3. Health insurance is available, voluntarily, to protect against genuine catastrophic risk.  These plans will be more consistent with genuine insurance coverage, insofar as they have nothing to do with routine well-care and everything to do with protecting against major loss from serious, unexpected injury or unforeseen acute medical conditions.  Trauma risks (e.g., getting hit by a car) could be covered in full, with a fairly low annual premium to reflect the relative infrequency of major traumas.  Protection against clinical risks like strokes or heart attacks would also be available for optional purchase — a risk-adjusted model based on factors like behavior or family history would be more expensive, but may be an option that some would prefer to purchase.  Actual prices would be based on an actuarial assessment of a person’s likelihood of loss, relative to the total pool of covered lives, in accordance with free-market principles.  Allowing companies to offer insurance across state lines is a good first step toward building the right kinds of pools that would make true catastrophic care comprehensive but inexpensive in an open, personal market.
  4. State or community programs will manage risk-adjusted chronic-disease populations.  A major question within the health-care industry today is how to best manage people who have long-term chronic conditions like cancer or diabetes or HIV.  There is no right answer.  Some people respond well to ongoing medication, others to diet and exercise modification. Some people need ongoing dialysis or expensive drug therapies.  These are things that contribute to insurance costs. However, a registry-based program that allows teams of specialists including doctors and nurses and community health workers to engage with patients in a comprehensive manner to address all aspects of their chronic condition is a step in the right direction. The question, however, is cost:  Who pays?  A chronic condition is not an insurable condition, but it’s also not clear that it’s appropriate that the rest of society subsidizes treatment costs, particularly for conditions that are largely the result of lifestyle choices.  One option: Registries.  Allow people to sign up for programs to treat their condition at low or no cost, with actual costs borne by drug companies or community non-profits or even local or state governments. Hospitals and physician practices could receive tax incentives for contributing to registries, because there is a public interest in managing chronic conditions before they become major (and expensive) health crises.  The market could work its magic with registries.  For example, a leukemia registry may be funded by pharma companies that actively solicit patients to engage in drug research.  Or a diabetes registry in one state may be funded by a health-focused private foundation that thinks it has a better option for disease management and is willing to fund a demonstration project that is applicable across the country (Gasp! Federalism! Diversity in programming!  Oh, l’horreur!)
  5. Local communities could provide well-care subsidies for low-income families.  Yes, we all want to make sure babies, including poor ones, get proper treatment and immunizations.  To that end, local communities could provide health clinics to assist low-income families cover costs.  Churches could pool donations with local foundations to hold a free-clinic day every few months, for example.  Or county governments could operate basic clinics for families with incomes below a certain level.  There are many options for assisting low-income populations short of a massive, mandatory, one-size-fits-all social-welfare scheme.

The bottom line:  We must inculcate the attitude that the only person responsible for my health is me.  Not the government, not my boss, not an insurance company.  Me.  Health care is a routine part of life, and the provision of health insurance as an employer-provided benefit to so many for so long has led some people — mostly on the Left — to conclude that the government has an affirmative duty to keep people healthy.  This assumption is patently absurd, but it persists, and any viable repeal-and-replace program must convincingly show an average citizen how self-responsibility provides greater flexibility and lower cost than the chimera of Obamacare or the siren song of universal single-payer insurance.

Some readers of this blog are aware that the author is affiliated with a West Michigan-based hospital. The comments in this posting reflect only the author’s perspective and should not be considered a reflection on the hosptial’s perspective, nor a statement offered in the author’s capacity as a hospital employee.

Politics & Culture

Thoughts on the "With What" Part of "Repeal and Replace"

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Diagnosis: Miserable Failure.
Yuval Levin’s analysis of Obamacare is a cogent but brief summary of the problems arising out of the newly passed Patient Protection and Affordable Care Act. His review is merely one of thousands, from both sides of the political spectrum, that tears apart the new law.
Concerns about Obamacare are as substantial as they are plentiful:

  • The new law does very little to reduce costs — indeed, it is likely to increase them substantially in the long run, because of the “trick” in delaying the provision of benefits against the immediate collection of tax revenues in order to bring in a 10-year cost of less than $1 trillion.
  • The expected revenues (e.g., Medicare cuts and the long-delayed tax on “Cadillac plans”) are almost surely not going to be imposed because of a lack of Congressional fortitude, which will add to significantly higher long-term federal deficits and unsustainable growth in state liabilities for Medicare and Medicaid recipients.
  • The law is internally incoherent: It was designed to accommodate a public option, which was later stripped, but the context of the law does not adequately reflect the removal of the public option.
  • The most serious barriers to public access to health care are not addressed.
  • The law creates perverse incentives to dump employees from company benefit plans into private exchanges, but the exchanges are unlikely to materialize as intended because it would be financial suicide for an insurance company to enter the private market under the current Obamacare regulations.

Conservative activists are pushing the “repeal and replace” mantra. Whether this goal is politically feasible is too early to tell — realistically, repeal cannot happen until after 2012, assuming Obama doesn’t win a second term. In terms of public discourse, three years is an eternity.  Some options, like refusing to fund the development of Obamacare if the GOP takes the House this fall, are on the table, but any opposition strategy could backfire horribly. Only a crystal ball will show whether the public’s zeal for repeal will survive the test of time.
That said, the question remains of what the “replace” part of “repeal and replace” might look like.  Some conservatives have offered incremental reform options that are essentially tweaks to the current system. Although there is a degree of prudence to this, there is also a danger — the current system’s whole approach is methodologically flawed.  Employer-paid comprehensive health insurance is simply a dead end, and propping up the system’s inevitable collapse seems dangerously short-sighted.
So if I could blow up the system and impose a new health-care industry by fiat, it would look like this:

  1. Employers would get out of the health-insurance business altogether. There is absolutely no reason that my boss needs to help me pay for a doctor’s visit.  Employer-provided insurance is a relic of World War II, when business first offered benefits packages as a way of getting around Roosevelt’s wage and price controls. Although the people tended to like these benefits, as a matter of pure reason, there is no justification for keeping employers in the middle of a person’s relationship with their doctors.  None whatsoever.  And freeing individuals from the perceived need to stay in a job with benefits may improve employee portability and risk-taking and encourage entrepreneurship.
  2. Routine well-care and ordinary medical expenses are solely the responsibility of individual citizens. We sometimes forget that insurance is a risk-adjusted method for protecting a person against possible loss. In a health context, however, we use insurance to handle things that have very little to do with risk mitigation, a practice that is borderline irrational and shifts the financial burden from those who are high-cost consumers of health services to those who are low-cost consumers (after all, you pay the same premium as your coworker even if your annual insurance billings total $100 and hers totals $15,000). In a perfect world, people will attend to their routine medical needs just like they attend to things like hygiene and clothing and auto repairs, none of which require an employer or governmental subsidy — and if they don’t, then this reflects a disordered prioritization of expenses by the consumer and not a systemic problem requiring an expensive public fix. Especially if we impose meaningful tort reform, to limit malpractice claims to situations that a team of physician advocates (instead of a lay jury) agree rises to the level of gross malpractice, the cost of services like annual physicals, immunizations, and diagnostic radiology will plummet and be affordable across the board.  To assist with individual cost management, a person could open a health savings account, accessed at the point of service by a debit card, funded with pre-tax voluntary contributions from payroll, so that even routine care doesn’t require a direct out-of-pocket cash outlay. Side note:  To those who are concerned about costs … what about costs for people who overpay?  In the last five years, I have paid more than $8,000 in insurance premiums while collecting less than $3,000 in total benefits.  Economically, it would have been significantly cheaper for me to forego insurance and pay for everything out-of-pocket, but if all the healthy and self-reliant did that, then those seeking insurance under the current system would have astronomically high premiums.  Hence the need for Obamacare’s “individual mandate” — it shifts costs to people like me, from people who go to the doctor every time they get a sniffle.  How, exactly, does forcing the healthy to subsidize the unhealthy pass social-justice muster? Under what ethical paradigm does forcible charity become an intrinsic public good?
  3. Health insurance is available, voluntarily, to protect against genuine catastrophic risk.  These plans will be more consistent with genuine insurance coverage, insofar as they have nothing to do with routine well-care and everything to do with protecting against major loss from serious, unexpected injury or unforeseen acute medical conditions.  Trauma risks (e.g., getting hit by a car) could be covered in full, with a fairly low annual premium to reflect the relative infrequency of major traumas.  Protection against clinical risks like strokes or heart attacks would also be available for optional purchase — a risk-adjusted model based on factors like behavior or family history would be more expensive, but may be an option that some would prefer to purchase.  Actual prices would be based on an actuarial assessment of a person’s likelihood of loss, relative to the total pool of covered lives, in accordance with free-market principles.  Allowing companies to offer insurance across state lines is a good first step toward building the right kinds of pools that would make true catastrophic care comprehensive but inexpensive in an open, personal market.
  4. State or community programs will manage risk-adjusted chronic-disease populations.  A major question within the health-care industry today is how to best manage people who have long-term chronic conditions like cancer or diabetes or HIV.  There is no right answer.  Some people respond well to ongoing medication, others to diet and exercise modification. Some people need ongoing dialysis or expensive drug therapies.  These are things that contribute to insurance costs. However, a registry-based program that allows teams of specialists including doctors and nurses and community health workers to engage with patients in a comprehensive manner to address all aspects of their chronic condition is a step in the right direction. The question, however, is cost:  Who pays?  A chronic condition is not an insurable condition, but it’s also not clear that it’s appropriate that the rest of society subsidizes treatment costs, particularly for conditions that are largely the result of lifestyle choices.  One option: Registries.  Allow people to sign up for programs to treat their condition at low or no cost, with actual costs borne by drug companies or community non-profits or even local or state governments. Hospitals and physician practices could receive tax incentives for contributing to registries, because there is a public interest in managing chronic conditions before they become major (and expensive) health crises.  The market could work its magic with registries.  For example, a leukemia registry may be funded by pharma companies that actively solicit patients to engage in drug research.  Or a diabetes registry in one state may be funded by a health-focused private foundation that thinks it has a better option for disease management and is willing to fund a demonstration project that is applicable across the country (Gasp! Federalism! Diversity in programming!  Oh, l’horreur!)
  5. Local communities could provide well-care subsidies for low-income families.  Yes, we all want to make sure babies, including poor ones, get proper treatment and immunizations.  To that end, local communities could provide health clinics to assist low-income families cover costs.  Churches could pool donations with local foundations to hold a free-clinic day every few months, for example.  Or county governments could operate basic clinics for families with incomes below a certain level.  There are many options for assisting low-income populations short of a massive, mandatory, one-size-fits-all social-welfare scheme.

The bottom line:  We must inculcate the attitude that the only person responsible for my health is me.  Not the government, not my boss, not an insurance company.  Me.  Health care is a routine part of life, and the provision of health insurance as an employer-provided benefit to so many for so long has led some people — mostly on the Left — to conclude that the government has an affirmative duty to keep people healthy.  This assumption is patently absurd, but it persists, and any viable repeal-and-replace program must convincingly show an average citizen how self-responsibility provides greater flexibility and lower cost than the chimera of Obamacare or the siren song of universal single-payer insurance.

Some readers of this blog are aware that the author is affiliated with a West Michigan-based hospital. The comments in this posting reflect only the author’s perspective and should not be considered a reflection on the hosptial’s perspective, nor a statement offered in the author’s capacity as a hospital employee.

Politics & Culture, Social Media, Marketing & Privacy

Online Privacy: Time for Action

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You visit a favorite Web site. You browse a while, and then you notice that all the ads you see are remarkably well-tailored for your unique preferences. The banner ads or AdSense offerings are for things that you like, or for businesses that are local to you. Product suggestions are for things you’ve recently browsed or purchased from a mail-order company.

How on earth does “teh Internets” know these things?

Simple.  You are a number in an enormous database, and the data associated with that number is growing at a frightening rate.

Savvy Web users already know that cookies can track your browsing history, but the old standby of blocking or deleting cookies is no longer enough.  Marketers are increasingly integrating offline data, or data from other online sources like social-networking sites, to develop a comprehensive profile about you. This profile worth its weight in gold — it can be sold and shared as an asset.  Worse, this aggregation is happening behind the scenes, with users unaware of the wide variety of information being integrated into their marketing profiles.

Ryan Singel, writing in Wired on April 9, reports that some privacy-protection groups have had enough:

Politics & Culture

Foursquare Foolishness

1 Comment

Chilling.

Yes, chilling.

Foursquare — a smart-phone application that provides real-time, published geolocation — is riding a wave of popularity.  The application allows users to indicate their present location, which is discoverable by others. People are encouraged to use the application by means of a series of meaningless “accomplishments” (e.g., being named “mayor” of a location for being the Foursquare user with the most registered visits) and partnerships with oh-so-clever businesses that provide trivial incentives like beverage discounts only to Foursquare users.

So why is this chilling? 

Because I already see where this is going.

Picture this scenario.  The spread of voluntary, social-media-inspired geolocation early in the 2010s lays the cultural framework for geolocation as an intrinsic good, with an able assist by tech companies that are happy to offer a few cheap baubles to eager users in exchange for the goldmine of data they provide.  Later in the decade, a few forward-thinking lawmakers determine that as a cost-saving measure, certain classes of evildoers including child molesters and parolees, would be issued limited-access smart phones by the government with geolocation services continuously enabled and an implanted RFID chip to ensure that the phone was in the offender’s possession. Concerned parents could check Foursquare or a similar public geolocation service to track where the offenders are — in a generic sense, at first, but with increasing granularity after a few high-profile child rapes.

In 2019, a few larger companies require employees to use geolocation services to check in during off-site conference attendance, to ensure that the employee is actually attending the conference and isn’t simply taking a vacation on the company dime.  Although some people grumble, the technology was sufficiently mainstreamed because of its origin in social media that discontent is fairly muted. A court challenge on free-association grounds is dismissed at the appellate level because the tracking devices are employer issued and the employee is free to seek other employment.

In 2023, after a series of well-publicized rescues for people using geolocation services, and as lines at airports mount, the federal government allows people to register for a national geolocation service, with special TSA lines for people who simply pass through security checkpoints much more quickly than their non-geolocated counterparts.  Citizens are provided a generous tax credit for voluntarily participating in the program, and having been offered a free lunch as compensation for their liberty, they eagerly engorge themselves.

In 2027, as creeping expansion of mandatory geolocation gains steam, a series of high-profile serial killings in New York City prompts the NYC government to require all New Yorkers to continuously enable broadcast geolocation or pay a hefty fine. The matter is taken to court by civil libertarians, who lose on a twofold finding that the public safety is enhanced by by mandatory geolocation and that the widespread social adoption of voluntary, published geolocation makes “location” an attribute that is not subject to a high level of personal privacy protection under the Fourth Amendment.

A dystopian nightmare?  Probably not.  The pattern repeats itself time and again — as the market socializes new expectations on the electorate, the public desensitizes to the implications of the change.  Call it market-assisted incrementalism, if you wish.  It seems people will gladly trade their souls for the chance to be named mayor of the Burger King at the corner of First and Main and thereby obtain a $5 gift certificate.

But consider this cautionary tale: Before 9/11, institutions as diverse as banks and departments of motor vehicles did not routinely capture a person’s residential address; it was sufficient that a valid mailing address was provided.  But the terrorists struck, and the people — fearing another attack — agreed to sweeping restrictions on individual anonymity.  Today, a financial institution is prohibited from opening an account for a person without knowing that person’s residential address.  Although there are certainly benefits to this regulation, there are also downsides — and one of them is that a citizen is no longer free to engage in substantial aspects of white-market economy without wholesale public disclosure of substantial personal information.

For example, a person who wished to keep his residential address private used to have recourse to Post Office boxes or private mail boxes through companies like Mailboxes Etc.  Today, disclosure of a residential address is mandatory for banking or possessing a driver license.  And guess what? Driving records are, in some jurisdictions, public records, and can be pulled by anyone in most states upon payment of a modest fee.

Do I care if people know where I am?  Not really.  But that’s also not the point, which is this:  Products like Foursquare and the new geolocation tagging in Twitter and Google Buzz are making something that is intrinsically personal, a matter of public record, and this trend reduces the chance that in the future, we may voluntarily opt-out of the new geo-located social reality.

As John Derbyshire would say … “We are doomed.”

Politics & Culture

Anna the Bisexual

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It is mildly amusing to see the mainstream media’s bewilderment at the reaction to Anna Paquin’s announcement that she is bisexual, through a tolerance-themed public-service TV ad. As one wag suggested, it’s odd that media types should be so surprised that the public is eagerly engaged in the news that a hot chick likes it both ways.

I’ve often thought that bisexuality is grossly misunderstood. People get “gay” and “straight” — but “bi?”  Really?  Isn’t that just code for “I’m gay but don’t want to admit it?” or “I’m a dirty whore screwing anything that moves, just waiting for the right person with whom to settle down and procreate?”

Well, no.  Bisexuality is the result of a complex interplay of biological and sociocultural factors, and a person who is bisexual may favor one sex over the other.  Although it’s open to criticism, the Kinsey Scale is one measure of bisexuality; a person, after undergoing a battery of tests, is given a score of sexual orientation on a zero to six axis, with zero being “completely heterosexual” and six being “exclusively homosexual.”  Most people do not score zero or six, by the way, but since we are culturally programmed to accept a gay/straight dichotomy, we have some greater social aversion to accepting bisexuality for what it is.

Perhaps for that reason, most people are unfamiliar with just how many bisexuals are out there. Wikipedia has a list of prominenet bisexual persons, an selection of which is as follow:

Alexander the Great (ancient conqueror), Drew Barrymore (actress), Marlon Brando (actor), Caligula (Roman emperor), Joan Crawford (actress), James Dean (actor), Dominick Dunne (writer), Fergie (singer), Megan Fox (actress), Cary Grant (actor), Sir Alec Guiness (actor), William A. HenryIII (writer and critic), Angelina Jolie (actress), Florence King (writer), Herman Melville (writer), Lord Louis Mountbatten (last viceroy of India), Iris Murdoch (philosopher), and Gore Vidal (writer).

I do not hold out hope that the broader public will grasp the challenges confronting bisexuals — the minority within the minority that often has no real home anywhere in the gay or straight worlds. But perhaps Paquin’s announcement, and the reaction to it, will help plant a seed that will flower into something fruitful.

Politics & Culture

Health Care, Deformed

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It’s official: ObamaCare is the law of the land.

To be honest, I really thought it was going to fail by the narrowest of margins.  I expected Stupak to hold the line (instead of selling out for the flimsiest of protections), and I believed that enough grown-up House Dems would realize that they could obtain meaningful reform in a slower and more bipartisan manner that would not entail electoral suicide.  In short, I didn’t expect the House Democratic caucus to re-enact Jonestown.

Alas, the grown-ups never showed up — and now I’m angry.

The Senate Bill was flawed from the beginning.  It was a legislative proposal designed to pass the Senate and be modified by the House in conference. Although many folks don’t necessarily understand or appreciate the sausage-making of federal law, the reality is that the Senate bill was, in essence, a first draft — filled with such pork as the Cornhusker Kickback and the Louisiana Purchase.  No one expected it would be enrolled, unamended, into the Federal Register, and so it wasn’t designed to be an airtight law. 

This new Act is premised upon a dangerous gamble: That federal courts will sustain the notion that the Congress can compel private citizens to purchase a service from a private company as a condition of citizenship. That the courts will uphold this assumption is by no means guaranteed — there is a point where the “general welfare” clause must have a logical outer boundary, and if it’s not here, then the whole idea of limited government has become a dead letter.

Although the individual mandate is necessary for this whole scheme to succeed, its invalidation is unlikely to force the rollback of ObamaCare.  Instead, it will shift the cost burden so significantly (after all, if individual citizens aren’t required to purchase insurance, many won’t — and the “capitve audience” of premium-payers who use few resources will not be around to subsidize care for everyone else) that either single-payer or economic collapse looms in the near future.

More to the point, thoughtful activists on the Right (e.g., National Review) and the Left (e.g., FireDogLake) allege that the bill does absolutely nothing to cut costs. The Congressional Budget Office claims the bill is likely to force many people off of their current employer-sponsored plans, and thoughtful commentators believe that the rosy assumptions about revenue and expenses are almost surely off by an order of magnitude.

Of course, we have had bad legislation before. We can lament it, but getting upset isn’t necessarily the best response.

So why am I angry? Because of what the process around ObamaCare’s passage means for the future of federal governance.

As much as people decry the arcane procedures and special deals that keep Washington moving, the reality is that Senate collegiality is what keeps the whole enterprise somewhat on track. The passions of the House, controlled by majority will, are tempered by the supermajority demands of the Senate. America has been spared much populist nonsense because the ship of activism foundered on the rocks of Senate procedure.

The Democratic leadership pulled out every possible trick to squelch the Republican minority. They are using reconciliation to “amend” ObamaCare. They contemplated the Slaughter Rule (a.k.a. “deem and pass”) to pass the bill without actually voting on it. They completely shut the Republicans out of debate and negotiations in the House, and except for some minor tinkering last summer in the Senate Finance Committee, Senate Republicans were likewise shut out. Not only do the Democrats own this bill 100 percent, but they spared no procedure in slamming the door on Republican objections — especially when the public polled overwhelmingly in opposition to both the bill and the process for passing it.

In short, the Democrats burned collegiality for the sake of a policy win — and for a law that is so fundamentally flawed that conservative and progressive activists alike are pessimistic that it will do what it purports.

The value of divided government and Senate supermajorities is that radical change is necessarily muted. This “gridlock” protects the people and provides the essential stability and predictability that greases the wheels of political and economic growth.  It forces public policy reasonably close to the center.

The Democrats decided that respecting public opposition to their bill and honoring the longstanding restraint in the abuse of legislative procedures was less important than in appearing to be the saviors of a “century-old ideal” of the far left. In so doing, the partisan divide is inflammed to astronomical levels, inter-partisan trust is low, and voter anger is widespread — and none of it needed to happen, if only the grown-ups had stepped in and forced bipartisan incrementalism over radical unilateralism.

This. Will. Not. End. Well.

Politics & Culture

Silence

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I’ve wanted to write for some time now about the ongoing drama related to health care reform, but the words won’t come. Maybe this silence is a function of frustration — as in, Who the hell do the Democrats think they are, forcing this crap on an unwilling people?  Or maybe it’s because there’s not a lot to say that hasn’t already been said 364,710,578 times already.  Perhaps it’s because the two sides simply aren’t speaking the same language — compare FireDogLake against The Corner at National Review.

As someone who has spent a decade working for a major midwestern health system, a majority of that time as the senior analyst for front-end revenue-cycle operations (which includes insurance companies), I think I have a perspective to add that doesn’t amount to ideological combat.

Yet although I am strongly opposed to ObamaCare, I find that the sanest response is silence.

Maybe one days the grown-ups will fix this mess.

Politics & Culture

Apple, Google, Microsoft

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Some observations about the tech industry:

  • iPad was a curious direction for Apple. Not sure there is a market for oversized iPod Touches. It’s as if Apple is starting to believe its own hype, that it can do no wrong and everything it releases is magic. It’s a company whose motto ought to be, “I did it my way” — from locking down the App Store to eschewing the likely mods needed to be a player in the enterprise market, the company does what it wants to do so it can retain maximal control over its brand.  That’s fine.  But it’s also self-defeating.
  • Google terrifies me.  Yes, I have a GMail account, and I use Google Voice and Google Analytics. But the company scares me — it tracks too much, archives for too long, and appears to have some sort of master plan. And I don’t like companies that have master plans. It would not surprise me that when the Cylons finally come, they will be running Android (come to think of it, Android is a curious name for an OS …).  Google’s core business is search, and matching ads to search. But the forays into other areas (which have been successful mostly through acquisitions and not in-house development) suggests a growing monstrosity lurking in the corners: Why, exactly, does Google need to own broadband spectrum, fiber, cell phones, operating systems, social networks, IM systems, and such?  Because it archives and profiles data, for reasons that are not yet public.  That bugs me.  Especially when the company’s motto is “Don’t be evil.”  It’s as if they cynically believe that merely saying “don’t be evil” will lead people to believe that you are a force of good in the world.
  • I’m increasingly impressed with the “new” Microsoft. Windows 7, IE8, the demo Windows Phone 7 Series, and Bing are solid products.  Office 2010 Beta is positively orgasmic. And more to the point, given Microsoft’s “battlin’ business unit” model, I don’t really worry that info I store in a MS property will eventually be used to profile me for my assignment in the Brave New World of the Googleverse.

So:  Microsoft good, Google bad, Apple as emo adolescent.

Politics & Culture

Stupid Voters?

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Jacob Weisberg writes in Slate that “the childishness, ignorance, and growing incoherence of the public at large” is the chief reason that “our political paralysis seems to have gotten so much worse over the past year.”

Weisberg makes a point that has been echoed, more subtly, by President Obama, who has hinted that the reason voters have rejected his health initiative is because they were too dumb to figure out how they’ll benefit from it in the long run. So, in his State of the Union speech, he graciously agreed to accept his “share of the blame for not explaining it more clearly to the American people” despite that, according to columnist Charles Krauthammer, Obama has given 29 speeches in the last year on the subject of health reform.

Indeed, there is evidence that some Democratic pollsters and activists are encouraging the White House to push ahead on the health bill despite its toxicity at the polls, on the theory that once it’s signed into law people will start to like it.

Who knows?  Perhaps the Kool-Aid drinkers are correct. After all, as Weisberg notes, Medicare was unpopular when it passed but now seniors cling to it like lawyers to an ambulance.

My current vade mecum text is On Democracyby political scientist Robert Dahl. Dahl argues that one of the five main criteria of a democracy is that the electorate be sufficiently informed, with access to solid data with which to make reasonable decisions about matters of public significance.

It is intriguing that the media — Did I fail to mention that Weisberg is the editor-in-chief of Slate? — has picked up the people-as-rubes trope and now suggest, ala New York Times columnist Paul Krugman, that the Democrats should simply force a health bill irrespective of the wishes of a public that is, in their consensus view, too uninformed and excitable to appreciate the benefits of Obama-style reform.

Blaming the voter for being too stupid to know what’s good for him is a timeworn elitist attack on democracy, but surely we have outgrown it by now. After all, the media and the Democrats have prided themselves as being something of a voice for the common man. So if the public speaks and it’s not in the voice of the elite consensus position, then golly — the people are insufficiently informed. And if more and more and more information doesn’t change their perspective — recall Obama’s 29 speeches? — then it’s simple fear or intransigence that is leading the people astray.

No, there can be no chance that the people know better than the political elite. Can there?

That’s the curious thing about Dahl’s perspective. If we concede that the value of a democracy is that citizens debate and discuss weighty public matters before registering their collective will, it should be a no-brainer that when 61 percent of the public wants Congress to drop health reform, the political classes will act accordingly.

Instead, the political classes suggest the people have debated the subject and came to the wrong conclusion, and because the conclusion was wrong, the Democrats should do what they think is best.

The question is simple: Given massive, sustained public displeasure with the specific proposals generated in the Democratic Congress, and factoring the widespread debate across the nation about health reform, should political leaders pull back and re-tool the plan, or abandon it altogether? Or should they press ahead, on the theory that they know better than the folks who elected them?

Yet Weisberg’s column is about more than just health care. Across the board, he argues, the people seem to want conflicting things. In principle they want health reform and banking reform and housing reform, yet they oppose the plans put forward by lawmakers or the Administration.

Weisberg’s eminently predictable conclusion is that the people are dumb: They don’t know what they want, so they want conflicting things simultaneously. He seems incapable of accepting another logical possibility — that the people may want a governmental fix on big-picture subjects, but reject the specific proposals advanced by a left-leaning Democratic Congress and a left-leaning Democratic President.

Is it possible that a center-right electorate wants specific policy proposals that reflect a center-right mentality, instead of solutions arising from left-wing ideology?

Perhaps the public wants health-insurance reform, but not a government takeover of one-sixth of the economy. Perhaps the public wants banking reform, but not massive TARP bailouts. Perhaps Americans want the Detroit automakers to be successful, but not be subsumed into the Executive Office of the President.

Public discourse is not advanced when thought leaders like Weisberg and Krugman and Obama act as if disagreements with their specific policy positions are tantamount to ignorance.

Perhaps the issue isn’t that the voters are stupid. Perhaps, instead, the voters simply prefer different and less ideological solutions to America’s pressing problems than those favored by Weisberg and his ideological compatriots.