Thus Spoke Ezrathustra

Says the Ezra Klein of today:

we need to distinguish between different types of public plan. There's the public plan which is actually a version of Medicare-for-All. Everyone can buy in, the plan can partner with Medicare to become the largest bargainer in the system, and the expectation is that it will eventually take over the insurance market. I could understand making that the definition of health-care reform, as it is a fundamental transformation of the health-care system. But if you don't think we can pass Medicare-for-All, there's not much reason to think we can pass that.

Sure, I can see how the insurance interests will hate all over the robust public plan which we could call Medicare-for-everyone-who-wants, knowing that it's a one-way trip to Medicare-for-all. And that's going to be a big obstacle.

But if Ezra has taught me anything, it's that we don't want to change everybody's health care all at once through legislation. Here's what he wrote in January 2008, and I doubt I'm the only person who took it to heart:

The line the Clinton campaign did use, "health security that can never be taken away," foundered because, before the plan offered that security, the health security that Americans currently trusted would be taken away.

"They couldn't defend it in simple terms," says Hacker, "because it actually meant a complex set of changes for most Americans." There was no concrete reference point, because the legislation was building something that didn't yet exist. The administration's argument, in essence, was "trust us." But when it comes to health care, it's one thing to make the system better. It's a whole other to remake it entirely. You can ask Americans to walk forward, slowly, knowing they can scramble back to the ledge if need be. You cannot ask them to jump.

That's why all us lefty kids had been loving the John Edwards plan subsequently picked up by Hillary Clinton and Max Baucus. Even if the insurance companies fought us just as hard as they would if we were trying to replace all the private health care with the model of efficiency that is Medicare, we had a one-line knockdown answer to the baseless fears that national health care in America would look like some bureaucratic nightmare from Stalinist Canada: "If you like your current health insurance, you can keep it."

That was the plan -- offer Medicare-for-everyone-who-wants, watch everybody make the choice to switch on their own, and perhaps go the last mile to true Medicare-for-all once a supermajority of Americans had come under the program and you wouldn't be messing with so many people's stuff. It was a good plan, just because it's politically easier to pass a robust public option and use individual choices as the vehicle for change than to mess with everybody's insurance by running straight to Medicare-for-all.

Certainly, I appreciate Ezra's attempts to enlighten us about parts of health care reform that get less attention. And the things he talks about look really important! Maybe he's trying to lower the emphasis on the public plan relative to robust subsidies and Medicaid expansion and health insurance exchanges and other stuff. And that might be a good idea. But I find myself a lot more convinced by his positive arguments for the importance of other stuff than his newfound negative arguments against the importance of the public plan.

The Sarah Palin Show

Posting has been slow lately, as I've been in a house party full of wonderful geeky friends with whom I've been playing Magic and participating in a live-action roleplaying game based on these books. But this blog owes its readers a Sarah Palin post! So post I will. First, Hilzoy:

I do not believe for a moment that this is about taking time off to prepare for 2012. Nothing I know about Sarah Palin leads me to believe that she would give up power voluntarily, let alone for something that is such a long shot, and in such a transparently self-destructive way.

Personally, I'm closer to the Jesse Taylor position, or lack of a position: "I really have no idea what she thought she was doing, or what she was saying."

There's a point at which somebody acts so weird that you lose the ability to make ordinary assumptions about what they think or want, and every remaining option seems to posit something implausible. Has Sarah Palin tired of politics? Does she think resigning will help her position herself for the presidency in 2012? Does she think resigning will help her promote conservatism from outside the system? Has she formed a desire to go mer-Galt? I really don't know what to say here.

Lots of people speculate that another scandal is in the works. And hey, it could be -- we had a new Palin scandal every other day in September, and I was left with the impression that her closet had more skeletons than the human population of Alaska. But it's rare that Governors face scandals so tremendous that they resign in advance. So I have no idea if it would be something huge, or something that she mistakenly thinks it's huge, or nothing at all.

Also, Emily Thorson's charts are really good. If you look at when the McCain-Palin ticket loses support in 2008, it's at the same time that Palin's approval ratings fall through the floor, even more so than when people get freaked out by the bad economy.

Reading Between The Lines

My read of Ezra's interview with a Wal-Mart spokesman (and I swear we read bloggers other than Ezra and Matt Yglesias) is that Wal-Mart signed on to an employer mandate hoping that by being on the inside of the tent pissing out, they can the level of coverage and/or at least force tighter cost controls onto the medical-industrial complex. I suspect that that's a deal I would be hunting for if I were Democrats; passage will require substantial business support, unless we adopt the Bernie Sanders method of returning to up-or-down votes for most legislation. Much better to get Wal-Mart to sign on to 85% of what we're looking for, then convince them to go lobby a few Republicans, than to strike a deal with Joe Lieberman's gang of wankers that gives us only 60% of what we're looking for.

Can We Eliminate The Agricultural Committees Without Assuming A Can Opener?

I'm getting more and more convinced by the Ezra Klein view that it would be good to eliminate the agricultural committees, which have become dens of regulatory capture for the subsidy-hungry forces of Big Corn.

But I'm wondering how one would go about doing this. For one thing, I don't know much about the procedural mechanics of eliminating a committee or demoting it to subcommittee status. But whatever those mechanics are, won't the Senators on those committees fight like crazy to protect their power? I'd imagine that they and agricultural interests would be fighting with all their might and main to prevent this from happening, while the rest of Congress would feel blase enough about Agricultural Committee elimination to be bought off. That's how regulatory capture works.

Of course, I'd like to believe otherwise. So how do we do this?

[Those who haven't heard the can opener joke should click here. I'm wondering which of the academic jokes I know are in-jokes and which are widely known.]

The Oil Ran On Time For Mooseolini

Todd Purdum's Vanity Fair article on Sarah Palin should've been edited down to a lower words-to-new-info ratio. There's not a whole lot that's new there if you've been following this stuff. As you might expect, McCain people are dissing on her off the record but unwilling to say anything publicly, for fear of being attacked by the pro-Palin echo chamber that they and their right-wing media allies created.

Palin has provided plenty of fodder for cultural and political analysis, but the strictly economic reason why someone like her could somehow get picked as VP in summer 2008 is captured by this line:

Rising oil prices provided an added lift. Palin was able to increase the annual distribution from the state’s Permanent Fund to about $3,000 per resident, almost double the amount received the previous year. She could be a fiscal conservative and a big spender all at the same time.

It's not hard to maintain high approval ratings in your state and generally be regarded as successful when the earth and the global economy are combining to pour forth vast rivers of money. Especially when the circumstances that make you look so good -- $100/barrel oil -- are dragging down all of your competition.