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If Democrats Don't Pass Health Care Reform, Republicans Will

Over the past several weeks I have suggested that a smart Republican health care strategy would be to introduce a series of smaller fixes that have broad public support and that are already in the larger Democratic reform package. This would put Democratic lawmakers in the position of having to support Republican health care reform or vote against ideas supported by the public and that are in reform bills that have already passed the House and Senate. The result would be demonstrating that Republicans are the party of responsible reform and that the Democrats are hypocritical insiders more concerned with big government and self-interest than they are in real solutions for real people. Not a good spot for Democrats to be in. (Those who may have missed my posts on health care strategy can catch up here, here and here).

Republicans appear to have adopted that strategy. Kaiser Health News reports (via Politico’s Pulse):

“With health care legislation stalled, Republicans are touting their own remedies, including allowing Americans to buy health coverage across state lines. Currently, consumers can buy policies only from insurers licensed by the states in which they live.

The Republican idea has actually been incorporated into the Democrats' House and Senate health bills, though in a somewhat different form. And it's expected to be included in any legislation that wins final passage.”

The best course for Democrats would be to aggressively move on health care reform. Passing significant reform will demonstrate strength, give the Democrats a victory on which they can run in the fall, and take important steps to solving a problem that is a drain on the economy and wrecks lives. All good things for Democrats going into the fall elections.

Failing to do so would leave unsolved a critical problem that is important to voters, demonstrate to voters that Democrats incapable of leading even with large majorities in the House and Senate (and with a Democrat in the White House), and let the Republicans claim victory for reforming health care even though they are the minority party in Congress. All bad things for Democrats going into the fall elections.

Location, Location, Location

Where a speech takes place can be at least as important to how the speech is received as the content of the speech itself. Location led to a Republican a near-miss in their response to the State of the Union a hit for the President in his appearance before the Republican retreat a few days later.

The location of a speech helps tell the audience what the speech is about, and intentionally or otherwise can effectively become, the contents of the address.

An example of this is President George W. Bush’s third address to the nation after 9/11. A New York Times Magazine story on the address noted that the location of the speech was determined before a single word was written. The options being discussed were the Army War College (the President would look strong), the Oval Office (he would look in control and the setting would be intimate) or an invitation to speak to a joint session of Congress. Without yet anything to say beyond the two speeches on the attack he had already given the decision was made to address Congress because it would present an image of national unity and the President did well when addressing large audiences.

Which brings us to the Republican response to the State of the Union address.

The State of the Union is delivered by the most powerful leader on the planet, before the federal elected and appointed leaders of the world’s leading democracy, in one of the most important deliberative chambers on earth. This year the speech was given by one of the most gifted political orators of our generation. The Republicans saw this strength as a weakness and moved to exploit it. If the President was going to be surrounded by powerful Washington elite and use high rhetoric to inspire the Republicans were going to be surrounded by actual people and talk to them as if there were actual people, thus highlighting the inside/outside, us versus them dynamic that helped elect Republican Senator Scott Brown in Massachusetts. The speech was given from the Virginia House of Delegates to an invited audience of policy makers, business owners and others. A great idea, but the House of Delegates, no matter how impressive, pales in comparison to the House of Representatives. An assembled audience of non-politicians in a political chamber that is not as nice as Congress makes that audience look not as good as Congress. It was the State of the Union – light, a local access version of a network news program. A better option would have been to hold the response in a local diner – same crowd, same words, different place and different message.

On the flip side is the President’s discussion (debate?) with Republicans at their meeting in Baltimore. By going to them the President, in the words of some pundits, entered the “lion’s den.” He demonstrated power and strength by taking on Republicans on their turf and coming out glowing ; it’s the Red Sox beating the Yankees in New York. The exact same conversation with the exact same people in the White House mess or on a meeting room in the Rayburn House Office Building would not have had the same effect – it would have been a different and less persuasive event.

Advocates often use the power of location to their advantage. But too often they either don’t think about the location and thus miss an opportunity to make their point (or even undermine it), or they carefully select a location that contradicts the larger point they are trying to make.
In rhetoric, as in real estate, location matters.

To Russia with Chatter

For those who haven’t had enough pre- during- and post-State of the Union Analysis, check out my appearance on The Alyona Show on RTTV, an English language Russian television network. The panel I’m on starts at about 14:30.

Search Engines as Reality Checks

Professional advocates, the consultants (like me) who work with them, the reporters who cover them, and the elected officials and candidates at whom they advocate, often become our own echo chamber. We repeat the same things to each other and quickly mistake those things for reality. This is nearly inevitable – we all live and work in the same areas, socialize in the same circles, send our kids to the same schools, and so on. Everyone we know lives in our world, so we assume everyone we don’t know lives there too.

But of course few people live in our world, most live in theirs (and make the same assumptions). Everyone says “well everyone I know thinks….” As a result we can lose touch with those who don’t live in our world and on whose behalf we advocate, cover, represent and so on.
One way to conduct a quick reality check comes via Predictably Irrational. Search engines like Google, Bing and others have an auto-fill function, offering suggested searches based on words that are entered. Predictably Irrational uses this function to demonstrate the differences between what men and women search for in Google. Advocates can use it to get a peek into whether or not people online care about their issue and if so, how.

There are two parts to this check, both of which can be valuable.

First, do people know or care about your issue or candidate at all? As a baseline, type “Barack Obama is” into the search bar and look at the range of suggested searches (the Anti-Christ, communist, Muslim, Mason, etc.). “Harry Reid is” and “Nancy Pelosi is” generate similar results. But “Mitt Romney is” gets only six suggestions, two of which are Israel and Issues. As much as political professionals focus on the former Massachusetts governor and Presidential candidate (past and possibly future) the online world just doesn’t seem to care that much. “Mitch McConnell is” gets two suggestions: “issues” and “is an idiot” – this is the top Republican in the U.S. Senate. “The federal deficit is” has zero suggestions, as do most variations of “campaign finance is/campaign finance laws are/etc.”

Second, what do people think about your issue or candidate? “Global warming is” generates results that should not be shown to your children. “The death penalty is” results in a mix of suggestions, pro and con, while “gun control is” has more one-sided results (hint: “hitting your target” is one suggestion).

Using Google or Bing is not a substitute for actual research into public opinion, but it can provide a quick reality check for all of us who too easily mistake what we do, care about and think for what everyone does, cares about and thinks.

It Was The Truck

In The Spot: Rise of Political Advertising on Television by Diamond and Bates there is a terrific anecdote about a truck. The story, attributed to Mark Shields, is of a minor party hanger-on who is concerned about an election in Iowa. A few days before the election he persuades the campaign to give him $100 to rent a truck, cover it with signs, put a sound system on it and drive around town. Sure enough the truck driver’s candidate wins and he proudly proclaims “it was the truck!”

Almost a week after Democrats lost the Senate race in Massachusetts, and with it apparently the ability to pass sweeping health care reform, nearly everyone is saying it was their truck. Tea Party Patriots are saying it is proof they have political power, Senator Evan Bayh (D-Ind.) said those who didn’t see the election as a wake-up call to move to the center were incapable of waking up, professional campaign field organizers are saying Brown won because of a vastly superior field operation (and a woeful Democratic field effort), U.S. Representative Bill Pascrell says the election Democratic arrogance, and so on. All maybe right, of course, but similarly all may be wrong (the election can’t be re-run like an experiment adding or subtracting a variable).

Most of us bring our biases to bear on a situation and say “I told you so!” at the outcome. I recall (possibly falsely) a study around the 1983 post-apocalyptic film The Day After that found those who believed the United States needed a strong nuclear deterrent, and those who believed nuclear disarmament was critical, both said the movie proved their point. A recent study about incarceration rates that some advocates hoped would prove America had too many people in prison had the opposite effect on those who support ‘lock ‘em up’ policies – rather than looking at the data and saying ‘”too many folks are in jail”, they said “crime went down when we put a lot of people in jail, I told you locking up lots of people was good.”

Advocates should learn the lesson of the truck. Everyone with an opinion about a situation will find something in the situation that proves them right. One advocate’s clear evidence of A is another advocate’s obvious proof of B. Before launching an issue campaign based on examples you and your coalition allies agree makes your point, check with folks who different points of view (polling is one way to do this) and find out what, if anything, they think your examples prove. Checking your biases against the biases of others can help refine your message, help you make sure you’re making the point you want to make, and help prevent you from making your opponents argument for them.

Unsolicited Advice for Democrats on Health Care Reform Based on Unsolicited Advice for Republicans

The Democrats best strategic decision on health care is to immediately pass a scaled-back package of health care reforms. If Democrats don’t move quickly, Republicans will. This will hand Republicans a big win, will result in policies that Democrats in the House like even less than the Senate bill and make the losses in November even greater.

Assuming no feedback, the Democrat’s options on health care reform are limited to ‘worse’, ‘worser’ and ‘worstest.’ The House could pass the Senate bill – unlikely and it would look like Democrats were cheating to get around the Brown victory (which accurate). They could cram as much as possible through reconciliation – extremely tricky, which is why it wasn’t done last fall and it would look like Democrats were cheating. Or Democrats could give up on reform which would fail to address a major economic and social problem, fail to deal with an issue important to voters, and prove that Democrats are incapable of governing.

But of course Democrats are not the only players in this game. If one takes into account possible Republican actions the best course of action becomes obvious.

If I were a Republican I would modify my advice from several weeks ago (here) and introduce a series of smaller health care reform bills that would be popular with the American people and that are already part of the Democratic package such as barring rescissions, lifting the anti-trust exemption for insurance companies, allowing people to buy health insurance across state lines, and so forth. I would do it a bill at a time which wouldn’t require full agreement on the massive package (different Republicans could defect on different bills as long as the overall vote on each were large) wouldn’t look like massive over reach, and would rack up a series of wins. It would also force Democrats to support reforms they have already voted for and that the American people like or vote against health care reform because they don’t want to be bi-partisan. The Republicans would go into November saying (correctly) they led the charge on health care reform, they forced bi-partisanship and changed the tone in Washington, and they are better equipped to run the country. As a policy matter the bills probably wouldn’t provide long-term solutions to health care and would almost certainly be worse (from the perspective of Democrats) than similar individual bills that Democrats would write

Given this obvious strategy, if I were a Democratic I would start introducing small packages of fixes immediately. These fixes would put Republicans in a tricky spot (supporting reform or being obstructionists), would demonstrate momentum and prove the Democrats can govern. Republicans, in response, would declare victory because it was only their hectoring and the Massachusetts Senate race that led to these changes – but they would be following Democrats, and Democrats would deliver reform. And, not insignificantly, the reforms would be better (from the perspective of Democrats) than the Republican versions. If Democrats do nothing they will likely lose to an obvious Republican strategy. If Democrats act immediately they can still claim victory and get the health care debate moving in a good direction for the first time in decades.

The choice is easy: play and win, don’t play and lose.

Massachusetts and Meaning

With the Massachusetts special Senate election over the battle for its meaning is in full swing.

Elections don’t “mean” anything. The effects elections have are a function of the meanings we put into them.

One way to think about elections is to think about language. Words don’t have meanings. This medium is no more a “blog” than it is an artichoke, there is nothing inherently blogly about it, and should we all agree to call it an artichoke it wouldn’t suddenly taste great dipped in butter. For convenience, communities assign words to concepts. A “blog” tends to be a place where people post short writings on a variety of subjects. They are drafted and exist “virtually”, readers may print a blog post, but it is written to be consumed online. These and other conventions, which emerged as the medium developed, are all crammed into four squiggly lines and a short sound-pattern: b l o g. With the word standing in for the concept we no longer think about the many attributes of blogs, the history of the medium, how the internet works, and the countless other aspects of a blog. Instead we act as if the word were the “thing in itself.” We read, write and judge blogs based on this shortcut rather than on the broader conception (for example I have about 200 words left to make my point – what if we called the medium “blovels”, could they be longer and assumed to be fiction?). Meaning determines action.

Which brings us back to the Massachusetts Senate election. A lot of things went into that election – campaign management, money, messages, weather, in at least one case an openly gay liberal radio personality on a vendetta against Democratic candidate and Attorney General Martha Coakley for issues unrelated to the campaign. Elections, like concepts that words represent, are big and complex beasts that cannot possibly be entirely described all at once (if for no other reason than no one has that kind of time). As a result we assign a quick meaning to elections: a mandate on health care, a lousy candidate, a repudiation of Obama’s liberal agenda, proof that cautious Democrats in the Senate fell for Republican stalling tricks, and so forth. We then act as if our explanation were true. If the meaning becomes “repudiation of Obama’s agenda” people will act as if this were the case, ignoring all of the things the election simultaneously means. Candidates will run against Obama, Democrats will distance themselves from Obama, and so forth. The outcome of the election, like the emergence of a new medium, cries out for definition so that we know what to do with, and about, it. The explanation, like the word, “becomes” the thing in itself and we behave as if the explanation were complete, given and true.

Whoever wins the definitional battle will have won the meaning of the election, and thus largely determine political behavior until the next political event that cries for explanation.

A Natural Experiment in Behavioral Economics

Recent events in the life of my friend “Bill” provide a natural experiment in behavioral economics.

Bill works at a national advocacy organization we’ll call Our Future (the person and organization are real but the names are made up). Last year the OF was nervous about its budget and in mid-year told everyone that the organization would be closed between Christmas and New Years, and that no one would be paid for that week. OF also took a small amount out of everyone’s paycheck for several months and “paid” the employees with that money for the furloughed week. Depending on your perspective, OF either cut everyone’s pay and closed the office for a paid vacation week or it borrowed money from its employees that it paid back (without interest) during an unpaid furlough.

But that’s not how Bill saw it. Because the amount removed from his pay was relatively small and because he received a paycheck during a week when he was away vacationing in warm places, it felt like he got an extra, paid vacation. Of course Bill could have saved a little amount from each paycheck all year and simply taken the time, or invested a small amount from each paycheck and made money on the deal, but (like most of us) Bill probably wouldn’t have done that.

There is a recent plot twist: OF did just fine last year and is giving Bill and his co-workers checks for the amount removed from their paychecks last year. In other words, OF is paying people this year money it promised to pay them last year, and in addition Bill got an unexpected paid vacation. Since Bill felt as if he’d already received a paid week in the sun, the new money (really last year’s promised money) feels like a bonus. Bill’s 2009 salary was cut by 1 week’s wages and he involuntarily lent his employer money without interest. Because of the way the arrangement was structured (and because Bill knows the people who have been laid off) Bill thought it was terrific. OF is now paying Bill what it promised to pay him to begin with, and he feels as if he’s getting something special.

In addition to being of a “taa-daa” moment (behavioral economics! Taa-daa!) this offers lessons for policy makers. People like big checks because they feel like windfalls, and don’t notice (as much) small hits they never see (this is why automatically deducting retirement and other savings from paychecks before we get them works).

Tax policy, including tax credits and rebates, can be more popular if they offer lump rewards rather than small ones (see here on the Earned Income Tax Credit for example). Similarly, the government could use lots of small bits of money that we would rather receive all at once later and invest it now, making money off of it. Policymakers advocates would do well to learn from OF’s cleverness and Bill’s happiness.

Calls for Transparency Aren't

Those who feel as if they are on the losing side of debates that are happening (at least in part) in private often call for increased transparency. They do so assuming that if the debate or negotiations are happening in private the interests of the larger public are being ignored. If only, the logic goes, the public really knew what was going on they would be outraged, raise and outcry and change the outcome. Further, advocates argue, sunshine increases confidence in the democratic process thereby adding a selfless reason to their argument.

Predictably, I disagree.

The first flawed assumption is that if everyone knew what I knew then everyone would agree with me (and if you don’t agree with me after I tell you what I know you are either irrational or in the pockets of special interests). Most of us consider ourselves to be rational reasonable people who examine the evidence and reach our conclusions for good reasons. If I explain my position and you disagree you did not understand me, you have selfish reasons for denying the obvious truth, or you are by definition irrational. So I repeat myself louder and more slowly. If you still don’t agree with me, you are stupid, selfish, or both (while I of course am neither of those things).

The logic is that if negotiations were transparent then you the public would see the obvious truth and worth of my position as an advocate; the only reason to keep conversations closed is to hide selfishness or stupidity.

What this logic misses is that we all think that we are rational, etc. Those in the closed meetings want them closed because you, the advocate, miss the obvious truth of the positions in the meetings and are, as an advocate, either stupid or selfish (or both). Democrats are negotiating health care reform behind closed doors because the Republican cries for transparency are really just political games – the Republicans don’t understand the reality of health care reform or want to score points (or both). And, of course, Democrats are selfish political insiders afraid to let the American people see what’s really going on and are afraid to have an honest and open, non-partisan, non-political discussion with Republicans. Those in, and locked out of, closed meetings on copyright believe the same about each other’s motives. Those in, and locked out of, and so forth.

The second flaw is that transparency raises confidence in the process. As Prof. John Hibbing and others are have shown, the opposite is true. Transparency can decreas confidence because Americans dislike political debate – ironically we see political disagreement as a failure of democracy (see for example Stealth Democracy). If I’m right about people’s views of their own rationality and selflessness and the irrationality or selfishness of those with whom we disagree, such should not be a surprise. If there is debate over what is obviously true (as I see it and as defined by me) then someone must be a jerk and it ain’t me.

Book and Blog Plug

The book and blog Predictably Irrational by Dan Ariely are worth reading.

Those who familiar with my approach to politics know that I work from the premise that we are all bears of little brains. We think we are very clever (we blog – that’s about as clever as you can get!). We like to think we approach the world rationally and that we make good decisions for good reasons. None of us gets up in the morning and thinks “I could do what makes sense, helps people and advances my own personal goals or I could be an idiot, kick a dog and send my bank information to that nice Nigerian prince who keeps emailing me…I know, I’ll email the prince.” (Those unfamiliar with my rants can get samples here, here and here).

But…

We’re not fully rational in a classical economics sense. We do not carefully, fully and dispassionately weigh all of the options. Instead we rely on mental shortcuts to help us make sense of our world. We aren’t irrational, but rather boundedly rational or intendedly rational. We behave in ways that make that are predictable within the confines of what makes sense to us.

This is the space in which Prof. Ariely writes. His book is a fast, fun and accessible introduction to behavioral economics. He provides lots of examples of experiments demonstrating that we act in ways that are predictable but that may not make sense (for example preferring a free $10 gift certificate to a $20 gift certificate for which we have to pay $3). The book is not a great piece of scholarship – there are frustratingly few footnotes and charts, and most of his experiments seem to have been conducted with (on?) MIT students who may or may not reflect anyone other than MIT students – but it is a good poke at how people behave. Anyone who engages in politics or wants to understand how so many candidates, voters and elected officials (to say nothing of consumers, family members and neighbors) can make so many obviously foolish decisions will find the book and blog interesting.

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