Network News

X My Profile
View More Activity

Why We Can't Have Good Policy

So Sarah Palin was for death panels before she was against them. Sen. Johnny Isakson's staff is blasting out press releases emphasizing the difference between Isakson's amendment and the House bill when Isakson has, in the past, supported much stronger — and wiser — measures than anything considered by the House. Chuck Grassley, who surely knows better, is carefully calibrating his words to sound like he's opposing end-of-life directives. The House version of the Medicare Prescription Drug benefit — the more conservative version of a Republican bill — turns out to have included end-of-life counseling provisions. Let's not even get started on Newt Gingrich.

Isakson, alone among these politicians, had the courage to defend the concept in his conversation with me, even if his staff did scramble when the White House used Isakson as a prop. Since then, though, plenty of politicians have had an opportunity to step forward and say that end-of-life counseling is a good idea, but there's been virtually no effort to do so. Instead, we've had a lot of carefully-crafted language meant to imply that the speaker disagreed with this awful Democratic plan even as the specific words didn't quite rule this out.

The point here isn't that politicians play to public sentiment. It's that in the judgment of these professionals, there's no political upside to doing the responsible thing. You get more mileage from bowing to the base than from stepping out and defending a good policy that's long been touted by respected conservatives. End-of-life counseling is, in the final analysis, a fairly small issue, but the speed with which its former defenders have agreed to polarize and abandon it is terribly depressing. And they wouldn't be doing that if they didn't think it the right move for their careers.

By Ezra Klein  |  August 13, 2009; 6:00 PM ET
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: Do We Have Enough Doctors For Health-Care Reform?
Next: Tab Dump


The lack of credible journalism is a huge factor. The media,print and television, has abdicated a professional role as a fact checker to call politicians out on their deceptions. Now media outlets, out of laziness, out of cowardice, out of any professional preparation or ethical commitment simply provide a mouthpiece for anyone who stakes a claim gives them all equal weight, or more than equal, especially if they are big screamers and make a big noise that can improve ratings.

Posted by: cmpnwtr | August 13, 2009 6:48 PM | Report abuse

An addendum for my first response to your question:
Why don't we have good health care policy in this country? Here's why. My sister in law, Paula, is 57 years old and single. She has life threatening cancer, and a lousy insurance policy provided by employer that is leading her to medical bankruptcy as she faces tens of thousands of medical bills not covered by her insurance. Her insurer fights coverage every step of the way. At the same time she is coming to a point where she may be too sick to work so she will lose the lousy coverage she has, and won't have the money to cover COBRA. And when COBRA runs out she will have nothing, and her treatment may be denied at that point. She is more than aware that had she had no coverage she wouldn't have been able to see the doctor to get a diagnosis at all or to initiate treatment. So here she is, she has paid all her life to pay for medical care for others, but when she needs it for herself, it isn't there. When she most needs a safety net, it isn't there. And she knows full well that if she lives, she will never be insurable again for the rest of her life, at least until she reaches 65.

Why won't we get a good policy? Because too many Americans, especially those on the right, think this won't happen to them. Republicans don't get cancer and too disabled to work. That's why we don't get good policy.

Posted by: cmpnwtr | August 13, 2009 7:17 PM | Report abuse

You state that "The point here isn't that politicians play to public sentiment. It's that in the judgment of these professionals, there's no political upside to doing the responsible thing." and on that point I happen to agree. But then I step back in time a few hours where you purport to proclaim "What Social Security Teaches Us About Health Care".

Social Security is a popular, but unsustainable, program; however, you seem to suggest that it should be a model for other policy. Does this mean that popularity makes the best policy?

If so, we ought to simply begin passing out Heroin -- it's popular and makes folks feel good... an opiate of the people and all that.

How DO we help legislators perceive "a political upside to doing the responsible thing"? Why aren't more legislators talking about the need for measures (such as S.426) to prop up the failing Social Security System? Why should we ENABLE legislators to create a similarly popular, and likewise unsustainable, program for health care?

Already, there are comments regarding your Social Security message which discuss how the System created a permanent underclass which elects not to save money for retirement (JonWa @ 5:04), how it suffered inevitable program bloat (ostap666 @5:42), and how it suffers from corruptibility (michaelterra @5:53). Why don't we hear more about the experience of Social Security?

Again, I agree that popularism (as opposed to progressivism) does guide policy. The only suggestion I have is better voter education -- education which includes propaganda analysis, honestly rendered history, and honestly presented and well-circulated news. Mainstream media plays a role.

Posted by: rmgregory | August 13, 2009 7:30 PM | Report abuse

"Why don't we hear more about the experience of Social Security?"

We do. The experience with it has been pretty popular and universally helpful for the citizenry. The reason it works so well is that it's universal: you can't cut it without offending _everyone_. And it has proven to be sustainable and helpful. The funny thing is that the only way it was able to pass was by cutting the "disfavored" out of the system-- the domestic servants and farmworkers, who were heavily black.

By way of extension, I might speculate that the way to pass universal healthcare is to pick some disfavored group, make them a scapegoat, and prevent them from taking part in the system. I'm going to say we should pick on the childless under-30 demographic... maybe something like, "if you and your spouse have less than 10 years of combined work experience, you don't qualify for the public option," or something like that. It makes beneficiaries seem like they are getting something from the government because they "earned it," and they get to mock the people who can't take part in the system as being losers. Everyone loves that.

Posted by: tyromania | August 13, 2009 7:44 PM | Report abuse

I just wish you weren't so partisan in this analysis. The Republicans are the only ones who can't be honest about policy reform?

DeParle just told you in her interview that health policy experts have told them that cost-sharing is needed for Medicare. Has Obama come close to saying anything like that? Instead he just declares he saving money from things like preventative medicine-- when the medical literature is pretty clear that that's not the case. Yeah, that's honest.

Replace the word Isakson for DeParle/Obama and you've got the same story.

When it comes to the tough choices, there's no one in DC who's speaking the truth. Let's stop pretending the Republicans are the only ones at fault.

Posted by: wisewon | August 13, 2009 7:49 PM | Report abuse

"Let's stop pretending the Republicans are the only ones at fault."

Death panels, wisewon. And Grassley's strange freakouts. At some point, blame needs to be laid for serious transgressions. If you're not willing to do that, you're being dishonest, and you're simply enabling the worst of the malefactors.

Posted by: tyromania | August 13, 2009 7:54 PM | Report abuse

"The experience with it has been pretty popular and universally helpful for the citizenry."

That depends on whether you are counting the citizenry who receive a benefit or the citizenry who provide it.

Unless you lived before the Baby Boom, your Social Security "benefit" will be smaller than what you'd have earned by simply investing the money. Is that what you call "helpful"?

Posted by: whoisjohngaltcom | August 13, 2009 11:12 PM | Report abuse

The commentator 'wisewon' is right. Obama does not have guts to come out clean and honest in this debate. It does not matter how many times Republicans flunk here. The point is how blatantly and openly President lies in saying that 'Grandma's plug will not be pulled' (when it is on public money).

The whole point of controlling cost means rationing care. And if we want Government of United States of America to do the constitutional duty of being guardian of collected taxes; President of that government cannot be stating flatly that there is no rationing.

No Ezra, it is a hopeless endeavor to call bluffs of Isakson or Grassley (who I suspected for long) when our beloved President himself refuses to be honest in this debate.

There is simply no scope for the smaller personalities in Congress to be 'profile in courage' when the Messiah is failing American Public in so Royal manner. President Obama is simply not showing any leadership here, his ticket to get 'above the fry' is completely lost. No wonder then others don't bother.

Posted by: umesh409 | August 14, 2009 1:03 AM | Report abuse

Further more, it needs to be understood that framers of out constitution intended very specific and narrow role for the Government. Government is not God so that it can write infinite checks to support abundant, infinite care of the populace. It is expected to be simply guardian of the tax dollars collected.

President Obama needs to understand that the real glory, and the ultimate service to Americans, is in 'carrying the cross' - the cross here is to educate Americans that limited Medicare taxes cannot result in unlimited, unrestrained medical care. And actually credentials of Sarah Palin are so impeccable in telling 'what is that cross', President Obama simply needs to stick to what she criticizes. GOP's hypocrisy and dishonesty are the leading lights in this journey; they are there for Obama and Dems to follow the right path.

Posted by: umesh409 | August 14, 2009 1:28 AM | Report abuse

umesh409, we're not going to pull grandma's plug. We're going to give her a pain pill.

Big difference.

Posted by: whoisjohngaltcom | August 14, 2009 7:29 AM | Report abuse

You see this, Chuck? Look at me when I'm talking tou you! See this mess you made? This is why we can't have nice things!

Posted by: tomveiltomveil | August 14, 2009 10:50 AM | Report abuse

Well, Ezra, you're right. I think I'll go throw myself off a tall building now. Damn you!

Oh, wait. Gotta fill out my will.

Phew. That was close.

Posted by: Rick00 | August 14, 2009 11:11 AM | Report abuse

The comments to this entry are closed.

RSS Feed
Subscribe to The Post

© 2010 The Washington Post Company