Some Should Do One, Others the Other

A friend writes:

In August 1968 I was on an SDS trip to Cuba, one of about 30 student activists from around the US. One day we went to the mission of the Provisional Revolutionary Government of South Vietnam in Havana (it had been called the National Liberation Front but had recently taken on a new name). We decided to see if the NLF, as we called them, could settle some debates in the US antiwar movement. After exchanging pleasantries with the representative of the PRG/NLF, we had the following exchange.

SDS students: We have a debate in the antiwar movement. Some of us think we should organize militant, obstructive demonstrations that are openly in support of victory for the NLF. Others argue we should organize much larger, peaceful, legal demonstrations around the demand of immediate US withdrawal from Vietnam. Which should we do?

PRG/NLF rep: Some of you should do one, and others should do the other.

SDS students: We have another debate in the antiwar movement. When a male antiwar activist gets a draft induction notice, some of us think he should refuse to serve, either going to jail or going to Canada. Others of us argue that he should quietly go into the military to organize among the soldiers for an end to the war. Which should we do?

PRG/NLF rep: Some of you should do one, and others should do the other. And when an antiwar activist goes into the military and ends up in Vietnam, there are ways to arrange contact between the activist and the local NLF fighters.

After that exchange, I began to see why the NLF was so successful in their struggle to force the US out of Vietnam.

Here is a parable for the Left! How many pointless debates about tactics could be avoided if someone just said, “Some of you should do one, and others should do the other.” Except in the case of a specific, finite resource, and a decision-making body able to allocate it, the merits of one approach aren’t an argument against another.

Peaceful demonstrations, or direct action? Challenge foreclosures in court, or block them in the street? Work within the Democrats, or build a third party? Support organizing and contract fights by AFL-CIO unions, or help build rank-and-file insurgencies? Try to shift the Obama administration from the inside, or pressure it from the outside? Debate the economics mainstream, or build a heterodox alternative? Nationalize the banks, or shoot the bankers? Fight for women’s access to male-dominated professions, or for greater social recognition of traditionally female activities? Well-funded public universities, or an end to credentialism? Green capitalism, or cooperatives? Theory, or practice? Recycle, reuse, or reduce? Some of us should do one. And others should do the other.

Is Liberalism Done Yet?

I don’t have much to add to Mike Konczal’s respectful but thorough rebuttal of the idea that the passage of health care reform marks the end of the liberal project; Yglesias is so clearly wrong, for so many reasons. Most immediately, the health care bill as passed will leave 8 percent of the population uninsured, so even if universal health insurance is the finish line, we haven’t crossed it yet. More generally, there are clear areas where expansion of public provision and regulation is almost inevitable, whenever the political climate turns favorable. Most obvious is childraising (and caring labor more generally), where our current system of uncompensated household labor is being steadily eroded by the acid of the market, even while the demands on it increase. In a few years, universal childcare will be seen by liberals as essential to a civilized society, just as universal health coverage is now.

More broadly, I’m reminded of Stephen Resnick’s story of his fellow MIT grad student Stephen Hymer going in to Robert Paul Samuelson’s office (this would be the early ‘60s) and asking him if there was anything important in Marxism that you couldn’t talk about using conventional economics. Samuelson’s answer: “Class struggle.”

Liberals and radicals do disagree over ultimate ends – more stuff, more equitably distributed, for them; the full and free development of human capacities, for us. But the more salient disagreement, at least in the current conjuncture, is over means. Liberals believe that the political process is ultimately a form of rational debate, in which the objectively best ideas win out and are then executed by a neutral administrative mechanism. Political engagement means situating yourself within shouting distance of the seat of power, and then making the case that your preferred policy is in the best interests of everyone. Who you are doesn’t matter, just the merits of your views. Carl Schmitt, interestingly enough, gives one of the clearest statements of this conception of politics:

All specifically parliamentary arrangements and norms receive their meaning first through discussion and openness. This is especially true of the fundamental principle that the representative is independent of his constituents and party… The characteristic of all representative constitutions … is that laws arise out of a conflict of opinions, not out of a struggle of interests. … Conduct that is not concerned with discovering what is rationally correct, but with calculating particular interests and the chances of winning and with carrying these through according to one’s own interests is … not discussion in the specific sense.

Schmitt, the anti-liberal, saw better than liberals that this mode of politics is specific to the particular institutional context of parliamentarianism. A context that remains very important, of course, outside of the formal political domain as well as within it. [1] But it’s not universal, and in particular it can’t be the last word in a society that is divided by fundamentally conflicting interests.

Radicals, by contrast, see the conflict of interests as fundamental. Or rather, we see it as inescapable in politics as long as it exists in economic life and society generally. From this point of view, arguments are won in parliament only thanks to the rioters, literal or figurative, in the streets outside. And liberalism as a concrete political project is a compromise between opposing interests, one that’s always open to renegotiation when the balance of forces changes. So unlike in science (liberalism’s implicit ideal), progress is always reversible, so no political struggle is ever definitely finished. Any given compromise is only sustainable to the extent that there are social forces striving for a horizon beyond it.

[1] For example, I’m current serving on a university hiring committee, and the norm that discussions must be conducted only in terms of differing opinions, never opposing interests, is very strongly felt.

The atrophy of the liberal imagination, a continuing series

My buddy Mark Engler wrote an interesting piece for the Dissent blog on why the left should oppose the Kagan nomination. Interesting, but not convincing, at least not to me. It’s not that I like her, altho I’ve been more or less convinced by people who know the academic-law world from the inside that her publication record is perfectly adequate. On substantive political issues there’s not much to say for her, and that’s on Obama, not the “process”.

What I don’t see, tho, are what are the principled demands being made here. “Liberal justice” is almost an empty signifier; I suspect that beyond the important, but fairly narrow, areas of civil liberties and executive power, most of us on the labor or socialist left will find a wide range of legal issues on which our views and Glenn Greenwald’s sharply diverge. Just as importantly, what is the public debate that this is clarifying or polarizing? Will this fight help develop a left opposition in Congress? Does it mobilize people? Could we win? Looks like no on all counts, to me.

Being on the left can’t just mean bitching about everything, it’s got to mean staking out clear, principled positions, organizing people around them, and having concrete victories to show for it. Opposing Kagan does not seem to meet this test.

Anyway — the reason for this post, or at least its title — I was going to say all this in a comment to Mark’s Dissent post. But it turns out the Dissent blog has no comments section. Yes, Dissent does not allow comments. Doesn’t that say it all?

Health bill thoughts

Short version: It’s an expansion of Medicaid, with some doodles in the margin.

Longer version:

Today, the US has the world’s highest medical spending and poor-to-mediocre health outcomes. It’s the only rich country where health coverage is provided by private insurers; where most people’s coverage is linked to their jobs; with a large number of people without health insurance; where millions of people lack any health coverage; and where medical problems often mean financial catastrophe. When this legislation is fully phased in, by 2016 or so … it still will be.

We know what the bill won’t do: fundamentally change the structure of health coverage and finance. But what will it do? My own bottom line is, Enough to be worth passing.

The bill’s provisions break down into half a dozen major categories: (1) new insurance regulations; (2) health insurance exchanges; (3) individual and employer mandates; (4) Medicaid expansion; (5) Medicare (and Medicaid) spending cuts; (6) tax on high-cost insurance policies, plus a bunch of other smaller taxes; and (7) a grab bag of experimental measures to improve the efficiency and quality of health care. And then there’s the provision that’s not there, (8), the public option. There are serious questions about the logic and impact of most of these provisions, many of which I have not seen analyzed seriously. As time and inclination permits, I’ll dig more into the most glaring ones. The bottom line, per the CBO, is that the uninsured would fall from 19 percent of the population today to 8 percent after 2015. [1]

I was thinking of walking through the major provisions of the bill one by one. But you can find that elsewhere. (Start here.) I might come back and write up a full summary, but in the meantime, I want to flag a half dozen important issues and questions that I haven’t seen discussed much elsewhere.

1. The individual mandate — is it really necessary to make community rating and related regulations work?
2. the distribution of new Medicaid spending, which is highly unequal between states.
3. The cuts in DSH payments, which could be catastrophic for some urban hospitals.
4. The crazy-quilt employer mandate.
5. Why the public option mattered.
6. How meaningful in practice are the limits on out-of-pocket costs, premiums, and medical loss ratios?
7. How much do insurance companies gain?

There are a couple other issues that have gotten a bit more discussion, where I don’t think I have anything much to add.

First, what is the role of insurance companies under this system? It seems they no longer have access to the two main choice variables on which they maximize profits currently: the terms on which they offer coverage, and the mix of benefits they will pay for. If they must offer policies on publicly-fixed terms with a publicly-set package of benefits, there’s no margin left for them to operate on. (Which doesn’t mean they won’t be profitable, just that their profit will depend on federal policy, not on factors under their direct control.) Two possibilities here: First, they will find ways to continue selecting healthier populations and limiting payments; the medical loss ratio restrictions won’t bind; in short, the status quo. Second, the insurance companies become essentially vestigial, simply taking a cut off the top of what is basically a public system. Purely parasitic insurance isn’t something anyone would propose, but it does have to be admitted it’s an improvement on insurance companies that take their cut and try to increase it by denying people health coverage.

Anyway, this is looking at the bill through the lens of universal reform — what is the logic of the system it creates? Whereas it plainly isn’t fundamental reform, and it doesn’t create a system with any particular logic, just tweaks the system that’s formed itself willy-nilly.

Second, the abortion restrictions. It’s clear that for some women, the bill will actually make things worse — it will restrict abortion coverage compared with the status quo. How much, for how many? I don’t know. But I did want to flag this lovely quote from The New Republic: “Poor people pay surprising amounts for cell phones and cable TV. They can be surprisingly resourceful in paying for abortions, too.”

[1] Also, at The New Republic, Jonathan Cohn writes, “For nearly a hundred years, the political system has been debating whether access to basic medical care should be a right all citizens enjoy. When reform passes, the political system will finally render its verdict: ‘yes.'” But 92% — or even 94%, if you don’t count undocumented immigrants — is not “all”. This kind of dishonest rhetoric has been all too common among those defending the bill.