The politics of illegitimacy

I think the WaPo editorial board has it right that pre-emptive cynicism painting any decision that does not uphold the Affordable Care Act as being illegitimate is not great for the country. I confess to being bored by the legalese about the individual mandate since I am a policy guy, think the ACA was a good step that was the best that could be gotten, understand that Republicans have no track record on health reform, and am fully confident that if that changes in the future, they will construct something that looks a lot like the ACA.

The justices may well render an opinion that is fairly viewed as overly political and also not good for them as an institution, or the country, but we should read what they say before reaching this conclusion.

The politics of illegitimacy–branding any outcome “my side” doesn’t like as illegitimate–is one of the most pernicious aspects of our modern political culture today. I personally think “the other side” does this more than does “my side” but blind spots are, well blind. The following is a post I wrote on January 11, 2011, two blogs ago after the shooting of Rep. Gabby Giffords. I reproduce it below because it seems apt as I think about illegitimacy today.

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The Politics of Illegitimacy

It is a bit off-topic for this blog, but several students have written and asked me what I think of the events in Tucson. It was a terrible human tragedy and a very sad day for our nation. It was a particularly grievous act in my mind simply because the shooting took place while an elected representative was going about her duties to represent her constituents.

We don’t know why the shooter did what he did, but from past assassinations we know there is often a complex etiology for such attacks that tends to include mental illness. The role that rhetoric and imagery could have on violence is an important question, but I simply don’t have an evidence-based answer. Yet, this event feels like a momentous occasion that is worthy of introspection.

As I thrash about and try and make sense of this tragedy and what it means for our nation going ahead, I settle on something I have been thinking about for awhile, and which has crystallized in my mind the past few days. The disturbing trend in American politics for losers of elections to decry the winners as being illegitimate.

I first voted for President in 1988 and I voted for the winner in that election. The country moved on pretty well.

I voted for the winner again in 1992, but there was a very different context to the aftermath of Bill Clinton’s election. There was a general sentiment from some quarters that he was illegitimate as President because he received less than 50% of the popular vote cast due to the presence of Ross Perot’s strong third party candidacy. Of course, the President is elected by the Electoral College and there is no stipulation that the winner must get a majority of the votes cast, though that typically was the case in modern times.

In 1996, President Clinton was re-elected with less than 50% of the votes cast (49.2% to be exact), again due to Perot being a candidate. It always bothered me that opponents of the President whom I knew personally would argue that he was illegitimately elected due to the fact that ‘more people voted against him than for him.’

President Obama won approximately 53% of the popular vote, and had the largest Electoral College victory since President Reagan. Of course that hasn’t stopped some of his political opponents from arguing that he is illegitimately elected even though the issue of his citizenship was long ago decided. Much of the opposition to the President has been tied to his ‘otherness’ I think, which is all designed to label him as illegitimate, which would make his policies all the more heinous.

Of course, my chronology skipped an election.

In 2000, the tables were turned, and I voted for the loser, Al Gore, who got more votes than did President Bush. Even though I had been irritated by the phrase after the 1992 and 1996 elections, this didn’t stop me from saying to some that ‘more people voted for Al Gore than President Bush’ which is of course true but constitutionally irrelevant. I can vividly remember calling President Bush the ‘President Select’ before his January 2001 inauguration in derision of the Supreme Court’s ruling in Bush v. Gore that settled the disputed election.

Several people older than I who are not big fans of President Obama have told me that they haven’t seen the country ‘as angry as it has been the past 2 years’ in their lifetime. I always remark that they must not have come to Durham or Chapel Hill, N.C. between 2003-2008! Self righteous rage against one’s political opponents is truly bipartisan.

There was a ubiquitous bumper sticker and tee shirt in Durham, N.C. around 2003 that said ‘Somewhere in Texas a Village is Missing its Idiot.’ This always made me chuckle until one day I heard one of my young children say that President Bush was dumb. I sternly told her that was disrespectful and asked her who she had heard that from. She said simply, you Daddy.

For some reason, I cannot get that out of my mind this week as I try and make sense of the tragedy in Tucson.

I think the essence of the progressive/liberal hubris is that we think we are smarter than everyone else. Instead of listening, and then trying to be persuasive and make the case, we are tempted to construct a defense mechanism that says that if you don’t quickly adopt my view it is just because you don’t understand. If only the country was filled with those as smart as me…..

I think the essence of the conservative hubris is the belief that conservatives are more moral/noble/patriotic than others. They are tempted to write off those who disagree with them as being unworthy of America because they think we don’t love it enough. If only the country was filled with those as good as me…..

At their heart, both sources of hubris say that people with different views are illegitimate in one way or another. Someone who is illegitimate is not worth talking to, respecting, listening to, understanding, or even debating reasonably. Certainly not worthy of compromising with to solve the huge problems facing our nation.

What about universal burial insurance?

What about burial insurance was one of the counterfactuals–is this ok too?– that was batted about yesterday as the Justices heard arguments about the individual mandate and Conservatives were asking where the limit of federal power might be. Doesn’t Social Security already provide something like this? Sort of, maybe.

Social Security today provides a one time payment of $255 that is payable upon death to a surviving spouse or children. However, the history of this one time lump sum death benefit (that has existed since the program inception in 1935) is a bit more ambiguous, and it was initially meant to recompense the estate of someone who paid in but who would otherwise get no benefits due to an early death. When survivor benefits were added in 1939, the lump sum death benefit was retained and became viewed as ‘burial insurance’. Says the SSA website:

The major Amendments of 1939 introduced survivors benefits into the program and began regular monthly benefit payments in 1940. Due to the addition of survivors benefits, the original LSDB was discontinued. In its place, the current LSDB was introduced, with the intention that this would assist surviving family members when regular survivors benefits were not otherwise payable. If there were no surviving family members, the LSDB could be paid to an individual who assisted with the burial expenses of the worker. So the LSDB was not strictly a burial benefit, although it evolved over the years to be considered as such.

The amount of the LSDB was defined as 6 times the Primary Insurance Amount (PIA). The PIA is basically the monthly benefit amount for the worker at full retirement age.

The average LSDB payment in 1940 was $145.79. The minimum payment ever made under this 6X computation rule was $63.75 and the maximum payment $273.60.

The purchasing power of the lump sum death benefit has obviously been greatly reduced (average pay out was $145.79 in 1940; today it is a flat $255); that amount may have paid for a burial 70 years ago, but certainly would not today. As survivor benefits expanded, the ‘burial insurance’ component of Social Security was greatly reduced in real terms (not updated for inflation, etc. in the same way that other benefits have been).

On The Record (with daily recap)

Today in TIE: Austin on the VA drug benefit and how twitter broke twitter, Aaron on added sugar, while Kevin brings us a leap day win in the fight against tobacco and therapeutic substitution and pharmaceuticals. On The Record just forgot to post yesterday, which I am sure is a bad sign of something.

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On The Record (with daily recap)

Today in TIE: Austin with more on creditmongering, a closer peek at redistribution and an estimate of how much Medicare could save by purchasing drugs like the VA does, and Aaron focuses on the PSA test.

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POTUS and the Fiscal Commission

Jackie Calmes with an interesting piece on President Obama and the Fiscal Commission report.

In my book Balancing the Budget is a Progressive Priority, coming out in April 2012 from Springer, I write that I think the President made a mistake in not embracing the Fiscal Commission report. This doesn’t mean that I think his embrace would have meant it would have passed. In fact, there is plenty of evidence that Republicans would oppose Obama on just about anything. However, there are several ways in which President Obama embracing the report would have helped politically, as well as in policy terms (maybe).

• The Fiscal Commission report assumes the implementation of the Affordable Care Act, and identifies next steps. Republicans have gotten away with only being clear on what they are against on health reform, and have not coalesced around a replacement plan. Embracing the Fiscal Commission plan could have made it harder for Republicans to get away with only being clear about what they are against.
• The tax reform approach offered in the report raises around $2 Trillion in taxes over 10 years. While this plan was noted as being too conservative when it first came out, it raises more in taxes than any other plan that has come out. It raised far more in taxes that the outlines of the ‘near deal’ between Speaker Boehner and the President.
• The goal posts have moved ‘right’ on almost every issue since the initial release of the plan. For example, the Fiscal Commission plan does not propose raising the Medicare age, but that was a part of the potential Boehner/Obama deal, and momentum for this idea has increased.

As the Calmes piece notes, the Fiscal Commission report has remained in the mix, and it is the yardstick to which most any proposal put forth is compared. I think there is a sense in which to eventual grand bargain is likely to look a great deal like the Fiscal Commission report, the question is whether such an agreement can be made short of some sort of economic calamity or not. My book tries to make the Progressive case for seeking such a deal sooner, rather than later.

On The Record (with daily recap)

Today in TIE: Austin notes that Romney refined his Medicare plan, Don on access to taxpayer funded research, and Aaron discusses the relative importance of diet and exercise for weight loss, and takes on the issue of who owns ideas and the linking economy of blogging.

Over the weekend, TIE had its One Millionth visitor and Harold on how consumers will view health exchanges.

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On The Record (with daily recap)

Today in TIE: Austin wonders about the “8 hours of sleep a day” notion and has another edition of reading list, while Aaron points out that Medicaid is not really one program and cuts will be hard and will hurt people.

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On The Record (with daily recap)

• Committee for a Responsible Federal Budget: Report and related documents (incl video) analyzing the impact of Republican Presidential Candidate policies on the deficit/debt

Today in TIE: Austin on the basis of value driven health insurance and Marsha Gold’s NEJM piece on private insurance Medicare options, Don looks at the possible impact of the Seniors’ Choice Act on under-age-65 Medicare beneficiaries, Aaron with some good news: some screening tests work, while Kevin looks at the SCOTUS ruling on California Medicaid.

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On The Record (with daily recap)

• POTUS: Full text of Corporate Tax Reform proposal
• CBO: website undergoes a facelift

Today in TIE: Austin on physicians may need an ‘amazon like’ logout, more on the media presentation at AcademyHealth, and the relationship between the VA and the ACA, while Aaron shows us that more people die from Hepatitis C than HIV, and Kevin demonstrates, yet again, than EMTALA is not a good safety net.

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On The Record (with daily recap)

Today in TIE: Austin with new estimates of savings from competitive bidding, Don adds one more thing on the Seniors’ Choice Act, Aaron points out that the “everyone can get care in an ER meme” is false, and Kevin enlightens us on “the heckler’s veto”.