The soft bigotry of low expectations: Conservative wonk edition

I like Don Taylor, I like reading him as I know that there is a very high probability of reading something that he writes that will make me think long and hard about something that I thought I knew but now need to reexamine, or something that I knew that I did not know.  He is a good high value read on health policy.  However, I think he has a blind spot on health policy, and that is his tendency to encourage conservative wonks without enough criticism:

From RBC on 8/14/14 regarding Avik Roy’s Manhattan Institute proposal:

I am not going to go all post-modern literary critic on this (only deconstruct), in part because a lot of it lines up nicely with things I have been writing about/calling for over the past few years, in search of a political deal that could move the policy ahead….

The biggest question facing Avik’s proposal is not in policy terms or what supporters of the ACA will think, but whether any elected Republicans will be willing and able to shift gears and begin trying to move health reform ahead instead of simply looking for what helps in the next election….

I commend Avik for offering this plan, and think there is a plenty to like in the proposal itself, as we look for the next step in health reform.

A serious deconstruction of the plan shows that Roy is fundamentally trying to occupy the wonky spot that Paul Ryan has been attempting to occupy as a legislative leader — that of the wonky Serious, Honest Conservative.  If that is the bar that needs to be passed, then we need to evaluate the wonkiness and honesty of the plan.  Anything else is just the soft bigotry of low expectations that a conservative can write 60 pages of not seemingly gibberish with a couple of graphs and references to complex modeling. 

A deeper examination (Part 1, Part 2, Part 3, Part 4) allows one to determine if Roy is proposing something out of good faith albeit coming from a different weighing of “ought to be”/moral factors, or if he is attempting to pull a fast one by engaging in significant and easily detectable instances of truthiness and misdirection.  I think Roy is repackaging bog-standard conservative health care plans with a few technocratic policies (hospital consolidation trust busting for instance) and hoping that the later is sufficient to buy his reputation as the honest, wonky reformicon that liberals can work with even if they have massively different weights on what moral values should be expressed in new healthcare law. 

We know that Roy knows or should know about the methodological power issues about the Oregon study. We know that Roy knows or should know about the Massachusetts insurance study.  We know that Roy knows or should know that the critical lifespan changes for Medicare finance are not life spans from birth but life spans during working age years (for income purposes) and life spans after eligibility to collect Medicare (for expenditure purposes).  We know Roy knows or should know that premium age banding is for 21 to 64 year olds.  Those are some of the obvious things that we know Roy should know about and consider in his writing, but he does not.

The charitable conclusion is that he is trying to pull a fast one.  The less charitable conclusion is that he is lazy as a stoned senior a week before graduation. 

I agree with Don that in the long run, the United States is much better off if there are significant factions within the Republican Party that are interested in weighing policies, making explicit choices with positive benefits and negative impacts, and then engaging in horse trading with Democratic factions that are applying their own moral, ideological and interest group preferences on the same problem set but in different manners and getting to something that has a committed backing to work or at least to make it work eventually for most people.  That is a good thing but right now and in the medium term, this country is still going on blind dates where the preferred dish of one party is still tire rims gently sauced with anthrax. 

However, as liberals, we barely have any influence on internal Republican factional polictics, and we do not serve ourselves well by not being critical and engaging when there is a conservative policy proposal that is either lazy or misleading as hell in its core tenets despite there being a few, minor areas of agreement and a few more areas of secondary importance that could be sites of productive horse trading. 

We owe it to ourselves to be critical and aggressively probe policy proposals for their explicit and implicit assumptions, the probable outcomes generated, and the evidence used to argue to those outcomes.  Being a liberterian or reformicon should not mean that person’s policy proposal receives a gentleman’s C nor a participation ribbon.

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39 replies
  1. 1
    Epicurus says:

    It’s not “laziness,” Richard, it’s called “Lying.” Let’s not use any euphemisms here, Roy is carrying water for the GOP, pure and simple. And if we know anything, it’s that Republicans lie when they can not handle the truth. Thank you for all your hard work in ‘fisking’ this ridiculous proposal. Alan Grayson had it right; the GOP health care plan is “Die Early.”

  2. 2

    Honest conservative is an oxymoron and most conservatives of the Republican kind are morons, also too.

  3. 3
    Xantar says:

    I think the anthrax and tire rims analogy is going to become John’s lasting contribution to human literature.

  4. 4
    Amir Khalid says:

    Back in 2012, I noted that Paul Ryan practised a cargo-cult version of economic wonkery. If Avik Roy is aspiring to be the Paul Ryan of health-care economics, well …

  5. 5
    Hunter Gathers says:

    Roy’s just trying to cover the entire ass of the Conservative Movement. So when they scream ‘Repeal and Replace Obamacare!’, Roy can go on Morning Joe and tell Joe The Scar that ‘See, we have a plan, and it conforms to conservative principles! Aren’t I clever!’. Of course, the Conservative Movement could give a rat’s ass about universal health coverage, unless it specifically bars ‘those people’ from coverage.

    It’s about Roy getting a permanent seat on the Sunday shows, along with invites to Sally Quinn’s cocktail parties.

  6. 6
    hoodie says:

    The charitable conclusion is that he is trying to pull a fast one. The less charitable conclusion is that he is lazy as a stoned senior a week before graduation.

    “Pulling a fast one” is otherwise known as “lying.” “Lazy as a stoned senior a week before graduation” means that he’s just another guy with a Ron Paul sticker.

    We owe it to ourselves to be critical and aggressively probe policy proposals for their explicit and implicit assumptions, the probable outcomes generated, and the evidence used to argue to those outcomes. Being a liberterian or reformicon should not mean that person’s policy proposal receives a gentleman’s C nor a participation ribbon.

    Yeah, but don’t give any credibility to pure bullshit. When I critique a brief or other document written by an associate and I find more than 2 obviously false premises in the first page, I usually stop reading, write “Start Over” and send it back. Anything includes such obviously disingenuous elements as raising the Medicare eligibility to 75 should presumptively be considered an “F.”

  7. 7
    NonyNony says:

    @hoodie:

    The charitable conclusion is that he is trying to pull a fast one. The less charitable conclusion is that he is lazy as a stoned senior a week before graduation.

    Yeah – I was going to call this one out too Richard. It’s more charitable to assume that he’s lazy than it is that he’s running a con, isn’t it?

  8. 8
    Roger Moore says:

    I agree with Don that in the long run, the United States is much better off if there are significant factions within the Republican Party that are interested in …

    IOW, people who care about policy. I think that would be great, too, but we won’t get any until people who matter are willing to look at lying liars like Roy and call them what they are. As long as a Republican can be treated as serious by putting together a brief that doesn’t fall apart on casual inspection of the executive summary, there will be no incentive to engage in actual policy making.

  9. 9
    Villago Delenda Est says:

    Roy is a worthless sack of shit, just like Ryan. Death by slow torture is too humane a treatment for either of them.

  10. 10
    Richard Mayhew says:

    @NonyNony: My logic on the ordering is to pull a fast one means the person who is lying through their teeth knows enough how to lie and how to shade and how to bullshit — it destroys credibility but there could be interesting nuggets in forenscic reconstruction — lazy, it ain’t even worth thinking too hard about.

  11. 11
    Calouste says:

    @hoodie:

    Any overarching health insurance proposal that doesn’t start with explaining why the US can’t copy one of the various systems around the world that provide better results at lower cost should be send back with “Start Over” in big fat red letters on it. And “Soshulism!1!!” doesn’t count as an explanation.

  12. 12
    JPL says:

    @Richard Mayhew: Your posts have been informative and I appreciate your time and effort. One thing that I haven’t heard Republicans mention is emtala. It’s the most inefficient practice but no one talks about it.

  13. 13
    Richard Mayhew says:

    @JPL: There have been a couple mentions here and there — the Georgia GOP Senate primary had a short ‘debate’ on repealing EMTALA (for everyone else, that is the 1986 law that mandated emergency rooms have to treat a person to a point where they are stable enough for transfer without regard to the patient’s ability to pay) and letting magic conservative pixie dust handle the surge of people dying on the sidewalk in front of the hospitals which are not last resort hospitals. But no, there has been little talk on EMTALA

  14. 14
    jl says:

    Thanks for great series on Roy’s proposals.

  15. 15
    OzarkHillbilly says:

    thanx, Richard.

  16. 16
    Warren Terra says:

    I’ve been down this path with Taylor before, back when SameFacts had a functioning comment system and before they disappeared a decade’s worth of comments. I’m sure Taylor has many redeeming qualities, but he ties himself into pretzels and utterly abases himself in a misguided and desperate attempt to convince himself that he has sincere interlocutors on the Conservative side. So he winds up writing the most blitheringly pollyanna nonsense about how wonderful it is that conservatives are engaging in policy proposals, even though a reader with a fraction of his experience and none of his expertise can examine those conservative proposals and rapidly see that they are nothing that could be taken seriously, a criminally poor mixture of the fraudulent, the unworkable, and the cruel.

    A less charitable interpretation would be that Taylor recognizes he’s been handed a steaming pile of feces from his conservative colleagues, but wishes to promote and protect his career by appearing balanced, nonpartisan, etcetera.

  17. 17
    Richard Mayhew says:

    @Warren Terra: I’m actually going to be a lot more charitable with Taylor and older liberal wonks and say that when they were young wonks, they were formulated in a culture where conservative wonks were actually engaging in some serious policy work, and the politcal mileau meant that the significant veto points of active national policy implementation were conservative(s), so political liberals that wanted to implement policy had to be extraordinarily aware of conservative thought and proposals. That is the formative environment, and people stick with the habits of their formative environment unless there is a massive system shock. Some older liberal wonks (Krugman for instance), radicalized when they saw the Republican Party incentivize insanity and reward dull incuriousity, while others are continually looking for an almost extinct species — a Republican who is both interested and capable of talking complex policy AND in position to do something about the first capability. Getting one or the other is tough, both are a near impossibility at the national and state level today.

    Me, I’m lucky, my formative environment presumed the GOP as a policy making party is either lazy as hell and/or batshit insane, and those assumptions serve me well today. I hope they misserve me when I am as old as Taylor, but that is not the case.

  18. 18
    Barry says:

    “He is a good high value read on health policy. However, I think he has a blind spot on health policy, and that is his tendency to encourage conservative wonks without enough criticism:”

    No, Don Taylor is now not a good high value read. As you’ve pointed out, Avik Roy’s plan is 100% bullsh*t, both in terms of the numbers, and the politics. Avik was also caught lying about plan prices (by Kevin Drum?), where he looked at the offered rates, and never filled out the forms to see if he qualified (which anybody knows is a major issue for insurance).

    Avik Roy also works for the Manhattan Institute, an intellectual house of p*stitution.

    Don ignored all of that, and added a bullsh*t comment about how ‘we can’t pick their tactics’, which he took to mean ‘go along with any lies they suggest’.

    At this point he’s a hack and wh*re just as much as Avik, with the difference that he’s supposed to be either liberal and/or reality based, so he’s a traitor.

  19. 19
    Barry says:

    @Richard Mayhew: “I’m actually going to be a lot more charitable with Taylor and older liberal wonks and say that when they were young wonks, they were formulated in a culture where conservative wonks were actually engaging in some serious policy work, and the politcal mileau meant that the significant veto points of active national policy implementation were conservative(s), so political liberals that wanted to implement policy had to be extraordinarily aware of conservative thought and proposals. That is the formative environment, and people stick with the habits of their formative environment unless there is a massive system shock.”

    I disagree – for every decent idea and competent, honest intellectual, they had several which were bad, and many frauds. Remember the Laffer Curve, ‘ketchup is a vegetable’, ‘welfare queens’, ‘strapping bucks buying t-bone steaks’, ‘Star Wars’, propping up every mass-murdering tyrant they could find?

    And in terms of system shocks, we’ve definitely had several, starting in 2000, with the Bush/Cheney sh*t-reign, the financial crash, and the motherlovin’ Tea Party.

    Krugman, you might notice, figured this out back in 2000. What’s Don’s excuse?

    Also, an ‘intellectual’ who hasn’t noticed both that the world has changed over the past 30 years, and that most of the premises from back then were false, is no intellectual.

  20. 20
    Sherparick says:

    Speaking of Conservative bad faith and playing politics, Linda Greenhouse has blog entry that will surely create much screaming on the right about their bad faith on Halbig in their attempt to take health insurance and care from millions.

    http://www.nytimes.com/2014/08.....type=Blogs

  21. 21
    StringOnAStick says:

    @Richard Mayhew: Love your writing here, Richard; I’ve learned more than I ever could anywhere else. You are a BJ treasure.

  22. 22
    jwest says:

    You liberals get far too full of yourselves in thinking that everything can be wonderful if only you could get the mean old conservatives to see the light.

    Healthcare is a bit too important to be left to the left, isn’t it? This is something that needs to work for everyone’s benefit, so it isn’t hard to see why the country turned so abruptly away from Obama once they saw how ridiculously incompetent he and his team were.

    Taking care of those who can’t take care of themselves is a conservative value. Where we differ with liberals is that we strive to help people become independent instead of making an industry of keeping people poor.

    When speaking of healthcare, even F.A. Hayek in “The Road To Serfdom” outlines the conservative position on the role of government:

    “Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

    Of course, Hayek is speaking of a system for universal catastrophic coverage. He knew that the proper role of government is to do that the individual cannot do for themselves. However, he also knew that the idea of providing first dollar birth to death coverage was an invitation to disaster.

    Liberals advocate programs that make them feel good. Conservatives advocate for programs that work.

    As it stands now, the vast majority of catastrophic coverage is provided under government single payer. Only a small sliver remains in the private market. Eventually, this tiny segment will be traded for Health Savings Accounts and a system of direct patient to provider payments that bring back accountability and customer knowledge to the health industry.

    Judging from how emotional liberals get over every subject, it’s best if you just sit back and let us handle this. We understand you feel very strongly about a lot of things, but this is too important to let you fuck it up.

  23. 23
    Mnemosyne says:

    @jwest:

    However, he also knew that the idea of providing first dollar birth to death coverage was an invitation to disaster.

    Really? Hayek wrote his book in 1944. Please name which of the following developed countries with universal healthcare coverage have ended up in “disaster” as you claim Hayek predicted:

    Australia
    Austria
    Bahrain
    Belgium
    Brunei
    Canada
    Cyprus
    Denmark
    Finland
    France
    Germany
    Greece
    Hong Kong
    Iceland
    Ireland
    Israel
    Italy
    Japan
    Kuwait
    Luxembourg
    Netherlands
    New Zealand
    Norway
    Portugal
    Singapore
    Slovenia
    South Korea
    Spain
    Sweden
    Switzerland
    United Arab Emirates
    United Kingdom

    Please note that “All of them” is not an acceptable answer. Be sure to explain exactly what “disaster” these countries have experienced and why it is specifically because of universal healthcare.

    I would also keep in mind that Hayek’s book was published before penicillin was mass-produced and before the first effective chemotherapy drug for cancer was introduced in 1946. When you answer my questions, please take into account the medical advances that have occurred in the 70 years since Hayek published his book and explain why they should not be taken into account.

  24. 24
    Villago Delenda Est says:

    @jwest:

    Taking care of those who can’t take care of themselves is a conservative value

    This is so hilarious. It certainly explains the intense desire of Paul Ryan to stave grandma.

  25. 25
    Cervantes says:

    @Villago Delenda Est: Glad to see you’re not heart-sick any more!

  26. 26
    Villago Delenda Est says:

    @jwest:

    Where we differ with liberals is that we strive to help people become independent instead of making an industry of keeping people poor.

    This explains “conservative” enthusiasm for living wage laws, for liberal parental and sick leave policies, and fierce opposition to “flex time” programs that benefit management but make it impossible for labor to schedule their off-the-job life around..

    The shit that’s packed into your post is flowing off my screen and on to my keyboard. I’m going to send you an invoice for the cleanup costs. You will of course dodge your responsibility and stiff me, as is the norm for your loathsome ilk.

  27. 27
    Cervantes says:

    @Barry:

    Krugman, you might notice, figured this out back in 2000.

    Figured what out in 2000? (Thanks.)

  28. 28
    Cervantes says:

    @jwest:

    Liberals advocate programs that make them feel good. Conservatives advocate for programs that work.

    I recommend you keep telling yourself that.

  29. 29
    pseudonymous in nc says:

    @jwest:

    Liberals advocate programs that make them feel good. Conservatives advocate for programs that work.

    So, like the one in Canada, or the one in Germany, or the one in Israel, or the one in Singapore, or the one in Australia, or the one in Israel? As opposed to the ones conservatives actually talk about (“skin in the game”, tort reform, out-of-state policies) which have no precedents and no evidence other than Austrotological feels and clap-louder?

    The ACA is already a compromise to accommodate the profiteers and intermediary skimmers who have too much money and power to be ignored. It still forces people into making choices they don’t understand, because health coverage is still not a consumer product.

    But anyway, we know you’re just an arsehole with history. Arseholes gonna arsehole.

  30. 30
    pseudonymous in nc says:

    Having cleaned up the trollshit: Avik Roy is a con artist, nothing more, nothing less.

    Conservative wonks need to earn back the right to be trusted on the subject of healthcare, and before that can happen, they need to eat a fuckload of crow.

  31. 31
    Patricia Kayden says:

    @Hunter Gathers: If Republicans have such a great plan, why didn’t they get it passed during the Bush 8-year administration? That would have been the perfect time to pass it, right?

    They have nothing and have no regards for poor people without healthcare (or with healthcare for that matter).

  32. 32
    eyelessgame says:

    @Xantar: “Anthrax and tire rims” needs to show up in the Lexicon.

  33. 33
    Richard Mayhew says:

    @Cervantes: Krugman radicalized between late 1999 and early 2002 with the initator being him looking at the Bush budget math, getting 2+2=19 on how the surplus (remeber those days) was going to be spent, and having no one on Team Republican push back on an irresponsible candidate.

    Up to the late 90s, Krugman’s political tone was technocratic with a slightly liberal bent but he assumed that he was working within a broadly shared consensual reality with conservative wonks who prioritized different things but acknowledged the same evidence. One of the assumptions he was making was that Republican wonks saw part of their duty was to tell their candidates and political leaders that 2+2 =4 and not 19, and if they did not reduce the claim that 2+2=19 to 2+2 = 6 (close enough for politics), they could exert pressure on their political leaders. Democratic wonks did this repeatedly and with decent success.

  34. 34
    Richard Mayhew says:

    Hey guys; any possibility that #21 is just DougJ trolling us as it fits his style.

  35. 35
    Rekster says:

    You lost me at Avik Roy, what a total fucking tool!

  36. 36
    Cervantes says:

    @Richard Mayhew: Maybe radicalization is a matter of degree. I recall in the early 90s some scandalized comments — possibly even entire books — re, for example, income inequality (never mind “supply-side economics” and the like).

  37. 37
    Barry says:

    @jwest: “Healthcare is a bit too important to be left to the left, isn’t it?”

    Yes, and that’s why the Democrats worked to hard to get Republican support, which they reneged on. The rest of your comments is similar plant food.

  38. 38
    Barry says:

    @Cervantes:

    Me: “Krugman, you might notice, figured this out back in 2000.”

    Cervantes: “Figured what out in 2000? (Thanks.)”

    Richard Mayhew was excusing hacks like Don Taylor on the grounds that things were different in the Long Long Ago (like right-wingers had good ideas).

    I was pointing out that (a) for every good idea, they had a large number of bad ones, and that (b) things had change. If somebody still accepts that theory after the Bush/Cheney debacle and the financial crash and the Tea Party, they are at best serious fools, and more likely liars, hacks and wh*res.

    The comment about Krugman is that he had had his change back in 2000, and was quite publicly pointing out what was going on. And every single thing that the right has done since then has proven his case.

  39. 39
    Cervantes says:

    @Barry: I’m not saying Krugman was wrong in 2000 or later. I’m asking in what way he was incorrect earlier. (Thanks.)

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