The Organisation for Economic Cooperation and Development has released their latest health indicators report, and while you may not find 200 pages of charts and graphs on cross-national health comparisons as fascinating as weirdos like me do, let me just point to a couple of interesting things. Most of the findings will be pretty familiar to people who have followed the health care issue in the last few years, but there's at least one thing that surprised me, which I'll get to in a minute. First though, I have to point to this graph, which shows just what an outlier the United States is in terms of what we spend on health care and what we get. It shows the relationship between spending and life expectancy:
I apologize for these pastries. (White House photo by Pete Souza)
We're now negotiating the terms of our sort-of-departure from Afghanistan, and there's no doubt the Afghan government needs America more than America needs it. Imagine, if you would, that we just packed up and left. There would almost certainly be a full-on civil war, one the Afghan government would be hard-pressed to win. And back here, we'd pay about as much attention as we do now to the river of blood flowing through Iraq, which is to say, every once in a while we'd see a news story and say, "Gee, that's terrible," and then go back to wondering how long it'll be before Miley Cyrus and Lindsay Lohan go on a cross-country crime spree.
So if you were the Afghan government, you probably wouldn't want to drive too hard a bargain in negotiating the terms of the future American presence there. And it's all getting hung up on whether the Americans are going to apologize for killing Afghan civilians, and whether they might offer an apology that isn't really an apology, and whether they can do it in a letter that's signed by Secretary of State John Kerry or if the letter has to be signed by President Obama himself. This is the silliness on which the future of an entire country, and who knows how many lives, depends.
As fake as the moon landing, obviously. (White House photo by Sonya Hebert)
We're about to have ourselves a little filibuster crisis, and the only surprising thing is that it took so long. We've now reached a point where Republicans no longer accept that Barack Obama has the right, as president of the United States, to fill judicial vacancies. Unlike in previous battles over judicial nominations, we're not talking about the nominees' qualifications or their ideological proclivities. It's merely a question of the president's constitutional privileges. Republicans don't think he has them. This is only the latest feature of a long descent for the GOP away from considering any Democratic president—but particularly this one—as a legitimate holder of the office to which he was elected.
There has never been a president, at least in our lifetimes, whose legitimacy was so frequently questioned in both word and deed by the opposition party and its adherents. Even today, many Republicans, including some members of Congress, refuse to believe that Obama was born in the United States. Right after he was re-elected, 49 percent of Republicans told pollsters they thought ACORN had stolen the election for Obama, a decline of only 3 points from the number that said so after the 2008 election, despite the fact that in the interim, ACORN had gone out of business. Think about that for a moment. How many times have you heard conservatives say that the Affordable Care Act was "rammed through" Congress, as though a year of debate and endless hearings and negotiations, followed by votes in both houses, followed by the president's signature, was somehow not a legitimate way to pass a law? In short, we've seen this again and again: it isn't just that Republicans consider Obama wrong about policy questions or object to the substance of one or another of his actions, it's as though they don't quite accept that he's the president, and everything he does carries for them the taint of illegitimacy.
Last week, President Obama announced a "fix" to the problem of people in the individual health insurance market getting cancellation notices from their insurance companies: he'd allow the insurers to offer those substandard plans for another year. Does he want the fix to work? We can't read his mind, but depending on how you define "work," it would be better for the Affordable Care Act's ultimate success if it didn't. And as things have played out over the last few days, there are reasons that as a political problem this could fade.
As you may know, insurance markets are governed by officials in each state, and if a state's insurance commissioner doesn't want to allow the substandard plans to be sold, he or she can say no, no matter what the President might want. And a few of those insurance commissioners—from Vermont, Rhode Island, and Washington state—have already said they won't allow it. So what you have here are heavily Democratic states not supporting Obama. But here's the key to the story: those states also chose to run their own health exchanges, and all of them are working well.
We could end up with a situation in which the states that adopt Obama's fix are the ones most opposed to Obamacare, and the states that support Obamacare don't adopt it. And I wouldn't be surprised if that's just fine with Obama.
When a bunch of Democrats voted last week for a Republican bill meant to sabotage the Affordable Care Act, a lot of liberal commentators, myself included, reacted with, "Ugh, here we go again." While there had been some remarkable unity on the Democratic side in recent months, particularly during the budget showdown, the default status of Democrats is not just cowardice but fractiousness (though obviously, it's easy to stay together when things are going well). This is representative of the broader liberal movement, where it's extraordinarily difficult to get ostensibly allied people and groups to act in concert. Liberals are always looking with envy at their conservative counterparts, who seem to be much more unified, both in beliefs and action. Conservatives would tell you that they spend plenty of time at each other's throats, but this broad stereotype—disconnected liberals, unified conservatives—has its origins in truth.
Today I read a study that sheds some light on why this might be. It isn't just that liberals are more divided and conservatives are more united, it's also that liberals believe they're more divided, and conservatives believe they're more unified, even when it's not necessarily true. The study asked people about their opinions on a range of questions on both political and non-political topics, then asked them to guess what proportion of people who shared their general ideology agreed with them on that particular question. The results showed that liberals displayed a "truly false uniqueness effect"—they were more likely to think that their views were different from those of their peers, even when they weren't—while conservatives displayed a "truly false consensus effect," believing that their views were the same as their peers, even when they weren't.