It's been said to the point of becoming cliche that once Democrats passed significant health care reform, they'd "own" everything about the American health care system for good or ill. For some time to come, people will blame Barack Obama for health care problems he had absolutely nothing to do with. But there's a corollary to that truism we're seeing play out now, which is that what used to be just "a sucky thing that happened to me" or "something about the way insurance works that I don't particularly like"—things that have existed forever—are now changing into issues, matters that become worthy of media attention and are attributed to policy choices, accurately or not. Before now, millions of Americans had health insurance horror stories. But they didn't have an organizing narrative around them, particularly one the news media would use as a reason to tell them.
The latest has to do with the provider networks that insurance companies put together. This is something insurance companies have done for a long time, because it enables them to limit costs. If an insurer has a lot of customers in an area, it can say to doctors, "We'll put you in our provider network, giving you access to all our customers. But we only pay $50 for an office visit. Take it or leave it." An individual doctor might think that it's less than she'd like to be paid, but she needs those patients, so she'll say yes. Or she might decide that she has enough loyal patients to keep her business running, and she wants to charge $100 for an office visit, so she'll say no.
So every year, doctors move in and out of those private provider networks, and the insurers adjust what they pay for various visits and procedures, and inevitably some people find that their old doctor is no longer in their network. Or they change jobs and find the same thing when they get new insurance. And that can be a hassle.
But now they have someone new to blame: not the insurance company that established the network, and not the doctor that chose not to be a part of it, but Barack Obama. It's not just my hassle, it's a national issue.
As we all know, this is the age of information, when the entire media world changes every week or so. We're about to enter 2014, which will surely be a year of transformation and reconfiguration, of cascading synergies and exponential upendings, in which the hidebound old ways are cast off and the day belongs to those who plug in to the rushing river of revolution. If you're going to be prepared to grasp it all and not be left behind like some pathetic dinosaur, you'd better strap in, bite down on your mouth guard, and get ready to have your paradigms exploded.
What will happen in the political news media in 2014? There's one thing you can be sure of: Games will be changed.
If you've been perusing conservative web sites, Facebook pages, and the like since Nelson Mandela's death was announced, you would have seen two things: some kind of tribute to Mandela, and a series of comments following that tribute denouncing Mandela as a communist, a terrorist, or worse, and expressing all kinds of vile racist sentiment. It's happening not just at magazines and blogs, but to politicians as well, who are getting denounced by some small minority of their supporters for praising Mandela. That's not really their fault; no one is completely responsible for their fans, after all. And as I've read through a few of these threads I've also seen some people pushing back against the racist comments. Even if, say, the National Review was for many years a fierce defender of white supremacy in both South Africa and the United States, if nothing else they're doing their best to claim that they were on the side of the angels all along, which is better than nothing.
I'm pretty sure she's a Democrat. (Flickr/Philip Marley)
Today I have a piece in Politico Magazine under the grabby but somewhat misleading headline "Left Turn = Dead End?" (So you know, for better or worse, writers don't usually write their own headlines.) My main point is that while economic populism is always good politics for Democrats, it isn't enough to just stake out the leftmost position (on economics or anything else) and hope that can win you the Democratic presidential nomination, just as it isn't enough to be the most conservative candidate in a Republican primary. There will indeed be an ideological debate within the Democratic party in advance of the next presidential election, which is a good thing. As they approach the end of the Obama years, Democrats are going to have to hash out who they are, what they believe, and where they want to go. But the reason being the most liberal candidate is insufficient is that primary voters aren't ideological maximizers, they're ideological satisficers.