Avdat

Sexy and not-so-sexy health care reform

Ron Brownstein has written a long and somewhat wonkish assessment of the health care reform bill currently being debated in the Senate. Long story short, the bill's chief purpose is to cut skyrocketing health care costs by moving the system away from a fee-for-service template and toward a fee-for-outcomes template.

Republicans outside elected office like the bill, but wish it had as many sticks as carrots to encourage better coordination of care among providers. And malpractice reform. But since Republicans have decided to not play ball with the White House and the Democratic majority, there's no one at the table lobbying for the latter.

Like a lot of liberals, I've tended to view the success or failure of the bill almost solely in terms of the survival of the public option, but the article points out that a state-sponsored insurance plan "would affect who writes the checks in the medical system, but not what the checks are written to pay for." It raises the question of the relationship between universal coverage and cost containment, and the priorities of the two.

Apparently, President Obama is rather smitten with the article, and Rahm Emanuel has made it required reading for the White House staff. 

Campaigning for universal coverage is sexy in that social justice kind of way. But the HCR bill detailed by Brownstein's article isn't a bit sexy. It's the government using its regulatory and reimbursement power to encourage a set of best practices that are designed to make health care less expensive and the nation's citizens healthier.

And that's OK. In fact, that's probably the best we can expect from people at the pinnacle of power in 21st century America.

It's the difference between Amos's passion and Joseph's prudence. So long as the prudent are seeking to achieve the aims of the passionate, we ought not denigrate reform just for lacking sex appeal.

A bit of Gnosticism

Gnostic scriptures are as esoteric as advertised. But the wild ride they take you on is worth the tedious struggle of making sense of them! Unfortunately, Irenaeus's rejoinder to the Gnostics, that our hope is in the renewal of creation, not in our escape from it, seems lost on many contemporary Christians. A lot of people who got all bent out of shape at The Da Vinci Code are, ironically, crypto-Gnostics without realizing it. My paper on one Gnostic text, The Gospel of Truth, is below the fold:

Church and state in the high middle ages

Periodically I have to write 4-5 page papers on my seminar readings. The purpose of these papers is to jump-start the seminar conversation. One seminar has me doing a bunch of these shorter papers instead of a final term paper, so that's what I've spent much of my fall composing. Not blog posts. But since I'm one of these bloggers who, A. Gets anxious when I'm not posting a lot, and B. Doesn't have time to blog a lot, I've decided to put some of these class papers up here. This one, on Church-State issues, is where this earlier post about wrestling over the mantle of John Howard Yoder came from. These might not be everyone's cup of tea, but if they suit, you are welcome, as usual, to comment.

Getting to yes on health care reform

Even though health care reform leaped yet another hurdle yesterday, I'm less buoyed than before. With Blanche Lincoln joining Joe Lieberman in threatening to filibuster a final bill that contains a public option, it seems like the prospects for a public option are now rather dim. And without a public option, will Congress wind up passing a bill that forces people to buy health insurance they can't afford? That's neither a policy nor an electoral winner.

Lincoln's is a frustrating case. One might hope that she's posturing, but apparently she spoke in such categorical terms that there's no way she could walk away from her threat without a loss of face. Even stranger, Lincoln's web page still shows her supporting a public option. I definitely expected more party discipline than this.

Then again, it may be that the last two elections are masking the real ideological balance of power in Congress. The Democrats built large majorities in Congress running against the Bush administration's manifold incompetence, but that doesn't necessarily mean that Congress or the nation as a whole has moved as far to the left as those numbers indicate. Under more normal circumstances, we might have watched Democrats negotiating with moderate Republicans to overhaul the health care system this year, but since there are no moderate Republicans left, Democrats are negotiating with Democrats. The result is starting to look like a centrist compromise, rather than the more progressive bill that 60 Democratic Senators could theoretically enact.

Then again, as Yglesias is so fond of pointing out, we wouldn't being having this discussion if the Senate ran according to majority rule, or, even better, if we didn't have a legislative body in which Wyoming, population 532,688, has the same representation as California, population 37,756,666. So we have the Founding Fathers to thank. Even now they are saving the Republic from the mob rule of the uninsured and the price gouged.

UPDATE: Here's Robert Reich on the slow withering of the public option.

Andrew Sullivan has jumped the shark

Andrew Sullivan, teasing us with the "possibility here of such a huge scandal that we would be crazy not to take our time either to debunk it or move it forward for further examination" suspended blogging operations so that he and his staff could go over Sarah Palin's new book with a fine toothed comb. His blogging seems to have returned to normal today, but his Face of the Day is none other than Palin family outlaw Levi Johnston posing for Playgirl.

Gay man lust. Eww. But, "Not that there's anything wrong with that!"

Look, I agree with Sullivan to the extent that I think that Sarah Palin would be an awful President, and that Barack Obama is a good President. But the effusive gushing over Obama, the creepy man crush he appears to have on Levi, the vendetta-like preoccupation with Palin, and the pompous self-importance he's attached to said vendetta, makes reading his blog extremely uncomfortable at times.

I especially don't get the breathless shilling for Levi. The Palins are right off the set of Judge Judy. When dealing with such people, it is best not to get too involved, much less choose sides. Even if Sarah Palin is a liar, that doesn't make Levi a truth-teller. Turn the channel, I say.

Crappy Christmas carols

Mark Kleiman hatin' on Frosty the Snowman before Thanksgiving is here. Eager to avoid the wrath of Bill O'Reilly, he is careful to point out that his problem is with secularized Christmas music, not, say, Adeste Fideles. Kevin Drum, who as far as I know is not a believer, agrees, and proposes that O'Reilly and Kleiman ally themselves in a War on Bad Christmas Music.

I'm glad that there are some secularists out there who appreciate Christian artistry, if not Christian doctrine.

The comments, naturally, devolve into an argument about which Holiday Carol is the crappiest. A couple point out that Frosty the Snowman and I Saw Mommy Kissing Santa Claus are really kinda creepy and sinister, if you think about them, which reminds me to link to this post by Camassia about pop songs you loved in middle school which, in retrospect, make you want to go Eww.

But if you really want your soul sucked out of you, you should wait tables at Ruby Tuesday during the Holiday Season. The soundtrack satisfies one's spiritual and aesthetic palate as well as flat Diet Coke. The absolute dregs was Christmas Is Going to the Dogs, by eels. You can listen to it here! Since the song blatantly violated management's mandatory perkiness, a co-worker was convinced a surly employee in the home office slipped it in as a subliminal critique of where the company was going. 

I don't miss waiting tables, but I do miss my co-workers, who cope with daily humiliation by cultivating the best sense of humor of any group of people I've ever met. So a dreadful song like Christmas Is Going to the Dogs is able to evoke feelings of nostalgia that I'll Be Home for Christmas could never. Ironic, eh?

More Monday morning Paschals and fewer Occams, please

Both Deadspin and Yglesias are defending Bill Belichick's bone-headed decision to go for it on 4th and 2 from inside the Patriots' own thirty yard line. Both link to this seemingly unassailable proof at Advanced NFL Stats:

With 2:00 left and the Colts with only one timeout, a successful conversion wins the game for all practical purposes. A 4th and 2 conversion would be successful 60% of the time. Historically, in a situation with 2:00 left and needing a TD to either win or tie, teams get the TD 53% of the time from that field position. The total WP for the 4th down conversion attempt would therefore be:

(0.60 * 1) + (0.40 * (1-0.53)) = 0.79 WP [win probability]

A punt from the 28 typically nets 38 yards, starting the Colts at their own 34. Teams historically get the TD 30% of the time in that situation. So the punt gives the Pats about a 0.70 WP.

"Lies, damned lies and statistics!" I say. Leave the actuarial mumbo jumbo to baseball; take a step back, and look at the big picture. The Patriots weren't playing teams called "Historical" or Typically." They were playing the undefeated Colts. Team Historical has started David Carr. Team Colts starts Peyton Manning. Maybe it would be worth the risk to give team Typical the ball with a short field and the game on the line, but not the Indianapolis Colts.

Did someone say "risk?" Aha! I see your algebra, and raise you some philosophy. Consider Pascal's wager. As you can tell from the graphic, Pascal attempted to show that belief in God was prudent because the worst case scenario of serving God (missing out on all that Saturday night sin and Sunday morning tee times for nothing cuz God don't exist) is not nearly as bad as the worst case scenario of not serving God (going to hell if he does exist).

Now, apply the same logic to the game Sunday night. The worst case scenario of going for it (giving Peyton a short field with the game on the  line) is far worse than punting (giving Peyton a long field with the game on the line). Yes it would have been great if they'd made it, but is that a risk you really want to take?

In fact, we wouldn't be having this conversation if any other coach had gone for it on 4th and 2. This is all about the Cult of Belichick's painfully public failure to adjust in the face of massive cognitive dissonance. The Cult of Belichick says, "If Belichick made the call, it must be a good call because Belichick is the apotheosis of NFL coaching awesomeness." Ask yourself, If Jim Zorn had made this call, would it have been just as good a call? That's what I thought.

Please, spare me this strange Boston sports bar nominalism.

Marathons and other secular ascetic regimes

You know, studying the awesome lengths our ancestors in faith went to punish their bodies for the Lord is one of the more inspiring aspects of studying medieval history. I know; I know, you're wondering, So what's it going to be, Marvin? Bricking yourself up in the wall of a church? Corporal punishment for sneezing in worship? Naw, I decided to run a marathon instead.

The Richmond Marathon is a great event. Patrick Henry himself came out with a bullhorn to cheer us on. I grunted "Give me liberty or give me death" at him, and he said that he liked the sound of that that so much he'd have to remember it. A great gospel choir was singing where the course ran by Virginia Union. The race organizers add a few junk food stops to the usual water/gatorade stands. Gummy bears. Coke. Krispy Kreme donuts. Best of all, at mile 22, there were dudes out in the median of Fauquier Avenue handing out shots of Yuengling. You guys were my guardian angels!

Geneva tops Wittenberg

Good news on the pigskin front. Union Seminary is the Luther Bowl XLIV Champions! I don't know which one of my classmates is going to Disney World, but man, does he or she deserve it, after putting a serious beat down on those crypto-Eutychian cannibals!

Don't tread on me and all that yada yada

I watched some history made last night. No, not the Bama-LSU game, the House vote on health care reform. I did catch some of the football game too, but for sheer entertainment purposes, watching the House debate won hands down. My nine-year-old would watched a bit with me, and he could always identify the Republican members of Congress because they sounded so angry. In a sense I can't begrudge them anger. Having preached for 14 years I know what it's like to be condemned to making arguments that you are sure will fall on deaf ears.

What I can begrudge them are the sheer incoherence of their arguments:

"This is a government takeover of our health care system!"

• Um, no, it's not. If you have private insurance and you like it, you get to keep it.

"This plan cuts Medicare!"

• Well now, Medicare IS a takeover of the health care system, at least for Senior Citizens. If you're against "gubmunt run health care," then you shouldn't be fighting Medicare cuts. You should be fighting to kill Medicare.

"This plans FORCES you to buy health insurance whether you want it or not!"

• Pardon me if I don't pick up my pitchfork and march on Washington about this one. The government already forces me to buy auto insurance if I want to drive. My seminary forces me to buy health insurance as a condition of my enrollment. People should carry health insurance instead of parachuting into an ER when they get sick and letting me pick up the tab with higher premiums on my policy. It's a matter of personal responsibility. And if you can't afford it, you'll be subsidized, which is more efficient than the current system.

"This plan fosters government dependency. Why, I used to be a judge and I had to send away too many boys born to welfare queens who got paid by the gubmunt to have babies."

• Not a direct quote, but pretty close. Some Congressman from Texas. Please see the above comments about personal responsibility.

"We're going broke!"

• Ahem, the Congressional Budget Office estimates that the House bill will reduce the deficit over the next ten years.

"Pelosi bill, Pelosi bill, Pelosi bill!"

• Yes, some people don't like strong women from the Left Coast, but really, can't we do better than ad hominem attacks? Besides, the House-approved bill is a bi-partisan bill. That's right. One GOP lawmaker voted for it. Only one, but it counts.

I think that when all is said and done, the Republicans were opposed to this bill, not because it might fail, but because it might succeed. Tactically, they want to deny the President a legislative victory. Strategically, even if the government can solve problems, they don't want it to. You see this dynamic in spades with global warming. That kind of ideological rigidity gives birth to the kind of angry, non-sensical ranting we saw on the House floor yesterday. I have no use for it, nor do most people. It's taking longer than we thought, but the reform movement continues to jump every legislative hurdle. I remain confident that it'll happen, and years from now, everybody will wonder what all the pitchfork-brandishing was about.