Saturday, February 4, 2012

Commentary: Plenty of skepticism about Americans Elect

  • Posted on Wednesday, September 28, 2011

Americans Elect is nothing if not audacious.
A startup political organization seeded with $20 million from anonymous donors, Americans Elect promises to offer voters a centrist candidate who will challenge Barack Obama and whomever the Republicans nominate for leadership of the Free World in 2012.
Be skeptical, very, very skeptical. Odds are that Americans Elect will be a footnote in the coming presidential campaign. But before shrugging it off, take a look at some of the political brains working on the effort.
There's pollster Doug Schoen, who helped elect President Bill Clinton and is an expert on independent voters. There's Mark McKinnon, a Texan who helped elect and re-elect President George W. Bush.
McKinnon worked for Sen. John McCain in 2008 until Obama locked up the Democratic nomination, at which point he stepped off the Straight Talk Express and declared that Obama's election would send a "great message to the country and the world." Disappointed by a president he thought would be The One, McKinnon is volunteering for Americans Elect because the system is "utterly broken and incapable of reforming itself."
And there is Darry Sragow, who recently signed on as political director. I wrote about Americans Elect a few months ago and would not revisit it so soon, except that Sragow, at 65 and having run campaigns for four decades, is worth listening to.
"The political system is out of date and it is broken," said Sragow, whose role will be to recruit potential presidential candidates. "It is delivering nothing that voters expect."
Unlike most of the rest of us, Sragow has seen up close the warts of the denizens of the political system. He ran the late Sen. Alan Cranston's re-election campaign in 1986 and worked as the Assembly Democrats' main consultant in the 1990s and early last decade. He has had his losses, having worked for the failed gubernatorial campaigns of Sen. Dianne Feinstein and rich guy Al Checchi.
He quit campaign work a few years ago, becoming managing partner of the Los Angeles office of the international law firm SNR Denton. But junkies never truly change their ways, and he remained involved, studying focus groups and polling, and advising candidates, Jerry Brown among them.
For years, Sragow has worried about societal upheaval, that jobs once held by people with few skills have become automated, that the divide between rich and poor is widening, and that political leaders fail to address basic issues.
"People we elect get stuck fighting in the sandbox over the debt ceiling, whatever that is," he said. "Voters' needs are not being met. But I remain optimistic about the vibrancy of this country. It is time to bring something new to market."
Americans Elect could be just another gimmick. It certainly has elements of gimmickry. But it also could have an impact, especially given the level of discontent.
A Public Policy Institute of California poll shows that even in the Democratic stronghold of California, barely half the voters approve of Obama's performance, and almost two-thirds of the electorate disapprove of the Republican Party.
"President Obama promised hope and change. He has delivered neither," Sragow said. "But the fact is that Americans still want hope and change."
Americans Elect offers itself not as a third party but rather as a You-Generation political vehicle. Billionaire investor Peter Ackerman gave $2.5 million to seed the group, and signed a 47-page pitch last year soliciting other donors and describing the concept. It's not simple, which is one of its flaws. Tentative rules read a little like those for a rather complicated board game.
The key, the pitch says, will be to gain ballot access in all 50 states, no small feat. In California, the group gathered more than a million signatures and will learn in the next few weeks whether it has gained a spot on California's ballot. Other states have different rules. The group may need to sue to gain access in some states.
We don't yet know who that candidate is, except that organizers expect him or her to be a centrist. The candidate to be named later would be nominated in voting conducted on its website starting next May. Any registered voter can shape a platform or campaign to draft their ideal candidate.
Americans Elect's assumptions, described in the booklet, certainly are hopeful. Candidates will emerge once it is understood that 50-state ballot access is certain. A ticket representing the center-right and center-left can win. Delegates, on their own initiative, will fund the ticket.
It sounds more hopeful than realistic. But lots of ideas are weird. Imagine thinking that what people truly need is to post personal photos on a public website and invite "friends" to comment, or that revolutionaries could use 140-character messages to plot to overthrow dictators.
"It's either going to be iTunes or Friendster. ... They're either going to change the world, or not," said Dan Schnur, a former GOP political consultant who teaches government at USC.
Americans Elect's pitch invited donors to give $500,000 and join what it called the John Hancock Society, named for the first brave man who signed the Declaration of Independence. The booklet also said donors would be publicly disclosed. That hasn't happened. Americans Elect attorney Daniel Winslow of Boston said some donors fear retribution if they become known.
That's, of course, a canard. John Hancock risked being hanged. People able to shell out $500,000 on an upstart have nothing of significance to fear.
Winslow, long a supporter of Mitt Romney, says Americans Elect is not a project of any candidate. Sragow says candidates could include politicians, military officers, business or labor leaders. It could be a Republican, including one who fails to win the GOP nomination, or a Democrat. Al Gore? Michael Bloomberg? Without knowing the donors, it's impossible to know the organization's motives.
Americans Elect most likely will be little more than a blip in 2012. History is littered with failed third-party candidates. At most, its candidate might be a spoiler. Then again, smart guys are involved. Maybe, just maybe, 2012 could be different.

Foundation Auction 2012: Bought Health Care

Auction 2012 is a week long series in partnership with The Huffington Post and United Republic.  

The point of seeing a doctor -- or being one -- should be to improve health.  After all, besides your mother or spouse, who do you count on to care about your well-being more than your doctor does?  That is literally his or her job.  But what I've found, and I've written about in my new book Greedy Bastardsis that the same incentives distorting banking, energy, education, and government are distorting our very bodies.
The American health care system has incentives so out of alignment for everyone involved that it's a Greedy Bastard paradise.  For American health care providers, the goal isn't to get you healthy, but to get you paying.  And similar to banking where the costs of a low interest loan might be a hidden balloon payment, the costs of our health care system are hidden from the end consumer.
One basic problem with the system is how doctors are paid, the fee for service model.  In fee for service models, doctors are paid based on the treatments they deliver rather than the health outcomes they generate.  So for instance, if you need an expensive surgery, your doctor gets paid to operate.  If you don't need surgery, your doctor doesn't get paid.  This creates an obvious incentive to recommend surgery, even when you don't need it.  And it also discourages looking at the evidence of what works and what doesn't, because expensive but ineffective procedures create more profit for the doctors and hospitals that host and perform them.
This prioritizing of money over health outcomes shows up in the political influence the American Medical Association uses to stifle competition.  Shikha Dalmia, a senior policy analyst for the nonprofit think tank Reason Foundation, described in Forbes how the AMA used its political influence to insist that only doctors could deliver babies, even though midwives have performed this service for years.  "In 1995 thirty-six states restricted or outright banned midwifery, even though studies have found that it delivers equally safe care at far lower prices than standard hospital births."
Then there's the prescription drug problem, where pharmaceutical companies leverage their political influence to protect and expand drug monopolies.  In one case, a company called KV Pharmaceuticals got the FDA to give it an exclusive franchise over a hormonal agent used for years by obstetricians.  The price jumped from $300 a treatment to $25,000.  Pharmaceutical companies advertise to convince you that you are sick, and spend $61,000 per doctor on promotional costs to get doctors to prescribe you their drugs.
This wouldn't be affordable for most of us if we had to pay the sticker price.  But we don't, because most of us are covered by increasingly expensive third party health insurance (through our employers, which is yet another problem).  This insurance is protected by a law granting health insurance companies the right to monopolize state coverage, a monopoly retained by the enormous sums spent by the health insurance industry in Washington ($263 million from 2009-2010 alone).
None of this improves health outcomes, or is necessary for good health.  Sometimes it is counterproductive, because it discourages collaboration and the adoption of best practices.  In my book, I spent time learning about the Mayo Clinic, where doctors are paid on a flat salary, and where they operate in teams.  This promotes the sharing of information, and leads to far better health outcomes.  I also spoke with Jeff Brenner, a specialist in Camden, New Jersey, one of the poorest areas in the country.  He assembled a team to specifically target the most expensive cases, and using this technique of hotspotting, was able to save millions of dollars.  For instance, he found out that one diabetic was continually relapsing because he wasn't wearing his glasses when he injected himself with insulin, and so was taking the wrong dose.  This alone saved thousands of dollars in hospital bills, but in our fragmented health system, it wouldn't be anyone's job to tell you that you aren't taking your medicine correctly.  In fact, the hospital would make money on every return visit.
As with banking, energy, and education, we have the skills and tools we need to improve outcomes and cut costs.  We know how to stop Greedy Bastards from ruining the system and bankrupting us.  They are after all operating according to certain incentives, and those incentives are malleable.

The Venn of Ron Paul and Other Mysteries of Libertarianism Explained

| Fri Jan. 6, 2012 11:26 AM PST
Congressman Ron Paul's third-place finish in Tuesday's Iowa Republican Caucus was a remarkably strong showing for a candidate who has so little in common with mainstream Republicans. Perhaps the nation's most politically unique congressman, Paul shares policy stances with conservatives, liberals, and libertarians, while differing markedly from all of them.
So where does Paul fit in the Libertarian universe?

Susan G. Komen’s priceless gift


A radical decision woke the country up to an alarming rightward drift, and gave new life to women’s health advocacy

Members of Planned Parenthood, NARAL Pro-Choice America and more than 20 other organizations hold a "Stand Up for Women's Health" rally in Washington
Members of Planned Parenthood, NARAL Pro-Choice America and more than 20 other organizations hold a "Stand Up for Women's Health" rally in Washington  (Credit: Joshua Roberts / Reuters)
The starling intensity that we saw this week in response to Susan G. Komen for the Cure’s decision to pull its grants from Planned Parenthood — an intensity that prompted the Komen foundation to reverse its decision today — may be the best thing that’s happened to the conversation about reproductive rights in this country for decades. It certainly should be.
Practically since Roe v. Wade was decided in 1973, reproductive rights activists have been left to play stilted defense against ideological opponents who grabbed the language of morality, life, love and family as their own, always deploying it with reference to the fetus. The rhetoric around reproductive rights, which has more recently begun to creep into arguments over contraception, has become suffocating in its emotional self-righteousness, but too muscular, too ubiquitous to effectively combat.
But the overreach by the Komen foundation, while surely intended to strike yet another blow on the side of antiabortion activism, succeeded instead in waking a powerful constituency — armed with precisely the language and emotional heft they’ve been lacking for too long.