Opinion

Reihan Salam

No matter who wins, there’s still a healthcare cost crisis

Reihan Salam
Oct 1, 2012 17:10 UTC

One of the strangest aspects of the 2012 presidential campaign is that President Obama has barely bothered to make the case for the Affordable Care Act (ACA) and Mitt Romney has only rarely summoned the will to make the case against it. This is despite the fact that ACA is arguably the most consequential domestic policy legislation since 1965, when President Johnson presided over the creation of Medicare and Medicaid.

The usual explanation for why we haven’t had a serious debate over ACA is that Democrats recognize that the law is not wildly popular and that Romney is boxed in by his continued support for the universal coverage law he backed as governor of Massachusetts. All of this may well be true. But the foundations of America’s patchwork health system are unraveling before our eyes, and conservatives need to make the case for a more cost-effective reform sooner rather than later.

It is commonly understood that the United States spends an incredibly large amount of money on personal healthcare – the number was $2.19 trillion in 2010 – and that health spending is increasing rapidly as a share of GDP. A high level of health spending isn’t necessarily a bad thing. It makes perfect sense that an affluent country will spend a great deal of money to keep its citizens healthy, and medical care is a complex service that demands a lot of skilled labor.

What is worrisome is that the cost of medical care seems to be outstripping our ability, and more to the point our willingness, to pay for it. We tend to think about this in the context of the dramatic growth of Medicare and Medicaid spending, and understandably so. There is virtually no elected official, Democrat or Republican, willing to support the tax increases we would need to pay for these programs at their current growth rates, which is why the Obama White House and congressional Republicans alike have called for aggressive, and some would say unrealistic, cost controls.

Yet the clearest indication of our unwillingness to pay for rising health costs is the slow-motion collapse of employer-sponsored health insurance (ESI).

Actually, conservatives should favor even fewer people paying income tax

Reihan Salam
Sep 20, 2012 19:44 UTC

The outrage over Mitt Romney’s extended off-the-record riff to wealthy donors about the fact that “47 percent of Americans pay no income tax” has shown no sign of dying down. As of now, this looks like the defining moment of his presidential campaign. In lumping together those who have no federal income tax liability with those “who believe the government has a responsibility to care for them,” the former Massachusetts governor gave new life to every crude caricature of conservatives as class warriors for the ultrarich.

But did off-the-record Romney have a point? Is it a problem that we have narrowed the federal income tax base, or is there a case that conservatives seeking to contain the growth of government should strive to make the income tax base even narrower?

In a 2001 interview with Nicholas Lemann of the New Yorker, Republican Senator Jim DeMint of South Carolina called the narrowing of the tax base “a major crisis in democracy.” Just months before the first Bush tax cut removed millions of households from the federal income tax rolls, DeMint warned that “the tax code will destroy democracy, by putting us in a position where most voters don’t pay for government.” DeMint’s dark premonition wasn’t enough to get President Bush to revamp his tax cut, but the idea has grown more popular among conservatives in the intervening years, hence Romney’s riff.

How the Occupy movement may yet lead America

Reihan Salam
Sep 14, 2012 17:07 UTC

This coming Monday, Sept. 17, is the first anniversary of the day when protesters gathered in Lower Manhattan’s Zuccotti Park under the banner of Occupy Wall Street. The occupation was first dreamed up by Kalle Lasn and Micah White, the close collaborators behind Adbusters, a slickly produced, high-art magazine that uses the tools of commercial culture to make the case against capitalism. Having decided that America needed an uprising akin to those that had shattered authoritarian governments across North Africa, Lasn and White chose a date, created an arresting image emblazoned with the Occupy Wall Street slogan, reached out to potential collaborators and then watched as their creation seized the imagination of millions of Americans.

One year on, the encampments that had sprung up in Lower Manhattan and in cities, college campuses and foreclosed homes across the country have for the most part been abandoned. And so at least some observers are inclined to think, or to hope, that the Occupy movement has been of little consequence. That would be a mistake. Occupy’s enduring significance lies not in the fact that some small number of direct actions continue under its banner, or that activists have made plans to commemorate “S17” in a series of new protests. Rather, Occupy succeeded in expanding the boundaries of our political conversation, creating new possibilities for the American left.

As our slow-motion economic crisis grinds on, it is worth asking: How might these possibilities be realized? For some, Occupy was a liberating experience of collective effervescence and of being one with a crowd. As one friend put it, it was “the unspeakable joy of taking to the streets, taking spaces, exploring new relations and environments” that resonated most. For others, it created a new sense of cross-class solidarity. Jeremy Kessler, a legal historian who covered the Occupy movement for the leftist literary journal N + 1 and the New Republic, senses that it has already shaped the political consciousness of younger left-liberals. “There is more skepticism towards the elite liberal consensus,” and so, “for instance, there is more support for the Chicago teachers union and more wariness towards anti-union reformers.” Ideological battle lines have in this sense grown sharper. Yet it is still not clear where Occupy, and the left, will go next.

Obama and the ghost of Walter Mondale

Reihan Salam
Sep 6, 2012 17:47 UTC

When Barack Obama accepts the Democratic presidential nomination in Charlotte, he will no doubt channel party heroes of the past like Bill Clinton and JFK and FDR, all of whom are celebrated still for their charisma and raw political skills. But he would do well to heed the wisdom of Walter Mondale.

Yes, that’s right. Most Democrats see Mondale as a faintly embarrassing relic from an era in which Democrats had lost their way, and of course there is something to that. He was also one of the last Democrats to make the case that government was worth paying for, not just by the rich but also by the middle-income households that rely on expensive social programs.

By the summer of 1984, Mondale, the former Minnesota senator who had served as vice-president under Jimmy Carter, knew that he was facing an uphill battle for the White House. The brutal Reagan recession had given way to a V-shaped Reagan recovery, and Reagan Democrats were thick on the ground. So Mondale decided to do something very strange at that year’s Democratic National Convention. Rather than make the most anodyne, ultra-cautious, poll-tested argument he and his team could conjure up, he told the truth as he understood it. “Mr. Reagan will raise your taxes,” he told the assembled delegates. “And so will I.”

Artur Davis and the crucial role of party switchers

Reihan Salam
Aug 29, 2012 15:07 UTC

TAMPA, Florida – If you’ve been watching the Republican National Convention at home, you probably missed the speech former Representative Artur Davis of Alabama gave on Tuesday night. Sandwiched between Ted Cruz, the Tea Party darling who won an impressive come-from-behind victory in Texas’s GOP Senate primary, and Nikki Haley, the strikingly youthful Indian-American governor of South Carolina, Davis was overshadowed in most of the media coverage. MSNBC decided not to air Davis’s speech at all, which was a noteworthy omission given that Davis had cut his political teeth as a Democrat and indeed as an enthusiastic early backer of President Obama.

But on a star-studded night, before hotly anticipated speeches by Ann Romney and conservative action hero Chris Christie, it was Davis who gave the most effective performance. It was so effective, in fact, that I heard many of the assembled participants speculate about which office he’d run for next.

Party switchers are a staple at these quadrennial affairs. They dramatize the case against the opposition by offering dispatches from within the belly of the beast and signal that it’s safe for voters to forswear their old allegiances. And so they serve the double function of rallying the base and wooing the center.

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