Brooks and Krugman

In “The Sidney Awards, Part Deux” Bobo presents a second batch of what he thinks are the year’s best essays.  Prof. Krugman has a question in “Snatching Health Care Away From Millions:”  Will Trump really kill Obamacare?  I’ll bet if he does the 2018 midterms ought to be very interesting.  Here’s Bobo:

Every December I read hundreds of long-form essays to select the Sidney Awards, and every year I regret that I spend so much of the other 11 months reading online trivia. Then, every January, I revert to Twitter.

Andrew Sullivan got sucked into the online addiction in a big way, yanked himself away from it and wrote a brilliant essay on the process for New York magazine called “I Used to Be a Human Being.”

Sullivan was the superstar of what I guess we can call the blogging era, consumed with online volleying all day, every day. Everything else — health, friendships — atrophied: “Every minute I was engrossed in a virtual interaction I was not involved in a human encounter. Every second absorbed in some trivia was a second less for any form of reflection, or calm, or spirituality.” He also came to understand that we don’t really control our time online. Our clicks are seduced by technologists superbly able to suck us in.

There is also something emotionally comforting, if cowardly, about life through the screen: “An entire universe of intimate responses is flattened to a single, distant swipe. We hide our vulnerabilities, airbrushing our flaws and quirks; we project our fantasies onto the images before us.”

Sullivan cut the cord, went to a silent retreat center and promptly collapsed. Issues from his traumatic childhood flooded back. “It was as if, having slowly and progressively removed every distraction from my life, I was suddenly faced with what I had been distracting myself from. Resting for a moment against the trunk of a tree, I stopped, and suddenly found myself bent over, convulsed with the newly present pain, sobbing.”

Sullivan’s essay marks an important turning point as more people realize that smartphones have made online life so consuming as to become a monster.

Martha Nussbaum is one of America’s most brilliant philosophers, her work often focusing on the content and nature of emotions. Rachel Aviv’s wonderful New Yorker profile, “The Philosopher of Feelings,” opens with Nussbaum writing a lecture while flying to see her dying mother:

“In the lecture, she described how the Roman philosopher Seneca, at the end of each day, reflected on his misdeeds before saying to himself, ‘This time I pardon you.’ The sentence brought Nussbaum to tears. She worried that her ability to work was an act of subconscious aggression, a sign that she didn’t love her mother enough. I shouldn’t be away lecturing, she thought. I shouldn’t have been a philosopher. Nussbaum sensed that her mother saw her work as cold and detached, a posture of invulnerability. ‘We aren’t very loving creatures, apparently, when we philosophize,’ Nussbaum has written.”

The profile is a subtle exploration of a woman who is extreme at both ends of the sense and sensibility spectrum, who is almost fanatically organized and professionally accomplished, but also deeply emotional and open to the things in the world that can leave you shattered.

I have left the election largely out of the awards, named for the philosopher Sidney Hook, since we’ve been so consumed by the madness all year. But I should mention a few deserving political essays:

In “How American Politics Went Insane,” in The Atlantic, Jonathan Rauch argues that generations of well-intentioned reformers have destroyed the informal structures of politics, like parties, congressional hierarchies and pork barrel spending, that make government work. The reformers saw insiderish corruption, but these mediating structures held leaders accountable to one another. Without them, we are left in a world of chaos, political dysfunction, atomization and demagogy.

The economist Tyler Cowen of the Marginal Revolution blog excellently suggested that I include a pro-Trump essay, to give the winning side its due. I’ve picked “The Flight 93 Election,” from The Claremont Review of Books, by the person who writes under the name Publius Decius Mus. The core argument is that modern conservatism has failed at everything except its self-preservation, that a figure like Donald Trump could arise only in deeply corrupt times and that only the radical shift he offers can protect the nation from utter destruction.

Some sort of prognostication prize should go to Ronald Brownstein for “Is Donald Trump Outflanking Hillary Clinton,” also in The Atlantic. One week before the election, Brownstein wondered why the Clinton campaign was spending its energies on states it didn’t need to win, like Florida, while neglecting the “Blue Wall” states it absolutely had to win, like Wisconsin and Michigan.

Finally, to lift our eyes to the heavens, let’s throw in Alan Lightman’s “What Came Before the Big Bang?,” in Harper’s. Lightman describes current thinking about the creation of the universe. He suggests that the universe moves from tidiness to messiness, that the entire universe may have once been like a subatomic particle, that before-and-after, cause-and-effect thinking might be a human construct that prevents us from understanding cosmic events.

Lightman’s account of cosmology explodes our mental frameworks and normal categories, and thus serves as a good preparation for 2017.

Now here’s Prof. Krugman:

If James Comey, the F.B.I. director, hadn’t tipped the scales in the campaign’s final days with that grotesquely misleading letter, right now an incoming Clinton administration would be celebrating some very good news. Because health reform, President Obama’s signature achievement, is stabilizing after a bumpy year.

This means that the huge gains achieved so far — tens of millions of newly insured Americans and dramatic reductions in the number of people skipping treatment or facing financial hardship because of cost — look as if they’re here to stay.

Or they would be here to stay if the man who squeaked into power thanks to Mr. Comey and Vladimir Putin wasn’t determined to betray his supporters, and snatch away the health care they need.

To appreciate the good news about Obamacare you need to understand where the earlier bad news came from. Premiums on the exchanges, the insurance marketplaces created by the Affordable Care Act, did indeed rise sharply this year, because insurers were losing money. But this wasn’t because of a surge in overall medical costs, which have risen much more slowly since the act was passed than they did before. It reflected, instead, the mix of people signing up — fewer healthy, low-cost people than expected, more people with chronic health issues.

The question was whether this was a one-time adjustment or the start of a “death spiral,” in which higher premiums would drive healthy Americans out of the market, further worsening the mix, leading to even higher premiums, and so on.

And the answer is that it looks like a one-shot affair. Despite higher premiums, enrollments in the exchanges are running ahead of their levels a year ago; no death spiral here. Meanwhile, analysts are reporting substantial financial improvement for insurers: The premium hikes are doing the job, ending their losses.

In other words, Obamacare hit a bump in the road, but appears to be back on track.

But will it be killed anyway?

In a way, Democrats should hope that Republicans follow through on their promises to repeal health reform. After all, they don’t have a replacement, and never will. They’ve spent seven years promising something very different from yet better than Obamacare, but keep failing to deliver, because they can’t; the logic of broad coverage, especially for those with pre-existing conditions, requires either an Obamacare-like system or single-payer, which Republicans like even less. That won’t change.

As a result, repeal would have devastating effects, with people who voted Trump among the biggest losers. Independent estimates suggest that Republican plans would cause 30 million Americans to lose coverage, with about half the losers coming from the Trump-supporting white working class. At least some of those Trump supporters would probably conclude that they were the victims of a political scam — which they were.

Republican congressional leaders like Paul Ryan nonetheless seem eager to push ahead with repeal. In fact, they seem to be in a great rush, probably because they’re afraid that if they don’t unravel health reform in the very first weeks of the Trump era, rank-and-file members of Congress will start hearing from constituents who really, really don’t want to lose their insurance.

Why do the Republicans hate health reform? Some of the answer is that Obamacare was paid for in part with taxes on the wealthy, who will reap a huge windfall if it’s repealed, even as many middle-income families face tax hikes.

More broadly, Obamacare must die precisely because it’s working, showing that government action really can improve people’s lives — a truth they don’t want anyone to know.

How will Republicans try to contain the political fallout if they go ahead with repeal, and tens of millions lose access to health care? No doubt they’ll try to distract the public — and the all-too-compliant news media — with shiny objects of various kinds.

But surely a central aspect of their damage control will be an attempt to push a false narrative about Obamacare’s past. Health reform, they’ll claim, was always a failure, and it was already collapsing on the eve of the G.O.P. takeover. When the number of uninsured Americans skyrockets on their watch, they’ll claim that it’s not their fault — like everything, it’s the fault of liberal elites.

So let’s refute that narrative in advance. Obamacare has, in fact, been a big success — imperfect, yes, but it has greatly improved (and saved) many lives. And all indications are that this success is sustainable, that the teething problems of health reform weren’t fatal and were well on their way to being solved at the end of 2016.

If, as seems all too likely, a health care debacle is imminent, blame must be placed where it belongs: on Donald Trump and the people who put him over the top.

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