Positive Politics

    Positive politics: health care

    Well, it’s been a while since I’ve written something on positive politics. Let’s dive in to another completely non-controversial topic: health care.

    I’m tempted a little bit to say “just read everything Matthew Loftus has written on the topic” and leave it at that. But that would be cheating, so I’ll leave that as a secondary recommendation.

    Maybe this’ll be easier if I just state some positions first, then I’ll try to justify them.

    • A modern, first-world society should have among its goals that its people have the ability to get health care, including medical and mental health.
    • This ability should largely be independent of a person’s individual income level.
    • The only practical way this will happen is via government involvement including taxation and funding for care.
    • Provision of some sort of universal coverage would benefit the American people and society in measures other than just physical health.

    OK, let’s dig in.

    A modern, first-world society should have among its goals that its people have the ability to get health care, including medical and mental health

    This seems like it should be almost self-evident. Government should exist to promote human flourishing. And humans will flourish much more when they have access to medical and mental care than when they don’t.

    The ability to get health care should largely be independent of a person’s individual income level.

    Again, because it encourages flourishing. Because poor people are currently forced to make bad choices about health care because they don’t have the income to make better choices.

    Preventive care isn’t freely available, so treatable issues get ignored until they become emergencies. Emergency care gets used and abused for all sorts of inappropriate situations because it’s legally more available to the poor.

    Health issues snowball and drive other societal issues. Lack of basic preventive care leads to more serious health issues. Which can lead to lack of employment, which makes it even harder to afford any care. Repeated or chronic health issues can lead to self-medicating with tobacco, alcohol, and drugs. Which leads to other health issues, and to deterioration of social relationships, and to crime.

    There’s no just reason that only wealthy people should have medical care. And poor people might find it easier to work their way up the ladder if they had health care available to them.

    The only practical way this will happen is via government involvement including taxation and funding for care.

    I’ve heard lots of arguments for why this isn’t the case.

    A lot of right-wing Christians will say that the church should provide for these needs. To which I say great, but that solution doesn’t scale. There are by rough estimates about 350,000 churches or other religious communities in America. American health care spending is roughly $3.5 trillion per year. That means each church in America would need to put $10 million per year toward health care. It doesn’t scale.

    Update: a friend pointed out that church giving might only need cover the gaps, not the whole medical cost for the country - an excellent point that I missed here. But in 2016, per the Census Bureau, about 9% of the country was without health insurance coverage. So maybe the cost of the gap is only $1M per church instead of $10M… still doesn’t scale.

    But there are other collaborative ways that people can band together to fund medical care! I know people who have been in faith-based health care cooperatives where everyone sends in their bills and the costs are split among all members. Great as far as it goes, but at the macro level it still fails the care-for-neighbor test.

    Over the past few years we’ve seen a proliferation of social media campaigns for health care help. Donate to this GoFundMe to pay for my uncle’s kidney transplant! Or my sister’s cancer treatment! Or my friend’s medical expenses from his car accident! Seeing successful responses to campaigns can be heartwarming, but how many are there that go unfilled and wither in quiet desperation?

    twitter.com/igerner/s…

    Provision of some sort of universal coverage would benefit the American people and society in measures other than just physical health.

    This is closely tied to the point about coverage not being tied to income. How many people would take an entrepreneurial plunge or feel freedom to pursue some other dream if they didn’t have to worry about keeping a standard job at a corporation just so their family could keep health insurance?

    How many people would have their mental, social, and community lives significantly enhanced simply by being healthier? How many people’s lives would improve from eliminating the mental stress associated with wondering how a loved one will get care?

    But isn’t this gonna cost a lot? And isn’t the government super-inefficient at managing things?

    Well, yeah, it’s gonna cost a lot. But the current system isn’t cheap or super-efficient, either. Multiple levels of for-profit for corporations involved ensure that everyone involved gets a cut. It doesn’t take much more than looking through a single hospital bill detailing hundred-dollar Tylenol, thousand-dollar titanium screws, billed costs vs. negotiated costs, and on and on, to recognize that the current system has significant issues.

    I know it’s not a simple problem to solve, but the rest of the first world has found ways to address it, and America should too.

    Evaluation

    So let’s evaluate these against the five-principle framework.

    1. Is it good for the poor?

    Yes.

    2. Is it good for the planet?

    I don’t know that it affects the planet one way or another.

    3. Does it promote peace?

    More broadly available health care should, in the end, help promote peace, since healthier people will be happier and more stable people.

    4. Does it challenge the powerful?

    If more equality in this area challenges the powerful, then yes.

    5. Does it let the marginalized have a seat at the table to speak for themselves?

    Indirectly, more available health care would help the marginalized be in a better place to be able to speak for themselves.

    Positive Politics: Religious Liberty

    It’s been too long since I’ve written in this series. So let’s tackle something that I’m sure isn’t controversial at all - religious liberty.

    Free exercise

    I think this part is actually pretty straightforward. As guaranteed by the First Amendment, each person should have free exercise of their religion. This will feel strange at times as our country, which has traditionally been majority Christian, becomes more diverse. But at the basic level, we should welcome and spend time getting to know our neighbors of other faiths, and encourage the building and protection of mosques and temples in the same way we care for Christian churches.

    “Congress shall make no law…”

    Congress shall make no law respecting an establishment of religion…

    Here’s where it gets a little more challenging. What does it look like to respect an establishment of religion? What about this “separation of church and state”?

    From a Christian standpoint, we first need to have a clear recognition of how closely tied our American governments have been to the Christian church and Christian principles. This isn’t inherently a bad thing. However, it gets more and more difficult as our country becomes more diverse and as the general population becomes less and less devotedly (or at all) Christian.

    The positive influence that Christianity can bring to this country must come from the church, not from the government. People will be drawn to Christ through the beauty and love of the Gospel message, not because Christians win legal battles to have school-sponsored Christian prayers and exclusive access to the city park for a Christian nativity scene.

    But what about…

    The current sticky places in the religious liberty discussion are where evolving cultural views of civil rights and protected classes come into conflict with sincerely held religious convictions. So let’s talk about just a couple of them.

    The Gay Wedding Cake

    This one is currently before the Supreme Court. Gay couple wants to order a custom wedding cake. Christian baker refuses. State prosecutes the baker for violating anti-discrimination laws. What’s a man to do?

    If it were me personally, I think I would’ve been OK baking the cake. I’m not a professional baker, but I am a musician who has occasionally been paid for playing at weddings, receptions, and the like. And I would be OK with providing my musical services at the reception after a same-sex wedding. But that really just speaks to the state of my convictions, not the overall principle.

    I’m still on board with Andrew Sullivan’s summary statement from last month: if the Christians had been more Christian, or the liberals more liberal, we wouldn’t be in this situation. There’s no question that our societal views are changing. What we need in an age of significant shifts is time for adjustment. Bend a branch too hard and too quickly and it will snap and cause significant damage. Apply pressure gently over time and it will accommodate the changes.

    Contraceptive Coverage

    The Hobby Lobby case is the exemplar here. The law requires employers to provide a basic level of health insurance, including contraceptive coverage for women. The owners of Hobby Lobby have a religious objection to the use of some forms of contraception and refuse to provide the coverage. Slightly more challenging is the Little Sisters of the Poor case, in which a Catholic order that runs a group of homes for the low-income elderly similarly refuses to participate in providing contraceptive coverage, even to the point of refusing to sign a form saying they won’t provide it, because that form would then trigger government coverage, which the Little Sisters believe would make them complicit in the sin.

    In these cases I’d like to sidestep things a little bit.

    First, we need to take a long look at the rights of corporations. While corporate entities are necessary for the economy, the pattern of extending the rights of persons to corporations has a weakening effect on our democracy. When corporate entities are entitled to free political speech (spending), the richest can quickly overwhelm the political messaging arena in ways that ensure they get richer. With the Hobby Lobby case, the court allowed for corporations to exercise the religious rights of their owners. As a basic principle I would suggest that for-profit corporations should not receive all of these rights reserved for the people.

    Second, the United States should get away from the employer-provided health care system altogether. Having health coverage tied to employment makes less and less sense in an economy that is moving toward more fluid employment situations and more self-employment / freelance work. While that discussion belongs in another post focusing specifically on health care, I bring it up here just to note that in a system where health coverage was not tied to employment, Christian employers would not be put in the position of needing to make decisions on covering procedures that conflict with their beliefs.

    Evaluation

    So let’s evaluate these against the five-principle framework.

    1. Is it good for the poor?

    Well, yeah, on principle free exercise of religion is good for everybody, including the poor.

    2. Is it good for the planet?

    Same answer.

    3. Does it promote peace?

    A focus on true religious tolerance would indeed help promote peace.

    4. Does it challenge the powerful? 5. Does it let the marginalized have a seat at the table to speak for themselves?

    If we follow the line of thinking that free exercise and free speech are rights that properly belong to individuals and not all corporations, then yes, it would be a challenge to the powerful.

    Positive Politics: Internet and Technology Policy

    Well I’m not ready to jump into one of the big ugly topics yet, so maybe this one will be a little easier. (Maybe.) Let’s talk about the internet and overall technology policies.

    Access / Control of Internet

    There’s a current debate about a concept called “net neutrality” that, as typical, is highly spun by both sides on the issue. So I’m going to avoid that term in my discussion. I’ll try to make this one fairly simple.

    Access to the Internet should be thought of and regulated like a public utility, analogous to water, gas, and electric. Market competition is difficult here because the cost for infrastructure development is relatively high and a physical connection is required to each home and business. (We don’t expect that we’ll have three electric companies run lines to our house so we can choose the one with the best rates!) Pricing should be overseen and controlled just like it is for other utilities. Access to the internet should be unrestricted - no paid “fast lanes”, no filtering, no blocking.

    Once that level of utility access is in place for the internet, I’m more open to allowing mobile providers to offer variation and experiment within the market space, because there is more room for genuine competition within the mobile internet (aka cell phone) market.

    Encryption

    The government should not restrict the use of encryption or push for the inclusion of “back doors” into encryption systems. From a technical standpoint, if a back door exists, the probability is 100% that at some point the bad guys will figure out how to get through it. The FBI may complain that good encryption slows their investigations down, and may dream up scenarios where they suggest having a backdoor would help avert some impending attack; I don’t believe that because we can imagine such a scenario that it justifies crippling our encryption systems. Encryption helps enable the right to digital privacy. We need it.

    Consumer Data and Privacy

    Big data analytics, whether by the government or by corporate interests, are affecting our lives in ways we struggle to understand (or are hidden from us). While it’s folly to think we can get the genie back in that bottle, I’d be interested to explore the idea of a Consumer Data Protection agency similar to the Consumer Financial Protection Bureau that was created after the 2008 financial crisis. We need awareness of what’s being done with our personal data, and we need real penalties for companies that mismanage or abuse it.

    Social Media Transparency

    And then there’s Facebook. And #FakeNews. And election meddling by way of Facebook propaganda. I don’t know what it’ll take for the giants like Facebook to get serious about trying to patrol that type of obviously fake material - maybe they shouldn’t. But what we do need is a populous that is more educated about how to identify fake news stories so they can evaluate things on their own.

    Evaluation

    So let’s evaluate these against our five-principle framework.

    1. Is it good for the poor?

    When compared with the possibility of pay-for-access, a Net Neutrality position is good for everyone, and benefits the poor who otherwise might be shut out of the benefits that internet access provides.

    2. Is it good for the planet?

    I’ll rate this one as neutral.

    3. Does it promote peace?

    The internet can be used for peaceful ends… or for not so peaceful ends. Better consumer education about how and what to consume would help us learn to ignore propaganda, which would be a positive and usually peaceful improvement.

    4. Does it challenge the powerful?

    Net Neutrality and awareness / limitation of big data collection would serve to at least give us awareness of what the powerful are doing with all that information… and knowledge is the first step toward taking action.

    5. Does it let the marginalized have a seat at the table to speak for themselves?

    Free and neutral access to the internet would provide each user, regardless of wealth or status, the same ability to distribute their message as anyone else. While access to already-popular channels isn’t automatic, the internet provides more ability than ever before in history for an unknown person with a notable message to spread virally.

    Positive Politics: Education

    None of the topics I’ve teed up for my Positive Politics discussions are easy ones, but in the interests of easing into things I’ll try to take one that’s maybe not super-controversial to start. (Of course, as with anything political, I may be surprised by what becomes controversial.) So let’s talk about education. For my own organizational purposes, I’m going to break this down into three pieces: early childhood, K-12, and college.

    My Background

    My background is probably relevant here. After attending two different public schools for kindergarten, I was homeschooled as a child from grades 1 - 12. My maternal grandmother spent her entire career as an elementary school teacher. My parents, after some years as public educators, blazed the homeschooling trail when it was not quite and just barely legal. Thanks in large part to their efforts I did well on the college admissions tests, was named a National Merit Scholar, and graduated with an engineering degree from a private university. My wife and I are now on year 8 of homeschooling our three children, which we anticipate continuing with them through their high school years.

    Early Childhood Education

    Gone are the days when we could expect that preschool-age children would be cared for by a parent at home. Our modern society is nearly based on the assumption that even if both parents are present in the home - that itself a less frequent condition than it used to be - that both parents are working outside the home to make ends meet. For those with means, children may be left in educational day-care facilities and preschools, but poorer children may more usually get left in a less beneficial environment. Research shows us that these early years are critical to a child’s intellectual and emotional formation.

    So what should we do? I suggest that the government should fund early childhood education opportunities. These need not be mandatory - parents should be welcome to choose their own option such as a stay-at-home parent, family member, or private setting - but it should be available for those who would need and use it. Yes, these programs would cost money, but as an investment in the good of those individual children and in society as a whole, they would be a wise choice.

    K-12 Education

    When compared with the benefit they provide society, I believe teachers are one of the most underpaid groups of workers in America. We require advanced college degrees, often expect that to a great extent the teachers will self-supply their classrooms, and then pay them a barely middle-class salary. I guess then I shouldn’t be surprised - just appreciative - when I see so many teachers with such strong altruistic desire to teach. Why else would they do it?

    I suggest that we should significantly increase our commitment to public education, while allowing alternative options with appropriate safeguards in place. We should pay teachers at a rate more commensurate with other professional career paths and should fund associated school programs similarly. While I think local control and direction of the school system is important, schools should be funded from a broader pool - say, at the state level rather than the municipal level - so that we don’t forever build bigger and bigger rich suburban schools while having no funding available for poor districts.

    Alternative options such as home schools and private schools should be allowed, but I’m skeptical of the case for routing funds to those schools via things like voucher programs. While on the face of the argument, vouchers seem like a reasonable idea - pay for results, regardless of where the results come from - the metrics make it very tricky. The example of the No Child Left Behind Act over the past 15 years should be enough for us to seriously consider whether we really want to couple educational funding to test-based outcomes. Should assessment tests be a part of an overall institutional evaluation? You bet. But funding contingent on those specific outcomes is problematic. Metrics are tricky things - design the wrong one and you get the wrong behavior.

    College education

    There’s probably a whole separate post to be written on this topic, but I’ll try to restrain myself. I see two primary problems with our higher education system at present: first, that the costs are increasing exponentially, resulting in college graduates with huge piles of debt; second, that a college diploma is considered nearly a de facto requirement for most jobs.

    My grades and test scores helped when I went to college in the mid-90’s. I passed up several full-ride scholarship offers at public universities to attend a private school that offered more minimal scholarships. After graduating in four years, I still had enough college debt that I was writing significant checks every month for 10 years to pay it off. Now 20 years later, the College Board reports that, even adjusted for inflation, public school tuition and fees have more than doubled since I was in college. I’ll guarantee you that inflation-adjusted salaries for parents and students haven’t doubled accordingly! The result: even more debt for students and parents.

    Unemployment rates make the story clear: for college graduates, the unemployment rate is nearly zero. (2.5% in January 2017, which is in practice full employment.) For high school graduates, unemployment is more than twice that - 5.3% - and for high-school dropouts, the unemployment rate nears 8%. So the most job opportunities would seem to be available for those who have a four-year diploma. But need this really be the case? Sure, in some disciplines a significant professional education is a must. (I’d like the guy designing my bridge or the woman operating on my heart to have the best education they can get!) But many blue collar and even white collar job fields shouldn’t require four or five years and a mound of debt just to buy entry to the field. Vocational training programs should be developed and encouraged for job areas that can reasonably be done without a four-year degree.

    Evaluation

    So let’s evaluate these against our five-principle framework.

    1. Is it good for the poor?

    Increased funding for the education system, with funding spread more broadly, should work to help improve education for the poor.

    2. Is it good for the planet?

    I’m not sure that the education system has a direct ecological impact - other than that ecological education could be part of a well-balanced system.

    3. Does it promote peace?

    Similar answer as to #2, though I would add here that education practices that lead to more diversity in our school populations should in the long term encourage more tolerance among diverse groups, which should promote peace.

    4. Does it challenge the powerful? 5. Does it let the marginalized have a seat at the table to speak for themselves?

    I’m not sure what all powerful groups need to be challenged in this area, but I would hope that the combination of more broad-pool funding combined with local control would help restrain more impersonal national forces in favor of more accessible local ones, and would empower even those in poor districts to make decisions that are beneficial for their children and communities.

    --

    [As a reminder: while this blog post is cross-posted to Facebook, I’m on a social media fast through the end of 2017, which means if you comment there I won’t see it. If you want to interact, comment here on the blog!]

    Positive politics: a little bit of foundation

    Before I start in on specific political topics, I want to lay out some foundation that will lie under the specifics.

    First, I’m a Christian, so my approach is necessarily rooted in Christian values and a belief that the Bible gives us God’s direction for what is best for human flourishing.

    Second, the Bible provides very little direct instruction on what a government should look like other than some basics like punishing evil, encouraging good, being righteous and just. There has been a lot of teaching and assumption in the American evangelical church over the past 40 years that “Christian values” are closely aligned with Republican party positions. I’m going to challenge that assumption while hopefully not irrationally rebelling against it.

    Third, politics is the art of the possible, and inherent in good politics is compromise. If all stakeholders are a little bit happy and a little bit unhappy with an outcome, it’s probably a good result from a political viewpoint.

    Fourth, I believe that tolerance and freedom are values that should be promoted in our society. While I am a Christian, I do not believe that the best government would promote the Christian faith over other faiths. This includes not compelling uniquely Christian rules or practices simply because they are Christian. The government should foster a society that encourages the flourishing of all its members, regardless of their faith.

    Finally, while I would hope the evaluation framework I’m borrowing from Brian Zahnd (as amended by my friend Misty Granade) is rather self-evidently good, I’d like to briefly outline my justification for each principle.

    1. Is it good for the poor?

    God cares deeply for the plight of the poor, as is demonstrated across the full sweep of Scripture. Old Testament laws command farmers to leave food on the edges of their field for the poor to glean and define jubilees that revert bought/sold property wealth. The New Testament gives instruction to provide for the poor and examples of offerings being taken up for them. This one seems pretty clear.

    2. Is it good for the planet?

    God is the creator. The earth displays His handiwork. Man’s first task is to care for the garden in which he was placed. God’s ultimate plan is for restoration of all things, including creation. In the same way the government should promote human flourishing, it should also promote the flourishing of all creation.

    3. Does it promote peace?

    I’m going to hope this one is self-evident. While peace is not always possible, it is always the goal.

    4. Does it challenge the powerful? 5. Does it let the marginalized have a seat at the table to speak for themselves?

    These two are closely related. It’s a given that there will always be power imbalances, and this isn’t inherently wrong or unreasonable. But power corrupts. Look at any government and you’ll see too many in power who are using that power not as good stewards promoting general flourishing but instead as selfish stewards out for their own gain.

    James Madison summed it up brilliantly in Federalist #51:

    If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself.

    As such, having systems designed to challenge the powerful and let the marginalized have a voice are good because they put an elements of self-regulation into the system.

    Onward!

    With that set of background and caveats in place, I think it’s time to start writing on specific topics.

    Thinking in more positive terms about political issues

    From time to time over the past year when I’ve been tempted to write political rage posts, it has seemed to me that even though they’d be cathartic, that wouldn’t be all that constructive. And while I haven’t studied political theory or public policy much, writing helps me work through my thinking on issues. So, my thought goes, maybe I should spend some time thinking through and writing constructive opinions on various political topics.

    Then I came across this tweet from Brian Zahnd (this was before my social media fast, honest!) that seems like a good framework to work from:

    twitter.com/BrianZahn…

    Off the top of my head, some topics I’d like to consider:

    • Taxation
    • Religious Liberty
    • Health Care
    • Gun control
    • Foreign trade policy
    • Foreign military presence
    • Middle East policy / terrorism
    • Racial justice issues
    • Social programs / social safety net
    • Education
    • Internet / technology policy
    • Campaign finance
    • Term limits
    • Science & space
    • Environmental issues

    I’m not working through this all to get Brian Zahnd’s vote - I’d need to run for office first! But it might be constructive to think positively about what policy should be instead of just saying “well, that’s a bad idea”.