What the Anti Gay Rights Folks Fail to Understand About the Gay Rights Movement Today

What anti gay rights folks fail to understand about the current gay rights movement is that young gay men and women just don't give a fuck anymore.  Let me give you an example.  I'm 28 years old, when I was a freshman in high school, half my lifetime ago, I had a classmate who was out.  He had been out since middle school.  No one cared.  Did I mention that I went to an all boys catholic high school.  No one cared...except of course for the administration, and that was really only when he forced them to care.  You see, he was one of the top students (he got a full ride scholarship to a name institution), he sang at chapel, he was one of the stars of the theater department, he was a really nice guy, he was everything that they could possibly have hoped for in a student. They didn't make an issue of his being gay.  But then senior year rolled around, and he wanted to bring a date to prom, a guy.  They said no.  He circulated a petition, and we all signed it.  They still said no, and of course when we debated it in religion class the answer we got was "because his taking a date implies they'll have sex, and that's a sin."  Well that's good old catholic church hypocrisy for you; no one in our class was married, making the implied sex we might have with our dates a sin too.  But that's not really the point I'm making. The point I'm making is that when the Church, or any societal institution or group in America tells young gay men and women what they can and can't do these days, they tell them to go fuck themselves. And their friends do too.  Everything that the anti gay rights movement is fighting for, from this bullshit anti-gay marriage constitutional amendment in North Carolina, to the mealy-mouthed walk back of Joe Biden's statement about his comfort with gay marriage,  all of this will be rolled away some day.  My generation knows this, we grew up with it, we don't give a fuck.

Battleship! F@%&ing Battleship is a F*#@ing Movie!

I like bad movies, I like them a lot actually. And of course by bad I mean stupid, I mean movies that don't even try to be rational or coherent, that just aim purely at entertainment, but manage to succeed in not quite the way they intended.  I mean something like John Carpenter's Vampires (Actual Quote:  "Can I ask ya somethin, Padre? When I was kickin? your ass back there... you get a little wood?"). 

But then there are movies like Battleship, movies that make you weep for the souls of Hollywood executives. It's based off of a fucking game!  Are you kidding me!  Some people might be annoyed with all of the comic book movies coming out these days, but those movies are drawing from a deep reservoir of content and character development, Battleship is based on a game where each player randomly guesses where the other person's battleships are located on a board.  I'm guessing the decision to make this movie was made in much the same way.  I honestly don't care whether this movie would be enjoyable to see, the whole concept of it makes me want to insert pencil shavings in my eyeballs every time I see that stupid trailer.

There are so many stories to be told and Hollywood has the capacity to only tell so many.  I accept the fact that most of the stories that will get told are stupid and pointless (at least in the grand scheme of things) but it would nice if the movies that Hollywood made didn't have to have an already developed brand behind them.  I suppose that would involve taking risks and of course actually using one's imagination, two ideas anathema to the species Homo Hollywoodexecutivus, but a boy can dream, can't he? Or have I just watched too many movies?

This is a great article from Dahlia Lithwick on how Stephen Colbert has masterfully, through satire, rendered the Supreme Court's Citizen's United decision allowing unlimited campaign spending utterly ridiculous.  I thought this was an especially insightful point from the article articulated by Colbert's "personal lawyer" Trevor Potter.

Potter says Kennedy’s majority opinion is not so much disconnected from reality but, rather, “assumed that the world would work in the way he thought it would.” (In Kennedy’s fantasy, there would be no chance of corruption, no coordination between PACs and candidates, and full disclosure of corporate contributions.) And had the FEC done its job, had Congress passed better disclosure rules, had shareholders been better able to control corporate activity, the Kennedy decision would have been less monumental. (Potter is quick to point out that the court needn’t reverse itself completely for the country to fix the worst problems in the post-CU system.) Still he adds that Citizens United “epitomizes the problem of having a court where no justice has ever run for any office, including dogcatcher.”

I think this is an oft overlooked point.  The members of the supreme court do not have a lot of experience being answerable to the public whose lives are affected by their decisions.  Often coming directly from the federal bench, they have spent large portions of their careers completely insulated from any meaningful consequences arising from their decisions.  Also, they don't have a lot of experience actually making laws. Developing case law and what the Supreme Court does are not the same thing. The Supreme Court actually makes laws (or unmakes them), it doesn't just develop a body of interpretation around them. And of course the supreme court makes laws in perhaps the worst way possible, it makes them in the form of individual cases, it transforms seemingly limited disputes into massively influential precedent. It does so without much debate, maybe an hour or two and a nice 30 to 50 page brief from each side, and then a neat little conference, where they decide the cases in complete secrecy (take that openness and accountability!).  Say what you will about Congress, but the legislating that it does allows far more outside input and involvement, which helps to add a lot more reality to the deliberative process, and is actually openly visible to the public (except with regards to certain national security issues and the usual influence peddling).  People who are going to be impacted by the new laws Congress makes actually get to weigh in. The Supreme Court accepts briefs from outside groups, but it knows that no matter what, whichever way they vote, they'll have a job.  Members of Congress usually have a healthy dose of fear of the public (however, that often includes lobbyists).

Congress is imperfect, but at least it allows in information capable of disabusing it of any absurd notions it has about the way they world works. It still makes rotten decisions, but its at least usually been forced to reckon with those who know they're rotten. The Supreme Court doesn't have to reckon with anyone, except maybe being chastised by the President or Stephen Colbert on national TV.  This allows it I think to continue to hold onto many absurd theoretical precepts that just don't work in the real world no matter how much their legal philosophy says they should.  The public doesn't honestly care whether freedom of speech means that cop orate speech should be protected.  Most people have enough common sense to realize that the consequences of the Citizens United decision tilt the playing field massively in the favor of the few over the many.  That the Court was unable or unwilling to see this, or that they frankly didn't care is just one in a  long line of reasons I think the Court should be reformed and greatly reduced in power.  You can't hand 9 unelected people a job with unbelievable power and influence for life and not expect them to become corrupted and more disconnected from the rest of society.

Downton Abbey and It's Historical Lessons

Downton Abbey is addictive, and besides its wonderfully gossipy nature that's probably most of all because it shows a world caught up in such fundamental change.  World War I is the defining event of the past 100 years, it presages everything, from World War II and the Shoah, to the Cold War, to women's suffrage, to globalization, to decolonization, to the conflicts in the middle east. World War I and its deciding aftermath at Versailles defines our world to this day.  The characters in Downton are living through that rending tumult.  Their lives are not as much their own as they might hope. They're being forced to make decisions that the world they grew up in has not well prepared them for. That world is ending. This of course this isn't a new phenomenon, the world is always being remade.  But I think that two things make the world of Downton particularly ripe for current obsession.  One is that its world is different enough from our own to attract fascination, but not so different as to be incomprehensible.  And the second is that by living before so many of the defining moments of our age gives their world a sort of graceful wonder.  There are values on display, especially a certain gallant honor, that I think we find sadly missing in our modern world that has only recently come down from its temple built to greed. That honor would be prized above happiness is shocking to our sensibilities that prize happiness above everything. Of course the characters at Downton are also corrupted by all the pre-progressive mores of Edwardian England, especially the Crawley family and their spoiled remove from life's inconveniences, which is sadly not so incomprehensible to our time.

This isn't to say that the picture Downton portrays is wholly accurate.  Especially with regards to its depiction of the War, it is far too antiseptic.  It displays tragedy, yes, but not nearly with the necessary gruesomeness and tragic meaninglessness to give the Great War its due. Perhaps because it is so hard for anyone who has grown up with the Iraq and Afganhistan Wars as their touchstone for what conflict feels like as a nation this is understandable, but World War I existed on a wholly different scale.  Why Lady Sybll says that "It seems as if all the men I ever danced with are dead," she is speaking for every woman her age in Britain.  Every class, every city, everyone in Britain felt the pain of the war intimately.  We haven't seen anything like that since World War II.  I think it would be impossible in a mini-series to do it justice. I think perhaps only a documentary could recreate the kind of terror and tragedy experienced by the soldiers and their families and friends back home. But I love that Downton has tried because it is such a defining period in our world, and people should be exposed to it however imperfectly.  

Our Times

I've been reading Tyler Cowen's The Great Stagnation lately. It is a rather dour book for our rather dour times. It is impressively, lucidly argued, and I do think that Cowen is onto something about the disappearance of what he calls "low hanging fruit" or the easy wealth derived by the 19th and 20th centuries' defining innovations such as modern communications technologies that enabled many of our problems to be solved without too much sacrifice. Now in Cowen's argument we've entered a time of less innovation and therefore less easy wealth. It is therefore far more difficult for society to make the now comparatively tough decisions about how we will fund the solutions to our most vexing social problems, such as how do we pay for health care, or education. But I wonder too if it isn't a bit too easy to write a book like the Great Stagnation at a time like this. It's easy to see no way out of the hole when you've hit the bottom. I don't pretend to believe that it won't take us a while to get our economy back on track, but for a recent, hopeful example look at Germany. I was studying there 7 years ago when they began their labor market and government reforms that have now made them such a competitive economy with their strongest employment market in a generation. Those reforms were not easy. I can remember seeing lots of protests by students and workers against proposals to raise tuition and to cut back on worker benefits, and of course those reforms ultimately cost the SPD and Gerhard Schroeder their majority. But the reforms worked, and Germany is stronger for it. I don't think it's so hard to believe that the U.S. won't be able to find its own way out of the mess it's in right now. There are ideas out there about reforming the tax system by lowering rates but eliminating loopholes to increase the overall amount of revenue being generated (and also perhaps reducing the amount of taxes that go uncollected, in part because the system is too complicated), lowering the rate at which healthcare costs increase by reforming the incentive structure of doctors and health care providers, and by using the powers of the affordable care act to keep a tight leash on health insurance rate increases, modifying our patent system to better serve the new methods and modalities of our times, allowing innovators to enjoy the fruits of their inspiration but not stifle creativity and further innovation in the process, and so on. These ideas could help us get rid of a lot of the rust that has ossified our political economy.

America is at a turning point I feel. We're at a low ebb. We reached the height of our post-war economic boom during the late 1990s and we've been searching since then, or probably since even before that, for a new direction, a new unifying system to help drive our unrivaled run of prosperity into the future. There is no guarantee that we will soon find the answer, but as I said I think there are a lot of good ideas out there waiting. And so I can't feel as dour as I probably should reading Mr. Cowen's book, and perhaps that is a luxury I have that others do not. If you're part of the long-term unemployed right now it's hard not to feel like you've unknowingly signed up to eternally receive the short-end of the stick. I can know that without really knowing what it feels like, and so I am able to believe that we will get out of this, I have that luxury, the luxury of knowing that even if we never make it out I'll probably be alright. But I don't think that makes me wrong, I just think that makes me lucky, and I am most of all grateful for that.

Writing

I've had this goal for a long time to write everyday. But maybe I'm just not gritty enough.

I think what has always appealed to me about writing is the ability to create something out of seemingly nothing. Your thoughts, which are constantly spinning during the day, can be transformed into coherent thoughts by the focused force of concentration it takes to put words down on the page. If you do it often enough it no longer even feels like work, and the words just pour out of you. When you're hammering away at the keyboard, and the words appear on the screen just as fast as you type them, as if your hands were directly connected to the synapses in your brain, it's a wonderful feeling of accomplishment. But of course real writing requires rewriting, requires rethinking. It's not enough just to hammer away, you also have to be critical of what you're actually saying. Is that what I mean? How will someone reading this understand what I just said? Is that the point I want to make? What's the most important thing I'm trying to convey? Is this boring? And so on. If you don't think about those things your writing becomes little more than typing.

What am I trying to say right now? I suppose it's that I needed to start typing to start writing again. I've made a lot of excuses about why I didn't want to write, and all of those moments of laziness have added up over time to a lot of non-writing, which was the opposite of my goal in the beginning. I want to write, and so I had to start with something, and sometimes nothing turns into something quite worth writing.

Hard Not to Yell

If we default on our national debt, or come close enough that the market demands higher interest rates on our debt, adding hundred and hundreds of billions of dollars in long term debt liabilities for current and future tax payers to pay, it will be one of the most needlessly stupid self-inflicted errors of any government ever. To wit here is a collection of comments from sane conservatives (no, those words do not have to be mutually exclusive, and for most of this country's history they weren't) compiled by Adam Ozimek with some sensible words about the debt ceiling compiled . As Ozimek says

I’m trying not to get shrill here, it’s getting hard.

I wanna go to Grand Rapids

A Long Dark Shadow

This is just a startling quote from Adam Hochschild's new book To End All Wars

More than 700 million artillery and mortar rounds were fired on the Western Front between 1914 and 1918, of which an estimated 15 percent failed to explode. Every year these leftover shells kill people-36 in 1991 alone, for instance, when France excavated the track bed for a new high-speed rail line. Dotted throughout the region are patches of uncleared forest or scrub surrounded by yellow danger signs in French and Enflish warning hikers away. The French government employs teams of demineurs, roving bomb-disposal specialists, who respond to calls when villagers discover shells; they collect and destroy 900 tons of unexploded munitions each year. More than 630 French demineurs have died in the line of duty since 1946. (Hochschild, xii)

I suppose I shouldn't be surprised at the enormity or the staying power of the Great War in our lives, but I am. It is still hard to grasp death and destruction on such an absurdly industrial scale, and yet the reality of the modern mechanized war that World War I inaugurated has been with us now for almost a century. A contemporary example is useful to illustrate the relative destructive power unleashed from 1914-1918. The people of Afgahnistan, and the allied soldiers fighting there know all too well the reality of modern war, and the all the deadly detritus it leaves behind. But even Afganhistan, the "most minded country in the world" with it's 30 years of internecine conflict, currently has only an estimated 100,000 land mines (past figures have indicated numbers as high as 500,000 land mines, but the US military has helped clear a lot of mines). The unexploded ordinance remaining at the end of World War I according to Hochschild's numbers would number over 100 million. I know that land mines and unexploded ordinance are different (land mines are intentionally hidden, unexploded ordinance is not), but this gives you an idea of the extreme scale of destruction that World War I unleashed.

And even beyond the shear number of bombs and the dead they left behind, there is something terrifyingly special about the First World War's brand of mechanized destruction. Perhaps because it was the first, perhaps because so many of its participants didn't yet understand the new rules of war, the First World War has always seemed especially cruel. It murdered the innocence of the modern world, and we've lived in its shadow ever since.

This Says it All

h/t Slate and Think Progress

Scott Adams Should Take a History Course

Scott Adams is famous for writing a satirical cartoon that makes a number of astute, funny observations about life in the modern office environment. He also now has a rather well-read blog, which I've enjoyed reading on occasion. A post of his from last week though caught my eye for its particular obtuseness, a characteristic I hadn't often associated with Adams.

h/t andrew sullivan

The post is about what Adams calls the "Education Complexity Shift," which is short-hand for his observation that life in the modern world has become very quickly very complex, too quickly for the U.S's education system to keep up. Thus our education system is failing most of our students (the "B Students" Adams calls them) by not providing the kinds of basic practical education that they're really going to need in life to help them succeed, and is instead focusing on topics that most students will forget quickly like history, calculus, trigonometry, etc. Adams wants schools to focus on more "practical" topics like teaching students how to start a business, or how to compare financial documents, because presumably these are the kinds of skills that businesses are looking for. Adams doesn't have a problem with history or trigonometry per se, he thinks they're certainly better than teaching nothing, just not better than practical subjects that teach "marketable" skills. But lets take his argument piece by piece. Here is Adams first point

I'll begin by stipulating that any field of study is helpful in training a student's mind to become more of a learning machine. Two hundred years ago, when life itself was simple (feed the horse, plant the corn) you needed to make school artificially complicated to stretch a student's mind. Once a student's mind was expanded, stressed, stretched and challenged, it became a powerful tool when released back into the relatively simple "real world."

What's interesting is that Adams while maligning history's practical value in today's "complex" society decides to begin his post by just making up his own history to justify his argument for why history is not particularly valuable for most people to know in the modern world. Yes, back in the good old days in early 19th century America when life was so simple, when feeding horses and picking corn were our only concerns. It's totally reductionist. The early 19th Century wasn't really less complex than our lives today. We were fighting wars in Libiya just like today. America was expanding rapidly westward and usurping land from Native Americans as they went. Not what one would consider an uncomplicated endeavor. Slavery was a very present evil in American society, which of course did not complicate society at all (wink wink). Women were denied equal standing with men, again not a complication at all. Oh, and I almost forgot, the U.S. was trying out this little known experiment called representative democracy, which had never succeeded before, except in some tiny Greek city states 2000 years ago, and that could really only be considered a minor complication, I mean James Madison just made slight mention in the Federalist Papers of the fact that what the U.S. was doing was totally revolutionary in every sense of the word and might very well fail, though he was optimistic. Basically early 19th Century America was pretty freaking complicated, and there was a lot for a person to learn to succeed in it (imagine being an ambitious woman in 1811, just imagine it for a second, and basically every thing that Scott Adams says in this paragraph turns to dust), so this idea that all of a sudden we've arrived in 2011 in an uncomplicated world is a total reductionist invention that has no support from the real world that Adams presumes to know so much about. The world has always been full of complications, lets just accept that as our base reality as human beings. It's why we're so lucky to be an adaptable species. Our systems of education are to my mind best when they enhance our abilities to adapt, but we'll get to that more as we move further into Adam's argument. On to his second point.

The Education Complexity Shift observes that the real world has become more complicated than school. Imagine trying to teach a young child how to do the routine adult task of planning the most efficient trip by plane, or getting a mortgage, or investing. How about planning a wedding? How many pieces of software do you use for your job?

His point here is clearly that these are all important things that kids need to know how to do but which are never (or at least very rarely) actually taught in school, and it would be better if they were taught them because unlike history or calculus these things will actually be used in almost every person's day to day life with measurable consequences if not used correctly (e.g. lost time, money etc.). But while I'd agree that it's useful to know each of these things, I still think that it's much more important to learn how to think clearly and learn how to reason well and learn how to learn well, and learn to treat others with respect and dignity, which is what education is supposed to teach us. So these things that Adams mentioned like finding the most efficient flight seem trivial by comparison as each one can be overcome if the prerequisites of clear, critical thinking, learning to learn, and treating others with respect are first met. Let's move on to Adams closing argument

Today, life is more complicated than school. That means the best way to expand a student's mind is by teaching more about the practical complexities of the real world and less about, for example, the history of Europe, or trigonometry.

I'll pause here to acknowledge that both history and trigonometry are useful for students who plan to become historians or rocket scientists. For the other 99.9% of the world, little from those classes will be retained. The only benefit from much of what is taught in school is generic training of the mind, and for that we now have a better and more complicated option: the real world.

Some of you will argue that learning history is important on a number of levels, including creating a shared culture, understanding other countries, and avoiding the mistakes of the past. I agree. And if the question was teaching history versus teaching nothing, history would be the best choice every time. But if you compare teaching history with, for example, teaching a kid how to compare complicated financial alternatives, I'd always choose the skill that has the most practical value. You get all the benefit of generic mental training plus some real world benefits if any of it is retained.

I'd still teach history in school. But I think the world will survive if some of the details are skipped to make room for more relevant coursework.

Well you see it's interesting because in college I majored in History and German Literature and now I work as a budget analyst (go figure) and yet I've still maintained the ability to pull apart and critique reductionist historical arguments (which by the way comes in very handy in analyzing budgets).

I see Adams' point about the added benefits of teaching kids how to do things like compare complex financial alternatives, and I think that such lessons can and should be made a greater part of current curriculum, but I am absolutely not a believer in dismantling our liberal arts education system in favor of a dramatically greater emphasis on practical education. You see, this goes back to my point about adaptability. I think that school should focus on developing skills like critical thinking, reading comprehension, logical reasoning, verbal communication, written communication, etc. that would be applicable to any job. There should be practical elements to each of those skills that are taught, but by providing a good general base of skills to our students we can ensure that they have the ability to change careers both when its suits their interests and when its a necessity. I got the job I have now because I could write clearly, think clearly, and communicate clearly. I happened to learn that studying history and German literature and a whole lot of other stuff. Those were the things that interested me, and that made acquiring the skills I just mentioned a whole lot easier to stomach. You have to provide kids with enough opportunities to spark their imagination, and that includes teaching them a lot of different things, not just practical things, in order to teach them the core skills you know they'll need. In an op ed piece for the Wall Street Journal, Adams mentions that for him in college that meant having the opportunity to try his hand at entrepreneurship. For some other kid it might be learning trigonometry, or it might be physics, or it might be music, or basketball, or whatever. The point is there are a lot of different ways for a person to learn. We shouldn't be too focused on practical application from the start. We need to get kids attention first. I don't presume to think that that's easy, but I do know many people have tried this before, and perhaps the best place to start is by taking a look at history, the repository of all our mistakes, a pretty good place to learn about literally anything you want to know.

Ranting on Healthcare and Human Nature

I am not an expert in health care policy, the subject of my following rant, but I do know something about human nature, which is my primary critique in my following rant.

Andrew Sullivan is my favorite blogger by a wide margin, and not because I agree with him on every issue, but because I find his temperament to largely fit my own. He cares passionately about a great many issues, and is always ready to voice his opinion on them, but he is also often willing to listen to the other side and acknowledge the other side of the issue and even admit when he is wrong and change his opinion accordingly. But there are a few issues on which he becomes very stubborn and fixated on some truly unworkable positions. One of those issues is the deficit, and as health care costs are the single biggest driver of long-term budget deficits, Sullivan is now fixated on Paul Ryan's draconian plans for Medicare (never-mind Medicaid).

Sullivan, as he usually does, opens his post on Ryan's Medicare reform proposal by directing his readers to a substantive, well-reasoned, thought-provoking article on the issue at hand.

The most helpful piece I've read on Paul Ryan's proposal suggests that a voucher system for Medicare may be popular - but it likely won't cut costs, as the history of Medicare Advantage shows. Money quote from Austin Frakt:

'The politics of Medicare are such that Ryan’s idea, paying for care entirely through private plans, costs more. That's not due to a market failure, but a political one. Congress likes to spend money; insurers, providers and beneficiaries like to receive it. Congress spends even more when it can satisfy those interests under the guise of a seemingly pro-market, pro-competitive program. When it comes to cost control and considering the political calculus of Congress, vouchers and Medicare don't add up.'

Sullivan is right, Austin Frakt, an Assistant Professor at Health Policy and Management at Boston University, has written a very illuminating piece on Paul Ryan's proposal to turn Medicare fully into a voucher program while also reducing its benefits overall. Here's the evidence that Frakt uses that leads to the conclusion that Sullivan quotes above:

About Ryan's plan, economist Paul Krugman wrote in the New York Times, "[W]e already know, from experience with the Medicare Advantage program, that a voucher system would have higher, not lower, costs than our current system." Krugman is correct: When it comes to Medicare, vouchers and cost control, it seems you can't get all three.

Though rarely described this way, the private Medicare Advantage plans are a (voluntary) voucher system. When covering a beneficiary, an Advantage plan receives a fixed monthly payment from Medicare that depends on the beneficiary's county of residence and health status. That fixed monthly payment is tantamount to a voucher. With it, beneficiaries can select from any Advantage plan operating in their county. They can also stick with traditional fee-for-service Medicare--and about three in four beneficiaries do so.

But today, the market-based arm of the program costs more, not less, per beneficiary. Those fixed monthly payments to Advantage plans are, on average, 13 percent above fee-for-service Medicare costs. It didn't start out that way. Originally, private Medicare plans were paid 95 percent of per beneficiary fee-for-service costs. The logic was that private plans ought to be able to provide Medicare services more efficiently than traditional Medicare through a combination of controlling utilization and driving hard bargains with providers. So, Medicare used to take five percent off the top.

Then Congress began to ratchet up payments, first with the 1997 Balanced Budget Act and more recently with the 2003 Medicare Modernization Act. (This year’s health reform law aims to reduce Advantage payments, though still not below 100 percent of fee-for-service costs on average.) Ironically, traditional Medicare payment regulatory reforms--like the prospective payment of hospitals and home health agencies--have been more successful (even if not anywhere near successful enough) in mollifying the rate of growth in the program's costs.

What's going on? Why is the market-based Advantage voucher system not helping to control Medicare costs? The answer is that health care cost control is tough, technically and politically. Provider groups typically resist it. When it pertains to Medicare, beneficiaries resist it too. By adding another private-sector layer to the program--health insurers--the Advantage program invites a third source of political pressure. Rent-seeking by providers and insurers, as well as the power of the beneficiary constituency, align in their encouragement of higher Advantage payments. Congress, apparently, is willing to yield to that encouragement.

This is not a particularly surprising state of affairs as there are a whole host of issues where rent-seekers have captured the votes of Congress, the insurance industry just happens to be one of the most powerful and effective rent-seekers lobbying Congress. But Sullivan isn't convinced that the insurance industry couldn't be made to heel in order to keep the deficit down:

The argument seems to be that private insurance companies have so much political clout that they would be a more formidable impediment to cost-control than traditional, single payer Medicare. That seems defeatist to me. And, as Krugman points out, there is a very strong and simple mechanism for cost control in the Ryan-Rivlin proposal:

I’m sure that the Republicans will claim savings — but those savings will come entirely from limiting the vouchers to below the rate of rise in health care costs; in effect, they will come from denying medical care to those who can’t afford to top up their premiums.

But of course Sullivan doesn't quote Krugman's most important argument for why Ryan's Medicare plans are in for a bumpy ride.

Oh, and for all those older Americans who voted GOP last year because those nasty Democrats were going to cut Medicare, I have just one word: suckers!

Krugman is a little too glib here for my taste, but his point stands: it's very hard to imagine seniors (and the baby boomers who are about to join them) taking on more of the costs of covering their medical expenses just when they're reaching the age when those costs are the highest without putting up a very big fight that they would most likely win. As Krugman alludes to, Medicare is a very popular program with both republicans and democrats, one that even many supposedly small government conservatives support, though sadly many of them mistakenly believe that medicare is not a government program (in no small part because their leaders lie to them repeatedly). But somehow Sullivan expects seniors to go along with something that is so obviously against their own self-interest when there is seemingly no political reason why they should have to besides the deficit being big (which isn't yet an economically pressing concern as interest rates are really low, and of course low interest rates make seniors even more sensitive to higher medical care costs as low interest rates are really bad for savers).

Yep: seniors will have to accept limits to the care they receive. And instead of the government rationing, they will just have vouchers that do not keep up with the price of cutting edge medicine. That should not mean abandoning the cost controls in health insurance reform, and constant exerimentation to make the health sector more efficient. And such an austere remedy requires, to my mind, sacrifice from those who earn over $250,000 a year.

However much I might want to agree with Sullivan that drastic measures are needed to shore up the US deficit, especially over the long-term, which as a matter of course involves tackling medical costs, I don't see for the life of me how he can possibly think that Paul Ryan's plan is anything but DOA. Not only does Ryan's plan make the wrong assumptions about Congress, but it makes the wrong asumptions about seniors, the most powerful voting block in America. Sullivan can hope that politicians will show some back bone and stand up to insurers, but given their history and absolutely no change in their incentive structure there is no reason to believe they would. Sullivan can hope that seniors would act altruisticaly in their golden years to help safeguard their grandchildren from a crushing debt burden, but again, with no change in their incentive structure, why would they? Imagine you're 68 years old, you have just enough saved to make it relatively comfortably to 85, but you don't know how things would work out beyond that. Then the economic crisis hits, and while your retirement is safe since you were smart and hid it in bonds and savings accounts, all of a sudden the math has changed dramatically on your rate of return on your savings with interest rates being so low. Also, your only daughter's husband has just lost his job and your daughter is struggling to take care of her family as the primary bread-winner, so it's pretty hard to imagine having her take care of you too. Now someone comes along and says they might be raising the cost of your health care. How do you feel right now? I don't think you're feeling really generous, and I completely understand even though I'm 27 and I might be paying for the costs of your health care for the rest of my life.

Finally, just to add one more substantive critique to the Ryan plan, I encourage you to take a look at a report [pdf] McKinsey and Co. did a few years ago on why health care costs are so high in the U.S. I suggest reading the whole analysis, it's very good, but here's their final conclusion, which I think provides one final simple substantive reason why I think both Sullivan and Ryan are off base:

Our analysis shows that the high costs of US health care are widespread across the system. In the public debate about how to bring costs under better control, different advocates have proposed a variety of preferred targets for change--whether the administrative complexity of the privagte system, the profitability of the pharmaceutical companies, or the compensation system for physicians. Yet, our analysis shows that most components of the US health care system are economically distorted and that no single factor is either the cause, or the sivler bullet, for reform actions. To be effective, refrom in the US health care system will need to involve all key stakeholders and will require the proposal of solutions that are placed in the context of a coherent set of principles covering both the demand and the supply sides of the system.

Ryan's proposal only tackles one side of the issue by artificially reducing demand by reducing the amount of money that people have to spend on health care. It does nothing to address the issue of costs on the supply side, except by assuming that they'll be taken care of with less demand. But regardless of whether that's good economics, can you really imagine big pharma, the AMA, or the big medical supply companies, just giving up all the money they've made off the system without a fight? You have to address that issue or it will eat you alive. The worst assumption that both Ryan and Sulivan make is that they assume that to solve the issue of high medical costs all you really need to do is get a few groups of people to give up some very large government funded benefits. But in reality you actually need a whole lot of groups of people to give up a whole lot of government funded benefits, and I'm not entirely sure why seniors need to be first on the list of people needing to give up benefits.