Read the NY Times or listen to NPR and you would conclude a little known state senator won the Senatorial seat long held by Ted Kennedy due to the faults of Democratic contender, Martha Coakley.
Not so. Scott Brown made one promise to vote against ObamaCare. People listened, believed him, and he rode to victory.
The “Martha blew it” interpretation completely misunderstands Massachusetts voters and the votes they cast this week.
First, let’s address the stereotype of Massachusetts–Taxachusetts, the People’s Republic, home of the ‘Moon Bats,’ and the like.
That image of tax and spend is so ingrained outside the state that our former governor, Mitt Romney, used it as a foil in his presidential campaign. He actually ran against neighbors, friends, and family. Go figure.
Of course, our Senators haven’t helped in the past, forgetting that every time they vote for another huge federal program, Massachusetts pays way more out than it will ever see in return. The Big Dig was our revenge, but boy, we would do much better with a ‘take care of the home folks’ Senator like Ben Nelson any day.
Here is the truth. Yes, our taxes are high, but largely because we invest locally–schools, police, fire, clearing the roads in the winter–that’s a big deal, and so forth. By and large Bay Staters spend, but we want that spending on things we cannot do individually.
Furthermore, we want to keep things local. Think about it. Our biggest city, Boston, is but 600,000 people. It seemed at times my high school in New York City had as many.
Pretty much everywhere else is The Town of This, the Town of That. We’re really big into local self government. If Newton wants to spend a ton on a fancy new high school, hooray for them. It’s their money. Let them do what they want. We’ll do what we want in Brookline, Cambridge, Mansfield, Peabody, Andover, Wrentham, and so on. It shouldn’t be some clown on Beacon Hill or Capitol Hill for that matter telling us where to put street signs.
So, what happened to Coakley? A popular office holder got washed away in a wave of discontent. It’s not clear the legendary Carl “Yaz” Yastrzemsky could have won on the Democratic ticket (though he probably would not have made the faux pas of labeling local hero, Curt Schilling a Yankee fan).
Bay Stater’s looked at Washington and concluded those clowns failed in the basics of maintaining the system–the financial system was rigged for insiders, the political system was rigged for insiders, and the whole thing came crashing down. We were angry–the basics were fouled up–the equivalent of not keeping the roads cleared.
But, in the face of that, what did these characters do? After mucking things up, they tried to take on ever more things best done locally–perhaps with some government facilitation to make sure practitioners are up to snuff, truth in advertising, no bait and switch, that sort of thing. But to take control of one dollar out of seven? No way.
Remember, for all the other issues, Scott Brown made one promise: To be the 41st vote against ObamaCare. People heard that, believed it, and cast their votes accordingly.
To spin it any other way is quite wrong.
Don’t forget. We had the first tea party at which we told some government big wigs to stick it. It wasn’t that long ago, and things haven’t changed that much.
Synopsis: Health care reform is ostensibly aimed at improving quality, affordability, and access. But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume-the stark opposite of the healthcare experience? The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward improvement and innovation necessary to achieve excellence care delivery.
If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution. Instead, it should focus on repairing health care markets, so health care markets can repair the delivery of care.
In the meantime, health care leaders can focus on improving the delivery of care. Then they can advertise to patients and payers when they’ve made breakthroughs in complication-elimination, wait-time reductions, outcome-improvements, and the like, drawing more work to the best providers and denying it to the least capable.
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David Brooks is right (”The Hardest Call,” Dec. 17, NYTimes) and Paul Krugman is wrong (”Pass the Bill,” Dec. 17, NYTimes).
Health care reform is ostensibly aimed at improving quality, affordability, and access. But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume—the stark opposite of the healthcare experience?
The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward the improvement and innovation necessary to achieve excellence. This penalizes the providers most innovative in achieving excellence and rewards the laggards who don’t.
If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution. Instead, it should focus on repairing health care markets to allow informed choice by patients and reward innovation in delivery by providers, so health care markets can repair the delivery of care.
In a previous post, I suggested public sentiment that government does too much but not enough is not contradictory. It reflects a recognition that government does too little of what it should do, too much of what it shouldn’t. Today’s news that retails sales were dragged down by a drop in auto purchases, a deflation after the ‘cash for clunkers’ program ended supports that point (”Retail Sales Drop on Fall in Autos” Wall Street Journal, Jeff Bater, October 14, 2009).
There is a wealth of evidence and theory that markets work best in directing resources to their most productive use. The general consensus is that government’s role is appropriate to counteract market failure–unavailability of reliable information for markets to work, absence of decision rights to act on information even if it were reliable, or decisions that have consequences external to the decision maker.
Our financial market meltdown was triggered particularly by the first and third forms of market failure: Regulators allowed less and less transparency about transactions and credit risk and people were able to make transactions where they enjoyed the upside but dumped catastrophic costs on the rest of us.
The right response then is to fix the markets.
Pretty well accepted is that government is lousy, absolutely lousy at intervening in markets to pick winners and losers. If government does so, it is a likely as as not to pick wrong, diverting resources from better to worse purposes.
The cash for clunkers was a case study in such wrong headed policy. It pulled forward purchases that would have been made anyway, so net sales were likely flat, were an exceptionally expensive way to protect a relatively few number of jobs (albeit in politically influential districts), and probably was bad for the environment in the end, given the enormous energy required to make a new car relative to the energy required to propel an existing one
The public sentiment that the government is going too much and also too little is not self contradictory. An effective, market based democracy depends on people being able to make informed choices well. Government does too little when it fails to ensure the health of markets. It does too much when it tries to replace the market as the decision making mechanism rather than restoring its healthy functionality. Read the rest of this entry »