It would be a terrible mistake for Democrats to abandon comprehensive health care reform just because voters in the Massachusetts Senate race last week decided that they liked the Republican, Scott Brown, more than the Democrat, Martha Coakley.
– “Don’t Give Up,” NY Times, January 26, 2010
Does the NY Times think we had a popularity contest last week? This is Massachusetts, birth place of liberty, not 90210. Gee whiz!
Maybe it is a Red Sox Yankee thing, but the Gray Lady is incredibly dismissive of the Massachusetts electorate and its ability to vote on the issues and not the campaign fluff it it thinks Scott Brown’s victory was anything but a referendum on Obama Care and Capital HIll policies more generally.
Let’s be clear. This was a referendum.
The Times also says:
Many panicky Democrats see Mr. Brown’s win as proof that angry voters will punish them in November if they press ahead with reform. We believe that is a misreading of what happened and what’s possible.
Those Democrats are right and the Times is wrong. Proof? I was in NYC the day after the vote, and when people on the subway saw my Red Sox cap, they gave me a thumbs up and said “Thanks!”
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.
The question was asked; In times of budgetary pressure, what quality initiatives should be sacrificed.
Asking that asks the wrong question. The right one is asking what can be done to better design and operate care critical processes to advance quality, affordability, and access simultaneously.
The first question reflects unwarranted arrogant pessimism, the latter better justified humble optimism.
Here is a fuller explanation.
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In a recent e-mail, Jim Womack urges the lean manufacturing community to get beyond Toyota, implying that what can be learned from Toyota has been, in particular tools of shop floor production control.
That is the wrong challenge, in my view. The real challenge is to expand beyond understanding lean as a set of tools, and more aggressively pursuing an understanding of the comprehensive approach to managing organizations so they are capable of self-diagnosis, learning, and relentless internally generated improvement and innovation.
After all, Toyota didn’t displace GM, Ford, and the rest because it out value streamed them. It displaced its rivals because it out discovered them.
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Dear Reader,
Thanks for the added note about health care markets and regulation. In a separate note, I’ll pick up the idea of ‘commons.’
SUMMARY: Markets and regulation are not mutually exclusive. Markets exist as a means for customers to allocate scarce resources over competing needs and for suppliers to offer competing alternatives to meet those needs.
The question is: Does regulation foster market health or does regulation replace markets as the means of making resource allocation decisions? There are appropriate applications of both forms of regulation.
Sometimes, regulations promote market health by fostering the flow of necessary information and making choices/contracts/decisions/agreements enforceable. Other times, regulations replace markets because reliable contracts cannot be written or conditions lead to monopolies.
When we look at health care, we see that regulation to foster competition is more appropriate than regulation to replace competition.
Please read below for more elaboration.
Thanks!
Steve Spear
Related Posts:
“Repair Healthcare Markets So Markets Can Repair Healthcare”
“Theory and Evidence for Repairing Health Care Markets So Markets Can Repair Health Care Delivery…”
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