Making It Explicit

by hilzoy

James Pethokoukis in US News (h/t Sullivan):

"Recently, I stumbled across this analysis of how nationalized healthcare in Great Britain affected the political environment there. As Norman Markowitz in Political Affairs, a journal of "Marxist thought," puts it: "After the Labor Party established the National Health Service after World War II, supposedly conservative workers and low-income people under religious and other influences who tended to support the Conservatives were much more likely to vote for the Labor Party when health care, social welfare, education and pro-working class policies were enacted by labor-supported governments."

Passing Obamacare would be like performing exactly the opposite function of turning people into investors. Whereas the Investor Class is more conservative than the rest of America, creating the Obamacare Class would pull America to the left. Michael Cannon of the Cato Institute, who first found that wonderful Markowitz quote, puts it succinctly in a recent blog post: "Blocking Obama's health plan is key to the GOP's survival.""

The Michael Cannon post quoted is on the Cato Institute's blog, here.

Pethokoukis and Cannon claim that if Obama succeeds in passing health care, then people who might have been conservatives will like it, and will be more likely to vote for the people who passed it. This is unexceptional. An honest conservative might accept this claim and say: well, I guess our ideas are unpopular, so we'll just have to make our case more persuasively.

But that's not the conclusion they draw. Pethokoukis and Cannon say: because people will like health care reform, if we do not block it, our party will lose support. So precisely because people would like it if they tried it, we need to make sure that it fails.

At least they're honest about it.

Comments

[felix culpa]

Oh dear; and but of course.

At least these people resemble pariahs more than power brokers now, and the forces aligning for reform are impressive and determined.

I’ve lost track of the number of blood tests, X-rays, and CT scans, etc. I’ve had since late August. Thank Heaven this is Canada, eh? Give me the liberty of public health insurance, or give me a miserable death.

How terribly cruel to make health care a blind, blustering bull-headed occasion for opposition. With a posture like that they will make their moral and political bankruptcy crystal-clear and confirm their loss of credibility, and yes, power.

[Hartmut]

Reminds me of the opposition to the new GI bill. Giving soldiers a perspective outside the military could persuade them to leave, so that has to be prevented (and people lacking limbs sent back for the next Iraq tour).

[Neil the Ethical Werewolf]

I've been trying to find the original text from Bill Kristol's 1993 memo on how Republicans should respond to the Clinton health care plan. Instead I just have to dig up the Rick Perlstein article citing it:

"Health care is not, in fact, just another Democratic initiative... the plan should not be amended; it should be erased.... It will revive the reputation of the... Democrats, as the generous protector of middle-class interests."

[Jesurgislac]

One key difference between the UK and US is that in the UK, people aren't nearly as scared of losing their jobs. If you get sacked, you don't lose your health care. I've personally known people who stayed on in jobs they desperately wanted to leave - they were highly motivated to leave - but because of a pre-existing condition, which their current employer had to cover, they were scared to take the step of leaving their current job - they couldn't be sure the insurance on their next job would cover what they already had.

Conservatives would tend to hate anything that fostered workers' independence and a feeling that you weren't quite wholly under your boss's screw.

[liberal japonicus]

I would love to see Obama and the various health care surrogates go out and hang this around the right's neck. Make em carry it around their neck like an albatross. And then tear down the Cato Institute and plow salt into the ground.

[Dan S.]

And see John Holbo's famous review of Frum's Dead Right"

"[Frum is quoted]“The great, overwhelming fact of a capitalist economy is risk. Everyone is at constant risk of the loss of his job, or of the destruction of his business by a competitor, or of the crash of his investment portfolio. Risk makes people circumspect. It disciplines them and teaches them self-control. Without a safety net, people won’t try to vault across the big top. Social security, student loans, and other government programs make it far less catastrophic than it used to be for middle-class people to dissolve their families. Without welfare and food stamps, poor people would cling harder to working-class respectability than they do not.”

[Holbo] The thing that makes capitalism good, apparently, is not that it generates wealth more efficiently than other known economic engines. No, the thing that makes capitalism good is that, by forcing people to live precarious lives, it causes them to live in fear of losing everything and therefore to adopt – as fearful people will – a cowed and subservient posture: in a word, they behave ‘conservatively’. Of course, crouching to protect themselves and their loved ones from the eternal lash of risk precisely won’t preserve these workers from risk. But the point isn’t to induce a society-wide conformist crouch by way of making the workers safe and happy. The point is to induce a society-wide conformist crouch. Period. A solid foundaton is hereby laid for a desirable social order"

[Bellwetherman]

The last time this health care battle was fought there was virtually no internet to provide accurate information, flag disinformation, and correct misinformation. No wonder the forces of reaction are worried.

[von]

The premise makes no sense, so I don't know if the analysis (by anyone involved) follows. Here's the premise, which is neither linked nor supported:

After the Labor [sic] Party established the National Health Service after World War II, supposedly conservative workers and low-income people under religious and other influences [huh?] who tended to support the Conservatives were much more likely to vote for the Labor [sic] Party when health care, social welfare, education and pro-working class policies were enacted by labor-supported governments."

Was there some pool of pre-1945 pool of "supposedly conservative workers and low-income people under religious and other influences" who once supported the Tories but shifted allegiance to Labour? I don't know, but I frankly suspect not. Labour's traditional support was (unsurprisingly) among union workers. That was true before 1945 and after 1945.

Moreover, the history doesn't bear this out. The primary victim of Labour's rise wasn't the conservative party: it was the Liberal party. Leaving aside Tony Blair, the Conservatives did quite well after passage of the NHS, even substantially reforming the NHS under Thatcher -- reforms that persist through today. There's no evidence of which I am aware that Conservatives lost whatever support they had from "supposedly conservative workers and low-income people under religious and other influences". Indeed, I don't even know what category of voters this refers to: "other influences" seems to be a pretty broad category.

So: We have a journalist supporting a provocative but (thus far) completely unsupported Marxist thesis followed by a Libertarian making a stupid comment. And so it goes.

[Coyote]

"I don't want everybody to vote. Elections are not won by a majority of the people. They never have been from the beginning of our country and they are not now. As a matter of fact, our leverage in the elections quite candidly goes up as the voting populace goes down."

Paul Weyrich, founder of the Heritage Foundation

[Barry]

"The Michael Cannon post quoted is on the Cato Institute's blog, here."

I would say two things - first, we're seeing echos of 1992-4 here. The GOP's in bad shape, but the one thing which could make things worse is a successful Democratic president, so that's priority number 1.

Second, CATO is now an enemy of the Democratic Party, and Democrats in general. They've forgotten Bush before he left office, and clearly regard themselves as a GOP institution.

CATO delenda est.

[Dan S.]

" CATO delenda est."

Oh, sweet.

"e have a journalist supporting a provocative but (thus far) completely unsupported Marxist thesis followed by a Libertarian making a stupid comment. And so it goes."

Marxist-Libertarian cage fight! Whoo-hoo!!

(And anyway, we're gonna want some popcorn to go with teh leftover salt . . .)

[CaseyL]

Dan S and others: I think the classic 'conservative viewpoint is somewhat less purely predatory than you surmise. Remember, one of the basic differences philosophically between conservatives and liberals is their view of essential human nature. Liberals believe humans are basically good and perfectible; conservatives believe humans are basically sinners and always ready to cast off their responsibilities to sin some more.

Thus, economic structures that limit autonomy are 'good' because they control what conservatives see as the quintessentially bestial nature of humans. (This quasi-theological philosophy also allows for an entirely different morality for the rich and powerful, because the very fact that they are rich and powerful means they're favored by God, and so can be trusted to make their own rules.)

Because liberals believe humans are basically good, or at least seek to be good, they favor economic structures that allow for more personal autonomy, so humans can better grow into their theoretically perfect selves.

The problem with modern conservatism (as opposed to the classic variety) is that, in America at least, it has become unmoored from the idea that all of society is best served by keeping humankind's bestial impulses in check. I don't know what has replaced that in terms of philosophy, but in practice the result seems to be a whole-hearted embrace of a crypto-feudal viewpoint.

[hilzoy]

Neil: I went looking for the text of Kristol's memo, but couldn't find it either.

[Neil the Ethical Werewolf]

I just sent a message to Rick Perlstein to see if he knows where it is.

[JoshD]

I don't think conservatives necessarily fear a national health care system working so well that they lose power simply because they don't believe it would work well. I think conservatives do fear the system would work well enough so that the voters would fear changing it because they have become dependent on it even if it is subpar. See the third rails of Social Security and Medicare for examples of their thinking on this.

[hilzoy]

Neil -- if you find a copy, let me know.

[Gary Farber]

Von:

[...] Moreover, the history doesn't bear this out. The primary victim of Labour's rise wasn't the conservative party: it was the Liberal party.

[...]

There's no evidence of which I am aware that Conservatives lost whatever support they had from
'supposedly conservative workers and low-income people under religious and other influences'.

Labour, in the General Election of 1945, went from 154 seats and 38% of the vote to 393 seats and 49.71% of the vote. The Conservative Party went from 386 seats and 47.8% to 197 seats and 36.2%, but there's no evidence of Conservatives losing votes from the lower class? Where did these votes switch from? Mars?

(The Liberal Party went from 21 seats and 6.7% of the vote to 12 seats and 9.04% of the vote.)

"Labour's traditional support was (unsurprisingly) among union workers. That was true before 1945 and after 1945."

You can't be claiming that a 239 seat gain in the House of Commons was all due to new union members, but I don't understand what "history" you are referring to. Your assertion that most of the new Labour votes came from the Liberal Party, and not the Conservative Party, is wildly wrong.

[Gary Farber]

Hilzoy, some more of Kristol's old article is here.

[dj]

What JoshD said. The only thing worse than an expensive bad policy is a wildly popular expensive bad policy. (This from the POV of people whose minds are already made up that universal health care is a bad idea.)

This only reinforces hilzoy's point that they need to make their case more persuasively.

[jayann]

Was there some pool of pre-1945 pool of "supposedly conservative workers and low-income people under religious and other influences" who once supported the Tories but shifted allegiance to Labour?

Yes. But it didn't disappear in 1945. See, von, McKenzie and Silver, Angels in Marble (or Eric Nordlinger's work on this). In brief, historically, the UK had a very large hereditary manual labouring class and one third of that class consistently voted Tory (part of that was, I'd say, because of top-down welfare provision by One Nation Tories, part by the campaigns McKenzie portrays), after the death of 'Liberalism', anyway.

I agree the thesis, not IMO a Marxist one, is not all that well supported.

[jayann]

addendum (after reading Gary's comment): the Liberal Party was a 'Third Party' by 1929.

[wonkie]

There was a quote on Kos a day or so ago from a Republican Congressman from Tennessee or Kentucky describing the virtues of his conservative state: low wages, no health care, foreign investments.

If conservatives and libertarians had their way we'd be a bnana republic.

I'll see if I can find the quote.

BYW if Repbublicans are concerned that Democrtaic initiatives in health care would create third rate programs, why don't they put forth some policy suggestions of their own in staed of just functioning as obstructionists?

Oh yeah--McCain did. Well...

[mikkel]

"Conservatives would tend to hate anything that fostered workers' independence and a feeling that you weren't quite wholly under your boss's screw."

Don't forget higher education too...

Also this sums up the problems I have with the Republican party. It reminds me of this survey done in '07 that found Democrats had something like a 48%-44% advantage when policies were described and the party was attached, but a 55%-40% advantage when they were described without party attached.

This survey was done for Republican strategists and so of course the conclusion wasn't that their ideas were wrong (or at the very least they should focus on convincing people their ideas were right) but that they needed to hammer on party ID.

On the flipside you have someone like Andrew Bacevich which is super conservative but is so focused and accurate in his assessment of what's wrong that he has tons of liberal fans. If more Republicans were actually like him I think they could get a big chunk of the population to switch sides.

[Gary Farber]

"addendum (after reading Gary's comment): the Liberal Party was a 'Third Party' by 1929."

1924 was the big loss for the Liberals, when they went from 158 seats to 40.

1922, though, was when Labour first gained more seats than a then-divided Liberal Party. The most recent few elections prior to that were even more complicated sets of coalitions. But in 1910, the Liberals still had the most seats; it was over the next few elections that they disintegrated as a leading party. The Coalition of 1918 was ultimately rather fatal, and led to Labour as the primary Opposition.

[bob mcmanus]

70 years after Social Security, and 40 years after Medicare, here we are with massive inequality and a financial train wreck and 2+ wars.

Watch carefully. Yes, healthcare is important. What is equally important is who pays for healthcare.

A left that doesn't redistribute wealth will not retain the loyalty of the workers. As von says above, reactionaries will continue yo have their opportunities.

Liberals simply want well-tended productive peasants.

[Donald Johnson]

"Liberals believe humans are basically good and perfectible; conservatives believe humans are basically sinners and always ready to cast off their responsibilities to sin some more."

This may be a general tendency--certainly people say this all the time--but I think it oversimplifies things. Some of us lefties have a rather dark view of human nature--I want a nice large governmental safety net precisely because I don't know how much one can trust all the basically good humans to support the least well off without considerable prodding (myself included). And on human rights issues, the socialist Orwell had it exactly right in his "Notes on Nationalism". It takes a lot of conscious effort not to be a hypocrite on that subject--our ideology or self-interest or both tends to blind us to certain categories of atrocities. And some conservatives, IMO, pay lip service to the notion that we're all sinners--what they really mean is that people outside their in-group are sinners.

[Sebastian]

Yeah, that is dumb. I will support health care that is carefully crafted to avoid stupid incentive problems and which won't stunt research. I'm just afraid that isn't likely.

[CitizenE]

This sums up the current Republican/ Conservative conundrum. They are interested in tactics to remain in or return to power to serve their own agendas, whether or not their power or agenda serves the populace at large. That's fine for a while when things are going well, but when things go awry as they are right now, in a democracy, well the whirlwind such narcissism inevitably reaps will not be to a majority's taste. For the right to become relevant again, they need to become more adept at solving problems that the majority is concerned with, and this requires more than tactics for victory, but a strategy to move the entire nation forward. Liberals go in and out of power, and have foundered for decades now, but because they have long term strategies that benefit the populace at large long after they are out of power, in times like these the nation returns to their way of thinking.

[russell]

Liberals believe humans are basically good and perfectible; conservatives believe humans are basically sinners and always ready to cast off their responsibilities to sin some more.

Oddly, I share the conservative view of human nature. Too much reformed theology in my formative years, I guess.

I also share the conservative reluctance to throw off established institutions without very good cause, as well as the conservative preference for local, organic solutions to problems as opposed to large-scale, top-down, over-engineered ones.

So why am I a lefty?

I'm a lefty because whenever you really dig down into the positions held by modern American conservatives, it always ends up being about the money. Free market, road to servitude, blah blah blah. It's all about the Benjamins.

The social conservatives get to tag along, but the core motivation of the American conservative movement is keeping the world safe for the accumulation of very large amounts of wealth.

It's a corrupt, and a corrupting, basis for a human community, and for public life and policy.

There's more to human liberty than having no impediments on your ability to make lots and lots of money.

The premise makes no sense

The way we deliver health care in this country is wasteful and ineffective. We spend about 16% of GDP on health care, and that number is going up. For that money, we get mediocre results.

Spectacular health care is, in fact, available here, but only to people who have a lot of money.

Very good health care is available if you work for a company that can afford to provide it to you.

Otherwise, your access to basic health care ranges from just enough down to whatever you can get at an ER. A very large number of people fall in this last bucket.

If liberals can deliver a better solution, *of course* more people will support them. That's because they will be *doing a better job* than has been done for the last 30 years.

If conservatives didn't want that to happen, they should have produced a better result.

70 years after Social Security, and 40 years after Medicare, here we are with massive inequality and a financial train wreck and 2+ wars.

Leaving the wars aside, because I'm not sure how they are relevant to your point:

What did we have before Social Security and Medicare? And how did Social Security and Medicare create massive inequality and the current financial train wreck, let alone two wars?

Liberals simply want well-tended productive peasants.

mcmanus, you're a smart guy, but this is just nonsense.

Thanks -

[Dan S.]

"Where did these votes switch from? Mars?"

Hey, if you can't beat them with giant tripedal heat-ray-bearing war machines, might as well . . . um, vote Labour?

(CaseyL - will try to respond later, but have to catch train . . .)

[bob mcmanus]

"And how did Social Security and Medicare create massive inequality and the current financial train wreck, let alone two wars?"

They didn't create the problems, except by leaving intact a rentier class free to gamble on wall street and compete for profits overseas, but they didn't eliminate them either. Which is the point. Welfare capitalism is still capitalism, and will always be associated with war, financial disturbance, periodic reactionary swings (note,again, that von or sebastian aren't scared of the political effects of healthcare reform), and gross inequalities of wealth and power.

And funny how whenever I talk about how social programs should be financed, liberals act like I am advocating their elimination. These fear tactics are part of the bourgeios liberal toolkit to avoid substantive social change. Part of the liberal narrative is to focus on "individual responsibility" rather than contingencies and social conditions, and to blame Bush, Cheney and other "bad actors" for the last eight years. Hyman Minsky and the Socialists predicted our present predicament back in the 70s.

When I hear "Yah Health care Yah safety net" I know I'm being conned.

Get some massive redistribution, and you can have both health care and a likely end to wars.

[hilzoy]

I, too, tend to a dark-ish view of human nature. I could quibble about how dark, but the one thing I think is plainly, flatly false is that human nature is perfectible. And yet, strange to say, I am liberal...

[von]

Gary, you're off point: The thesis was that there was a realignment because of the NHS.

There is evidence, which you supply, that Labour won the 1945 election (pre-NHS) by a landslide. And that proves the thesis how?

[Gary Farber]

"Gary, you're off point"

I'm responding to your specific assertions. That I'm not responding to some other point you're interested in, I'm perfectly willing to grant. Are you still defending "The primary victim of Labour's rise wasn't the conservative party: it was the Liberal party," or not? Ditto "There's no evidence of which I am aware that Conservatives lost whatever support they had from 'supposedly conservative workers and low-income people under religious and other influences.'"?

[Gary Farber]

Oh, and to actually address your query, Von, the electorate overwhelmingly voted for Labour and Labour won in such a landslide because they campaigned for a near revolution (certainly as Churchill saw it, who claimed Atlee and Labour would need a "Gestapo" to enforce it) in changing to a complete welfare state, a National Health Service, and an explicit cradle-to-grave security from the state, including a guarantee of full employment. Surely if you're discussing this seminal election, you're familiar with these most elementary facts about it, so I don't understand what it is you're asking. You know they won on the Beveridge Report, right?

And this was a huge realignment in British politics, this Labour victory in 1945. Saying it wasn't "because" of the NHS seems like the narrowest of semantic wriggling if your only point is that it was only a huge part of the social welfare program of Labour. And if that's not your point, what is your point and claim?

[russell]

And funny how whenever I talk about how social programs should be financed, liberals act like I am advocating their elimination.

OK, I'll bite. How do you want social programs to be financed?

Thanks -

[OCSteve]

russell: OK, I'll bite. How do you want social programs to be financed?

Given the audience rating/participation for the kid that killed himself live on the Internet – I’d say make executions pay-per-view. $50 a pop. You’ll run a surplus. Man we are a sick people sometimes.

[AIMAI]

gary farber, oh thank you thank you for that cold shower of historical fact.

aimai

[Gary Farber]

Anyone can read from a nearly infinite choice of sources about the Labour victory in Britain in 1945, which is one of the most basic events 20th century British politics, but the summary below the numbers at the link I originally gave tells as good a short summary as anywhere. Evne more here. First-hand accounts. And, von, specifically, how the election was won on the middle class, written in 1948.

[Hartmut]

That Churchill wanted to prolong WW2 to kick the Soviets out of Easter Europe (with German help) may also have played a part (not the only of course).

[Gary Farber]

"That Churchill wanted to prolong WW2 to kick the Soviets out of Easter Europe (with German help) may also have played a part (not the only of course)."

Prolong the war? Not really.

Peacefully, yes, he didn't want the Soviets in Eastern Europe, but that's reasonable. If you mean he wanted to go to war with them in 1945, or 1946, or later, I'd ask you for some cites on that, because I don't recall anything of the kind. In the immediate aftermath of the war, he had no interest in fighting Stalin -- though he did earlier push for an Allied push to Berlin, but only fighting against the Germans. When he made his Iron Curtain speech in Fulton in 1946, he didn't call for war.

And later, well, here is a reasonable summary.

[yoyo]

WTF WTF WTF

Atlee's government lost power right after it created the cradle to grave welfare state. This idiot got his history totally wrong.

[RepubAnon]

So what the Republicans are saying is that they oppose national health care because:
(a) It would be good for the people of this country; and,
(b) It would be harder for Republicans to win elections.

What a bunch of pathetic losers.

[Anthony Damiani]

"CATO delenda est."

Oh, very cute.

[Michael Cain]

This sums up the current Republican/ Conservative conundrum. They are interested in tactics...

Exactly. The national GOP is being run by tacticians who are fighting every battle to its bitter end, whether or not that advances their long-term goals. If they could shake off the influence of the corporate interests, and decide that their goal is a simpler, less intrusive federal government that lets socially conservative states be socially conservative, well... that's a platform that played properly can get them a near-lock on 55-60 US Senate seats for a long time. There's 30 or so states that they care about, and 20 that they can just ignore.

National health care? When the new Congress convenes in 2009, introduce legislation that (a) makes Medicaid and SCHIP purely federal programs and roll them together with Medicare. In return, demand that the federal Dept of Education go away, and have states backfill the federal education dollars from their Medicaid savings. There isn't a state in the Union that wouldn't jump at that deal. And when it turns into single-payer? Under any national plan, and given the geographic distribution of wealth, the 20 states they don't care about are going to subsidize the 30 states they do.

Give the federal land holdings, excluding the National Park/Monument system, to the states in which the land lies. That alone can lock up control of the eight Mountain West states for decades. If you live "back east" where federal holdings are minimal, you don't realize what a big winner such a policy could be in the West.

With control of the Senate and an occasional President, slant the Supreme Court in the direction of reduced federal powers and increased state independence. Will enough voters in California really care if abortions are very difficult to get in South Dakota? Will enough voters in South Dakota really care that abortions are easy to get in New York?

Call it the "Two Americas" plan.

[Gary Farber]

"This idiot got his history totally wrong."

Which idiot?

"Atlee's government lost power right after it created the cradle to grave welfare state."

Atlee's government lasted through the 1950 election, and only fell in 1951, after Bevan and Wilson resigned because charges were being instituted for dental care and glasses, after the "austerity" budget, etc. (Labour also got a million more votes than the Conservatives, for what it's worth.)

The NHS was created by the National Health Service Act of 1946, based on the Beveridge Report of 1942, and the campaign of 1945.

[liberal japonicus]

Gary, Hartmut may be referring to Operation Unthinkable, though I don't know it that quite fits with what he suggested.

Going thru the wikipedia entry for Churchill, there was this that seems particularly apropos to the post

Churchill was appointed Chancellor of the Exchequer in 1924 under Stanley Baldwin and oversaw Britain's disastrous return to the Gold Standard, which resulted in deflation, unemployment, and the miners' strike that led to the General Strike of 1926.[79] ...

Churchill later regarded this as the greatest mistake of his life. However in discussions at the time with former Chancellor McKenna, Churchill acknowledged that the return to the gold standard and the resulting 'dear money' policy was economically bad. In those discussions he maintained the policy as fundamentally political - a return to the pre-war conditions in which he believed.[81] In his speech on the Bill he said "I will tell you what it [the return to the Gold Standard] will shackle us to. It will shackle us to reality.

Seems to be the same line of thinking as is discussed in the post.

[Gary Farber]

"Gary, Hartmut may be referring to Operation Unthinkable, though I don't know it that quite fits with what he suggested."

I don't see that it does, unless Hartmut was simply very careless with phrasing. "The plan was rejected by the British Chiefs of Staff Committee as militarily unfeasible." It was pure contingency, in any case. It also, if you read the document, contingent on "Russia allies herself with Japan."

I'm guessing you'll agree that the likelihood of that happening was minute? (For one thing, for that to even be a possibility, the U.S. would have had to have not succeeding in producing atomic bombs until at least a couple of years later, which would make attacking the Soviet Union even more impossible and "unthinkable.")

Churchill certainly wasn't happy at the idea of a Poland under the control of the U.S.S.R., given that the casus belli of Great Britain against Germany was protecting the independence of Poland, but he also was a realist and recognized that there was really nothing the Anglo-American forces could do beyond protest if the Stalin didn't live up to his promises.

[Gary Farber]

More on "Unthinkable," though. But I don't see it as construing a desire of Churchill to attack the Soviet Union.

(And the Siberian Intervention, which never got tons of talk in my lifetime, didn't exactly go swimmingly, fwiw. And that was with Japan on our side.)

[Gary Farber]

Last detail:

[...] The letter concluded: "By retaining the codeword "UNTHINKABLE", the Staffs will realise this remains a precautionary study of what, I hope, is still a purely hypothetical contingency."

[In the original draft, his final words were "still a highly improbable event", but this is crossed out and the new words written in his own hand in red ink.]

[bobbyp]

"If they could shake off the influence of the corporate interests...."

Some "if". Non sequitor? Non-starter? Nonsense? A refutation is superfluous.

[liberal japonicus]

A lot of this would hinge on what Hartmut was thinking, of which I am not privy to, but the fact that Churchill ordered the plan might be key.

I'd also note, apropos of nothing, that after the advisers gave their opinion on the general infeasibility of the plan, Churchill asked them to write up another plan for defending England itself, assuming that the Russians didn't stop and ended the letter with:

By retaining the codeword `Unthinkable,' the Staffs will realise this remains a precautionary study of what, I hope, is still a purely hypothetical contingency.

[Kenneth Almquist]

"So precisely because people would like it if they tried it, we need to make sure that it fails. At least they're honest about it."

Cannon isn't entirely honest about it, because he never acknowledges that Obama's health care plan would make things better. He quotes Norman Markowitz as saying:

"National health care [and other measures] will bring reluctant voters into the Obama coalition."

Here is the full quote:

"National health care, significantly higher minimum wages, support for trade union organizing, aid to education should all be on the agenda. These programs will improve the quality of our lives lives directly, giving us greater security and establishing the social economic changes that will bring reluctant voters into the Obama coalition."

The full quote makes it clear that Markowitz's conclusion is premised on the assumption that national health care will improve people's lives. Canon indicates he agrees with Markowitz's argument, which means he agrees with the premise as well as the conclusion. But you won't find the premise in Canon's article.

After reading Canon's post, I thought Hilzoy has misrepresented it. It's only after reading Markowitz that I could see that Hilzoy had nailed Canon's views exactly.

[yoyo]

[i]Which idiot?[i/]
I meant the article writer, not you Gary. Didn't mean to insult you.

And Labour didn't win again until '64. So i really don't understand how you can write an essay saying welfare state health care will doom the opposing conservative party and use the UK as your evidence. They hold power quite a lot after it was passed. doesn't that deny the thesis there?

[Gary Farber]

"I meant the article writer, not you Gary. Didn't mean to insult you."

Thanks for clarifying. (I'm an idiot sometimes, but I hadn't thought so in this thread so far.)

"And Labour didn't win again until '64. So i really don't understand how you can write an essay saying welfare state health care will doom the opposing conservative party and use the UK as your evidence."

My eye might have skipped over it, but I don't see that claim anywhere in the article. It's the headline that makes that claim, and periodical writers don't write their headlines. Only much more limited, and reasonable, assertions, such as "Passage would be a political gamechanger," and "Shrinking government would get exponentially tougher."

Chalk it up to an over-eager editor.

(And speaking of editors, "Republicans better earn to competently talk healthcare" should obviously be "better learn.")

[ThatLeftTurnInABQ]

"If they could shake off the influence of the corporate interests...."

Some "if". Non sequitor? Non-starter? Nonsense? A refutation is superfluous.

Not at all. I can spin a (what seems to me) mildly plausible scenario for that happening, albeit on a time scale of a couple of decades. The key is to understand two things: (1) corporate money picks their party, not the other way around (i.e. they don't have permanent friends, but rather permanent interests), and (2) the Dems and the GOP have effectively switched places with one another since the 1860s, and now have regional bases similar to what they each possessed in the late 19th Cen., but with the labels swapped. This means that aspects of our past political history can recur, as in the following scenario:

1. The Obama administration is very successful [note: we should be so lucky!], enough to cement a new Democratic majority. The 2008 election becomes for the early 21st Cen. what the realignment election of 1932 was for FDR and the mid 20th Cen. Dems.

2. Corporate interests abandon the GOP as the party is confined to a regional ghetto in the states of the Confederacy and the High Plains + Utah and Idaho which effectively deny it a voice in national policy making. The Democrats become the party of large corporations and monied interests, just as the then dominant GOP did in the 2nd half of the 19th Cen.

Basically money migrates towards power - note that this is already happening with the shift of hedge fund originated political contributions in favor of the Dems in the last several election cycles. What began under Clinton + Rubin continues, and will likely accelerate if the GOP is frozen out for the next couple of election cycles.

3. Eventually the GOP seeks to break out of this trap using populist rhetoric and class warfare from below, in alliance with lower class voters outside of their SE regional base, just as the Democrats did in the early 20th did under Wilson and FDR.

You can already see this trend germinating with the populist and anti-corporate rhetoric used by Mike Huckabee in 2008. Expect more of it in the future.

[russell]

The national GOP is being run by tacticians who are fighting every battle to its bitter end, whether or not that advances their long-term goals. If they could shake off the influence of the corporate interests, and decide that their goal is a simpler, less intrusive federal government that lets socially conservative states be socially conservative, well...

You know what? If you caught me on the right day, you can sell me your Two Americas plan.

Let the social conservatives fight for their righteous Kingdom of God dream in their own states and leave the rest of us the hell alone.

My guess is that not everyone who lives in, frex, Missouri actually wants, frex, to live in a place that is by law a Christian state.

Not everyone who lives in, frex, South Dakota will want, frex, an absolute ban on abortions.

Etc etc etc.

But by all means let them fight the noble fight on their home state turf, and get out of the hair of the rest of us.

Thanks -

[JeffB]

Imagine if Obama facilitates solutions for both healthcare and energy independence. That will pretty much leave the 'Pubs with the fundies who think abortiom and gay marriage trump the economy and national security as critical issues.

[Carleton Wu]

Give the federal land holdings, excluding the National Park/Monument system, to the states in which the land lies. That alone can lock up control of the eight Mountain West states for decades. If you live "back east" where federal holdings are minimal, you don't realize what a big winner such a policy could be in the West.

I dunno, I live in one of those states, and think that this drastically overstates the impact of such a plan. It might be popular with ranchers (but they're already getting a heck of a deal from BLM). It won't matter much to hunters, fishers, and other avid outdoor enthusiasts (who are already enjoying the national forests via their federally-funded road system quite nicely). It might be popular with some resource-extractors, if they can get a better deal from the state than from the Feds (state reps are cheaper than Congresspeople)- but they, like the ranchers, are usually getting a pretty good deal already.
Being in the "avid outdoor enthusiast" category, Id be against this- status quo is great for outdoorspeople, so the only possible change is negative (ie more resource extraction with less mitigation).
The only rationale I can see for thinking this would be a big move would be psychological impact, and even if it had a large one those tend to go away pretty quickly.

[Mr Parsifal]

All kidding aside wouldn't you want to be covered by some sort of plan, either private or public?

[Hartmut]

Re: Churchill
I can only refer to some German history books that say that Churchill proposed "to give the Germans* back their rifles" to drive Stalin back to Russia, that that proposal got public and was not very popular with the war-weary British public. An influence on the elections is either hinted at or even explicitly stated by the authors (including Sebastian Haffner who was a great admirer). I have no primary sources at hand (e.g. newspaper editorials).

*i.e.German POWs

[von]

That I'm not responding to some other point you're interested in, I'm perfectly willing to grant

I honestly have no idea what the hell you're getting at, Gary. You seem to have mistaken the forest for the trees, and then decided that you'd rather discuss ketchup. That is, you make no sense.

And this was a huge realignment in British politics, this Labour victory in 1945. Saying it wasn't "because" of the NHS seems like the narrowest of semantic wriggling if your only point is that it was only a huge part of the social welfare program of Labour. And if that's not your point, what is your point and claim?

OK, now you've moved from the bizarre to the disingenous. My disagreement was with Norman Markowitz's argument, which is, "After the Labor Party established the National Health Service after World War II, supposedly conservative workers and low-income people under religious and other influences who tended to support the Conservatives were much more likely to vote for the Labor Party when health care, social welfare, education and pro-working class policies were enacted by labor-supported governments."

Do you see the disconnect?

[von]

Jeebus, Gary, I've now read your ouvre on my single post (the main point of which you appear to concede). You seem to suggest that I was less than clear in my challenge to the claim the passage of the NHS resulted in a realignment. (Not, as some of your posts suppose, that Labour didn't campaign in the NHS as part of its landslide-winning victory in 1945.) I don't know how I could have been more clear. Let me try to put it this way:

Leaving aside Tony Blair, the Conservatives did quite well after passage of the NHS, even substantially reforming the NHS under Thatcher -- reforms that persist through today. There's no evidence of which I am aware that Conservatives lost whatever support they had from "supposedly conservative workers and low-income people under religious and other influences". Indeed, I don't even know what category of voters this refers to: "other influences" seems to be a pretty broad category.

Oh, wait. That was from my original post.

von

* From the post that you purportedly read and responded to: "Leaving aside Tony Blair, the Conservatives did quite well after passage of the NHS, even substantially reforming the NHS under Thatcher -- reforms that persist through today. There's no evidence of which I am aware that Conservatives lost whatever support they had from "supposedly conservative workers and low-income people under religious and other influences". Indeed, I don't even know what category of voters this refers to: "other influences" seems to be a pretty broad category."

[Jesurgislac]

von: Leaving aside Tony Blair, the Conservatives did quite well after passage of the NHS, even [systematically underfunding] the NHS under Thatcher -- [systematic underfunding] that persist through today.

Fixed that for you.

FWIW, the point at which my great-aunt, a middle-class Tory through-and-through, decided she'd never vote Conservative again was when a local hospital she knew well was sold off for the value of the ground it had been built on: she knew the value of the NHS (she was 38 when it was founded) and resented the Conservative attacks on it more than almost anything else.

FWIW, also, the key effect on making urban working-class people vote Conservative under Thatcher has always been said to be her decision to let council tenants buy their council houses in the 1980s.

Where I grew up, if you were a working-class Catholic you reliably voted Labour - but then, where I grew up, if you were working-class, you reliably voted Labour, especially since the Tories shut down the steel industry, the coal industry, the shipbuilding industry, and pretty much all the other highly-unionized industries. I'm not sure religion made much of a difference at all.

[jayann]

The NHS was set up in 1948. But that really isn't particularly relevant to Attlee's defeat in 1951. Labour would not regain power till 1964 but the NHS had become entrenched: a Butskellite consensus on welfare ruled till, I suppose, about 1970, election campaigns comprising boasts about (NHS) hospital building, and Old Age Pension rises. (That's in partial reply to von's point about Conservatives doing well after the NHS was set up.)

Further to von

There's no evidence of which I am aware that Conservatives lost whatever support they had from "supposedly conservative workers and low-income people under religious and other influences".

There is clear evidence, and rather a large amount of it, of a) the Conservatives losing ground among "working class Tory" voters, b) the demise, in large part, of that particular group ("deferentials"), c) (but) a massive fall in the size of the manual working class. (Religion is not totally irrelevant albeit it probably played a very small part in working class voters' behaviour.) Indeed Labour could never have won had it not captured some of that working class vote given the class's size (then) and the strong attachment of one third of it to the Conservative Party.

I doubt the comparison with Obama, however, I agree that the following is unexceptionable

if Obama succeeds in passing health care, then people who might have been conservatives will like it, and will be more likely to vote for the people who passed it

unless the Republicans behave like British Conservatives (prior to Thatcher and after 1997), i.e., pragmatically.

[Gary Farber]

"I can only refer to some German history books that say that Churchill proposed 'to give the Germans* back their rifles' to drive Stalin back to Russia, that that proposal got public and was not very popular with the war-weary British public."

Those German history books seem to be clearly wrong. At least, I see no reason to believe otherwise, absent some documentary evidence.

Von: "That is, you make no sense."

I have no idea what problem you're having with the fact that the 1945 election was won on the basis of creating the NHS, and a cradle-to-grave welfare system. What doesn't make sense?

"Do you see the disconnect?"

No. "...conservative workers and low-income people under religious and other influences who tended to support the Conservatives were much more likely to vote for the Labor Party when health care, social welfare, education and pro-working class policies were enacted by labor-supported governments..." is perfectly true. What's the problem?

"Leaving aside Tony Blair, the Conservatives did quite well after passage of the NHS, even substantially reforming the NHS under Thatcher...."

Um, yes, who claimed that the NHS, et al, forever locked Labour into power? Yes, 30 years later, Thatcher was in power. So what?

"There's no evidence of which I am aware that Conservatives lost whatever support they had"

Not "whatever support they had." Just a lot of it for quite a while, with a lot of residual effect. That's all.

See also what jayann wrote. You seem to be contesting very simple, commonplace, accepted-by-all observations about modern British political history.

[Geoff Robinson]

Better parallel is Australia. Labor govt elected in 1983 introduced national health insurance. Conservatives opposed it but were never able to present an effective and fiscally viable alternative. This contributed to Labor's record string of election victories in 1984, 1987, 1990 and 1993.

[bc]

If you get sacked, you don't lose your health care.

COBRA covers this situation except in cases of gross misconduct. It just means you get to pay the employer's portion as well as the individual portion.

I want a nice large governmental safety net precisely because I don't know how much one can trust all the basically good humans to support the least well off without considerable prodding (myself included)

This, IMHO, is an important distinction between most well-intentioned liberals and well-intentioned conservatives. I personally think charitable giving would increase if we discontinued turning huge social programs over to an inefficient government. Liberals disagree. We're stuck in this middle swamp with the government already paying huge amounts towards health care but not yet a nationalized health care system.

BTW, and as a somewhat relevant aside, lack of giving was the most notable portion of Obama's tax return-the almost complete lack of charitable giving before running for national office ($1,050 in giving on AGI of $259k in 2002; $3,400 on AGI of $238K in 2003; $2,500 in giving on AGI of $208k on 2004, etc.) Those, frankly, are sorry numbers to one allegedly committed to helping the needy in our country.

BYW if Repbublicans are concerned that Democrtaic initiatives in health care would create third rate programs, why don't they put forth some policy suggestions of their own in staed of just functioning as obstructionists?

Better parallel is Australia.

I realize these comments are unrelated but they are to me. I don't have the economic expertise to know whether the following would work, so I invite responses:

I pay $395 to insure my family of seven under an HSA plan. We were "tier IV" due to my daughter's heart surgery 13 years ago, just re-rated to tier II.

When I switch to a $7,500 deductible next year, I will pay around $200 per month. Great coverage if something really bad happens, but I have to pay that whopping deductible. Huge incentive to only go when I need services.

Australia has national health care, but when I was there on vacation a few months back, I noticed all the advertisements for supplemental plans. It got me thinking . . .

What is is the level of health care we as Americans think should be provided? State-of-the-art health care when I graduated from high school in the 80's was pretty darn good. Some of the costs are for the cutting-edge stuff.

So why not provide 80's or 90's care as a base allowing for supplemental plans? That would costs a lot less. And why not combine them with some sort of HSA-like incentive to not go to the ER for every little sniffle like the uninsured do now? The government could provide the basic premium for low wage earners (and a portion of the deductible as well) and at the same time provide some sort of economic incentive like I now have to avoid the ER. Perhaps, say, that the money in the HSA account would belong to the individual after a certain number of years (as my deposits are treated if they are still there down the road now, which hasn't yet happened due to braces).

To me, the incentive to only go to the doctor when needed is the beauty of HSA plans and why they are so affordable. Nationalizing health care as it is typically used today by those on full-coverage plans (go whenever you want; get cutting-edge services) would be prohibitively expensive.

[liberal japonicus]

I personally think charitable giving would increase if we discontinued turning huge social programs over to an inefficient government.

It is not simply a question of where the money comes from. If money is budgeted, one can make plans. Things like herd immunity and early detection occur because there are much larger social programs than would be done with charity. One of the keys to reducing costs is providing preventative care rather than incentivize to have people wait until the absolute last minute.

btw, the Healthcare economist has a series of posts of various systems around the world with various details.

[Phil]

BTW, and as a somewhat relevant aside, lack of giving was the most notable portion of Obama's tax return-the almost complete lack of charitable giving before running for national office ($1,050 in giving on AGI of $259k in 2002; $3,400 on AGI of $238K in 2003; $2,500 in giving on AGI of $208k on 2004, etc.) Those, frankly, are sorry numbers to one allegedly committed to helping the needy in our country.

May we see your numbers, please?

[Slartibartfast]

Here, Phil.

Interestingly, the last couple of years were completely omitted from bc's account. Which makes sense, them being inconveniently five-digit.

[Phil]

No, no, I meant can we see how much bc has given to charity? Since he believes it should be the preferred mechanism of helping the underprivileged and all.

[russell]

bc -

A couple of quick comments on your post.

COBRA does allow you to continue your health insurance after you're laid off, but as you note you have to pay the whole nut. When I was laid off in '04 it was in the neighborhood of $1K a month for me and my wife, for a good but not exceptional BC/BS plan.

I'd be curious to know what the average level of charitable giving actually was before any of the "safety net" stuff we have now was put in place. If anyone can find stats, I'd be grateful.

Finally, I think the idea of only going for health care when you're sick is a really bad idea. That's the way people go from not feeling so good to being really, really sick.

What we want to incentivize more than anything else is regular, preventive care. Both for everyone's health, and to save on cost.

If you only go to the dentist when you have a tooth ache, you're going to end up with no teeth. And a twice-yearly cleaning and checkup costs a hell of a lot less than filling every tooth in your head.

If you only go to the doctor when that occasional cough turns into something chronic, you die of lung cancer. A buddy of mine is dealing with that now.

People, in the main, are not that fond of going to the doctor. Folks who have coverage that offers, frex, a $10 or $20 co-pay for an office visit just do not spend their time visiting their doctor.

There are much more entertaining ways to spend $10 or $20.

Seriously, creating disincentives for people to get basic, routine preventive care is just going to make a lot of people sicker.

And *really* finally, it's said quite often but it bears repeating -- the reason uninsured folks go to the ER is because they have no other place to go. I don't spend a lot of time in ER's, but I've been in them occasionally over the years, including recently, and I don't see a lot of folks there for sniffles.

Thanks -

[JanieM]

Russell: I'd be curious to know what the average level of charitable giving actually was before any of the "safety net" stuff we have now was put in place. If anyone can find stats, I'd be grateful.

It would be interesting to have some numbers, but I wonder how easy it really is to compare the averages for different eras.

Based on my mother's stories of growing up during the Depression, for instance, it seems like a lot of the ways in which some people helped other people would have been far under the radar of what we would now call "charitable giving."

This may be more relevant to rural places than to towns, though: my mother's memory is that rural people like her family (widowed young mother raising 2 kids) had it easier in many ways than people in cities, not least because they could have big gardens. Then again, my dad's family lived in town and they managed to have a pretty big garden too. It was a town, though, not a big city.

Was it charitable giving when the railroad company guards looked the other way while the boys snuck in and stole a little coal off the boxcars late at night....?

Off on a tangent now...back to work.

[Gene2]

Part of the problem with national healthcare is an epistemic one, which will lead us to keep it till eternity. Suppose currently, X amount of new medical innovation is produced. After we enact national healthcare, say Y < X is produced. We can't do a controlled experiment in which we have two identical copies of the world, one with nationalized healthcare and one without to prove that nationalized healthcare is what caused a decline in innovation. So, once we get nationalized healthcare, there's no piece of evidence that its opponents can use to prove that it was a bad idea. Because people will always be able to explain away the decline from X to Y amount of innovation. Of course, perhaps 70 years down the line, some economists will be able to use some nice econometrics to show that nationalization did indeed cause the drop. But, 70 years of damage have been done.

Just look at US welfare policy before 1996.

[russell]

Based on my mother's stories of growing up during the Depression, for instance, it seems like a lot of the ways in which some people helped other people would have been far under the radar of what we would now call "charitable giving."

Yes, I think that's right.

My guess is that a lot of helping out that people do now, likewise, never finds its way onto an IRS schedule of deductions.

I'm always puzzled by the idea that people don't, or won't, contribute to charitable efforts because we have whatever level of social safety net that we do have.

Do people not contribute to food banks because welfare exists? Or to shelters because funded housing is available?

When someone asks for help, do they say "Sorry, I gave at the IRS"?

I don't know the answers to these questions, I just find it odd that they even come up.

Thanks -

[bc]

slartiInterestingly, the last couple of years were completely omitted from bc's account. Which makes sense, them being inconveniently five-digit.

I didn't overlook them. I said "before he ran for national office" and I might add before his run for national office created any sort of interest in his autobiography which created the millionaire who could THEN, and only then, find it in his heart to give to charitable causes to any great degree.

But I'm going against my position to not criticize the president-elect until he gives me cause to as President, so I'll shut up now.

Finally, I think the idea of only going for health care when you're sick is a really bad idea. That's the way people go from not feeling so good to being really, really sick . . .

I agree. But an HSA plan provides for preventative care. However, there is an incentive to only use the health care when needed (even if for prevention) and to keep yourself healthy. I do agree that the economic incentive can be viewed as a disincentive to not seek early care and I am open to early screening and detection programs in general. Certainly there could be adjustments for such things as they save money in the long run anyway.

[bc]

I'm always puzzled by the idea that people don't, or won't, contribute to charitable efforts because we have whatever level of social safety net that we do have.

I feel the same way yet that seems to happen all too often. Such people do not realize that the social safety net includes each of us and whatever efforts we are willing to personally give in terms of time and money apart from the taxes we pay.