Commentary on Policy and Politics–which includes pretty much everything
Mike Koetting’s career has been in health care policy and administration. But it has always been on the fringes of politics. His first job out of graduate school was conducting an evaluation of the Illinois Medicaid program for the Illinois Legislative Budget Office. In the following 40 years, he has been a health care provider, a researcher, a teacher, a regulator, a consultant and a payor. The biggest part of his career was 24 years as Vice President of Planning for the University of Chicago Medical Center. He retired from there in 2008, but in 2010 was asked to implement the ACA Medicaid expansion in Illinois, which kept him busy for another 5 years.
The 1968 advice of Mr. Robinson’s associate to Benjamin Braddock was all too correct. Plastics was the future. In the 50-some years since Mr. Robinson prognosticated, the world has produced more than 8 billion tons of plastic.
Less obvious on a day-to-day basis, but still receiving considerable attention, is the damage to wildlife, particularly marine wildlife. My seven-year old grandson was almost crying when he saw pictures of various creatures struggling with plastics. “It just…just isn’t fair,” he said, barely choking back tears. “It isn’t the animals’ fault.”
In almost everyone’s list of the reasons that Hilary Clinton is not the president of the U.S. is the Electoral College. As we all know, Clinton won the popular vote by almost three million votes (2%) but lost in the Electoral College, 304-227. The usual argument suggests the number of low-population red states–that get disproportionate influence because of the way votes in the Electoral College are distributed–threw the election to Trump.
men look at constitutions with sanctimonious reverence, and deem them like the
ark of the covenant, too sacred to be touched…..But I know that laws and
institutions must go hand in hand with the progress of the human mind. As that
becomes more developed, more enlightened, as new discoveries are made, new
truths discovered…institutions must advance also, and keep pace with the
Not surprising from Jefferson. He was a man with boundless
interest in and reverence for discovery, science and the empirical
understanding of human nature.
About 15 months ago, I had a series of posts on immigration. The issue has not gone away. In fact, Trump continues to bang the drum loudly on the all too plausible belief this is an issue that not only animates his core base, but slightly extends it to people who are genuinely concerned about this issue. The truth is that immigration is a real issue for both political parties, but a difficult and complicated one that can not be solved with slogans.
A recent article by David Frum in The Atlantic lays out the terms very clearly. This article is
must-reading for anyone who wants to talk about immigration. It is a
thoughtful, nuanced set of considerations, but essentially comes down to the
question of whether it is possible to maintain a country and a set of national
values without having borders and a common definition of citizenship.
As even occasional readers of this blog know, I think of myself as a reasonable guy who, biases and predilections notwithstanding, tries to see both sides of most policy arguments.
So I am uncomfortable with my growing sense that Republicans
have strayed so far from reasoned policy that they no longer deserve much
benefit of the doubt. I understand this attitude is potentially bad for
democracy. There is something inherently objectionable to me about broadly
discounting most of what one of our major parties says. But, and I didn’t get
here lightly, I think that is the point I have reached.
This is more than Donald Trump. It is a problem that started
when Richard Nixon decided to create a power base for Republicans by wooing
those populations left behind when Democrats, belatedly, started to take the
position that the situation of blacks was inconsistent with the stated goals of
This is the final post in my series on government workers. The
last two posts have addressed government jobs, particularly federal jobs, in
general. This post will focus more on government jobs at the higher end of the
education spectrum. Generally speaking, these jobs require some specific
expertise, are leadership/management positions, or both. As a society, we focus
a lot of attention on political jobs, but we don’t pay much attention to jobs
at the top range of the bureaucracy. Failing to get the appropriate people in
these positions is as potentially dangerous as electing the wrong politicians.
(See Michael Lewis’ new book, The Fifth Risk.)
You don’t have
to work very hard to find someone willing to criticize government workers, for
instance this investors’ newsletter dismissing the hardship of government
workers during the shutdown:
Let’s remember who we are talking about here. While there are
certainly plenty of hardworking, dedicated federal workers, they are, for the
most part, incredibly pampered. They get better pay and more generous benefits
than private sector workers doing the same things.
Complaints about government worker pensions are ubiquitous,
particularly here in Illinois where the pension system has been horribly
But I think there is a shortage of clear thinking on the topic. I
would make two fundamental points:
Maybe the problem is not in the government
sector, but in the private sector.
The net impact of moving good jobs to the
contracting sector contributes to other problematic trends.
The recent shutdown of the federal government got me
thinking again about something that has been on and off my mind for about 20
years, the state of government workers.
I started thinking about this one day in a class I was
teaching and it dawned on me that the students sitting in front of me had never
been alive when attacking government wasn’t the predominate mode. They were
raised in an era, as Ronald Reagan put it, not only was government not the answer,
but it was the problem. While it is possible that they grew up in houses that
offered a broader view, it is impossible to escape the society-wide attitude
that, even at its best, there is something suspect about government. (My niece recounts
a classmate at the Kennedy School saying in class: “Private industry is always
more efficient than government. Everybody knows that.”)
The government shutdown got me thinking again about the
longer-term problems of this attitude. This is the first of three posts on the
topic of government workers and the broader society.
Inevitably, people are starting to talk about 2020.
Many people I know—which is to say older people who will
under absolutely no circumstances vote for Trump—are worrying that the
Democrats are tending too far left. My advice: “Chill out!’ And It’s not just that
this is all ridiculously far-way—although it is. Unless the Democrats lose
their collective mind, I am not worried by this.
I consider myself progressive, but more of a gradualist. I supported
Clinton over Sanders. I have many concerns about the policies proposed by those
further to the left. But so what? As economist Brad DeLong points out (in a
interview by Zack Beauchamp, strongly recommended): “The
baton rightly passes to our colleagues on our left. We are still here, but it
is not our time to lead.”