At the heart of the healthcare challenge, a question of money in politics

When Congress and the President set out to remake the American healthcare system at the start of 2009, they were missing one pivotal ingredient: independence. Six months into the debate and with the August recess looming, the prospects for enacting sweeping reform that meets the needs of 50 million uninsured Americans, and millions more who forego basic care, are fading fast. And not for a lack of good intentions.

We believe that real reform of our nation’s healthcare system is floundering for one simple reason: lawmakers in Washington cannot afford to ignore the millions of dollars in healthcare industry money that goes to fund their campaigns.

Consider the numbers. Since the start of 2009, healthcare industry groups–including health insurers, pharmaceuticals, and HMOs–have contributed nearly $20 million to federal candidates and parties, according to the nonpartisan Center for Responsive Politics. Combined with the $150 million in 2008 industry contributions to elect our current leaders, and over $500 million in lobbying expenditures in 2008-2009, that puts the healthcare industry at the top of the special interest pyramid alongside Wall Street banks.

And their giving has been anything but haphazard. In nine of the last ten cycles, industry groups gave more to the party in power. Members serving on key congressional committees with jurisdiction over healthcare reform received the lion’s share of industry contributions, an average of $171,000 per cycle, compared with $87,000 for non-committee members. In a climate of rising campaign costs, where incumbent Members of Congress must raise a million dollars or more to keep their seat, it is little wonder that industries with the means and incentive to contribute large amounts are seated at the front of the room. And the public pays the price.

To get to the heart of America’s healthcare challenge, we must end the longstanding system of pay-to-play politics by fundamentally reforming the role of private money in federal elections.

This Thursday, July 30th, the Committee on House Administration will hear testimony on a new plan to do just that. The bipartisan, bicameral Fair Elections Now Act (HR 1826), introduced by Congressmen John Larson (D-CT) and Walter Jones (R-NC), would put an end to special interest contributions in favor of small donations and matching public funds. If passed, the Fair Elections Now Act would represent a major departure from current fundraising practice.

For candidates, the process is simple: show that you’re serious by collecting at least 1,500 individual donations from your constituents in amounts of $100 or less and you will be rewarding with a 4:1 match in public funds and a grant to jumpstart your campaign. For voters, it means that your voice and your small donation will be worth just as much to the incumbent as that of special interests. For the nation, it means a real commitment to core principles like fairness, competition, and accountability.

Seven states from Arizona to Maine, and more than a dozen municipalities from New York to LA, have already shown us that Fair Elections can have a real impact on whether and how we address our most pressing national priorities. The time for Congress to assert its independence from the healthcare lobby and other special interests by passing real reform is now. With the help of millions of citizens standing up for Fair Elections, such change will come in 2009. The future of American healthcare depends on it.

Daniel Weeks is President of Americans for Campaign Reform, a national nonpartisan campaign for publicly financed federal elections chaired by former Senators Bill Bradley (D-NJ), Bob Kerrey (D-NY), Warren Rudman (R-NH) and Al Simpson (R-WY).
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The Sorry State of Our Ship of State

Every time we wake up and look around, we find another example of how our society has become completely dependent on systems, standards, and complex technologies for the fundamentals of daily living.  While hardly anyone understands these systems, we are all asked daily to simply trust everything and proceed blindly through our lives.

This brings to mind the story of a magician who went as an entertainer on a cruise ship.

Another passenger on the cruise had brought his pet parrot. Whenever the magician performed his tricks of hiding/losing things, the smart-ass parrot spoke up saying “It’s under the chair. It’s under the chair”. The magician, understandably, was not crazy about the parrot. Four days out the ship hit a rock and sank. The magician and the parrot found themselves facing each other, clinging to a piece of flotsam. The parrot stared quizzically at the magician and finally said: “Ok, so where is the boat?”

The question facing our society today is: “What can we trust to help us when the ship is sinking?”

Consider this short list of some of recent disturbing events that have shaken mass confidence in how our world works:

–One volcano in Iceland erupts and completely breaks down air travel between Europe and the United States for over a week;

–One deep offshore well in the Gulf of Mexico unleashes perhaps the biggest oil spill in history, putting at risk much of the Gulf of Mexico and its marine life, and the livelihoods of thousands;

— The government of Greece for 20 years fails to take steps to adjust its economy and social costs to its national income, causing the rest of Europe to bail them out to save the Euro.

–A momentary, but nearly galactic, breakdown in securities markets gives investors everywhere pause about the reliability of the systems they trust with their savings.

–A simple snowstorm of about 3 feet shuts down a good deal of the East coast for about a week.

— The near collapse of the US and World economy brought on by a bubble of housing prices and the bankruptcy of one of the major US investment firms.

–Everyone has experienced hearing “sorry, we cannot help you, our computers are down!” And what happens when everything we depend upon in our computers is in the ‘cloud’ and IT goes down?

—Listening to “Car Talk” on the radio makes clear that almost no one any longer knows how to fix their car because they do not have the faintest idea how it works.

That is a short list of 8 items – who can’t add their own tales of woe in the face of failed technologies or faulty systems?

What it boils down to is that our advanced modern civilization is increasingly ill-equipped to cope with the world we live in, unless that world functions perfectly.  The inevitable bumps in the road (or ships run aground) leave us stranded, threatened, and seemingly helpless.

As is evident in viewing the National Museum of Natural History’s  current exhibit on the Evolution of our human species, our forbearers, when hit with catastrophes, simply regrouped (smaller in numbers no doubt) and quickly returned to hunting prey and gathering berries.  They understood the systems on which their survival depended, and were well-equipped to carry on after adversity.

Our modern fellow men and women, on the other hand, would be in for quite a rude awakening if robbed of electricity, transportation, communication and fully-stocked grocery shelves for even a short period of time.  Our penchant for panic, driven in part by our dearth of survival skills, makes our prehistoric brethren look positively advanced in comparison.

Should we be introducing “outward bound” training in all our schools to equip people for that kind of world? I doubt it. So, what can we do to equip ourselves, our children and grandchildren to deal with such bumps in their lives?

I guess first we have to teach them to be fatalistically-optimistic. But, we also need to teach/train them how to recognize problems that they should be able handle, if they properly anticipate and prepare. I have in mind, in particular, their developing a culture and system that constantly seeks a fundamental political will to deal with foreseeable problems well in advance of their actual occurrence, for example the inevitable American version of what just happened in Greece.

To do that, we need to work on educating people first to understand the modern world and how it works (and doesn’t).  From there, perhaps, we can rebuild a trust in the modern world, and the confidence of people to be able to rely on more than a simple hope that the sun will always come up bright and shiny every morning.

If we can do that, our grandchildren may NOT, while they are holding on to the flotsam in their future, have to say:

“Ok, so what happened to our Ship of State?”

Philadelphia Here We Come

The flip side of a coin that says “if it ain’t broke, don’t fix it”- says “but if it is broke, you gotta fix it”

Despite the ultimate success and passage of health care reform, nearly all Americans still agree that “the system” is broken, though there is no unanimity on exactly what is broken, as the health care Donny brook appeared to illustrate.  There surely is no consensus about what the fixes need to be. And, poll after poll makes clear that many of the biggest issues in the modern world carry a significant preponderance of public support contrary to and despite quite a limited minority of the population which holds hostage such issues through some contrived interpretation of constitutional law.

There are some minor, partial fixes in the works such as [1] Senator Schumer’s current bill to dampen the effect of the Supreme Court’s Citizen’s United decision to allow corporate campaign giving by requiring corporations to disclose contributions to all their shareholders, [2] plans for public funding of elections, [3] universal federal registration to vote, to name only a few. But, taken as a whole they would not appear to add up to a systemic solution.  And, the aggregated cost of those efforts probably would exceed the costs of a comprehensive attack on all the problems at the same time. As the military say, it helps to concentrate firepower to get a job done.

How did we get here and why is the system broken?

It began way back at the beginning of the founding of our Republic.

In the late 1700’s as the original 13 states were forming, counties were also forming. The standard used to size most counties was how far a person could ride a horse out and back in a day. The reason was that was the obvious practical limit a county executive could cope with in those days.  Perhaps this is an apt metaphor for changes since then in today’s world.

Of major significance, when the ‘founders’ were designing Congress, they gave the House of Representatives  2 year terms to keep its members closest to the changing sentiments of the public. Today, because of redistricting/gerrymandering which began early in the game, about 85% of all 435 House seats are basically 60/40 for one or the other major parties. So, today the House has become less sensitive to changing political winds, except on very rare occasions. Thus, today the 1/3 of the 100 Senate seats that turn over every 2 years have become the more important barometer and instrument of political change.

Some of the controversial issues that have divided and stymied the system are:

—-In 1800 the biggest controversy, besides general arguments over states’ rights, was slavery.

—- It was not until the 1830’s that Chief Justice Marshall finally gave real meaning to federalism, as well as the role of the Supreme Court, with his fundamental view that the Commerce Clause of the Constitution overrode  conflicts between the States.

—-In 1800 the issues now known popularly as “ right to life vs a woman’s choice” was not even imagined nor was women’s’ vote.

—-The right to bear arms was still thought of in Revolutionary War militia terms not personal gun control.

—–The idea of and term ‘filibuster’ had never been uttered.

——Though we have been a debtor nation from the beginning, Keynesian economics about all the benefits of deficit spending was 100 plus years in the future.

——Citizen mobility in 1800 was very limited and except for Presidential elections voting was primarily local in nature.

—– Newspapers were everywhere and virulent. Ahead lay telegraph/phones, TV and the Internet as well as the overwhelming power of money in politics.

In short, though our country has been well served for most of the 200 plus years since the Constitution was completed, the modern world has become such a very different place that the original rules for governing are not working well enough in the today’s world.

Perhaps the biggest general problem we faced in the past and still face today is how to allocate the largess of the Federal treasury. Until very recently that challenge was how to equitably distribute the ever increasing wealth of the nation. Today with the shrinking apparent size of the globe we are facing what appears to be shrinking domestic wealth and pie.

Historically the country as a whole appears overleveraged. It only ‘appears’ that way because when we inevitably begin to grow again, virtually all mainstream economists guarantee us that our national debts will rapidly shrink again as they did most recently in the 1990s.  In the meanwhile the leverage of capital throughout the whole economy that accompanied the internet and housing bubbles makes fiscal conservatives very nervous that the consequences of financial overextension will threaten our national foundations. In all events in the meanwhile, there will be serious reductions to citizens’ benefits by budget deficits at the city and state levels, where budgets are required by law to be balanced yearly and thus restricted. Accordingly, the federal government must pour on its spending in part to insure that local budget problems do not put too much drag on local economies that might further retard essential renewal of growth.

We have to find some way to manage our fiscal affairs, through a slow recovery, with some combination of [1] continuous stimulus [2] more deficit spending and [3] targeted taxes which do not starve investment.

Our present governing system is highly unlikely, in a timely way, to achieve those needs, since legislators, who naturally reflect the anxieties of their constituents, will have a very hard time bringing themselves to do and live with the tough things like more deficits and taxes.

The foregoing is admittedly a long windup, but is essential to presenting and understanding the following quite radical pitch.

The radical, but very serious, idea is to consider a new “go” at a constitutional convention to make some adjustments to reflect today’s world. The alternative is to struggle along with a series of partial, temporizing fixes which are very unlikely to really do the big job, or simply wait for a fearsome revolutionary fervor to force our hand, which would be a lousy time to try to get things right.

Futile many will say– may be? Daunting everyone should say– yes!

Many people already say that without Washington, Madison, Jefferson and Adams, etc. the great founding fathers, it will be virtually impossible to imagine a new beginning. Granted, it does seem that way, but we must also remember that they became great, as we see them now, in part because they took up the challenge of their time, persevered and succeeded.  We have plenty of talent in the country today ready for a call to be put to work, and have a chance to become refounders.

A new generation of “greats” positively can arise and be identified and ultimately celebrated.

This is an opportunity of our lifetime to again lead the county back to Philadelphia and launch an effort to address all the problems/issues in a systemic, coherent way that are plaguing the changed modern world.

At this moment it is hard enough to try to list the problems that need to be addressed; it is next to impossible to imagine at this stage what the solutions could be. But, that is not reason enough to throw up our hands in frustration. In fact it is THE very reason why we need a truly representative, well run civil convention to unlock the way ahead.

It will only take time, a lot of money and leadership. That’s all!

Around 5 Billion Dollars and about 8 years could produce a new blueprint to address the unbelievable future potential this country possesses. That potential will not only get us out of debt, it will keep us ahead of the rest of the world in global strength and standard of living for a very long time.

It will take the equivalent [or more] of a Presidential campaign—a 50 state organization, an army of scholars and experts, polls, public education and endless speeches and even more patience.

A legacy as a leader of a second founding is simply begging for someone who has the wherewithal to say: “What are we waiting for?”