Katrina recriminations: Blame federalism!

A mostly political Weblog.
Sept. 5 2005 5:21 AM

Faster Katrina Recriminations

Blame federalism!

(Continued from Page 4)

dropped a bomb by rejecting federalism and thus rejecting the constitution of the Kurdish-Sheat alliance putting the current ruling parties in a difficult position.
Sistani in his statement said "The Sunnis are your family. Stay by their side this time so that they stay by your side in the coming times…"

I can't find anyone else picking up on this report, so it may be epistemologically challenged. ... Wait! The Al Mendhar article has reappeared  with a new URL. It's listed on the Al Mendhar home page too. But shouldn't it be a banner headline?. ... P.S.: Juan Cole is apparently alluding to that story when he writes:

Despite a poorly sourced English-language report from an Iraqi newspaper, it is certain that Sistani strongly supports the new constitution, which says that the parliament may pass no civil legislation that contravenes Islamic law.

That's not the most iron-clad refutation I've ever read. But we'll see. ... 6:26 P.M. link

Spotty:Andrew Krepinevich's "oil spot" strategy may or may not be a good way to fight the war in Iraq. But Eduwonk thinks it's a good way to pursue education reform:

Instead of just supporting often isolated politicians who are constantly under attack or fighting hopeless guerilla warfare inside bureaucracies, establishing some oil spots in big cities, winning victories, and establishing some proof points ...

Wasn't that what Milwaukee was supposed to be--the "proof point" for school choice? ... In truth, I'm not sure the oil spot strategy works that well when you are confronting geographically pervasive, deeply entrenched bureaucratic interests, as opposed to mere armed insurgents. In manufacturing, for example, the "proof point" that relaxed work rules could produce high quality American goods was supposed to be GM's Saturn subdivision in Tennessee. In fact, Saturn succeeded. But the result wasn't that the Saturn model spread to other GM (or Ford) plants. The result was that the rest of GM--union and management--mobilized to make sure that Saturn got killed off as quickly as possible, a project they've almost completed. ... Similarly, the most successful welfare reform effort of the 1990s was Wisconsin's W-2 plan, with its public jobs component. Have other jurisdictions rushed to emulate W-2--as I, for one, expected? Not that I've noticed (with the exception of Guiliani's New York). ... 2:13 P.M. link

Cheap Dates at The New Yorker: Does Malcolm Gladwell believe that all health care copayments are a bad idea--an inappropriate invocation of the theory of "moral hazard" (i.e. the idea that if you have health insurance you'll consume more health care)? Should we all have first-dollar, no-copay plans like some UAW workers? If so--and Gladwell criticizes copayments as low as a $20 copay for a doctor visit--isn't he making more than an argument in favor of universal health care coverage? He would seem to be making an argument against many, perhaps most, of the universal health care coverage systems that have been proposed, which rely on copayments and deductibles to hold down the cost--including (I'm pretty sure) Hillary Clinton's plan. Gladwell might have a) explained this to his readers and b) either pointed out that this means universal health insurance will cost much more than people currently think, or else described an alternative means of cost control. Plus, even if copayments do discourage people from seeking benefiicial care, shouldn't Democrats be happy to settle for a cheaper universal health system with copays, at least as a start? ... 

On the other hand, why burden New Yorker readers with these complexities when you can just bash Bush's Health Savings Account plan?

P.S.: I'm willing to be convinced that copays discourage necessary care along with unnecessary care. But the assumption that they discourage mainly unnecessary care is not "plainly absurd," the position attributed to John Nyman, the University of Minnesota economist whose book Gladwell is discussing.** If people "go to the doctor grudgingly, because we're sick"--i.e. because we conclude we're sick--you'd think we could also conclude rationally when we're more sick and when we're less sick, when we really need of a doctor's visit (and never mind the copay) and when we have a cold we'll get over soon enough (so let's save the $20).  The anti-copay argument is hardly proven by pointing out that people with full insurance don't spend all their time at the hospital, or that --as Uwe Reinhardt puts it in Gladwell's article, "Moral hazard is overblown." "Overblown" isn't the same thing as "nonexistent." ... 

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