Sunday, March 28, 2010

Me and Scott Brown's Mom: How I Took Down a Fence, Sparked the Tea Party Movement, and Almost Killed Health Care Reform

In the winter of 2003 my wife Christine and I purchased our home from the Brown family. At that time George Bush was President, health care reform was a distant dream, and Scott Brown toiled in obscurity. On that day, as we signed those papers, we had no way of knowing what would transpire in days ahead. We had no way of knowing how our fate would intertwine with that of the Brown family. We could not know how our rash decisions in the years to come might endanger the health of this great nation. Now we know. Only now, can this story be told.

That fateful winter the Brown family was divesting their holdings in Portsmouth following the untimely death of Scott Brown's Grandfather. Their lands were substantial. Standing in what is now our yard, members of the Brown family could look out in any direction and rightly say that everything they laid their eyes upon belonged to them. The houses are in there pretty tight. You can't really see very far. Nonetheless, such a sight must have instilled in the Browns a sense of majesty and pride. Unless they were looking through the window at the pile of black trash bags and the random metal step ladder the tenants kept in the dining room. That was not so majestic.

This corner of Portsmouth was the Land of Brown. It has been thus for many a generation. The sale our home was held up due to a title dispute. Some great ancestor had been willed a portion of the land in the 1860's. The land hadn't been bought or sold since. The lawyers had to locate the papers lost during the Civil War before the sale could proceed.

Proceed it did. We moved into our first home and set about repainting, renovating, and making it our own. This was a time of transition for the Brown family as well. They sold most of the property in the area keeping only the duplex behind our our house as a rental unit. With the substantial income generated by the sale of these homes members of the Brown family would have the opportunity to follow their dreams. An ambitious Brown might have found the means to go into politics, become a nude model in a woman's magazine, or buy a truck.

Looking back now, I can see that the years that followed were, for us, a time of peace and stability. A contributing factor in the neighborhood tranquility was an lovingly constructed but decaying set of white picket fences that ran along each of the property lines, separating all the homes and duplexes. Those who know me best may not be surprised that I purchased a home with a white picket fence. They might also suspect that the painting and maintenance of such a fence is not a task I approach with a lot of energy or enthusiasm.

It was during the fateful spring of 2008 that we decided to take down the back fence. Many have questioned our motivation in this. But our reasons were simple. We had a fence on our property. And we didn't want it. The previous summer, the neighbors had all collaborated on a coordinated fence painting project. The Browns declined to participate claiming the fence was ours to maintain. Considering this and the property line, Christine asked me if we might take down the fence. We would have a more pleasant view from the back porch. Our children would have more space to frolic with their friends and neighbors. I said "Ummm. Sure." The die was cast. Saws and crowbars were deployed. The fence came down. 

For a time the decision to take down the fence seemed like the right one. The new view was an improvement and the neighborhood boys enjoyed multi-family nerf battles. But the good times would not last. Within two weeks Scott Brown's Mom discovered the section of fence had been removed. She was not amused.

Christine observed Scott Brown's Mom examining the space where the fence had been and went outside to confer. My wife was met with a flood accusation. Scott Brown's Grandfather had constructed that fence with his own hand. Why would we tear down a perfectly good fence? Like the Little Tailor confronting an angry giant with a piece of cheese, Christine tore off a chunk of fence remnant with her hand and presented it to Scott Brown's Mom. Scott Brown's Mom was not intimidated by this show of strength. Neither was she convinced of the fence's imperfection. She stormed off cursing our names. We knew she would return.

The men came the next day. They inserted thin metal posts in the ground and attached a 4 foot tall, bright orange, thin, plastic snow fence that ran the full length of the property line. The new fence was an abomination. It came be known as the Fuck You fence. It was a flimsy eyesore that mocked us with it's vastness, it's pointlessness and it's cheapness. It served no aesthetic or protective purpose other than to say "fuck you" to all who gazed upon it.

I placed a call to Scott Brown's Mom seeking to negotiate a settlement between our warring factions. Sadly, the call was not returned and the stand-off continued. For weeks we endured the tyranny of the orange snow fence. Then, one day, we looked out. The Fuck You fence was gone.

That same day, Scott Brown's Mom returned. Christine saw her exploring the fenceless void. Once again she went out in the spirit of inquiry and to extend a neighborly hand. Christine was subject to yet another verbal assault. This one was even more violent, sustained, and expletive laden than the last one. The orange snow fence had not been deliberately taken down by Scott Brown's Mom. It had been dismantled. This was vandalism. Sabotage.

Scott Brown's Mom found the orange fence rolled up on the ground. She tossed it into her car and departed in a storm of rage and recrimination. This would not be the end. This crime would not go unavenged. The police would be looking into this matter.

No doubt the fine officers of Portsmouth Police Department heard about the severed snow fence. They committed all the resources to the investigation that a crime of this severity warranted. And they must have conducted their inquires with great cunning and discretion as their presence went undetected by all.

Within the neighborhood, the case was the subject of intense speculation. Who would dare to perform this brazen deed? Who could have snuck out and struck down the dreaded fence in the dead of night? A thorough canvasing of the neighbors was conducted as well as a full forensic investigation. My son held up a thin strip of orange plastic before me. "Look Dad. This was cut. With scissors." The culprit was never identified.

The new fence was erected within the week. This fence would not be so small or flimsy. Nor would the new fences be constrained by the dimensions of the missing segment. Soon the house behind ours was wrapped end to end in a 9 foot stockade, creating the general impression of a frontier fort meant to repel Apache. But it wasn't quite as ugly as the Fuck You fence.

With the lines of demarcation so firmly established, tranquility returned to the neighborhood. We thought this would the last time we would have to concern ourselves with the Browns. But, of course it wasn't the end. It was just the beginning. 

During the winter of 2010 the nation was embroiled in a great debate about reforming the countries patchwork, expensive health care system. Contributing to that debate was a small but very vocal group of radical right-wing pseudo-revolutionaries that called themselves the Tea Party. At that time Scott Brown was a Massachusetts State Senator. Following the death of Ted Kennedy a special election was being held to determine who would fill the seat of the Lion of the Senate. Scott Brown aimed the win that seat. The Tea Party prepared to rally behind him.

At first glance, it is surprising that hard-line members of the Tea Party would make common cause with a moderate Republican like Scott Brown. The Tea Party was violently opposed to health care reform. Scott Brown has been an advocate and supporter of the Massachusetts health care reforms that had become the model for the national system. What could they possibly have in common?

That winter the Tea Party risked obsolescence. Without an electoral victory they would be forever branded an insignificant fringe movement. They were propped up by partisan media executives that hyped and magnified their every utterance. But their message was incoherent. Their numbers small. And they were seen as beholden to the paranoid ramblings of a crackpot television show host. If they could be seen as crucial to victory in Massachusetts it would catapult them to national prominence. More than anything, the Tea Party was enraged by what they saw as the systemic destruction of the barriers, carefully constructed by the Founding Fathers, between the rights of individuals and the powers of government. They turned to someone who was similarly enraged about the careful dismantling of barriers erected by fathers. They turned to Scott Brown. The Tea Party wanted victory. Scott Brown wanted revenge.

As a state senator Scott Brown's powers dissipated at the New Hampshire border. In the United States Senate he might hold the power to stop health care reform. From this mighty perch he would be able to strike our health, our pocketbook, and our ideals. His formidable will combined with the power of the Tea Party proved unstoppable. He won the election.

But would Scott Brown be too late to stop health care reform? In the weeks before the special election the reform bill had already passed the US Senate with an overwhelming majority. But Scott Brown was sure the Democratic majority would want to try and pass it through the Senate again. This time he would be waiting. With Scott Brown, the Republicans had a 41 seat super-minority. If they stood together they could not be overwhelmed. Heath care reform would be totally impossible. Because lots of people on television said so.

Panic ensued among Democrats and health care reform advocates. Suddenly the dreams of health care reform seemed to be unobtainable. The plan of Scott Brown and the Tea Party was working perfectly.

Just when it seemed that all hope was lost, a Democratic strategist discovered a little-known procedure called "reconciliation". This obscure parliamentary provision has only been used before by every single session of Congress to pass nearly every major piece of legislation in the past 30 years: including the Bush tax cuts, COBRA, and Medicare expansion. It was a bold  gambit but it might just work. They tried it. It worked. Health care reform became law. Scott Brown would not have his revenge.

Are we safe? Or is it just a matter of time before this feud changes form and the battle is joined anew? Even as I write this words, I cannot say what the future will hold. I don't know what fate awaits me, my family, or health care reform. Will we ever be able to extend a hand across the barriers that come between us? I fear there are some rifts that can never be repaired.

Monday, March 22, 2010

Finally, Health Care Reform

They passed it. The President will sign it. The Senate will debate and pass the clean-up "reconciliation" bill. But, mostly, the drama is behind us.

This law is the most significant piece of legislation in decades. It is also far less sweeping than it's critics claim and fear. It is comprehensive, smart, and essential reform. It is not a government take over of health care.

The irony is after a year of arguing and endless hour of debate and breathless news coverage, most Americans have little concept of what the law will actually do. This is a strange by-product of the process. The bill's broad framework has remained consistent, but the details have always been a moving target. In the media, and especially from the right-wing media, there been a relentless focus on the daily talking points, conflict, partisan hyperbole, and politics over policy. Misinformation crowded out information from the beginning. So, it bears repeating what this law will actually do.

 The core components of health care reform are:
  • Private insurance companies can join health care exchanges that will be able to sell insurance nation-wide.
  • Health insurance companies will not be able to reject individuals because of their health history.
  • Some people who don't have health insurance will get a tax credit to help purchase it.
  • There are a number of policies and pilot programs aimed at controlling health care costs.
  • It will be paid for by extending the %2.6 Medicare surcharge to include income greater $250K.
Most Americans will see no significant change to their health care insurance, to their relationship with their doctor, or to their taxes. For most Americans this is no big deal. Health care reform is a big deal for the uninsured, for people (like my family) who buy individual insurance, for anyone who loses their job, or wants to change job, or wants to start a new business, and for anyone dealing with chronic illness. The safety net just got stronger and wider.

This is also a big deal for anyone who cares about the effect of rising health care costs on their personal, state, local, and business finances or who cares about the national debt and deficit.

 For anyone craving more detail about what this law will actually do, I'll direct you to the excellent Ezra Klein who explains it all in great clarity and detail.

 Unlike the policy details, the politics of health care reform have probably gotten too much attention. Nonetheless, I'll offer my thoughts.

 A nice summary of the politics of health care reform comes from Lamar Alexander's comments during the President's conference:  

'Your stories are a lot like the stories I hear. When I went home for Christmas after we had that 25 days of consecutive debate and voted on Christmas Eve on health care, a friend of mine from Tullahoma, Tennessee, said, "I hope you'll kill that health care bill."
And then, before the words were out of his mouth, he said, "But we've got to do something about health care costs. My wife has breast cancer. She got it 11 years ago. Our insurance is $2,000 a month. We couldn't afford it if our employer weren't helping us do that. So we've got to do something."
And that's about -- that's where we are.'
Lamar's friend from Tullahoma captures the sentiments from the right and much of the American electorate. Reform opponents have been so vigorous and relentless in demonizing health care reform that even those who need it most, and who will benefit the most when it become law, are terrified and angry about it.

It is my hope that when health care reform becomes law some of the smoke will clear. Americans will realize that these are sensible, centrist reforms that provide great benefit to all Americans at relatively modest cost. It's my hope that the American people will realize that the tales of tyranny, taxation, redistribution, rationing, death panels, and government takeover bear little resemblance to the policies being enacted into law. It's my hope that people will recognize who has been feeding them this pack of lies and stop listening to them. And stop voting for them.

 The President and the Democrats should celebrate this victory. They should be proud of it. They have succeeded against mighty opposition from every quarter. They have prevailed where many have failed. This is good policy. It is also good politics. Victory polls better than defeat. The juicy sausage will be much more popular than the sausage making. I'm grateful for my own representatives Congresswoman Carol Shea-Porter and Senator Jean Shaheen. Both of them stood tall through it all and kept their promises to all of us.

Yes, we can.

Sunday, March 21, 2010

(GDW) Failure is Not an Option: Storytelling in Video Games

The only disappointing Christmas that I can recall is the year everyone got an Atari 2600 and I didn't. I think my mother still gets guilt pangs. She shouldn't. In the nearly 30 years since then I've more than made up for any lost hours of my youth that weren't spent staring at a flashing screen.

I was there at the birth of video games and never stopped playing. They retain their allure and continue to consume embarrassing amounts of my free time. Over the years the games have grown. I remember when moving around white blocks was the height of sophistication. Today characters can leap from rooftop to rooftop and freely explore a simulation of 15th century Florence modeled in astonishing scope and detail.

As the technology has improved video games have started to come into their own as a storytelling medium. Their promise is that these are interactive stories. Rather than just observing the story unfold you can inhabit the character. You are the hero.

Interactivity is the secret to the magic of video game stories. It is also its bane. The author of a book or film has complete control over their protagonist. The hero follows the author's arc without fail. Video game designers walk a fine line between telling the story they wish to tell and giving the player freedom to steer their own path.

The task of the game designer is further complicated by the limitations of technology and the complexity of human relationships. Entire cities can be modeled and populated with all manner of objects and individuals. But actually establishing a non-trivial relationship between the inhabitants of this virtual world is more difficult. Worlds can be simulated. People are much harder.

The byproduct of this constraint is that designers typically choose points A and B and constrain players to deciding how dispatch the hordes of enemies found in between. The questions of whether and why they journey is taken is out of the players hands-- as is the relationship between the player and characters met along the way. The player controls the action but not the plot. Love, revenge, betrayal, hope, fear, loss and growth may be components of the story. Rarely can they be chosen or avoided. They are simply watched.

In most every game you are called upon to perform some heroics and save the day. A good game will work to set the stakes and ratchet up the tension. Inevitably, failure in not a option. And this is literally true. The story and scenes progress until all adversity has been overcome. When you fail, you go back and do it again until you succeed. Boredom, frustration, tedium, and abandoning the story to go do something else are all options. Failure is not an option. A good game will end with enough spectacle to create a sense of accomplishment. But since perseverance was the only criteria, victory feels hollow.

The idea of interactive stories holds immense promise. I spend so much time with computer games because even the limited interactions of games have a powerful allure that non-interactive media such as books, movies, and television can't match. But I recognize the older forms as vastly superior storytelling mediums. For now.

Some game designers are pushing against the medium's limitations for character and story development. They endeavor, within the structure of the game and hero's journey, to include options and questions of morality, romance, friendship, and loss. In my next post I'll look at what the best of them are doing and explore how to do it better.

Part of the Game Design Workshop series.

Game Design Workshop

In addition to politics and policy another obsession of mine is gaming. Board games, card games, computer games. I play a lot of games. I spend a lot time thinking about games in general and aspects of game design in particular. Like any true gamer I've got some words of advice for the people making games today.

To further feed the gaming beast I'm starting a new feature on this blog: the Game Design Workshop. This will be an intermittent series where I'll analyze some aspect of a particular game, pitch game designs and explore the arcane art of making something fun.

Posts in this series will be marked GDW in the title. I'll keep this post updated with links to the other posts in the series.

Posts in this series:

Failure is Not and Option: Storytelling in Video Games
Building a Better BioWare Game

Saturday, March 13, 2010

Tales of My Tax Return

It's tax time. Last week I was preparing for the annual day of reckoning with my tax preparer. She is a charming Obama-volunteer who generally reckons the government owes us a sizable rebate check. So it's not such an unpleasant experience. But it got me thinking. For all my writing and arguing about taxes (it's slavery!) how much attention do I really pay to my own tax rates? Does anyone? Do you know how much of your income went to taxes last year? I had only a rough idea and I'm guessing I'm not alone.

We're a reasonable stand-in for the average, affluent American family. We've got two incomes (software architect and public school reading tutor), two kids, and own a house. We're doing well but aren't exactly independently wealthy.

Let's run the numbers:
% of our income paid in federal income tax: 12.7%
% of our income paid to social security and medicare taxes: 6.8%
% of our income paid to state and local taxes (mostly property because we live in NH): 3.6%
% of our income paid to medical costs (insurance premiums and expenses): 10%

% of our income paid to all taxes combined: 23%
% of our income paid to all taxes plus medical: 33%
There's some data. I won't try to draw any grand conclusions. Well, maybe one:

If this country got universal health care, and my family got a 75% income tax increase, we would still come out ahead.

Tuesday, March 9, 2010

FBB Part 4: Health Care

Critics of health care reform claim that now is not the time for it. With massive deficits and in the midst of a serious recession this is the wrong time to reform our health care system. President Obama has said the opposite. "Put simply, our health care problem is our deficit problem. Nothing else even comes close." The president is correct.

For more than a decade, private health care costs have had an average increase of more than 10% per year. The federal Medicare program cost $217 billion in 2000 and accounted for 2.3% of GDP. 10 years later Medicare cost $453 billion which is 3.5% of GDP. For the government, medical costs are growing faster than then economy. For the private sector it is worse.

Rising medical costs wiped out median income growth over the last 10 years despite rising productivity. Employers are cutting back on medical benefits they can no longer afford and passing the extra costs onto their employees. State budgets are swamped by rising Medicaid expenses. Municipal budgets are being squeezed.

We need to control rising health care costs in this country. That won't happen without comprehensive reform. Here, the status quo can not help us. Things are bad now. On our current path they continue to get worse. Much worse.

It may seem impossible to reign in medical costs. But many other countries manage to attain similar outcomes and life expectancy at half the cost. The nice thing about having a bloated, inefficient, patchwork system with few market incentives, local monopolies and inadequate cost control is this: There's room for improvement.

As a first step we must enact the health care reform bills before Congress today. Making affordable health insurance available to all Americans is a moral imperative. It will be an achievement worthy of celebration. It is also essential to control cost. Broader access to insurance will mean fewer emergency room visits, fewer medical bankruptcies, and fewer unpaid medical bills that get passed on as cost hikes for paying customers. Giving Americans access to a national health care exchange will provide more options and break local insurance monopolies. Eliminating exclusion based on health care history will mean health insurers will no longer be able to compete via risk management. They will no longer make profits by finding healthy customers and barring those that might get sick. Health insurance companies will be forced to compete by providing superior products at attractive prices. Instead of competing to keep away sick people they will have to learn to efficiently take care of them.

Beyond the basics of the bill, authors of the health care reform bill deserve a lot of credit for their thoroughness and dedication to creative cost control. The bill introduces market-based reforms such as price transparency. It includes a number of technical measures designed to reduce cost without cutting benefits. And much of the bill's frequently-maligned bulk comes for a host of pilot programs and experiments. These are designed to be tested on a small scale before the most successful ones are implemented and replicated nation-wide.

This is essential reform. We cannot afford to let it fail.

There are critics from across the ideological spectrum who say the cost cutting measures in the health care reform bill are insufficient. They may be correct. The current effort is an indispensable step. It it a giant leap forward. But really taming health care cost inflation may require we do even more.

There is a deep divide between the left and the right on the proper solution to health care cost inflation. Reformers on the right claim the insurance model itself is the source of the problem. Because consumers of care are separated from its cost they consume more than they otherwise would. People over-utilize and overpay because the bill is paid by someone else.

Reformers on the left point to model used in Europe, and Canada, and well, most every country on Earth. The public health is treated as a public good. The government provides for the health care of its citizens and manages the cost. It can control cost via massive purchasing power and regulatory authority.

If it to comes to Health Care Reform Part II (Secret of the Ooze?) the recommendation from Bank Slate health care economics team is that the American solution should borrow from both the left and the right. Do both. The government should offer a variety of public options and Medicare buy-ins. Some of these options should control cost aggressively. Some public plans should be less constrained. All plans should be priced to consumers to reflect their actual cost. Private health insurers should also be free to offer HSAs, high deductible plans, and other options that do more to put health care choices (and cost burdens) in the hands of consumers. Everyone gets their mandate. Poor people get their vouchers. Americans get to vote with their dollars and their feet.

Of all the budget problems we face, rising health care costs pose the greatest risk to our nations financial health. The one thing we can least afford to do is nothing at all.

Part 4 of the Bank Slate Federal Budget Blueprint series.

Thursday, March 4, 2010

FBB Part 3: Military Budget

Part 3 of the Bank Slate Federal Budget Blueprint series. The goal of this series is to make realistic recommendations that would allow the US to balance in the budget within 10 years. The basic tenants of the the Bank Slate Federal Budget Blueprint are:
  • The year 2000 should be used as a policy baseline. Tax and spending policies should be reset to the levels and rates they had in 2000.
  • Any policies enacted since 2000, that we wish to keep, need to be funded.

In the year 2000 U.S. military spending was $311 billion. Ten years later, the US defense budget has more than doubled and stands at $685 billion. Included in the $685 are the operating costs of the wars in Iraq and Afghanistan. That number does not include other defense-related spending such as Homeland Security and Veteran's Affairs. If those are included, total defense spending hits $1 trillion.

In 2010 defense spending in the US will be roughly equal to the combined military and defense spending of every other country on Earth.

Despite the massive expenditures, elements of the US military have been overextended by 7 years of war in Iraq and Afghanistan. Army, Army Reserve, Marine, and National Guard units have all been called up for multiple overseas combat deployments. Both of our ongoing wars have been plagued by the fact that our resources (primarily troop counts) have been insufficient given the magnitude of the missions. We've needed more, not less.

And then there's that $1.56 trillion budget deficit. What to do?

If there's one lesson to be drawn from the wars of last 60 years it is this: The age of empires is over. Historically, a great nation could increase its power and enrich its citizens via military conquest. In recent decades, in Vietnam, Afghanistan, Chechnya, Lebanon, Afghanistan (again), Iraq, and around the world insurgencies with minimal funding have been able to draw great nations into pointless, bloody, protracted stalemates. "Victory", if it comes at all, comes with a price well in excess of its value. The conquering of nations no longer serves anyone's economic purposes and may no longer be viable for anyone. Global economic interdependence makes conventional warfare between nations increasingly pointless and its likelihood increasingly remote. We have the power to destroy any nation's armed forces, but there is not much call for it. We lack the capacity to pacify any country at a price worth paying.

After a decade of asking to US military to do more and more with more and more it's time to change our motto. The military should be asked to do less with less. We should maintain our conventional superiority, but we can do this with less than we have now. We should recognize that militias, gangs, and warlords can wreak localized havoc and be prepared to be a strong and active partner in peacekeeping and stability operations. We should recognize that large scale military occupation and nation building is a fruitless activity that comes at great cost, and not much benefit to the American taxpayer.

The 2010 budget allocates about $128 billion to the wars in Iraq and Afghanistan. We should continue the withdrawal from Iraq this year. We will add more troops the Afghanistan this year. But we should follow through plan to begin withdrawing troops and winding down the war in 2011.

The baseline budget for the military should be maintained at around $550 billion and left there for the foreseeable future. End the wars in Iraq and Afghanistan and avoid new overseas adventures. Freeze the remaining budget at current levels. With inflation and economic growth this will mean, effectively, a slow reduction in spending. Without a blank check, the military will have do a more rigorous analysis of our actual needs and adjust expenditures appropriately. Years of spending increases have gotten us to a $1.56 trillion deficit. More and more is a luxury we can no longer afford. It is also something we no longer need.