Maybe it's another sign of the news establishment's impending demise that so many of the most interesting features and analyses come from unexpected outlets. I've mentioned in the past the schizophrenia of New York magazine, which offers obsessive coverage of "Gossip Girl" and which rich assholes are summering where alongside some of the sharpest coverage of local, state and national politics you'll find anywhere. Just as unlikely is Esquire, which seems to devote most of its institutional resources and print/virtual real estate to ogling the likes of Megan Fox but saves a chunk of the remainder for really insightful analyses and features on public affairs. Currently on their site are interviews with two of the higher-profile politicians currently between jobs: Howard Dean, former Vermont governor, presidential candidate and Democratic National Committee chairman, and Jeb Bush, former Florida governor and possible future presidential candidate. The Dean interview is probably more substantial, focusing exclusively on the prospects and politics of health care reform; the Bush interview is mostly of interest in what it tells us about the current state of the Republican Party.
Dean makes one point that's occurred to me for awhile now, and that I wish pro-reform Democrats would voice as insistently:
ESQ: What about rationing?
HD: I don't think there will be rationing. I think what there will be is elimination of unnecessary stuff, and there is a lot of it. There is no rationing in Medicare.
ESQ: But they do ration in England, don't they?
HD: Here's what they do in England. Let's say there is a very, very expensive cancer drug that will extend your life on average by four months. They may not pay for it. The reason they won't pay for it is that they know they'll have to cut back pediatric visits if you do. Is that rationing? Sure. But we ration in America today. If you are one of the 47 million people who don't have insurance at all or if you're someone who has a lousy plan because you can't afford a good one, that's rationing by price. I'll tell you who rations. It's the private insurance groups. This ridiculous nonsense that the right-wingers are talking about, that public insurance will put a bureaucrat between you and the doctor — that goes on every day in the system we have. But only in the private sector. It doesn't happen in the public sector. I have never had, in my 10 years of practicing medicine, a Medicare bureaucrat call me up and say, "You can't do this and you can't do that." But that used to happen every day with the private insurance companies. You'd beg to have your patient have this drug or that procedure.
Emphasis mine. The argument "against" rationing is really an argument on behalf of the rationing we have now. I guess it feeds back into the basic American idea that somehow anything that anyone has, he or she earned, so it's un-American to take even the slightest bit of it from that person to give to someone less deserving. That this is both demonstrably irrational and harmful, in so many ways, to the society as a whole, doesn't seem to weaken the notion in any serious way.
Sadly, Dean's tenure at the DNC probably rendered him too polarizing for a job like HHS secretary or "health care czar," either/both of which he would have excelled at. But if he can exert pressure from the outside on wavering Democrats to push for deeper reforms, including the public option, that's of value too.
Then there's Jeb Bush. I kind of hate to admit it, but one of the best things about this interview is the interviewer, Tucker Carlson. On TV, he's an intolerably smarmy bag of douche, but the guy also has at least something of a real journalist about him. His asides are entertaining, and (in other parts of the interview, not this excerpt) he asks Bush some tough questions and pushes him with follow-ups.
Okay, give me your forty-five-second pitch for a Republican future.
[Bush outlines four points, speaking for more than fourteen minutes. It's worth noting here that after two years out of the governor's mansion, Bush seems a little out of practice at this interview business.]
We need to empower people to be taking advantage, to turn their fears into opportunities in a variety of different areas. It seems to me four areas of greatest concern right now, outside of foreign policy, which is a whole other subject. [On education.] Are we educating our kids properly? Are enough of our children gaining the power of knowledge in the current system? The answer is unequivocally no. So we should have more school choice, we should have more pay for performance, we should be raising standards, not lowering standards, we should embrace technology in a radical way, we should have "seat time" eliminated.
[Timidly.] Seat time?
You show up for 180 days, you graduate. It should be based on what you learned... People learn differently. It's a simple fact that our education system ignores.
We're living in a world now where in order to create high-wage jobs, you have to have knowledge-based workers. There is no way to do that unless they have the basic building blocks of being able to think abstractly, understand math and science, be able to read, maybe once in a while express a thought in a three-syllable word, preferably do so in more than one language, and have a sense of history, because it has this crazy way of repeating itself. I don't think our education system in America is acceptable right now.
At the least, I give all the Bushes credit for good intentions on education reform. Remember that Old Bush wanted to be the "education president"; he was the first president to push for national standards (which, by some measures at least, are closer than ever to becoming a reality). Even Dubya had a very defensible idea with No Child Left Behind; it just didn't have enough teeth, a symptom of his characteristic failings as a manager and uninterest in the details of governance. In Florida, Jeb did more to align education, from pre-K through college, with the imperatives of the labor market (a big hobbyhorse of mine) than probably any governor this side of (now-Senator) Mark Warner in Virginia. He knows this stuff, he finds it interesting, and he's not particularly dogmatic about it; at one point, Carlson notes that Bush is a great admirer of Arne Duncan, Obama's secretary of education.
There is, of course, some of the characteristic Bush dickishness as well. He peevishly (and inaccurately) declares that his brother was as popular as Obama in his first months in office, puts all the blame for the "big government conservatism" he deplores on Congress rather than Dubya, and blasts Obama for the "unprecedented expansion" of government without even acknowledging that said expansion might have come in response to a real need. When you're a Bush, maybe the risk of home foreclosure or losing one's health insurance just doesn't register. But at least he's interested in policy; right now, that's about as good as it gets on that side.