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OPINION
East Oregonian
Saturday, January 14, 2017
Founded October 16, 1875
KATHRYN B. BROWN
Publisher
DANIEL WATTENBURGER
Managing Editor
TIM TRAINOR
Opinion Page Editor
MARISSA WILLIAMS
Regional Advertising Director
MARCY ROSENBERG
Circulation Manager
JANNA HEIMGARTNER
Business Office Manager
MIKE JENSEN
Production Manager
OUR VIEW
Obama’s ode
You can debate whether Barack
Americans were left behind in his
Obama is a great president, but he
chugging economy. His health care
is undoubtedly one of the greatest
law — though an improvement from
people this country has ever
nothing — was too imperfect to
produced. And as we send him
survive. Like most presidents, the
off this week into the annals of
mistakes and regrets are numerous.
history, we should take a moment
Still, in everything, Obama acted
to appreciate
with dignity
his numerous
and diplomacy.
achievements.
His two terms
We all know
have come and
his back story
gone without
by now: Born
the whiff of
in Hawaii to a
personal scandal.
black father and
His family and
white mother.
marriage are
He grew up
an aspiration
abroad in
and a sense of
Indonesia, on
pride for many
the wide plains
Americans. He
of rural Kansas
has somehow
and later among
held onto the
AP Photo/Charlie Neibergall
the skyscrapers
uncanny ability
President Barack Obama and first to joke and
of Chicago.
lady Michelle Obama dance together cry, talk about
He was always
at the Obama Home States Inaugural
fatherless. He
sports and music
Ball in Washington, Jan. 20, 2009.
was a troubled
and his own
teen, made
failings — like
plenty of
a real person
mistakes and
among a sea of
struggled with
cardboard-cutout
his identity. Yet
politicians. No
he endured,
president has
and then found
ever been as
strength and
cool, in the most
ambition. He
American sense
graduated
of the word.
from the finest
He was
schools this
always opposed,
country has to
often viciously
offer. He fell in
and sometimes
love. He became
blindly. Yet
AP Photo/Pablo Martinez Monsivais
a state senator
President Barack Obama waves on Obama kept
stage with first lady Michelle Obama his head and
and rocketed
after the presidential farewell held his tongue,
up the rungs of Tuesday
address at McCormick Place in Chicago.
political power
often to his own
with unmatched
disadvantage.
speed.
You can count on one hand his
He became president at a time
ineloquent words and insults leveled
when the country was mired in two
at others.
terrible wars, the economy was
President Obama has always
in utter free fall, and international
seemed like a man before his time.
terrorism was a growing enemy.
That has never been more clear than
Yet he pulled the country through. now, as he prepares to leave office.
Certainly, his eight years as the
Much of his work will be swept
away by the opposition, and the
most powerful person in the world
country has elected a man to succeed
was nowhere near perfect. His
actions often fell short of his soaring him who is his polar opposite — a
man endorsed by the Ku Klux Klan
rhetoric.
His speech at Hiroshima was
just to hammer the point home.
masterful, yet he did nothing to
But if Obama’s legislation doesn’t
reduce this country’s cache of
last, his words and actions will, as
nuclear weapons. He allowed
will the narrative of his life. He will
Syria to descend into a hellscape,
inspire and be admired throughout
which precipitated a worldwide
his remaining days and likely long
crisis. His decision to overthrow
after. Monuments will be built in his
Muammar Gaddafi in Libya caused
honor.
unnecessary suffering and death and
That’s because no American has
made America less safe. His drone
started with so little and achieved
policies have resulted in the death
so much. Barack Obama is the
of Americans and the bombings of
personification of the American
hospitals and noncombatants.
Dream and this country was great
Here within our borders, many
enough to let him live it.
Unsigned editorials are the opinion of the East Oregonian editorial board of publisher
Kathryn Brown, managing editor Daniel Wattenburger, and opinion page editor Tim Trainor.
Other columns, letters and cartoons on this page express the opinions of the authors and not
necessarily that of the East Oregonian.
The East Oregonian welcomes original letters of 400 words or less on public
issues and public policies for publication in the newspaper and on our web-
site. Submitted letters must be signed by the author and include the city of
residence and a daytime phone number. Send letters to 211 S.E. Byers Ave.,
Pendleton, OR 97801 or email editor@eastoregonian.com.
OTHER VIEWS
Do markets work in health care?
B
elieve it or not, we’re not
companies all the time. I spent part of
really going to have to spend
my week learning from an aviation
the next four years wading
mechanic how hard manufacturers
through wonky drudgery of Russian
work to prevent pieces of metal
spy dossiers and hotel sex cameras.
from shredding through the cabin if
At some point we’re going to have
an engine explodes. Airplanes are
a thrilling debate over the most
ridiculously safe.
scintillating question in health care
Proponents of market-based health
policy.
care rely less on theory and more on
David
The Republicans are going to try to
Brooks data. The most fair-minded review of
replace Obamacare. They’re probably
the evidence I’ve read comes from a
Comment
going to agree to cover everybody
McKinsey report written by Penelope
Obama covered, thus essentially
Dash and David Meredith. They noted
granting the Democratic point that health care
that sometimes market forces lead to worse
is a right. But they are going to try to do it
outcomes, but “we have been most struck by
using more market-friendly mechanisms.
health systems in which provider competition,
As you know, the American health care
managed effectively, has improved outcomes
system is not like a normal market. When
and patient choice significantly, while at the
you make most health care decisions you
same time reducing system costs.”
don’t get much information on comparative
There’s much research to suggest that
cost and quality; the personal bill you get is
people are able to behave like intelligent
only vaguely related to the
health care consumers. Work
services; the expense is often
by Amitabh Chandra of
determined by how many
Harvard and others found
procedures are done, not
higher-performing hospitals
whether the problem is fixed.
do gain greater market share
You wouldn’t buy a phone
over time. People know
this way.
quality and flock to it.
The Republicans are going
Furthermore, health care
to try to introduce more
providers work hard to keep
normal market incentives
up with the competitors.
into the process. They
When one provider becomes
are probably going to rely on refundable
more productive, the neighboring ones tend to
tax credits and health savings accounts so
as well.
everybody can afford to shop for their own
There are plenty of examples where
insurance and care.
market competition has improved health
This would still be nothing like a free-
care delivery. The Medicare Part D program,
market system — it would still be a highly
passed under President George W. Bush,
regulated, largely public benefit — but it
created competition around drug benefits. The
would rely more on consumer incentives.
program has provided coverage for millions
The crucial question is: Do market
while coming in at 57 percent under the cost
incentives work in health care?
of what the Congressional Budget Office
This is really two questions. The economic initially projected. A study of Indiana’s health
one: Would market mechanisms improve
savings accounts found the state’s expenses
quality and reduce costs? The psychological
were reduced 11 percent.
one: Do people want the extra cognitive
Laser eye surgery produces more patient
burden of shopping for health care, or would
satisfaction than any other surgery. But it’s
they rather offload those decisions to someone generally not covered by insurance, so it’s a
else?
free market. Twenty years ago it cost about
Most progressives say markets don’t
$2,200 per eye. Now I see ads starting at $250
work. They point back to a famous essay the
an eye.
economist Kenneth Arrow wrote in 1963,
There’s a big chunk of evidence that
which is the same year the Beach Boys had a
market incentives would work in health care,
huge hit with “Surfer Girl.”
especially in non-acute care. The harder
Arrow argued that there are several
problem for Republicans may be political.
features that make health care unlike normal
This is a harried society. People may not
markets. People’s needs for health care are
want the added burdens of making health
unpredictable, unlike food and clothing.
care decisions on top of all the others. This
The doctor-patient relationship is unique
is a distrustful society. People may not trust
and demands a high level of trust, empathy
themselves or others to make decisions. This
and care. Providers know much more about
is an insecure society. People may not want
medicine than patients do, so the information
what they perceive as another risk factor in
is hopelessly asymmetric. Patients on a
their lives.
gurney can’t really make normal choices, and
The policy case for the Republican plans is
payment comes after care, not before.
solid. Will they persuade in this psychological
These are all solid points, especially the
environment? I doubt it.
doctor-patient one. But health care has become
■
less exceptional over time. The internet and
David Brooks became a New York Times
other mechanisms help customers acquire a
Op-Ed columnist in September 2003. He
lot more information. Sophisticated modeling
has been a senior editor at The Weekly
helps with unpredictability in a bunch of
Standard, a contributing editor at Newsweek
fields.
and the Atlantic Monthly, and is currently a
We put our lives in the hands of for-profit
commentator on PBS.
The policy
case for the
Republican
plans is strong.
YOUR VIEWS
Politics is everywhere,
and it will get nasty
It’s the truth — politics is
everywhere and we cannot
escape it. If you feel caught
between two worlds as the present
administration takes over, I like to
think the world represented by the
Obama-Clinton coalition is still
the country we are becoming and
a Trump victory can only delay it.
Obama remains not only a popular
president, but a symbol of, and a
spokesman for, diversity, civility
and tolerance threatened by the
forthcoming administration.
As we enter the early months
of 2017, I keep trying to be
optimistic. Our nation will survive,
but it’s going to be fundamentally
changed. The Republicans have
control of all three branches of the
government and will promote their
own agenda. I worry about the
Supreme Court.
Our nation is healthy but it’s
going to take a lot of work to keep
it that way. Our complacency
must end and we must seize
opportunities without prejudice.
In a nation as complex as ours,
there are inevitable problems.
The crisis of the Republican Party
spoke for itself and new forces are
emerging on the populist right: i.e.,
immigration.
Whether the new politics of
national identity and belonging
control its less appealing aspects
is a difficult question, but if it
doesn’t, the radical activists will
prevail.
We must do something about
this endless war. We are not really
surviving George W. Bush’s anti-
intellectual, cavalier right-wing
policies, which brought this nation
and the world to a new kind of
disaster, terrorism: it continues.
President-elect Trump’s
proposed threats to our rights and
to the health of the planet must be
met with peaceful means to oppose
and expose his betrayal, not only to
the working man but to our nation
and worldwide.
The election of Donald Trump
speaks volumes about modern
inequality and insecurity of the
working class, whose economic
complaints show their loss of
identity and belonging, particularly
their opposition to immigration, for
many immigrants are more highly
skilled and are a threat to the labor
market.
This became apparent when
the corporation Carrier planned
to outsource abroad, leaving
thousands of workers with a
completely different reality.
As automation takes hold,
change is inevitable, and an
element of our population is losing
its traditional political core.
Progressive polities needs
more working class people who
understand that meaningful
politics is not the point of modern
capitalism. Ironically, the American
Dream is no longer possible for
most. Traditional work as we once
knew it is fading. In this new age
of automation we need to increase
the centrality of work and the
worker.
If we the people hope to
overturn the Trump reign in 2020,
we are going to have to work
together with the potential power
of the diversity that distinguishes
our nation.
The skirmish has just begun.
Dorys Grover
Pendleton
How to trust a president
that lacks integrity?
Integrity is the quality of
being honest and fair. Most of us
would probably like to be thought
of as displaying integrity since
we generally value integrity in
others. When someone, politician,
businessman, neighbor or family
member, shows us dishonesty
or deception, their integrity is
lost. Like virginity, integrity is an
attribute that, once lost, can never
be recovered.
In science, integrity is critical.
If one’s opinion is challenged by
the evidence, integrity demands
questioning the opinion and
rejection if it’s falsified by the
evidence.
We must hold science and
scientists to the bar of integrity.
Apparently, no such expectation
exists for politicians.
We have just completed an
election cycle where the candidate
guilty of more transparent
lies — probably than every prior
presidential candidate through
our nation’s history combined —
managed to secure enough votes
in critical states to achieve the
presidency.
We’ll soon have a president
totally lacking in integrity who
will serve as a model to our kids
and the world, demonstrating that
dishonesty, deception and blatant
lies are rewarded in this country.
And what are the missile
launchers expected to do if they
receive an order to launch our
nuclear weapons? Wonder if it’s a
joke?
Trisha Vigil
Talent