Think Tanks

Much ink and many pixels are being expended on writing health care's political postmortems, but the focus should rightly be on the policy front -- in the think tanks and in the legislative priorities of recent Republican administrations and Congresses. In short, the battle was lost before the first shot was even fired because Republicans did not present a compelling alternative story of what was wrong with the health care system, or how they would fix it. 

When it comes to health care policy, conservatives have been seriously outgunned. And I say this in all fairness to the friends I have who work night and day on free market solutions to health care. On economics, you always know what the conservative answer is: tax cuts and generally hands-off regulatory policies to spur economic growth. No matter how good the Democrats' promises sound, we return to these simple, pro-growth touchtones that resonate with a majority of Americans who intuitively get that you can't micromanage your way to a better future. 

On health care, I have no idea what our basic guiding principle is. Seriously, I don't. 

We have tried ineffectively to stretch free market rhetoric to health care without appreciating that health care is already too far removed from a free market for the analogy to make sense. Real markets are sensitive to price. Health care isn't. The insurance companies hide the cost of actual care from the consumer. 

What we have lacked in this debate is a simple clarion call to address an aching need -- bringing free market principles to bear to improve tangible health outcomes.

Instead, we have allowed the left to define the problem as exclusively one of access -- of the nearly 50 million without insurance dying in the streets (of course, we don't talk about that number anymore because nearly a third of that number are illegal immigrants, an issue Obamacare studiously avoids). 

And it's no surprise. The left has had a far greater number of health care analysts devising grand plans for the eventual takeover. And they have invested more political capital in this issue than any other. It should surprise no one that the conservative effort in this space has been paltry in comparison. We just haven't had as many people thinking about health care, and we didn't actively move legislation on it when we were in power. 

Perhaps you might say that's beside the point of the awfulness of this plan, and that our full efforts must go towards repeal. Be that as it may, Republican inattention to health care and the failure to develop a compelling free market narrative on the issue led to the place we are now. By pounding home the notion that the uninsured were the central problem with the health care system, and pointing to the fact that their numbers were growing each and every year, liberals built a sense of urgency that conservatives didn't have and were able to demand action -- even if that action was political suicide. 

At the outset of his Administration, George W. Bush set out to neutralize a key Democratic issue, education, with his No Child Left Behind Act. NCLB was a grab bag and not beloved by conservatives for its massive expansion in Federal spending in education, but it did insist on the vaguely conservative principle of accountability. 

The merits of that legislation can continue to be debated, but one political outcome is clear. We don't talk much about education at the federal level these days. There is a sense that the problem was "solved" by NCLB, which is now nearly a decade old. Likewise, no one will try to move welfare reform legislation because the successful 1996 reform law substantively and politically took the wind out of the sails of that issue. 

Imagine if instead of the Medicare Part D entitlement, the Bush administration had moved a smart, substantive health care bill that addressed cost as the key to unlocking access, making health plans dramatically more affordable, addressing medical liability, and moving away from employer-based plans by giving any group -- whether an employer or not -- the ability to organize their own health insurance pools? 

I was there, and I can attest that the Bush Administration did make good faith efforts to move medical liability and association health plans, but it was never the central, overarching focus. It was clear they would never expend political capital like they did on the prescription drug issue that they let themselves get baited on by Al Gore in the 2000 campaign, or the war, or tax cuts. 

A well-developed Republican health reform effort could have addressed the high cost of health care -- actually the most glaring issue in our system -- in a way that would have served as a kind of tax cut for the already insured. And in lowering costs, we could have covered the people who wanted health care but couldn't afford it -- the nub of the uninsured problem. 

Debate the details of this all you want, but the political upshot of this would have been to render the health care issue, a major Democratic hobbyhorse, politically dead for a generation. A bill less ambitious in scope, designed to address real pain points not a quixotic campaign for 100% insurance, could have forestalled this bill even in the event of a complete Democratic takeover. 

This may be oversimplified. There are certainly many very good conservative health care scholars whose work I should have been reading more closely these last few years. But politics is a battle of perceptions, and the perception -- that became reality -- was that Republicans brought a knife to a gun fight when it came a debate about the scope and reach of health care reform. We may have won the political battle over health care, in that a majority of Americans opposed Obamacare, but sometimes it is the policy battles that set the tone for the future political battleground, moving the entire spectrum on which they are fought further left. 

Promoted. Debate is good. -Patrick

Last week, my friend Jon Henke wrote a post criticizing Heritage President Ed Feulner and more broadly the entire conservative movement (full disclosure: Dr. Feulner is my boss, but in this post I write only for myself and am representing my own views) .

As you might have guessed, I have to take issue with Jon. While he makes some valid points (as always), I still think he goes too far on a couple.

First, Jon argues that the personnel of the Republican Party apparatus is composed of movement conservatives. As someone who spent a good deal of time working in the Senate, I am surprised that he would make that argument.

I think Jon and I are both painfully aware of some the types of staffers who have clawed their way to the top throughout the beltway-Party infrastructure. In many instances, these are people who have openly disdained us and our ideas. Far too many of them desperately cling to power for power’s sake. And far too many of them wouldn’t know a great, principled policy idea if it smacked them in the face.

To say that the conservative movement should bear responsibility in that arena is something I vehemently disagree with. I mean heck, as a staffer for Jim DeMint over the better part of the last two years, I saw first hand how the good Senator repeatedly went toe to toe with GOP establishment and received nothing but scorn for it – from staffers and senators alike.

And for Heritage’s part, they have been in the battle every step of the way. But frankly, since Heritage got banned from then-Majority Leader Tom DeLay’s office back in 2003 over our opposition to the prescription drug bill, it has been an adversarial relationship most of the way. And that is as it should be given the makeup of the Party right now.

This adversarial relationship has continued to manifest itself over the years. Whether it be on immigration reform, Harriet Miers, No Child Left Behind or Bridges to Nowhere, Heritage and the broader movement have stood opposed to the powers that be – both elected and unelected – in the Republican Party.

That leads to my second gripe. Jon says we need to push the reset button on ideas. Look, I am somewhat susceptible to this argument. I liked parts of David Frum’s book Comeback, I read Brooks regularly and can even stomach some Douthat on occasion. I certainly don’t agree with all that these guys are pushing, but I love the outside the box thinking when and if it advances the cause. But it is, in my opinion, unfair to write a post that portrays Ed Feulner and the Heritage Foundation as a group lacking ideas.

Stuart Butler, Heritage’s Domestic Policy VP, has been the national leader in pushing the idea of a revamped employer-based health system as the alternative to Obamacare as well as a major reform of the tax treatment of health care – a proposal that would achieve equity while empowering those without employer coverage. Who knows? Heritage’s persistence may even yield successes under our new liberal overlords. The rest of our health care team have been effective as well in pushing “transformational” ideas as evidenced by nearly all the major candidates adopting some form of our proposal.

Or take entitlements. Heritage convinced the top people at left-leaning Brookings and Urban Institute to seriously address this issue. It was Heritage who argued for a transformation in the budget process to “end entitlements as we know them” by putting Medicare, Medicaid, etc. on to the same budget basis as defense.

These are ideas that are, as Jon says, “transformational” and they would be enormously beneficial to the country if acted upon.

There is plenty more.

The problem has not been within the idea incubators, it has been with the politicians who either cannot explain their position, or frankly don’t have the heart and the passion to advance the idea. We make ideas, we don’t coach politicians. Not in our job description.

Finally, Jon ends with a call to “reset the movement” and develop a new guard to “compete” with the old guard. We are conservatives, not revolutionaries. We do not reset. Conservatives build on the past by identifying what has worked and discarding what has not. We stand on the shoulders of giants and we yes, we must train up the next generation. Edmund Burke said the true mark of a statesman is the disposition to preserve and the ability to improve. I bet we both agree that should be our model.

The Freedom Coalition is scrambling. Bipartisan bailouts and a profligate Republican Party seem not only to have conjured up the specter of Keynes but the American Left in force. The left has outsmarted the center-right Freedom Coalition in all the ways that count. That is, our democratic republic is, and always has been, about getting that 50 percent plus one. The left has figured this out and put the bulk of its investments behind this fact. And while we may like to tell ourselves that 'politics goes in cycles,' no one may credibly doubt the effort and organization of Democrats and progressives and the failure of the Freedom Coalition to adapt.

Meanwhile, as libertarians smugly explained the irrationality of voting – you know, clustering problems, paradoxes and the improbability of the tie-breaking vote – leftwing activists have spent a fortune in time and money getting people to do something irrational. And it worked. Aging right-wingers have been content to jockey their wingback chairs and will their estates to AEI, Cato or Heritage, so these goliath think tanks can print up yet more high-quality policy reports 250 people will read. This is a problem.

The Think Tank Bubble

F.A. Hayek is known among freedom lovers as describing the structure of production. The idea is often rendered as a triangle cut into thirds, like a simple hierarchy: At the top are the raw materials (say, silicon). The second slice is the capital goods (assembly line). Then come the consumer goods (iPod, marketing). The idea is of a production process whereby resources pass through each stage before finally satisfying human wants and needs.  Likewise, we can imagine socio-political change going through a similar process. First, you have some abstract academic theory, which filters down to the think tanks and policy shops, finally to be run through the legislative sausage grinder or presented to voters as talking points. That's the 30,000 foot view. From ideas to policy to implementation (or from academia to think tanks to ordinary politics). Obviously, the structure of social change is much more complicated than this simplified model reveals. But it's largely correct. The devil, as they say, is in the details.

Now, if we look at the average "freedom portfolio" we're going to see something that will go very far in explaining the Freedom Coalition's most recent voting booth humiliations—an investment bubble. Too many resources are going to think tanks—that is, that second slice of the structure. (The left has put most of its resources into implementation, never mind academia, which it has always owned.) Any renaissance of the Freedom Coalition will require freedom-lovers to divest themselves of legacy think tanks and start putting their freedom investments into something else. But where?

First, the Freedom Coalition is going to have to play catch-up on the one hand and tit-for-tat on the other. To figure out how to compete, it will have to look at the competition for benchmarks. What are they doing right? If the Freedom Coalition does its due diligence, it will find a second-mover advantage. Then, the right is going to have innovatively to reconfigure itself around what it has learned: new media; mass media, branding and marketing and get out the vote (GOTV)—and any other unseemly aspect of deadweight activism. Individualist-types may find this unsavory. We prefer ideas and analysis to groupish activism. We relish the holistic logic of market solutions and believe the world must kneel to rational argument. Tough. That's not the world in which we find ourselves. So unless we're prepared to argue with the machine or take up arms and rebel, we've got to play the implementation game and play it better. (Part Two here - Max Borders, Free to Choose Network)

Google Trends says the Heritage Foundation is winning the battle for traffic among prominent Think Tank websites, followed by the Cato Institute, Brookings and then the Center for American Progress. 

Note: Heritage.org traffic rose sharply immediately after the launch of the Heritage Foundry blog in early 2008.  I'm not sure how much of a causal connection there is, but it's very likely that the blog (a) improved their daily visitor traffic, (b) improved their Google visibility, and (c) led new blog readers to explore more of the Heritage site.

However, there is an interesting complexity.  The Heritage Foundation and the Center for American Progress are both 501(c)3 organizations, focusing only on policy analysis and education.  They "may not attempt to influence legislation as a substantial part of ... activities [and] may not participate in any campaign activity for or against political candidates."   That sharply limits their ability to use the information they collect effectively in the blogosphere or in audiences outside of policy, academic and some narrow media communities. 

However, political advocacy and campaign activity are fuel to bloggers and internet activists.  So, the Center for American Progress set up a separate 501(c)4 organization: the American Progress Action Fund.  501(c)4 organizations can engage in political advocacy and "some political activities".   The Action Fund produces the research distribution outlet, ThinkProgress.org, and the daily talking points newsletter, The Progress Report. 

Look at how Think Progress compares to the Heritage Foundation.

These, not its own legally limited website, are the communications weapons of the Center for American Progress. 

Rather than trying to consolidate power within a single bureacracy, they realized their goals required separate organizations, each specializing in one aspect of the larger goal.  They have created one organization to play in the academic and policy world and a second organization to play in the media and activist world.  

Differentiation allows specialization, and specialization allows...well, the kind of success you see above.  This allows them to pursue multiple, coordinated paths to achieve their goals.  As a result, the Center for American Progress is not so much a Think Tank as it is a Marketing Tank.

The lesson here is that, while organizations should think of information as an asset, but they should not necessarily assume they are also the best distributors of that information.  The collection and analysis of information is a task distinct from framing, synthesis and distribution of information. 

Note: the measurement tools are, of course, imperfect; consider this a best-available approximation.