Politics. Where you listening to the first debate between Vice President Richard Nixon and Sen. John F. Kennedy in 1960, you would have given the edge to Nixon. Had you been watching it – the first televised presidential debate in U.S. history – you would have declared Kennedy the victor but by a slim majority.
To the victor goes the spoils so the accounts of the 1960 campaign like Theodore White’s Making of a President came to define how we thought of that election in retrospect.
Since 1960, the American electorate has leaned into a heuristic that formed that year, with a few exceptions. As far as the presidency goes, awkward but earnest - and eventually paranoid and corrupt - Richard Nixon came to signify backwardness, a wet blanket on creativity and promise.
John F. Kennedy, on the other hand, came to embody youth and vigor and with it the potential of the postwar generation.
That was the tale that was told. Of course, none of it was particularly accurate. Worse, it has burdened politics and policy for over 50 years. Political leaders either fell into position as heir to the nearly fabricated vision of President Kennedy or risked accusations of luddite-like loyalty to complete squares like Richard Nixon.
The sustained power of certain 1960s-era policies owes itself to a frenetic media age that began the year Kennedy beat Nixon and ended last week. The heuristic that has sustained the tension between the cool kids and the scolds required increasingly less scrutiny and inquiry – which it got in spades. The natural result was dramatically diminished coherence.
Last week something called BlazeTV, a politically conservative news outlet, produced nine hours of interviews between former FoxNews personality, Tucker Carlson, and almost all of the rather large Republican primary field. For candidates whose strategy is to hew as close to the status quo as possible, it was not a good night.
I know, I know, for some that pesky heuristic forces a dismissal on the order of “Pffft, Tucker Carlson.” It is wise to remember former President Donald Trump owed much of his ascendency to good management of a one-minute media hit.
Policy. Without a doubt, nearly universal health insurance coverage has been a policy victory for President Kennedy’s political heirs. Only an estimated 8% of the population is without health insurance and given the American system of overlapping programs that could be an over-estimate.
Notwithstanding the obvious sea change of the last 15 years, health care policy apparatchiks remain at the nearly abandoned barricades of universal coverage. The latest salvo is over coverage of the newly approved over-the-counter birth control bill produced by PRGO.
The Affordable Care Act requires coverage by all plans (ERISA, Medicaid and ACA Marketplace) of contraceptives without cost-sharing. However, that requirement is predicated on turning the gears of the health insurance machinery.
Specifically, mandatory coverage would trigger the use of certain billing codes to override normally applied deductibles and co-pays. It would also process the purchase through a complex system of rebates and dispensing fees. The system does not and cannot consider coverage of a purchase made at the retail register instead processed through the pharmacy counter.
Sen. Patty Murray of Oregon has proposed legislation to require coverage of OTC birth control but to work it would have to force the purchase through the drug channel. In the typical incoherence of our day that would defeat the whole point of OTC birth control, accessibility.
Never underestimate the federal government’s power to force a work-around and in the interim, confusion.
Power. In addition to requiring less than the average amount of critical thinking capacity, enforcing the American political heuristics of the last 50 years demands only the briefest of flirtations with factual content. It has been very bullish for stupidity.
Fortunately, most people are not stupid. Johannes Gensfleisch zur Laden zum Gutenberg knew this when he began mass-producing bibles so 15th c. Europe could read it for themselves.
Journalists – the good ones anyway – are also not stupid and today are bringing a new golden age of inquiry and thought the likes of which we have not seen in decades.
Medium, Tablet Magazine, The Free Press, Substacks, Puck are among just a few of the platforms that are slowly transforming debate. They are also supplanting outlets that have refused to publish or retracted research as The Lancet recently did with a small study on post-vaccination autopsies. It seems that the best thing that can happen to a scientist now is to get censored by the scientific media.
While cynics will dismiss the idea that the American public has the attention span for long form and nuanced reporting, a dispositive data point will be Vivek Ramaswamy's poll numbers. He used his half hour on BlazeTV well.
To the victor go the spoils.
Have a great rest of your weekend.
Emily Evans
Managing Director – Health Policy
Twitter
(Politics, Policy & Power is published in the quiet of Sunday afternoon or holiday Monday and attempts to weave together the disparate forces shaping health care. It makes no attempt to defend or prosecute the views of any established political party or cause. Any conclusions to the contrary rest with the reader alone.)
