Wednesday, January 26, 2011

SOTU Part 2: Politics and Brands

First, thanks for the feedback on my last post about Obama's reelection prospects. For those of you who thought I might be over-thinking it a bit, I refer you to Daniel Henninger's latest, who basically says, "Obama is putting a moderate frosting on the same big government cake." That could well be true! But I think he wants to appease the center and get re-elected, and my point was that the Tea Party will ensure that symbolic gestures and half measures don't get much traction, so to get anything done he will have to make substantial concessions to the Republicans.

Underlying that post was some thinking about brands which I wanted to make explicit. Right now Obama is virtually synonymous with the liberal brand. (Nancy Pelosi could have staked a claim while she was speaker, but she's faded from the picture rapidly in the last few months.) Another way to put it is that Obama has a monopoly on the liberal market: if you're a liberal who wants to 'buy' a different option, where do you turn right now? Even Keith Olbermann is off the air. And like all monopolies, the Obama brand has gotten a little flabby. Is he the bipartisan uniter? The new Kennedy? The racial healer? The smartest guy in the room? The professorial President? The empirical pragmatist? All of these ideas have been floated in the past year or so as the Obama brand, but none of them really define him. Which is good for him to the extent it means he can redefine himself (again, as I argued he's doing in my last post. But it is bad for him to the extent that he can't rally the public behind his brand.

In contrast, I think the competition between the "Standard Right" Republicans and the Tea Party helps them to define their brands. Both groups want to control the more conservative side of the political spectrum. But, as you could see from Paul Ryan's speech last night, the Standard Right are trying to be the responsible adults who have learned from the past and are ready to fix America's problems, especially it's deficit crisis. And while the Tea Party also wants to take on the debt, their brand is much more about restoring America's founding vision and throwing out the 'impure' elements that have corrupted the country.

To the extent that this isn't just rambling, here's the point: the Republican 'brands' have similar goals, but they are quite distinct in tone and values, and they are competing for the same audience. Obama, meanwhile, as no competition for his audience. The competition, I think, will force Republicans to evolve and improve their thinking and their brands more rapidly, and I think ultimately help them succeed in the marketplace of ideas.

So the lesson for marketers: embrace competition, and use it to help you define who your audience is and why they should care about your brand more than the competitors.

Tuesday, January 25, 2011

Why Michele Bachmann Will Get Obama Re-Elected

First, let me say my hope is that someone at Daily Kos or the Huffington Post will come across that headline, link to it, and drive my traffic through the roof. But my point is decidedly not that Michele Bachmann is some evil, despicable quasi-fascist who will drive Americans screaming back into the President's arms. In fact, I thought her speech tonight was a strong distillation of the problems we face, even though it was a bit selective in its argument that the economy and the deficit got much worse when Obama was elected.

But I did have a moment of clarity while watching Bachmann's speech, and realized that she (and the Tea Party more generally) will very likely create the conditions for Obama's reelection. And the way that will happen, ironically, is by pushing him closer to Republican positions. Let's say, for the sake of simplicity, that Obama represents the Standard Left position in American politics, and the Republicans, as ably represented this evening by Paul Ryan, represent the Standard Right position. Normally those two positions are the only two with any serious traction in our politics, and so voters and interests align with one of the two teams. Then the two teams fight and from time to time one team wins enough power to do some of the things it wants, though that inevitably generates a backlash. Or else a few moderates cut a deal, and pass some watered-down halfway measure.

Well, then, Bachmann and the Tea Party represent a distinct third position, related to the Republican side but not the same. Let's call it, not far-right (which people say when they're trying to call someone a Nazi) but Strict Right. The principles aren't THAT different from the Standard Right, but they're taken a little further and there is little room for compromise.

Now, President Obama just laid out a lot of things he would like to get done in his State of the Union, and acknowledged that he can't do those things with Democratic support alone. So he needs Republican partners, and the Paul Ryan/Standard Right team is going to be the only place he can go to do that. So there will undoubtedly be talks between the President and those folks. But the Strict Right group will be very skeptical of any proposed deal, and put a lot of pressure on the Standard Right to resist any compromises. So the Standard Right will have to consider these factors:

1) If they go too far to the center, they are vulnerable to primary challenges from the Tea Party, and these challenges were remarkably effective in the last cycle. That puts an upper bound on what compromises will be feasible (and Obama will know this, too.)

2) If they are completely unwilling to work with the President, the public is likely to blame Republicans for the resulting lack of progress, as they did in the Newt Gingrich era during the government shutdown fight. This will tell the Standard Right that they can't just sit on their hands for two years and try to pin the blame on Obama.

3) There is a real financial and budgetary problem that people like Paul Ryan are truly committed to solving, and a bipartisan deal helps them do that while spreading the blame for painful decisions across both parties.

4) Obama knows that it will be hard for Democrats to keep the Senate in 2012, so even if he is reelected, he's unlikely to be able to pass liberal legislation, so he might as well make the best deals he can now, because his second term will likely be about defending past liberal achievements, not getting new ones.

So the solution is for Obama and the Standard Right to make deals that give the Republicans 75% or more of what they want (to blunt the effectiveness of Tea Party primary challenges) while giving Obama some small victories he can present to the Standard Left. The Strict Right may complain that the Standard Right have betrayed their principles, but as long as the legislation is popular, generally conservative, and effective at cutting the deficit, these arguments will seem inflexible and overly partisan. And the far (Strict?) Left will complain, to the same effect.

So Obama will be able to run as a centrist, instead of just saying he is, and the Standard Right will be able to claim a victory for American principles, and that they made democracy work again. Independents will reward them both, giving us a Republican House and Senate and an Obama re-election.

And while I'm not exactly an Obama cheerleader, that'd be just fine with me.

Sunday, January 23, 2011

Healer, Heal Thy Guidelines!

I found my way over to an interesting blog written by one Joseph Paduda on Managed Care. A number of his posts were interesting, but I was most captivated by this one on the limits of guidelines. This is a topic, as a healthcare marketer, that always catches my attention, because health guidelines cause an essential challenge: namely, that the guidelines can only be improved upon if physicians ignore them.

What I had always assumed, and what Paduda calls into question, is that guidelines are based on the best science of the day. He puts it as follows:
A recent study may well give you pause - the key finding is rather alarming - many guidelines are NOT based on solid research, but on work that is kindly described as rather more superficial.

Published in the Archives of Internal Medicine, the research found "More than half of the current recommendations of the IDSA (Infectious Diseases Society of America) are based on level III evidence [expert opinion] only." [emphasis added]

Paduda goes on to note that many guidelines are based on good science, but encourages people to be vigilant in asking about the basis of guidelines they come across.

And while that may be good advice for the healthcare professional, or even a well-informed lay person, most patients aren't going to be able to debate the merits of particular guidelines with their doctor, or, more importantly, their insurer.

This bothers me immensely, because care decisions are going to be further centralized in the coming years (probably whether or not Obamacare is repealed, by the way), and the centralizers are going to lean on guidelines to cut costs and standardize care. This seems highly likely to slow the adoption of medical innovation. So never mind that slavish conformity to guidelines limits the opportunities for smart individual physicians to come up with better approaches to care, many of those guidelines may not be worth the glossy medical journal paper they're printed on. Not comforting.

Wednesday, January 19, 2011

A Healthy Dose of Fear

My good friend Ben blogs over at A Healthy Dose, with some interesting, and often very personal, observations on the interaction between healthcare and culture. He flashes up some interesting stats here, with a link to more here, that imply one of two possible futures:

1) Baby Boomers retire in droves, swamp the government and corporate systems designed to ensure their retirements, and suck up an increasing share of the nation's resources.

2) Baby Boomers 'work until they drop', stay in the labor market a decade or more longer than expected, and lock up positions that otherwise would have been freed up for younger workers. (James K. Gilbraith at Foreign Policy argues that we should lower the retirement age for this reason.)

Our best hope is for a Goldilocks outcome, where enough Boomers keep working to avoid overwhelming the safety net, but enough retire to open positions for the younger unemployed. But it is just as likely that, given the number of Boomers, there will be too many retirees and too many senior workers at the same time.

Unfortunately, while our society has finally woken up to the problem, we don't seem to have the first clue what the solution to our senior citizen boom might be.

Tuesday, January 18, 2011

How Many People Do We Need?

Just to be clear, this is not a post on population control, exactly. Rather, I am forced to wonder what is going to happen to the vast majority of mankind when civilization only depends upon the productive work of a few of us.

Why am I worrying about this? In this post, Walter Russell Mead boldly challenges the complacent thinking that the 'developed world' has reached some sort of pinnacle, and reminds us that from the perspective of the future, many of our fundamental institutions are likely to look downright awful. He cites a few examples in the quote that follows:

Much of today’s production that doesn’t take the form of mind-numbing, repetitive work in factories comes in the shape of mind-numbing, repetitive work in offices. Government, corporate, legal and non-profit bureaucracies suck up inordinate amounts of human time and talent. It is not at all clear that the output is worth it — or to put it another way, we should be able to get equal or better results with less work. Information technology offers increasing opportunities to transfer more and more of the routine scutwork of administration over to machines, setting the office drones free to do more rewarding, more socially useful things.

Moreover, our bureaucracies are not just cumbersome time and creativity sucks; they are expensive as well. Federal, state and local government can become significantly cheaper as we strip out the layers of bureaucracy, dispense with work rules developed in some cases back when carbon paper ruled the world, and restructure patterns of organization and management that date back even farther. People who like low taxes and people who like on big government can agree at least that by systematically making government cheaper we can have all the government we need at rates we can afford.

All very true, but do you notice one common thread? All of these reforms imagine fewer people doing the work done by many today. I'm sure Mead would contend that freeing up these people from drudgery will allow them to create, innovate, and add new value to the economy, and that's true. But increasingly, those innovations will require far fewer people to grow them than the great businesses of the past. In manufacturing, men are replaced by robots. In services, the personal touch is replaced by the convenience of online ordering. In entertainment, fewer and fewer people chase the same experiences provided by the same few musicians, writers, and artists. I can even point to the relative traffic of Mead's blog versus my own as another example: the better thinkers get the traffic and the links.

We have 10% unemployment now, and maybe close to 20% underemployment. However, as has been pointed out elsewhere, the wealthy have recovered quite nicely from the recession, and seem increasingly to be detached from the concerns of their middle-class countrymen.

Historically, innovation has always had positive effects throughout society, from top to bottom. There have always been disruptions (Mead even cites the destruction of the family farm a century ago), but overall change has been for the good. And in all likelihood, it will be in the future, as well. However, we might be moving towards a future where a few people live lives of meaning, creativity and success, while the majority draft along in their wake, doing the jobs that can't be automated or living off of the charity their success allows. I'm not sure if this is likely, but I'd ask this: where are the middle-class jobs of tomorrow going to come from?

Saturday, January 1, 2011

How Do We Stand Up?

I was at a bar on Thursday night with my younger brother, an art student at Pratt here in Brooklyn. We were discussing our respective modes of artistic expression (his visual, mine written) and I was trying to explain a notion that the visual arts are more about human feeling than about concrete ideas. I used the painting here (The 3rd of May, 1808, by Goya) as an example, and said that it captures, to me, "the flickering flame of human defiance in the face of despair." My brother liked the phrase enough that he wrote it down and later sent it to me. As prose, it might be a bit much, but there's something to the notion that's been on my mind since.

In that painting, the man in the white shirt seems torn between fear of death and a proud resignation: I did what I thought I should do for my country, and now the bill is due. I am struck by how hard it is to follow your conscience in the face of forces beyond your control. Here, in the midst of deadly retribution being dealt out by the French troops, we see the toll taken on one man, and realize that the dreams, memories, skills and relationships that make up his existence are about to be snuffed out.

How many of us, in that moment, would be willing to renounce our ideals, our causes, for a chance to walk away alive? And that, I think, is why despair is always present for us: no matter how much we believe in a cause and are theoretically willing to sacrifice for it, for most of us, we despair of the thought of death (and especially a futile death) and know we may not follow through on the sacrifice when it matters. And yet, there is that flickering flame, the possibility that we may be able to believe in something bigger long enough to do what is right. For the man in the painting, he may in that moment wish to take back his rebellion against the French and live a peaceful life, but he made his decision to fight the day before (a scene Goya also painted) and now it is too late to turn back. His heroism, if it happened, happened out of the context of the painting. A believer in God may hold to faith not knowing it will lead to his martyrdom, but that makes him no less of a martyr when he dies for it.

I write this blog to think about tomorrow, and indeed I question how human defiance will manifest itself in the future. It isn't that people are unwilling to stand up for what they think is right, but rather that our systems (social, political, economic) are so complex that it is hard to tell exactly what the problems are and what should be done about them. On the whole, this is a good thing: in complex societies, there is room to carve out your little sphere of righteousness, and walk away from what it is that you think is wrong. But it also leaves the individual unsure of how to act morally, and leads to the possibility that despair will creep in, a despair that we are powerless to make our society better, or to address the wrongs that we see.