Thursday, March 29, 2012

On Health Care Reform

At the time of writing this paper, the constitutionality of the 2010 health care reform package is being considered by the Supreme Court. It is an opportune time to pause and reflect on the issues involved.

Many Democrats feel obligated to defend the Patient Protection and Affordable Care Act (PPACA, aka “Obamacare”) in all its particulars. This sense of obligation arises from Democratic voters’ deeply held conviction that a more ideal health care reform package would have no chance of succeeding in Congress. Even though the provisions of PPACA will produce a health care system that is demonstrably worse than the health care systems of every other Western industrialized nation, many Democrats have convinced themselves to become enthusiastic supporters of it. 

On what basis may PPACA be considered deficient?  Before answering this question, consider the “Iron Triangle” of health care, described by an eminent professor of medicine named William Kissick. The three points of this triangle correspond to the most highly prized and interdependent aspects of health care: affordability, quality, and access. The goal of affordability conflicts with the goals of quality and access, because quality and access are expensive. Therefore, access to health care and quality of health care both depend on the effectiveness of cost-controls and the ingenuity of medical professionals in finding less expensive ways of delivering high quality care. 

Logically, then, if PPACA does not guarantee cost-effective health care, quality and access will suffer as a result. If the cost that consumers are required to pay in order to receive health care – the unpopular “individual mandate” – is too high, consumers will have less money to spend. Consumers who have little money to spend, but are not sufficiently poor to qualify for government subsidies, will discover that they have less money on hand to buy food or heat their homes. They will delay necessary health care rather than take time out of work. They may wonder why they are paying high monthly premiums and are still asked for co-pays at the doctor’s office. 

Now, it is necessary to defend the position that PPACA does not do enough to address cost. President Obama’s assertion that the act will “bend the cost curve” is based on optimistic projections.[1] If one examines the particulars of PPACA, the emphasis is not on controlling costs. Instead, the emphasis is on increasing access to care. It achieves this by expanding Medicaid eligibility, allowing children to remain on their parents’ health plans until age 26, ending exclusions for pre-existing conditions and other provisions. 

A medical device which costs $100,000 in the U.S. may only cost $10,000 in China or India. The device is in no way inferior because of its reduced cost. The price differential is the result of Asian nations’ culture of frugality.[2] Because frugality is highly prized, the Asian people support their governments in insisting on low prices. Medical device manufacturers find ways to cut costs, maintain quality, and still earn a profit. 

At this Houston hospital, harpists perform for newborns. Source.
In contrast, Americans are inclined to be enamored by luxury. Oscar Wilde’s quote applies: Americans, it may be said, “know the price of everything and the value of nothing.” Costly items are assumed to be of higher quality. As a practical consequence of this love of luxury, Americans are not predisposed to insist on low prices, particularly not when it comes to healthcare. A courageous healthcare reformer will show sufficient faith in the American people to believe, first, that Americans can be educated about the hidden, unnecessary costs of healthcare and secondly, that properly informed Americans will make wise decisions. The healthcare reformer who values expediency will not take the chance of relying on the wisdom of the American people. 
In Houston, the average waiting time in an Emergency Department is over 4 hours. Source
Observers believe that the focus on access was the result of a strategic decision made by the Obama administration. The goal of expanding access to care is less controversial than the goal of reducing costs.[3] Cost control means a relentless effort to achieve the best possible value for the dollar. It means increased government involvement in physicians’ decisions about which treatments to select. It may also mean the use of waiting lists to deter consumers from seeking treatment for non-urgent medical conditions. Cost control means end of life counseling. So, in taking the more politically expedient path of focusing on access, the Obama administration has handed the American people an individual mandate that is more expensive than it needed to be.

After all of the provisions of PPACA take effect, for-profit health insurance companies will continue to operate very much the way they operate now. Insurance companies may try to negotiate lower prices with hospitals, but as it happens, insurance companies have little leverage over hospitals in the wake of a string of mergers and partnerships that have given hospitals monopolistic control over regions of the country. The CEO’s of companies like Wellpoint will continue to earn over ten million dollars per year. The health insurance lobby will continue to pour money into political campaigns. This will invite corruption. A politician may decide that increasing the amount of money he or she receives as campaign contributions from the insurance lobby is a more important consideration than ensuring that ordinary Americans receive the best value on each health care dollar they spend.

Having said that, it is important to consider the extent to which private insurers are guilty of profiteering. Private insurers regard healthcare payments as a “loss” and the term “medical loss ratio” refers to the amount of money they spend on healthcare. PPACA mandates that 80 to 85% of the health care dollar will be used to pay medical expenses. To put this in perspective, in 1993, private insurers spent an average of 95% of consumer premiums on reimbursing medical expenses.[4]
The question of how that remaining 15 or 20% is spent is germane to understanding what sort of value Americans are receiving for their health care dollar. Within this percentage are profit and administrative costs. It includes the cost of advertising, hiring insurance brokers to sell their product, lobbying, paying the salaries of “government relations” specialists, and supporting the costs of multiple private bureaucracies. The taxpayer should chafe at the idea that his or her health care dollar subsidizes the lobbying activity of the insurance activity, since the results of lobbying are often to the detriment of the taxpayer. Using the administrative costs of other Western nations as a basis for comparison, the amount of excess administration in the private insurance industry is about 24% of total revenue.[5]
Given the fact that they are inefficient at controlling administrative costs, it is curious that private insurance companies are being contracted by the federal government to administer programs such as Medicaid and Medicare Advantage. Under these agreements, private insurers will contribute nothing toward the payment of medical expenses; their task will consist of disbursing taxpayer money to reimburse healthcare providers. In part because of these lucrative federal contracts, private insurers have enjoyed increasing revenues and profits since PPACA was passed in 2010.[6]
Obviously, voters can still take the position, “if it weren’t for compromises with private corporations, PPACA could not have become law.” This view is regrettable. Choosing to appease private corporations does not serve the public interest. It merely allows these corporations a greater degree of control in setting the cost of health care. Vague promises have been made, to the effect that completion among health insurers will in time lead to reduced costs. The skeptical voter will recall that the insurance industry is exempt from anti-trust regulations, and recognize the discouraging parallels that may be drawn to banking deregulation. 

On the larger question of whether the United States ought to be actively involved in healthcare delivery, it is worth noting that John Locke sometimes included “health” alongside “life, liberty, and property” as the most important natural rights of a free people. Locke provides a touchstone when seeking to understand the Founders’ philosophy of government. One of the Founders was also a physician. He was a man named Benjamin Rush, and he warned us, “Unless we put medical freedom into the Constitution the time will come when medicine will organize itself into an undercover dictatorship … [allowing this to happen would be] un-American and despotic.”

Recommended Reading:
On Swiss Healthcare

[1]Dougherty. The Certitudes and Uncertainties of Health Care Reform. Annals of Internal Medicine.

[3] Marmor et al. The Obama Administration's Options for Health Care Cost Control: Hope Versus Reality. Annals of Internal Medicine.

[4] Potter. Deadly Spin.

Tuesday, March 20, 2012

On Religious Freedom

The establishment clause of the First Amendment reads, “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” The meaning couldn’t be clearer, but people still manage to find a way to disagree over it.

This was witnessed in February, 2012 after President Obama announced a policy requiring that employer-sponsored health insurance plans cover contraception. Heated objections were promptly raised by Catholic bishops. During the ensuing controversy, it became evident that some Americans believe that the establishment clause grants them freedom of conscience. As such, Catholic institutions should not be required to fund contraception if contraception is viewed as sinful. In contrast, other Americans believe that the establishment clause is designed to prevent the Catholic Church or any other church from interfering in government.
Notably, the controversy occurred during an election year. Both parties saw an opportunity to use it to their advantage. Republicans, wanting to shore up their base, opposed what they described as an “attack on religious freedom.” Many Christians in the United States believe that their faith is besieged by implacable secular humanists. Democrats, wanting to shore up their base, characterized the Republicans as enemies of reproductive freedom and women’s rights. Thus, the issue both inspired passion among feminists in the Democratic Party and helped to paint the Republican Party as the party of sexist Neanderthals.  This is all well and good, but as one grows older, these controversies, and the uses that political parties make of them, start to grow tiresome through sheer repetition.
These tactics wouldn’t succeed if it weren’t for partisans. Partisans readily believe that their favored party is defending a just cause. And they readily believe that the opposing party is conspiring to rob them of their freedoms. Those of us who have rejected partisanship realize that political parties are not particularly concerned about defending just causes or robbing folks of their freedoms. Parties are mainly about two things: raising money and winning elections. Just causes may be successfully defended or freedoms lost along the way, but those are ancillary concerns.
As it is with Coke and Pepsi or Tums and Rolaids, Republicans and Democrats need some way of demonstrating to the voter that there is actually a difference between the two parties. Therefore, election campaigns will invariably hinge on the few areas where the two parties actually disagree: God, guns, and gays. One year it’s contraception, the next year it’ll be gay marriage, abortion, gun control, stem cell research, infidelity in high places, gays in the military, and so on, all kept in steady rotation. God, guns, and gays differentiate the Republican and Democratic brands.
If one looks beyond the brand label at what’s inside the box, the product is the same. Neither party offers satisfactory answers to questions such as these: what do we do about the unchecked corporate predation of the American working class? How do we stem the loss of American jobs? How do we compel Congress to refrain from corrupt practices when members of Congress have a strong interest in continuing these practices? How do we prevent the stripping of American assets and the coming liquidation of this country by oligarchs who are only interested in short-term profits?
In an ideal situation, Americans would agree to disagree about religion, and put their heads together to solve these difficult problems. In reality, it seems inevitable that the matter of religion will continue to divide Americans. Therefore, it is in the interest of uniting Americans to study the establishment clause more closely. If people could agree on what the establishment clause means, maybe they’d agree that it was a good idea from the beginning.
The first step is to place the First Amendment in a historical context. The British monarchy, during the reign of Henry VIII, “established” the Anglican Church. In other words, the king decided that public money would be spent on building Anglican places of worship and paying the salaries of Anglican clergymen. Catholics had no say in the matter. Catholics were discriminated against and non-conforming Protestant denominations – the Puritans, for example -- were discriminated against. It wasn’t until 1840 that Catholics gained political influence in Great Britain and the Anglican Church was disestablished.
The first part of the establishment clause means, therefore, that Congress must not endorse or subsidize a particular religion. This makes sense. If Congress supported Catholics, the Protestants would complain. If the government supported Protestants, not only would the Catholics complain, but a lot of unemployed preachers will start calling themselves “Protestant.”  And who’s to say they aren’t?
Already, there is a problem. When the Obama administration announced its policy on insurance coverage for contraception, Senator Orrin Hatch complained that the policy had been developed without getting the blessing of Catholic bishops ahead of time. Admittedly, advising the president to consult bishops does not violate the First Amendment, but it does show a member of Congress expressing a preference for a particular religion.This is not true to the spirit of republican virtue.
One may ask, “why Catholics?” Why not rabbis, ministers, or imams? Only 24% of Americans consider themselves Catholic, and even devout Catholics ignore the bishops when it comes to birth control. Whereas bishops can only advise members of their flock to refrain from using birth control, politicians can say to women, “on the basis of religion, women who are employed at Catholic institutions, as compared to other women, will hereby face greater difficulty and financial hardship when seeking contraception.”
To this, John Locke would have retorted, “God Himself will not save men against their wills.” He believed that abiding by the dictates of a particular religion is only sincere and only capable of saving souls when it is done voluntarily. Thus, any form of cooperation between government and leaders of a particular religious faith will be to the detriment of that faith. Or, as Voltaire put it, “Politics has its source in evil than in the greatness of the human spirit.”
Rick Santorum, candidate for the Republican nomination.
Some may quarrel that no one has a right to contraception. It is a consumer product and obtaining it is simply a private economic decision. Having employer-sponsored health insurance is not a right in this country. In this country, health insurance is a fringe benefit that is subject to favorable tax treatment as an incentive to employers to offer it. Because employer-sponsored health insurance is subsidized by taxpayer dollars, the American people have an interest in urging that the same defined set of benefits be made available to all Americans. Or, at the very minimum, the American people have an interest in ensuring that people of a particular religious faith are not denied the coverage available to people of other faiths.
Still, there is the question of what is meant by phrases like, “freedom of conscience” or “free exercise of religion.” Thomas Jefferson explained: “religion is a matter which lies solely between Man and his God.” And, he noted that “the legitimate powers of government reach actions only, and not opinions.” Thus, it is necessary to build, “a wall of separation between Church and State.”[1] The idea of two separate spheres, private belief and civil interests, finds it origin in the writings of John Locke. Civil interests include the pursuit of a livelihood, liberty, health, and property. Locke writes that “no private person has any right in any manner to prejudice another person in his civil enjoyments because he is of another church or religion.”[2]
James Madison was especially insistent on maintaining the, “essential distinction between civil and religious functions.” When the state of Virginia sought to use public money to pay teachers of the Christian religion, he rose in opposition. In developing his position, he asserted that, “The Religion … of every man must be left to the conviction and conscience of every man.”[3] In his view, the very premise of a republican society is that people only abide by laws of their own making. If people are subject to laws that are not of their own making (i.e., laws belonging to a particular religious creed or tradition), Madison believed, they are slaves.
This conceptualization of religious tolerance has a long history in America, going back at least as far as Roger Williams’ A Letter to the Town of Providence, written in 1655. In that letter, Williams imagined a ship. “There goes many a Ship to Sea, with many a Hundred Souls in one Ship, whose Weal and Woe is common; and is true Picture of a Common-Wealth.” He added, “It hath fallen out sometimes, that both Papists and Protestants, Jews, and Turks, may be embarqued into one Ship.” Williams goes on to argue that members of the various faiths should be allowed to practice their separate faiths unmolested by one another or by the captain. Still, it is better that the passengers obey the captain, because he has the authority and qualifications to maintain peace and safety for all. The captain, of course, signifies civil government. It is not the Captain’s responsibility to proselytize or improve the morals of his passengers -- in these regards, the passengers are answerable only to God. The passengers on board the ship, even if they disagree with one another on matters of faith, are united by their desire for a safe and comfortable journey. If only it were so easy.

[1] Letter to the Danbury Baptist Association, 1802

[2] A Letter Concerning Toleration, 1689

[3] Memorial and Remonstrance against Religious Assessments, 1785

Monday, March 12, 2012

On Keystone XL and Political Corruption More Generally

A Gallup poll conducted in 2010 asked respondents to summarize their impression of the federal government, and over 70% indicated that they viewed the government as either corrupt or dysfunctional. They used words like bankrupt, broken, crooked, dishonest, and evil.  On the bright side, this is one issue where Americans can agree, be they Democrats or Republicans, young or old, black or white, Southern or Northern.  

To understand why the perception of corruption has not led to corrective action, the Keystone XL pipeline provides a timely and illustrative example. First, it is necessary to review the basic facts. The pipeline will traverse about 2000 miles, snaking its way from Hardesty, Alberta to refineries in coastal Texas. It is a project sponsored by a foreign interest called TransCanada.

Secondly, despite claims to the contrary, the project will not reduce America’s dependence on foreign oil and it will not reduce the price of oil. The oil is destined to arrive at a Saudi-owned refinery. When they testified at a Canada National Energy Board meeting, TransCanada representatives testified that the oil is intended for overseas export. They also mentioned that the price of oil in the Midwest is lower than they’d prefer owing to the oversupply of Canadian oil that is already flowing into these states. Therefore, it makes good business sense to sell the oil abroad where it can fetch a higher price. And, by reducing the supply of oil that is going to the Midwest, they will be able to command higher prices there as well.[1]
Thirdly, and despite claims to the contrary, the project will have a cost for taxpayers. Keystone XL will receive generous tax breaks. Also, when the oil reaches Texas, it will enter a Foreign Trade Zone; taxes will not be collected when the oil is imported to Texas, nor will taxes be collected when the oil is exported. This lost opportunity for revenue will mean that members of Congress will have to look elsewhere, and this is ominous news for taxpayers. 

Lastly, the members of government who are most enthusiastic when touting the benefits of the project are TransCanada stockholders. Representative Michael McCaul owned between $150,000 and $300,000 of stock when he wrote a letter to Secretary of State Hillary Clinton urging her to throw her support behind the project.[2] The State Department is responsible for approving the project. Meanwhile, Paul Elliot, who had been a senior staff member of Mrs. Clinton’s 2008 campaign and later became a TransCanada lobbyist, was also seeking her support.[3] It is fair to say that there is an appearance of impropriety. 

Motiva Enterprises, owned in part by Saudi Aramco, is expanding its export capacity. Source
For a Whig, the Keystone XL project provides a “teachable moment.” It illustrates the mechanism by which members of government might profit from their association with large corporations, and do so at the expense of the ordinary taxpayer. Two of the more notable Whigs, John Trenchard and Thomas Gordon, wrote that corrupt politicians will, in order to collect thousands for themselves, cost taxpayers millions.   

Whigs understand that the potential for corruption is an aspect of human nature. In contrast, modern day Democrats are inclined to believe that corruption emanates from Republicans, just as Republicans are inclined to believe that corruption emanates from Democrats.
Republicans have embraced the Keystone XL project, because it resonates with their credo “drill, baby, drill.” More importantly, several red states are dependent on the oil and gas industry. Human beings tend to be loyal to those on whom they depend. Because they have embraced the project as their own, Republicans scoff at the notion that the project is designed to satisfy private greed at public expense.

Democrats, for their part, remain indifferent to news regarding the Solyndra scandal. Yet, there is strong evidence of impropriety in that matter as well, and President Obama is directly implicated. Nonetheless, raising the issue of Solyndra as a riposte to the issue of Keystone XL is a pointless distraction. The two matters should each be judged on their merits.

Americans appear to believe that corruption will come to an end when their favored political party finally routes the opposing party. An illustration of this is the newly launched website, Republican House of Scandal. This site, sponsored by the Democratic Congressional Campaign Committee, lists various crimes and ethical violations associated with Republican lawmakers, whether they are proven or merely suspected. 

Republicans, likewise, are keenly aware of instances of corruption among Democrats. To cite one Washington Post editorial, Democrats are said to “wallow in a culture of corruption” and the column opens with the rhetorical question, “Some days you have to ask yourself, my God, what if these people were Republicans?”[4] The premise of the editorial is that the mainstream media are biased in favor of Democrats and avoid reporting on corruption when it is found among Democrats.

In fact, for every Elliot Spitzer (D) there is a Mark Foley (R); and for every Jack Abramoff (R) there is a Charlie Rangel (D). This disheartening reality is revealed in Peter Schweizer’s book Throw Them All Out. The author is scrupulous in giving equal treatment to Republicans and Democrats when exposing instances of corruption. For example, Senator John Kerry (D) and Representative John Boehner (R) both profited from health care stocks sold and purchased – one might suspect – based on their privileged knowledge of the status of the Patient Protection and Affordable Care Act.

A partisan might argue “scandals among leaders in MY party are less egregious than scandals among leaders of THEIR party.” This way of thinking excuses corruption in some cases but not in others. This leads to hypocrisy; famously, the most vocal critics of Bill Clinton’s infidelity – Bob Barr, for example – were unfaithful themselves. The revelation of scandals is used strategically to cripple one’s political opponents. Most Democrats came to Clinton’s defense; most Republicans joined the call for further investigations. Even Richard Nixon had his defenders, in the face of mounting evidence that he had indeed been involved in the crime of breaking and entering. The consequence of this opportunistic use of scandal is that partisan voters, Republican and Democrat alike, have been asked to surrender their principles as the price of party loyalty. 

Of course, neither Democrats nor Republicans in Congress would ever vote in favor of the kind of stringent campaign finance reforms and enforceable ethical standards that would stop this wholesale corruption. It is not in their interest to do so. Partisan Supreme Court justices are also interested in maintaining the status quo; in deciding Citizens United, Justice Kennedy declared – remarkably – that there was no evidence whatsoever that campaign contributions had ever influenced the vote of a member of Congress.[5]
As noted earlier, Republicans claim that the news media are biased in favor of Democrats. Democrats have similarly claimed that the news media are biased in favor of corporate interests. In fact, the leading news outlets have failed all Americans. The words of Benjamin Franklin have proven to be prophetic: “If all printers were determined not to print anything till they were sure it would offend nobody, there would be very little printed.” Today, there is little that is printed that amounts to much: Americans are better informed about the latest Kardashian gossip than they are about acts of Congress. The Colonial Era printer, John Zenger, wrote, “The loss of liberty in general would soon follow the suppression of the liberty of the press; for it is an essential branch of liberty, so perhaps it is the best preservative of the whole.” He did not anticipate that the people of a nation would allow independent news outlets to wither away out of sheer neglect, but the consequences of the loss are the same. 

In conclusion, then, the most needed changes are these: the dethronement of the Two Party System, the cessation of internal conflict in favor of united action on the part of the American people, and the re-awakening of Americans’ passion and determination to regain control over their own government. Americans would be well advised to stop viewing instances of corruption through a partisan lens. To achieve these ends, Americans must be alerted to the folly of partisan enthusiasm, made to feel the costs of political corruption, and encouraged to believe that sweeping reforms are possible. History shows us that Americans are capable of all of these things.   


Thursday, March 1, 2012

On Becoming A Whig - A Personal Note

I will confess that, for my almost entire adult life, and begging the reader’s forgiveness, I have been a staunch liberal Democrat. I sympathized with the Green Party but cursed their meddling in the 2000 election. When the Democrats fronted deeply disappointing candidates – John Kerry and Walter Mondale come to mind – the unwavering conviction, “my party is the lesser of two evils” carried my poor stupefied body to the voting booth. 

Saint Paul was knocked off his horse while on the road to Damascus, and stood up a changed man. The events that opened my mind are these. In 2007, presidential candidate Barack Obama brought hope to out-of-work Midwesterners by denouncing the evils of the North American Free Trade Act (NAFTA). Then, in February of 2007, he sent an emissary named Austan Goolsbee to Canada to reassure political leaders there that his anti-NAFTA rhetoric shouldn’t be taken seriously. But still, I believed Barack Obama – the one who spoke to the needs of unemployed Americans, and not the one who sent councils to foreign heads of state. 

After his election to the presidency, Mr. Obama took no action on NAFTA. To the contrary, during some manufactured crisis involving debt ceilings, he quietly signed a new free trade agreement with South Korea. The shameless dishonesty of this president is sufficient cause for becoming disillusioned. Nonetheless, the reader may ask, “Isn’t free trade a good thing?” And the answer is this: a free trade agreement, like a peace treaty, is only a good thing if the terms are honorable. Neville Chamberlain’s Munich Pact is a well-known historical example of a dishonorable peace treaty. However, if one were to seek a prima facie example of a dishonorable free trade agreement, there are no examples that are so blatant and unambiguous. In the 17th century, Great Britain established something it called “free trade” with India, but this was achieved by first conquering the Indian people by force of arms. 

The era of economic imperialism is remembered with shame. Very few people living today would believe the propaganda that the colonization of India, Africa, and South America was motivated by a humanitarian impulse. And now, an even more shameful phenomenon is occurring: political leaders are collaborating with international corporate oligarchs to colonize their own countries. In the case of NAFTA, this means taking jobs out of the hands of American workers and sending them to Mexico. The American auto worker does not benefit from this, but the CEO and shareholders of the Big Three American auto makers enjoy larger profits as a result. The American consumer does not pay reduced prices on produce from Mexico, but the American farmer starves. 
Internal colonization in Appalachia discussed here.            Image Source.

The heads of large corporations and the financiers who make this possible contribute large sums to election campaigns, and in exchange, corrupt political leaders casually ignore what is in the interest of the American people. 

When an American is no longer able to support the Democratic Party, he or she is seemingly left with few choices. First, the individual may decide to support the Republican Party instead, only to discover that the two major parties are equally responsible for the internal colonization of the United States. Secondly, the individual may decide to become an independent voter, which is in fact not a meaningful alternative to voting for one of the major parties. Or, as nearly half of eligible voters have done, the individual may decide to stop participating in the electoral process, and give up any hope of change. 

The last option is to vote for a so-called “third party.” The Green Party and the Progressive Movement are to the left of the Democratic Party, and the TEA Party and the Libertarian movement (generally speaking) fall to the right of the Republican Party. These parties have so far failed to make much of an impact because they are by nature partisan. They are not meant to provide a voice for all Americans, but are instead meant to provide a voice for people who are guilty of a nostalgic attachment to the ideals of conservatism or liberalism. 

Given these premises, the Whig Party represents an alternative way of thinking about “third parties.” The aim of the Whigs is not to defend either a conservative or liberal ideology. Instead, the Whigs aim to renew Americans’ faith in the wisdom of the Founders of this nation. The Founders saw what the British Empire meant by “free trade,” and when they recognized that the American colonies were about to suffer the same fate as India, they declared a revolution. The Founders understood that extreme wealth in the hands of a few oligarchs has the potential to corrupt political leaders and poison election campaigns. Also, the Founders articulated a set of beliefs regarding the nature of liberty, and these beliefs were embraced by individuals who had very different economic interests from one another: the farmers and shopkeepers, the landless and the propertied, rich and poor. 

Certainly, there is much to quarrel about when deciding on the “original intentions” of the Founders, and there is a time and a place for the more academic fine-points. The more important aim is to identify principles on which Americans can agree, and champion values that Americans can rally around. This is not the same as “centrism” or “moderation.” This is a matter of passionately defending liberty in the face of an unprecedented danger.