I was working on a post about the whole question of whether health insurance would really be affordable under the health care bill before the Senate, when I actually stumbled on a somewhat different point. This is a chart I made based on Consumer Expenditure Survey data showing health care spending as a proportion of income and as a proportion of household expenditures, broken down by income quintile:

What I think this really should remind us of is the basic fact that being poor in America is not affordable situation. For the bottom 40 percent, overall expenditures substantially exceed income. Indeed, the bottom 20 percent spend over 100 percent of their pre-tax income on housing and transportation alone. They have literally no extra income “left over” for food, utility bills, and clothing to say nothing of health care.

Which is just to say that to look at the health care situation in isolation and say “does this legislation really make it affordable?” is to an extent to miss the point. It’s already not affordable. Nothing is affordable at the bottom of the pyramid. The bill is, however, highly redistributive. The extra tax burdens will fall overwhelmingly on prosperous people, and gives a bunch of extra money & services to people in the bottom half. Unless you think health care is a really frivolous expenditure item such that getting more of it will do very little good (this, for example, is cool but totally useless and bizarrely expensive) then it’s hard for me to see how economically struggling families don’t on balance come out of this less economically struggling.

Everyone thinking about health care or climate change or really any other major issue ought to take some time this weekend and read Max Weber’s “Politics as a Vocation.” I quoted the final paragraph on this blog before with specific reference to the health care debate, but it’s not that long and the whole thing is brilliant and important.

I first started thinking about Weber and contemporary politics thinking about foreign policy. Especially this:

We must be clear about the fact that all ethically oriented conduct may be guided by one of two fundamentally differing and irreconcilably opposed maxims: conduct can be oriented to an ‘ethic of ultimate ends’ or to an ‘ethic of responsibility.’ This is not to say that an ethic of ultimate ends is identical with irresponsibility, or that an ethic of responsibility is identical with unprincipled opportunism. Naturally nobody says that. However, there is an abysmal contrast between conduct that follows the maxim of an ethic of ultimate ends–that is, inreligious terms, ‘The Christian does rightly and leaves theresults with the Lord’–and conduct that follows the maxim of anethic of responsibility, in which case one has to give an accoun tof the foreseeable results of one’s action.

There’s a whole long essay here, but to boil it down to its essentials the point is that there’s a place for the ethic of ultimate ends but that in politics you need an ethic of responsibility.

And a lot of what goes wrong in American foreign policy commentary, I came to see, was a refusal to adopt the ethic of responsibility. Instead, people would want to orient themselves in a way that expresses a sense of moralized outrage. So if some country is bad, a proposal to do bad things to that regime must be good, because what’s right is to be on “the right side” in some maximal way. Anything less is “realism” and a betrayal of ideals about human rights and democracy. The problem is that what’s needed, from a humanitarian point of view, is a foreign policy that does in fact make conditions around the world better not a foreign policy that expresses high ideals and a grand sense of purpose.

“Realism” pursued on behalf of purely selfish goals is immoral, but the pursuit of laudable goals in an unrealistic and destructive manner doesn’t help anyone.

And the same applies in other arenas of the political. On the climate front, in particular, I note a strong tendency among certain kinds of thought-leaders and activists to treat the issue as if it’s a phantasmagoria whose purpose is to demonstrate their own righteousness and the clarity of their searing moral vision. As if the goal is that hundreds of years after we fail, when our civilization has collapsed and a new one has taken its place, their archeologists will uncover records of our blog posts and determine that Bill McKibben’s prophesies of doom were the most eloquent and dire. The sensible goal, however, is to avert the collapse. To do the best we can today, and the best we can tomorrow and the best we can the day after that. And next week? To do the best we can. And again next month and next year and next decade.

Which is perhaps a long-winded way of explicating Weber’s maxim: “Politics is a strong and slow boring of hard boards.”

Part of what Ben Nelson seems to have gotten in exchange for his vote is an arbitrary extra year of federal Medicaid funding for Nebraska. There’s no conceivable policy justification for this, but it’s a small price to pay for the support of a crucial senator. But when I say it’s a “small price to pay” I mean that quite literally—the amount of money involved is tiny. The ability to do this mostly underscores how ridiculous Nelson’s Medicaid objections were to begin with.

Word on the street is that it’s to say he’s reached an agreement and will be the sixtieth vote for health reform.

Meanwhile, DC is covered in snow. Not that much snow by the standards of New England or the Upper Midwest, but probably more than enough to overtax the city’s limited “dealing with snow” capabilities.