Wednesday, May 30, 2007

UI Held Hostage Day 494 - Healthcare, Search, Downtown

May 30, 2007, 7:30 a.m., 8:30 a.m., 10:55 a.m.

Today's topics

Senator Obama's Heathcare Proposal
Search Committee II Meeting Today; Campus Visits Plan
Downtown Iowa City's Planning Meeting

Senator Obama on Healthcare

Although Senator Obama's healthcare proposals are in some ways only yesterday's news, and indeed were reported here in yesterday's blog entry, Nicholas Johnson, "UI Held Hostage Day 493 - Sen. Obama's Healthcare," May 29, 2007, it's all over today's papers. In fact, given how the national media is playing this story, it was a rather peculiar editorial decision at The Gazette that resulted in its placing its story this morning on page 3B rather than page 1A: James Q. Lynch, "Obama Unveils Health Plan," The Gazette, May 30, 2007, p. 3B.

I thought Dean Borg's report in this morning's "Morning Edition" on NPR an especially well edited, written, and delivered piece. (It should be available later this morning from Yesterday's blog entry linked to an early version of Kathryn Fiegen's story in this morning's Press-Citizen.

And, as you might imagine, State29 has his own take on what he characterizes as Obama's "snake oil health scare plan," State29, "Snake Oil Obama," May 30, 2007.

Clearly Senator Obama's is a "detailed plan" -- or about as detailed as you're likely to get as a campaign document from a candidate. It responds to the attacks from Senator Obama's toughest critics that he's just an inexperienced, charismatic, "empty suit" who won't reveal what he stands for. That has always been an unfair and inaccurate charge in any event, but yesterday's proposal should help answer it. It also responds to the SEIU demand that all candidates reveal their detailed healthcare proposals by August 1. (Senator Obama now joins former Senator John Edwards as one of the only two to do so.)

If you're hoping for "universal, single-payer" healthcare (as I lean toward -- and State29 leans as far away from as he possibly can without falling over) -- as is provided to the citizens of virtually every other industrialized nation -- this ain't it. But until we get meaningful public financing of campaigns, I'm not sure that's in the cards from this "best Congress that money can buy." So maybe this is a much better plan in its details than the "universal, single-payer" critics give it credit for. Maybe it's the most that a pragmatic, politically savvy healthcare policy wonk can honestly and realistically put forward.

Those who oppose any changes in the healthcare system will oppose this plan, just as they would oppose any other. But those who have a major economic stake in the present system, have disproportionate political power in shaping future changes, and are aware that some changes are simply going to have to come, may well get on board, figuring that this is the least-worst of the possible scenarios.

(1) The super rich don't need (and many don't even want) President Bush's tax cuts for the rich. That's a realistic source of funding for Senator Obama to look to for the modest public investment in healthcare he envisions -- but repealing those cuts will certainly not be a "slam dunk" for any president. (And, even if successful, we're still left with the roughly $40 trillion in unfunded entitlement obligations scheduled to become due and payable within the next 20 years or so.)

(2) His program will continue to be administered by the plethora of insurance companies we have now, which means doctors and hospitals will still be dealing with a variety of forms and reimbursement procedures, and we'll continue to pay these companies' executives healthcare administrative costs many times those of other countries. That should take at least much of the sting out of what would otherwise have been the overpowering objections of this politically influential group.

(3) The system will still be (in terms of numbers of persons covered) an employer-based healthcare system. So it's not disruptive in that regard. Why should employers support a proposal that continues to leave much of the burden on them? Because he lightens their burden. He points out that 80% of the cost of healthcare goes to benefit 20% of the people. And he proposes shifting much of that 80% to the federal government. He represents that this will result in lower premiums for the insured. Well, perhaps. But we've all seen lots of instances when that didn't occur -- as when the price of oil declines and the prices of gasoline goes up. (a) What provisions are there to insure that this element of his program won't simply further enrich insurance companies and employers, rather than reduce premiums for employees? (b) And, given the rate of inflation in healthcare costs, how many years will it be -- even under the best case scenario, with all the cost-shift benefits going to employees -- before the premiums are back up to what they are now?

(4) As for the currently uninsured, or under-insured, or only-sometimes-insured, Senator Obama proposes that the federal government "subsidize" the cost of premiums for those unable to pay market rates. But what will be the practical effect, and benefit, for, say, an unemployed, homeless, single, high school dropout, male in his mid-thirties? I mean that as a real question, not an assertion.

Look, I don't claim any more expertise on this subject (economics in general, and the economics of healthcare in particular; even though I guess I did serve for a time as co-director of the University of Iowa's Institute for Health, Behavior and Environmental Policy) than I do for any of the other subjects I write about. Moreover -- as also with those other subjects -- I quite regularly change my position once someone bothers to explain to me the errors in my thinking. So this is not, to borrow from the TV show, "my final answer." But it's what I'm thinking this morning.

Search Committee II Meeting Today; Campus Visits Plan

The quote from Professor Steve Collins, and the headline on Brian Morelli's story, make a powerful point in support of early revelation of the identity of potential UI presidential candidates. Brian Morelli, "Vetting Finalists Will Reveal Key Info," Iowa City Press-Citizen, May 30, 2007, p. A3.

He quotes Steve Collins as saying, "Once your candidates have been publicly identified, the search committee can then call a wide variety of people. You also start hearing from faculty members here and at other universities that have information about the person." Collins speaks from experience. He chaired the UI search committee in 1995.

Collins continues, "I think when presidential searches around the country get into to trouble it is because they haven't spent enough time with the search and screening process."

That squares with my own experience with search committees. I recall one where a supposedly high powered (and certainly well paid) search firm was involved. We didn't have assignments, but I decided to take on a little interviewing on my own. I merely checked the Internet, and called some folks who had worked with the candidate and seemed logical people to talk with. What I came up with was extremely relevant. And yet none of the information I easily found on the Internet was presented to us by the search firm. None of the people I interviewed had ever talked to anyone at that firm or the institution doing the hiring.

(As Morelli quotes Search Committee I vice chair and UI history professor Katherine Tachau as saying, "[there are] two types of reference checks, a formal check with calls to candidates' references and an informal process of finding your own sources. The formal check is minimally useful, she said. 'It is not enough to hire on. That in combination with background checks are not enough. . . . The disadvantage of formal [checks is that those you interview] will not want to tell you anything negative about a candidate. ... No one becomes an adult without an enemy here or there. There are going to be negative comments out there [that will come out of the informal process].")

The University and Iowa City communities are made up of individuals who, together, will have hundreds of potential sources of information about any candidate Search Committee II will come up with. But they are not going to be able to gather that information in 48 hours. Some Iowa City folks will be out of town, and won't even know the person was a candidate. Some of the potential sources we know will be out of the country, or on holiday.

And many of the potential sources aren't immediately obvious. They come out of the serendipity of chance encounters and conversations.

"Where did you say this provost is now?"
"X university."
"You know, I think my neighbor's daughter graduated from there last year. Let me see if I can find out anything from her."

or . . .

"X university, eh? You know, I was on a panel a couple of years ago with a woman faculty member from there. I'm now remembering something she said at the time about his treatment of women. She left shortly thereafter. Let me look through my notes, see if I can find her name, and track down where she is now. We probably ought to find out more about that."
When you are able to have 10,000 people having those conversations -- instead of just the 10 or 15 on a search committee -- and you give the process months, rather than two days, to work through all the people included within their "six degrees of separation" you can avoid the problems Steve Collins identifies: "I think when presidential searches around the country get into to trouble it is because they haven't spent enough time with the search and screening process. When a search fails or presidents are appointed and they fail, I would consider that failures of the search process."

Search Committee II has done an excellent job of meeting one of its goals: keeping the UI and Iowa City communities in the dark, and giving the potential candidates a veil of confidentiality and secrecy. Whether, as a result, they will have "spent enough time with the search and screening process" will only be known after we are able to evaluate our new president's performance over the next year or two.''

Downtown Iowa City's Planning Meeting

The Iowa City Press-Citizen is not exactly noted for being hostile to local business. So when there was absolutely nothing in the paper (that I saw) on Monday or Tuesday (before the meeting) or today (following it) I should have figured out that the meeting I went to last night was not intended to be a public meeting.

The problem was, I thought I had read about it in the paper and that it was open to all. It turns out the reason I knew about it was because of an email my wife had been sent.

The meeting was led by a woman from the "Marketek" consulting firm for which the City of Iowa City is picking up the $62,500 tab as a gift to the business community. The other sponsors of the undertaking are the Iowa City Area Chamber of Commerce and the Downtown Association (for the leadership of which, I should add, I have very high regard).

It was one of those meetings with which you are surely familiar at which a consultant stands in front of the room, asks questions, and then writes on a flip chart or white board, or puts little sticky dots on posters of ideas -- or, on this occasion, took little slips of sticky paper on which audience members wrote ideas and stuck them on the wall. Ultimately they write up what you've said and sell it back to you.

Well into the meeting I felt a little like I'd accidentally walked into the wrong restroom. But since it wasn't a restroom, and no one seemed startled or hostile, we stayed. It was kind of interesting in its own way, and got me to thinking about what my vision of a future downtown Iowa City might be were I to have a vision, and were it to make any difference what my vision was.

While the Press-Citizen didn't cover the event The Gazette did. Gregg Hennigan, "Housing Urged in Downtown I.C.," The Gazette, May 29, 2007, p. 1B. He picked up on my remark that "the area was no longer the business hub of the community it was when he was a child.' At that time, downtown was the mall,' he said."

My own vision builds on that observation -- as well as much of what I heard during the evening.

For starters, we should stop referring to it as "downtown" and start thinking of it as a "neighborhood."

When I was a kid (late 1930s, 1940s), the University of Iowa notwithstanding, Iowa City had a lot in common with any one of the other 98 county seat towns in Iowa -- except for the lack of a "square." It was where the surrounding farmers came on Saturdays to trade and shop. "Downtown" was the shopping area -- somewhat like today's malls -- with grocery and hardware stores, department and clothing stores, Sears and Wards, a couple of banks and book stores, movie theaters, and an ice cream parlor. There were no parking garages built by the City, nor parking meters lining the streets (though there were still some hitching posts around town). You parked in front of the stores.

Whether or not one would like to recreate that kind of shopping center downtown today (and I'm not sure I would) there's just no way that's going to happen. There's a reason why people like shopping malls and big box stores -- not the least of which is the freedom to park, for free, without the hassle of driving round and round in a parking garage while paying by the hour for the privilege.

So I think this new neighborhood needs to be a place where people live, not where they shop. And not just a place to live for those who desire, and can afford, condos going for between $250,000 and $1 million. A diverse population of college students and working class, and a variety of nationalities and ethnic groups, not just the wealthy. A place of arts and entertainment and restaurants. A bar or two, perhaps -- but not the 40 or 50 we have now. More trees and plants. A place that's friendly to bicycles and electric golf carts and those who like to walk. A place that's fed with shuttle buses running every 5 minutes to large parking lots (not garages) on the outskirts of the neighborhood. Interesting architecture. Historic markers telling the story of prior occupants.

But, quite frankly, I don't think my vision, or that of anyone else, will make much difference. I think we will continue to have the bars, traffic and parking garages. I think what will determine what downtown Iowa City becomes are those who profit from promoting Iowa City as the under-age alcohol abusers' binge drinking capital of America. That and the
profit opportunities perceived and seized upon in the projects of our wealthy developers -- at least those projects ultimately approved and funded with taxpayers' money by a subservient City Council.

But it was fun to think about for an evening anyway.

UICCU and "Optiva"

The UICCU-Optiva story is essentially behind us. There may be occasional additions "for the record," but for the most part the last major entry, with links to the prior material from October 2006 through March 2007, is "UICCU and 'Optiva'" in Nicholas Johnson, "UI Held Hostage Day 406 - March 3 - Optiva," March 3, 2007. Since then there have been two major additions: Nicholas Johnson, "Open Letter to UICCU Board" in "UI Held Hostage Day 423 - March 20 - UICCU," March 20, 2007, and "'Open Letter': Confirmation from World Council of Credit Unions" in "UI Held Hostage Day 424 - March 21 UICCU," March 21, 2007.

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[Note: If you're new to this blog, and interested in the whole UI President Search story . . .

These blog entries begin with Nicholas Johnson, "UI President Search I," November 18, 2006.

Wondering where the "UI Held Hostage" came from? Click here. (As of January 25 the count has run from January 21, 2006, rather than last November.)

For any given entry, links to the prior 10 will be found in the left-most column. Going directly to will take you to the latest. Each contains links to the full text of virtually all known media stories and commentary, including mine, since the last blog entry. Together they represent what The Chronicle of Higher Education has called "one of the most comprehensive analyses of the controversy." The last time there was an entry containing the summary of prior entries' commentary (with the heading "This Blog's Focus on Regents' Presidential Search") is Nicholas Johnson, "UI President Search XIII -- Last Week," December 11, 2006.

My early proposed solution to the conflict is provided in Nicholas Johnson, "UI President Search VII: The Answer," November 26, 2006.

Searching: the fullest collection of basic documents related to the search is contained in Nicholas Johnson, "UI President Search - Dec. 21-25," December 21, 2006 (and updated thereafter), at the bottom of that blog entry under "References." A Blog Index of entries on all subjects since June 2006 is also available. And note that if you know (or can guess at) a word to search on, the "Blogger" bar near the top of your browser has a blank, followed by "SEARCH THIS BLOG," that enables you to search all entries in this Blog since June 2006.]

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Media Stories and Commentary

See above.

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Anonymous said...

I can still recall the mall being built downtown. I recall them having a midway on that area downtown in the 70's and the "urban renewal" that created the ped mall, etc. I often wonder what it would be like downtown now if those streets had not been closed.

Anonymous said...

One of the things that I remember about the downtown of the 70s was the mixed population of the surrounding neighborhoods. There used to be many families who lived in the bowl; from Brown to Bowery and from Summit to the river. Now Northtown is the only area that remains mixed, there are very few families that still live south of Bloomington. I used to live in that area but I got tired of being woken up at 3 in the morning and finding drunken brawls in my front yard.
I would love to see a study of the residents of the Ecumenical Tower about their quality of life. If indeed they live above it all - the sirens, the mating howls of homo inebreatis and the stench of urine and emesis in the morning - then we may end up with a stratified downtown. Student culture will prevail on the first three floors and a Moen-Metro culture on the upper floors.