The Pity Party (27 page)

One defense of affirmative action was that while its costs might seem high, and even unfair, to the individuals denied educational and career opportunities for the sake of diversity, these costs were not particularly heavy for society overall, considered in light of affirmative action's benefits. Allan Bakke completed medical school, and went on to read in the
New York Times Magazine
in 1995 that he did not “appear to have set the world on fire as a doctor,” since he “has no private practice and works on an interim basis, rather than as a staff physician” at a hospital. The article, written by Nicholas Lemann, contrasted Bakke's career with that of Patrick Chavis, one of the black UC Davis medical students admitted under the affirmative action program struck down by the Supreme Court in 1978. Chavis “freely admits,” wrote Lemann, that “he would not have been admitted strictly on the basis of his grades and test scores. . . .” But while Bakke didn't set the world on fire, America was clearly a better nation for having gone out of its way to give Chavis a medical education, since he went on to become an obstetrician-gynecologist whose practice was devoted to the poor and underserved. “If Chavis hadn't gotten into medical school,” Lemann stated, “his patients wouldn't be treated by some better-qualified white obstetrician; they'd have no doctor at all and their babies would be delivered the way Chavis was—by whoever happened to be on duty at the emergency room of the county hospital.”
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Affirmative action became a central controversy of the 1996 election when California considered (and ultimately passed) a ballot initiative, Proposition 209, severely restricting it. Senator Edward Kennedy relied on the feel-good story about Dr. Chavis in telling a Senate committee in April 1996, “He is the supposedly less qualified African American student who allegedly displaced Allan Bakke at UC Davis and triggered the landmark case. Today, Dr. Chavis is a successful ob-gyn in central Los Angeles, making a difference in the lives of scores of poor families.” Unfortunately, in June 1996 Patrick Chavis also made a difference in the life of Tammaria Cotton, on whom he performed liposuction surgery, a sideline taken up to increase revenue for his medical practice. Cotton went into cardiac arrest while still at the clinic where Chavis had performed the surgery, after the doctor had left to check on another liposuction patient who was recovering in Chavis's home. Because of his absence and failure to leave adequate instructions for the clinic's nurse on caring for Cotton, she died later that day in the hospital. Other Chavis liposuction patients suffered severe infections and massive blood loss, according to the California Medical Board, which suspended Chavis's license to practice medicine in 1997 and revoked it in 1998. “Defenders of the policy said affirmative action should not be judged by one man's performance,” the
Los Angeles Times
reported after Chavis's medical career had collapsed. That's a prudent reminder, but an unpersuasive one coming from the same quarters that had so recently told the more encouraging parts of the Chavis story in order to argue that affirmative action
should
be judged by one man's performance.
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Diversity, finally, qualifies as meta-bullshit not only because it is a benign-sounding though problematic stalking horse for reverse discrimination, but because there's a strong argument that the net effect of implementing diversity is to harm, not help, members of minority groups. Affirmative action, a vehicle for feeling good while doing bad, is in that sense a paradigmatic case of prescriptive bullshit. According to Richard Sander and Stuart Taylor Jr., the primary consequence of plus factors in college admissions as hefty as those discovered by Thomas Espenshade is to mismatch students and institutions. The “beneficiary” of affirmative action “finds himself in a class where he has weaker academic preparation than nearly all of his classmates. The student who would flourish at, say, Wake Forest or the University of Richmond, instead finds himself at Duke, where the professors are not teaching at a pace designed for him—they are teaching to the ‘middle' of the class, introducing terms and concepts at a speed that is unnerving even to the best-prepared student.” Civil rights activists denounced the reduction in the number of black and Hispanic students enrolled at the very competitive University of California, Los Angeles (where Sander is a law professor) after Proposition 209 curtailed affirmative action. What they did not mention was that while fewer students served the function of being others' black and Hispanic experience, or imparted the warm glow throughout the university of furthering the cause of diversity, the number of UCLA
degrees awarded
to black and Hispanic students in the five years after Proposition 209 was the same as the number awarded in the five years before it. The students missing on account of 209 were mostly ones who would not have graduated from UCLA, having been induced to attend it rather than one of the many institutions where they might well have flourished.
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If the alliance of experts and victims is to prevail in a democracy, as many voters as possible must (a) either regard themselves as victims or feel sorry for others they believe to be victims; and (b) respect and defer to experts to solve the victims' problems. For their part in advancing the alliance's political arguments and cause, experts need to demonstrate their expertise not just by solving problems, but by characterizing the problems they propose to work on as big, urgent, and complex. To do otherwise, and suggest that some problems are small, manageable, and straightforward, would undercut the argument for relying on experts.

A vital term in the experts' rhetorical inventory is “comprehensive.” Big problems need big solutions. But when the experts are, in effect, getting paid by the hour, small solutions are never recommended because small problems are never detected. During the debate over President Obama's health care proposals, advocates for comprehensive reforms repeatedly deplored the fact that 47 million Americans lacked health insurance. Balamurali Ambati, a University of Utah ophthalmologist, contended that statistic did not mean what it seemed to. It included, for one thing, 14 million people who were eligible for existing government health programs, such as Medicare, Medicaid, or veterans' programs, but for one reason or another had not enrolled. Of the remaining 33 million without insurance, nearly 10 million were noncitizens. During the frightening economic reversals of 2009, Democrats insisted they were not interested in reforms that would give taxpayer-subsidized health care to people who came to the country voluntarily, and in some cases in violation of American immigration laws. Another 9 million uninsured Americans had household incomes exceeding $75,000. These were people who hadn't secured health insurance as opposed to people who couldn't. Subsequent policy debates and experience would make it hard to see these uninsured people as victims of America's health care system. They were, instead, the heedless “young invincibles” who were willfully exacerbating its problems by refusing to throw their healthy selves into the national risk pool. Of the remaining 14 million people without health insurance, somewhere between 3 and 5 million were, at any given moment, uninsured for a period of two months or less, mostly as a result of being between jobs or just beginning new ones. “That leaves about 10 million Americans who are chronically without insurance,” wrote Ambati, or some 3 percent of the population, a problem that should not “require a wholesale overhaul” of American health care.
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Sweeping solutions for what turn out to be discrete problems, however, elevate the status and importance of expert findings, and of expertise itself. No expert, as a result, is put in the embarrassing position of saying, “The fact is, we don't really understand this problem very well, or have any particularly encouraging ideas of how to solve it. Rather than try something big and bold, which would be reckless under the circumstances, we should make modest, incremental changes and carefully study their consequences.”

In 2009, during the debate over health care reform, the president's Council of Economic Advisers cited studies by the Dartmouth Institute for Health Policy and Clinical Practice in a report claiming that “nearly 30 percent of Medicare's costs could be saved without adverse health consequences.” Moreover, if the changes that would capture those wasted expenditures could be applied to all health care outside of Medicare, the result would be to reduce health care spending from 18 to 13 percent of GDP. Journalist Virginia Postrel asked why “a report that claims that Medicare is wasting 30 percent of its spending thinks it's making a case for making the rest of the health care system more like Medicare.” In other words, if we
are
wasting 30 percent of our Medicare outlays, why don't we apply a new set of reforms to Medicare
first
, and
see
whether or not they work, rather than just
assume
they'll work and apply them to the entire health care system? Peter Orszag, President Obama's first director of the Office of Management and Budget, responded to Postrel's question by saying that making Medicare efficient was politically impossible, since interest groups like AARP would oppose even the prospect of savings that might someday involve benefit reductions unless they were preceded by clear, irrevocable expansions in health care coverage.
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In a 2009 address to Congress, President Obama said that the “commitment” to “quality, affordable health care for all Americans” is “a step we must take if we hope to bring down our deficit in the years to come.”
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The face-value meaning of that declaration was that expanding health care to all Americans was going to save the federal government more money than it would cost, so much so that getting federal borrowing under control would be impossible without the commitment to health care for all. One assumption widely touted by advocates of what became Obamacare was that making sure no one lacked health insurance would cut down on the use of the expensive care offered by emergency rooms, especially by the uninsured who could not otherwise afford to see a doctor, even for medical problems that were not emergencies. A study released in 2014, however, showed people newly enrolled in Medicaid were 40 percent
more
likely to go to emergency rooms than socioeconomically similar people not covered by Medicaid. It turns out “covering people with health insurance doesn't save money,” economist Jonathan Gruber, who had advised the Obama administration on health care policy, told the
Washington Post
. Showing skills that would have served him well in diplomacy or public relations, he continued, “That was sometimes a misleading motivator for the Affordable Care Act. The law isn't designed to save money. It's designed to improve health, and that's going to cost money.”
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Comprehensiveness serves another political purpose. Insisting that comprehensive reform is the only path forward has the effect of stipulating that changes nonexperts might find sensible are ones that cannot be disaggregated from, and are going to be held hostage to, changes the experts deem necessary. Securing the nation's borders and enforcing its immigration laws, accordingly, is not a “viable” stand-alone option. It can only work, reform advocates have stated over and over, as part of a package that “normalizes” the status of “undocumented” workers, giving them a way “out of the shadows” and toward full citizenship. As with health care, the notion that we can address one issue
and
then
another, taking our bearings by analyzing the practical consequences of incremental steps rather than implementing entire systemic theories, is ruled to be somehow out of order.

The cult of complexity responds to that political challenge by enacting simple reforms in a complicated manner. Discovering complexity where it may not exist is always a useful way for experts to undermine policy measures they opposed but couldn't thwart. Thus, complaints that the border between Mexico and America was unacceptably porous led to an elaborate project for an $8 billion electronic “fence” relying on radar, cameras, and satellite signals. In 2010, after years of testing and futility, the director of the project at the Department of Homeland Security told the
Los Angeles Times
, apparently with a straight face, “It was a great idea, but it didn't work.” When Homeland Security secretary Janet Napolitano ordered “a department-wide assessment” of the project, a spokesman for the Federation for American Immigration Reform, a restrictionist group, said, “Instead of spending a lot of time reassessing, they should get out there and do the sorts of things we know work effectively to get control of the border, such as double fencing and more manpower.”
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In proclaiming “our credo” to the 1984 Democratic national convention, Mario Cuomo began by saying, “We believe in only the government we need, but we insist on all the government we need.” On the occasions when liberals rhetorically engage the question of how much government we need, they usually operate at such a high level of abstraction that the answer could mean almost anything. “All the government we need,” for example, is open to debate, which means citizens across the ideological spectrum could conclude their various, incompatible answers are each consistent with Cuomo's standard.

Liberals prefer to make the case for their position—we need much more government—by particularizing rather than generalizing. This means, above all, depicting suffering situations and imploring Americans to respond compassionately by demanding government programs that aid the sufferers. Liberals frequently connect programs with categories of sufferers. Nicholas Kristof of the
New York Times
, for example, wrote in 2013, “[S]lashing food stamp benefits—overwhelmingly for children, the disabled and the elderly—wouldn't be a sign of prudent fiscal management by Congress. It would be a mark of shortsighted cruelty.”
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