Category Archives: populism

an overlooked win for civic renewal: federally qualified health centers

My chief complaint about the health care reform of 2010 was its apparent failure to include active citizens as designers of the bill (the public could have been asked to deliberate about health reform, as Senators Wyden and Hatch proposed), or as proponents of the bill (the administration could have unleashed a grassroots movement to demand passage), or as active participants in administering health care (the bill could have empowered health insurance co-ops).

Yet the bill actually contains many excellent provisions that have received little attention. One reform is a major increase in the authorized funding level for Federally Qualified Health Centers (FGHC). The extra money should raise the number of such centers to 15,000. An FQHC is a local provider, serving a needy community, that gets favorable Medicare and Medicaid reimbursement rates, access to the National Health Service Corps, and other federal supports. It must be a nonprofit organization or a public entity, and it must have a board of which more than half are current clients of the center who demographically represent the population that the center serves.

Overall, the trend in public administration has been toward centralization and expertise. Based on data collected by Elinor Ostrom, I estimate that the proportion of Americans who serve on any public board has declined by three quarters since the mid-20th century, due to consolidation of public authorities and the replacement of elected offices with professional positions. This means that we have lost powerful educative experiences for our citizens. At the same time, our public institutions have grown remote and distrusted, and we have missed the energies and ideas of people not deemed to be “experts.”

Controlling health care costs is a classic “wicked problem,” involving complex, interconnected systems, rapid and unpredictable change, valid but conflicting values and interests, and misaligned motives. In general, wicked problems are best addressed by decentralizing control and empowering mixed groups of people, including those most affected by the problem. The administration’s support for Federally Qualified Health Centers promotes this populist approach and deserves recognition.

on public work and alienation

Neighbors love a local stream and are concerned about its health. Thanks to them, a pedestrian footbridge is built over it to provide access and to reduce car pollution. It doesn’t matter much whether people cause the bridge it to appear by lobbying the local government to build it, persuading a private company to donate it, or physically erecting it themselves. So long as the bridge was their idea and the fruit of their collective discussion and effort, several advantages are likely to follow: 1) Because they designed it, it will meet their needs and reflect their talents. 2) Because they made it, they will feel a sense of ownership and will be motivated to protect it. 3) Because they are formally equal as neighbors, not ranked in a hierarchy, each will feel a sense of dignity and status. 4) In shaping their public world together, they will gain a feeling of satisfaction and agency that is available nowhere else. And 5) By combining discussion with collaborative action, they will develop skills, relationships, and political power that can transfer to other settings.

None of these outcomes is guaranteed, nor would I ignore the possibility of arguments, tensions, and downright failures. But some of the advantages are impossible to obtain in other ways.

The bridge is just a metaphor. We don’t need to burden the earth with unlimited numbers of new structures. Restoring nature is equally valuable, as are various forms of non-tangible and non-permanent goods: events, performances, ideas, cultural innovations.

I don’t think that who owns the good is of fundamental importance. There are five basic options: no ownership at all (which is the case with the high seas), government ownership, an individual owner, a for-profit corporate owner, or a nonprofit corporate owner. These legal arrangements are relevant, but they do not determine whether people can do public work together. Other factors, such as motivations, norms, expectations, and rewards, interact with the legal status of goods in various complex ways.

Thus a great example of a publicly created space might be a coffee house, papered with posters for local events, populated by a cross-section of the community. That coffee house may belong to and profit one person, who (along with his or her customers) can rightly feel responsible for building a common space. Meanwhile, a government-owned underpass nearby may be the most forbidding and hostile, anti-public space in town.

As Elinor Ostrom noted in her Nobel Prize Lecture, how people manage a common-pool resource depends in part on whether they are organized as (for instance) “private water companies, city utilities, private oil companies, and local citizens meeting in diverse settings.” Their behavior differs, too, depending on the rules of the game: for example “when they meet monthly in a private water association, when they face each other in a courtroom, and when they go to the legislature.” Despite these differences, Ostrom and her colleagues have begun to build one overall framework for understanding the management of common-pool resources–a framework that tends to downplay the dichotomy between state and private sector that seems fundamental in other theories. One could say that in this framework, citizens are at the center and they have available a plurality of institutional forms and combinations of forms.

Still, I think there is a sense of “public” that makes the creation of public goods particularly precious. My imaginary bridge and coffee house may have different legal status, but they share the advantages listed in the first paragraph above. The outputs of government bureaucracies and private corporations usually lack those advantages, which is why people are alienated from the world that those entities jointly create. Governments can incorporate public creativity and work into their operations, and that would be the best way to make people like the government more. Unfortunately, it is not the main trend in public administration anywhere in the developed world.

against a cerebral view of citizenship

For a faculty seminar tomorrow, a group of us are reading Aristotle’s Politics, Book III, which is a classic and very enlightening discussion of citizenship. Aristotle holds that the city is composed of citizens: they are it. Citizenship is not defined as residence in a place, nor does it mean the same thing in all political systems. Rather, it is an office, a set of rights and responsibilities. Who has what kind of citizenship defines the constitution of the city.

According to Aristotle, the core office or function of a citizen is “deliberating and rendering decisions, whether on all matters or a few.”* In a tyranny, the tyrant is the only one who judges. In such cases, the definition of a good man equals that of a good citizen, because the tyrant’s citizenship consists of his ruling, and his ruling is good if he is good. Practical wisdom is the virtue we need in him, and it is the same kind of virtue that we need in dominant leaders of other entities, such as choruses and cavalry units. Aristotle seems unsure whether a good tyrant must first learn to be ruled, just as a competent cavalry officer first serves under another officer, or whether one can be born a leader.

In democracies, a large number of people deliberate and judge, but they do so periodically. Because they both rule and obey the rules, they must know how to do both. Rich men can make good citizens, because in regular life (outside of politics) they both rule and obey rules. But rich men do not need to know how to do servile or mechanical labor. They must know how to order other people to do those tasks. Workers who perform manual labor do not learn to rule, they do not have opportunities to develop practical wisdom, but they instead become servile as a result of their work. Thus, says Aristotle, the best form of city does not allow its mechanics to be citizens.

Note the philosopher’s strongly cognitive or cerebral definition: citizenship is about deliberating and judging. Citizenship is not about implementing or doing, although free citizens both deliberate and implement decisions.

But what if we started a different way, and said that “the city” (which is now likely a nation-state) is actually composed of its people as workers? It is what they do, make, and exchange. In creating and exchanging things, they make myriad decisions, both individually and collectively. Some have more scope for choice than others, but average workers make consequential decisions frequently.

If the city is a composite of people as workers, then everyone is a citizen, except perhaps those who are idle. It does not follow logically that all citizens must be able to deliberate and vote on governmental policies. Aristotle had defined citizens as legal decision-makers (jurors and legislators); I am resisting that assumption. Nevertheless, being a worker now seems to be an asset for citizens, not a liability. Only the idle do not learn both to rule and to be ruled.

Aristotle’s definition of citizenship has been enormously influential, but it has often been criticized: by egalitarians who resist his exclusion of manual workers and slaves; by Marxists and others who argue that workers create wealth and should control it; and by opponents of his cerebral bias, like John Dewey. The critique that interests me most is the one that begins by noting the rich, creative, intellectually demanding aspects of work. That implies that working, rather than talking and thinking, may be the essence of citizenship. I draw on Simone Weil, Harry Boyte, and others for that view.

*Politics 1375b16, my translation.

celebrating the intelligence of the worker

As the economy stalls, the earth bakes, oil streams into the Gulf, and politicians and reporters quarrel childishly, misanthropy is a temptation. It is tempting, too, to embrace manipulative or authoritarian politics to compensate for the evident frailties of humankind. This is an excellent time, then to read Mike Rose, The Mind At Work: Valuing the Intelligence of the American Worker.

I have read the whole volume but would like to focus on chapter 1, “The Working Life of a Waitress.” Rose doesn’t romanticize waitressing or minimize its physical and emotional toll. But he reveals how complex and difficult the job is and how much pride individual waitresses take in doing their work well. By the hundreds of thousands, waitresses demonstrate excellence in ways that can restore faith in humankind, if you pay attention.

Time is in short supply in a restaurant: customers, owners, and wait-staff want things to move quickly. Space is limited, too, and designed to satisfy other people more than the wait staff. A waitress navigates this crowded space under conditions of uncertainty.

    No matter how efficiently designed the physical layout of the restaurant … the waitress’s motion will be punctuated by the continual but irregular demands made of her. … A basic goal, then, is to manage irregularity and create an economy of movement. And she does this through effective use of body and mind. The work calls for strength and stamina; for memory capacity and strategy; for heightened attention, both to overall layout and to specific areas and items; for the ability to take stock, prioritize tasks, cluster them, and make decisions on the fly.

Her interactions are not merely physical, but also emotional. “Remembering orders, being vigilant, and regulating the flow of work all play out in an emotional field.” A waitress must resist abuse, inspire positive feelings that enhance tips, collaborate and compete with co-workers, and use “skill and strategy to regulate the flow of work. ‘The customer has the illusion that they’re in charge’ [one waitress says], ‘but they’re not.'”

Depending on the situation, the waitress has to play “servant, mother, daughter, friends, or sexual object.” One says, “You’ve got to be damned good, damned fast, and you’ve got to make people like you.” Overall, the restaurant provides a place “to display a well-developed set of physical, social, and cognitive skills.”

Rose moves on to describe hair salons, construction sites, operating theaters, and other everyday “arenas of competence.” The net effect is to remind you that you live among people who achieve great things when contexts call on their intelligence and diligence. (Thanks to Harry Boyte for the reference to this book.)

populism and “the government”

Today’s most prominent populists depict the government as alien to “the people.” They say the government is a threat that needs to be checked and hampered.

A different populist tradition says, “This is the people’s government. We paid for it, we built it, and it should serve our needs better.” The clearest recent national voice for that strain of populism was John Edwards, in the 2008 campaign, but the tradition goes back to William Jennings Bryan and before.

For my own part, I’d put the matter a little differently. It is our government: of the people, by the people, and for the people, in Lincoln’s phrase. Even in its current form, it is generally for us. Anyone is entitled to criticize the way the federal apparatus is run, but more than 80 cents of your tax dollar goes to Social Security, Medicare, Medicaid, interest payments on the national debt, and defense. Those purposes are supported by vast majorities of Americans. The government is by us in the sense that we determine its priorities, in rough strokes–for good and ill. We want low taxes and high spending, and that’s why we get a deficit. The accumulating debt is not only “ours” because we must pay it off; it is ours because we demanded policies that necessitated borrowing. Finally, the government is of the people because the individuals who run it and work for it belong to regular American society and culture. They may not be statistically representative of the whole population, but they are not all that far off.

Having acknowledged that the government is ours already–we own it, legally and morally, and must take responsibility for it–we can turn to the ways it is not of, for, and by the people. In broad strokes, it may come from us, but money influences its decisions far too strongly. There are no realistic pathways for many Americans to enter politics and public life. In the government, power is distributed in ways that make it difficult for the public to hold leaders accountable. (For example, the present administration should be able to determine economic policy so that the public can vote up or down in November; instead, abuse of the filibuster creates deadlock.) The public discussion is structured so that we can’t deliberate about common interests and learn from one another, but instead fracture into interest groups whose aggregate demands are irrational. Finally, the government is not of us sufficiently because it does not tap people’s energies, ideas, and values sufficiently to solve public problems.

That diagnosis leads to a positive program that seems much more worthy to be called “populism” than any simple diagnosis of the government as the enemy of the people.