Obamacare Repeal: Callousness as a Pre-existing Condition

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The numbers loom large, and so do the emotions involved.  The numbers first:  America’s annual national health care expenditures have reached $3.2 trillion or 17.8% of our gross domestic product. No wonder Warren Buffett is calling medical costs “the tapeworm of American economic competitiveness.” At the same time, about 25% of Americans have a medical history that means they have a pre-existing condition that has previously and may now again make them vulnerable to higher costs or even potentially no insurance coverage whatsoever.  As for the emotions involved in whether to repeal and replace the Affordable Care Act (Obamacare) with a Republican plan, they range from alarm, distress and despair to claims of “pride” and cries of “shame.”

What might cause such negative feelings should be obvious enough, even if not to the Idaho Congressman who told protesting constituents that “Nobody dies because they don’t have access to health care.” What stands out instead is Paul Ryan, the Speaker of the U.S. House of Representatives, saying on ABC’s “This Week” program, “We’re proud of this effort.”

Pride is a combination of anger and happiness, and results from a feeling that you’ve taken control of circumstances (anger) and achieved success in doing so (happiness).  For Ryan, overturning Obamacare is a “rescue mission” to save a “collapsing” system. In a world full of half-truths or less, I’ll leave both those characterizations and the who-knew-it-could-be-so-complicated pros and cons of health care policy aside to focus here on one specific question: what if pride is really window dressing for callousness somehow justified?

Ryan is a long-time fan of the novelist Ayn Rand, who wrote: “Selfishness is a virtue.” Ryan has credited Rand as “the reason I got involved in public service” to weigh in on the “fight of individualism versus collectivism.” As both a devotee of Rand and a self-professed “devout, practicing Catholic,” Ryan is in a conflicted position as he helps to decide the fate of health care legislation in America. To go with Rand means self-interest defined as good when it leads to being productive (versus engaging in robbery).  To go with the writings of the apostle Paul in Philippians 2 means to “do nothing from selfishness or empty conceit.”

what if pride is really window dressing for callousness somehow justified?

How can Ryan reconcile those two opposing perspectives? Rand’s invoking of “robbery” as a point of reference is no coincidence. For her as for Ryan, I believe, the dynamic is between those who are “makers” and those who are “takers” in society.  Barack Obama referred to some countries that benefit from America’s efforts as “free riders” and supported Bill Clinton’s welfare reforms. So note that the maker/taker debate isn’t necessarily a partisan debate. But it’s true that Republicans invoke the debate as to who’s “deserving” of help more often than Democrats typically do.

In Ryan’s case, to hew too closely to Rand would mean endorsing her notion of “rational selfishness,” which rejects making sacrifices for others in favor of productivity, independence, integrity and pride. But what if pride is really contempt, an emotion that blends anger with disgust? The two emotions share anger but otherwise part ways. Pride also involves happiness, an emotion about embracing yourself as well as perhaps others who got you to the success. Disgust is in contrast an empathy-killing emotion about distancing yourself from that which you find poisonous.

What are the odds that Ryan considers himself to be a “maker,” not a “taker”? What are the odds that Ryan considers those who require health care assistance to a degree greater than their means to be “takers” and perhaps even “robbers”? Does seeing the “freeloaders” as robbers free him from the teachings of the apostle Paul to “not merely look out for your own personal interests, but also for the interests of others”? To put it bluntly: does callousness become for Ryan philosophical bedrock, a pre-existing condition that he chooses to take pride in?

“Baby Buffett” Takes a Bath on Valeant

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No stranger to being in the business news headlines, William A. Ackman is at it again. This time, however, it’s for suffering a loss of about $4 billion for his investors after his firm, Pershing Square Capital Management, finally dumped its holdings in Valeant Pharmaceuticals. How does a billionaire investor like Ackman handle buying 27 million shares, on average, for $190 and selling for $12.11? He declares that “I have an enormous stomach for volatility,” and tries to quell the humiliation by having his firm say the change of fortune enables it to “realize a large tax loss.”

Only later in his annual letter to investors would Ackman admit that he had made “a huge mistake” by wagering so big on Valeant.

Eating humble pie certainly isn’t Ackman’s style. He cuts a dapper presence and as recently as last year was hailed by Forbes magazine as a “Baby Buffett” for becoming the hottest new name among the so-called activist investors who used to be known as corporate raiders. What distinguishes Ackman emotionally? Easily his most common facial expression is a combination of a slightly cocked right eyebrow, steely-eyed glares and slight, frosty smiles. Alert, determined and only a little congenial, Ackman couldn’t be temperamentally farther from the Sage of Omaha, Warren Buffett.

Bold with blind spots is a phrase that could describe both the since-departed CEO of Valeant and Ackman.

If Buffett has a signature expression, it’s the combination of furrowed eyebrows and a hearty smile. There’s a warmth to Buffett that eludes Ackman. Buffett exudes folksy charm, and his furrowed eyebrows express, among other feelings, an emotion that Ackman and his investors could benefit from: sadness. One advantage to sadness is that it slows you down and makes you more reflective. Certainly, Ackman has enjoyed coups. But he’s also been burned by his holdings in J. C. Penney and his on-going spat with the senior management at Herbalife may end badly for him.

At 28, Ackman made a name for himself by bidding for Rockefeller Center. Pershing Square’s office in Manhattan features a jet fighter’s ejector seat as a reminder that investors can bail on a bet any time they choose. The reminder is helpful, I suppose, but do Ackman’s investors fully understand that he’s not really running a hedge fund that hedges against risk so much as pushing the envelope again and again?

Valeant was a spiritual fit for Ackman, a pharmaceutical company rapaciously buying up other companies and refusing to do its own research and development work to establish new drugs. Bold with blind spots is a phrase that could describe both the since-departed CEO of Valeant and Ackman. Being a “Baby Buffett” on the other hand is a non-starter of a comparison. A Buffett lieutenant called Valeant a “deeply immoral” company for its loose accounting practices and price-gouging strategy. Ackman shot back at one of Buffett’s most famous investments, Coca-Cola, chiding the company for contributing to obesity and diabetes. Both men are wealthy investors, but one has plenty of EQ and the other isn’t bothered by himself or the management teams he invests in lacking it. A cocker spaniel and a pit bull are both dogs, for instance, but there the similarity ends.