If immigration reform passes, immigrants will potentially be forced to navigate a landscape filled not only with un-scrupulous legal advisers but with predatory financial service providers as well. That’s because any final legislation will likely include requirements that undocumented immigrants pay stiff penalties and back taxes before they can get legal status. The Senate’s Gang of Eight proposal, for example, requires $2,000 in fees and penalties, plus back taxes for every previous year of employment.

Since many immigrants will be hard-pressed to come up with that kind of money themselves, they could become prey to predatory lenders who are willing to front them the cash at exorbitant interest rates. Indeed, according to the Federal Deposit Insurance Corporation, more than half of foreign-born citizens and Hispanics either have no bank account or rely on “alternative” service providers—such as check cashers and pawn shops—for financial services. The profiteering has, in fact, already begun.

Valeria Treves, executive director of NICE, a New York-based advocacy group, says some tax preparers were urging immigrants at tax time this year to file back taxes for the previous ten years—and charging up to $250 per return. Some preparers, she said, were also selling a special—and nonexistent—tax form for undocumented people, while others were charging clients $200 for an Individual Tax Identification Number—the form for which is one page long and free on the Internal Revenue Service Web site.

Andy Posner, executive director of the Capital Good Fund, a nonprofit specializing in micro-loans to immigrants, is particularly concerned about predatory lenders fronting high-interest loans to help immigrants pay the required fees. “There’s already a $100 billion-a-year industry that provides financial services to the poor,” he said. Prospective citizens, he said, are a market just waiting to happen.

Fortunately, the solution to these potential problems already exists: the Consumer Financial Protection Bureau. Created two years ago by the Dodd-Frank Wall Street Reform and Consumer Protection Act as the first stand-alone agency to regulate the soundness of consumer financial products, the CFPB has already cracked down on predatory lending generally and is ideally situated to prevent the financial services fraud and predatory practices that could be an outgrowth of immigration reform.

At a minimum, the CFPB could charge its existing “advisory groups” with the task of formulating policy around financial services scams directed at immigrants. More ambitiously, it could create a separate office dedicated to immigrants’ needs, as it has for other vulnerable consumer groups, including seniors, students, and veterans.

Unfortunately, however, conservatives have been fighting like orcs to defund and dismantle the CFPB. Acting Director Richard Cordray has been a favorite target for Republican lawmakers, who have also refused to confirm his appointment. In April 2013, Republican Senator David Vitter boycotted a hearing with Cordray on the grounds that he “should not have testified today as if he is the legitimate director of the CFPB.”

If conservatives succeed in their effort to kill the CFPB, the result could be an even harder road to legal status and citizenship than immigrants already face.

The post Will Predatory Lenders Get Fat on Immigration Reform? appeared first on Washington Monthly.

On the last week of April earlier this year, a small committee of doctors met quietly in a midsized ballroom at the Renaissance Hotel in Chicago. There was an anesthesiologist, an ophthalmologist, a radiologist, and so on—thirty-one in all, each representing their own medical specialty society, each a heavy hitter in his or her own field.

The meeting was convened, as always, by the American Medical Association. Since 1992, the AMA has summoned this same committee three times a year. It’s called the Specialty Society Relative Value Scale Update Committee (or RUC, pronounced “ruck”), and it’s probably one of the most powerful committees in America that you’ve never heard of.

The purpose of each of these triannual RUC meetings is always the same: it’s the committee members’ job to decide what Medicare should pay them and their colleagues for the medical procedures they perform. How much should radiologists get for administering an MRI? How much should cardiologists be paid for inserting a heart stent?

While these doctors always discuss the “value” of each procedure in terms of the amount of time, work, and overhead required of them to perform it, the implication of that “value” is not lost on anyone in the room: they are, essentially, haggling over what their own salaries should be. “No one ever says the word ‘price,’ ” a doctor on the committee told me after the April meeting. “But yeah, everyone knows we’re talking about money.”

That doctor spoke to me on condition of anonymity in part because all the committee members, as well as more than a hundred or so of their advisers and consultants, are required before each meeting to sign what was described to me as a “draconian” nondisclosure agreement. They are not allowed to talk about the specifics of what is discussed, and they are not allowed to remove any of the literature handed out behind those double doors. Neither the minutes nor the surveys they use to arrive at their decisions are ever published, and the meetings, which last about five days each time, are always closed to both the public and the press. After that meeting in April, there was not so much as a single headline, not in any major newspaper, not even on the wonkiest of the TV shows, announcing that it had taken place at all.

In a free market society, there’s a name for this kind of thing—for when a roomful of professionals from the same trade meet behind closed doors to agree on how much their services should be worth. It’s called price-fixing. And in any other industry, it’s illegal—grounds for a federal investigation into antitrust abuse, at the least.

But this, dear readers, is not any other industry. This is the health care industry, and here, this kind of “price-fixing” is not only perfectly legal, it’s sanctioned by the U.S. government. At the end of each of these meetings, RUC members vote anonymously on a list of “recommended values,” which are then sent to the Centers for Medicare and Medicaid Services (CMS), the federal agency that runs those programs. For the last twenty-two years, the CMS has accepted about 90 percent of the RUC’s recommended values—essentially transferring the committee’s decisions directly into law.

The RUC, in other words, enjoys basically de facto control over how roughly $85 billion in U.S. taxpayer money is divvied up every year. And that’s just the start of it. Because of the way the system is set up, the values the RUC comes up with wind up shaping the very structure of the U.S. health care sector, creating the perverse financial incentives that dictate how our doctors behave, and affecting the annual expenditure of nearly one-fifth of our GDP.

It’s fairly common knowledge at this point that Congress does not allow Medicare to negotiate with pharmaceutical companies over the amount the government pays for their drugs. Each drug company simply sets a price for its own product, and Medicare either takes it or doesn’t. While that arrangement undoubtedly drives up Medicare spending—and health care spending more generally—it at least allows for some competition among the drug companies that manufacture similar products. But when it comes to paying doctors for the services and procedures they perform, the system is even more backward. In this case, Medicare actually asks the suppliers—the doctors themselves—to get together first, compare notes, and then report back on how much each of them ought to get paid.

Medicare is not legally required to accept the RUC’s recommended values for doctors’ services and procedures, but the truth is, it doesn’t have much of a choice. There is no other advisory body currently capable of recommending alternative prices, and Congress has never given the CMS the resources necessary to do the job itself.

The consequences of this set-up are pretty staggering. Allowing a small group of doctors to determine the fees that they and their colleagues will be paid not only drives up the cost of Medicare over time, it also drives up the cost of health care in this country writ large. That’s because private insurance companies also use Medicare’s fee schedule as a baseline for negotiating prices with hospitals and other providers. So if the RUC inflates the base price Medicare pays for a specific procedure, that inflationary effect ripples up through the health care industry as a whole.

Another, even more powerful consequence of this system is that while the prices Medicare and private insurers pay for certain procedures have increased—sometimes rapidly—the prices paid for other services have declined or stagnated. That’s largely because of basic flaws in the way the system is set up. For one, the RUC spends the vast majority of its time reviewing specialty procedures, which change more quickly as technology advances, rather than so-called “cognitive” services, like office visits, that primary care doctors and other generalists rely on for the bulk of their income. The result is that there are “a hundred ways to bill for removing varicose veins, and only one way to bill for an intermediate office visit,” one former RUC member told me. For another, the RUC is dominated by specialists, who have a direct interest in setting the reimbursement rates for specialty procedures much higher than for general services.

Those two factors go a long way toward explaining why we’ve seen an explosion of billing for certain types of lucrative procedures. After all, the incentives are perfectly aligned: ordering that extra test means more money for a doctor’s practice or hospital, more money for the labs, and often more money for the device makers and drug companies, too. (Oh, and, by the way, the device makers and drug companies are, not incidentally, major funders of the medical specialty societies whose members vote on the RUC.)

These manipulated prices are also a major reason why specialists are in oversupply in many parts of the country, while a worsening shortage of primary care providers threatens the whole health care delivery system. It’s precisely because the RUC has overvalued certain procedures and undervalued others that radiologists now make twice what primary care docs do in a year—that’s an average of $1.5 million more in a lifetime. While that little fact doesn’t explain everything (doctors choose their fields for a multiplicity of reasons), future income is, presumably, not entirely unimportant to a young MD.

And we’re not just talking about medical students here. Having the wrong kinds of doctors in the wrong places, with the wrong financial incentives, is one of the major reasons why Americans pay so much more for health care than do citizens in other advanced nations, and yet we live no longer.

Over the past few years, a few well-placed health care figures from both parties have spoken out—at least once they’ve left office—about how crazy this system is. “The RUC is really just a giant cabal run by the AMA,” Thomas Scully, former head of the CMS under George W. Bush, told me. “A private trade association should not have that sort of control over the biggest spending account in the government. It’s an outrageous travesty of democracy.” Bruce Vladeck, former head of the CMS under Bill Clinton, agrees, calling the RUC “a significant part of the problem.”

There have also been scathing reports issued by the Government Accountability Office, and by MedPAC, the agency that advises Congress on Medicare-related issues, as well as some hard-hitting investigative reporting by the Wall Street Journal and the Center for Public Integrity. In 2011, a bipartisan panel participated in a Senate roundtable, during which three former heads of the CMS took turns lamenting the RUC.

Yet, for the most part, the RUC continues to operate exactly as it always has—behind the scenes, without anyone, including actual doctors laboring in the clinics and hospitals across the country, even really knowing about it. (This spring, Scully told me that he went to lunch with a very high-ranking official at the CMS who had no idea how the RUC actually worked.)

The Affordable Care Act, for its part, includes a few lines that could potentially, if incrementally, limit the RUC’s power. But in general, it doesn’t much change the way the reimbursement system works. Taking on the RUC would have “started a nuclear war with the AMA,” as Scully put it, and alienated other key political allies that the administration needed to pass the law to begin with. Fixing the RUC, however, is essential to fixing health care in this country.

“Follow the money,” said Gail Wilensky, who headed the CMS under George H. W. Bush and has been critical of the RUC. “Change the way physicians are paid, and you change the system.”

The RUC, like that third margarita, seemed like a good idea at the time. When liberals were trying to pass Medicare in 1965, the staunchest opponent they faced was the AMA, which was dead set against the program on the grounds that “socialized medicine” would upend physicians’ livelihoods.

In order to get the bill passed, liberals made many big concessions to organized medicine. One was keeping the “fee-for-service” payment system, which we still have today, in which doctors bill Medicare (and private insurance companies and uninsured patients) according to every single service or procedure they perform. Another was that Medicare promised to pay physicians the “usual, customary and reasonable” rate for each of those services. One of the problems that quickly arose was that there was no benchmark for what was “usual” or “reasonable,” no nationally accepted standard for “customary” for the price of each individual service or procedure. Prices, unsurprisingly, began to skyrocket.

Someone who worked with the Bush administration in the 1980s told me a story about an ophthalmologist in Texas, known as the legendary “Cataract King.” Despite the fact that a cataract surgery had gotten much easier to perform—it took two to three hours when it was first invented, but by the ’80s clocked in at about a half an hour—he continued to charge the “customary” rate: up to $6,000 a pop. By the mid-’80s, Medicare was spending about 4 percent of its budget on cataract surgeries alone. Meanwhile, an hour-long visit with a patient resulting in a complex diagnosis fetched about forty bucks.

By 1985, doctors’ rates were, to say the least, wildly distorted and Medicare spending was outstripping the growth of both the economy and federal tax receipts year after year. Panicked, Congress amended the law in 1986 to require doctors to charge Medicare according to “historical” rates, but it was too little too late. “Historical” rates were already crushingly high, and Medicare was on the verge of collapse.

And that’s when Harvard economist William Hsiao entered the scene. In 1988, he and his team unveiled what they hoped would be a rational process for setting physicians’ reimbursement rates. The result came to be known as the resource-based relative value scale (RBRVS). By interviewing hundreds of doctors from dozens of specialties, they painstakingly compared thousands of medical procedures—everything from removing a polyp to a lung transplant—and assigned each a relative value unit (RVU) according to three main factors: one, the amount of work it takes for a doctor to perform a given procedure; two, a doctor’s practice costs; and three, malpractice liability. Every year, Congress then sets a multiplier, converting that RVU into dollars.

At the end of 1989, as part of the Omnibus Budget Reconciliation Act, Congress formally adopted Hsiao’s system, requiring that Medicare use the RBRVS in determining the prices it paid physicians. It went into effect in 1992.

The plan went downhill almost immediately. In order for the system to work in practice, new services and procedures had to be added and old ones updated every year. Certain procedures, like in the cataract surgery example, that were initially very difficult and time-consuming to perform had become steadily more routine and quicker to do, while other procedures had gotten more complex and required more skill to perform. Those RVUs needed to be adjusted accordingly. The question soon became: Who should be responsible for updating the RVUs for all those thousands and thousands of procedures?

The Bush administration, skittish of anything resembling government price setting, rejected the idea of establishing an independent council of advisers within the government. Instead, in 1991, they gave the task to the most powerful interest group in the industry, the AMA (which had, of course, graciously offered its services). “And that was the point where I knew the system had been co-opted,” Hsiao told me. “It had become a political process, not a scientific process. And if you don’t think it’s political, you only have to look at the motivation of why AMA wants this job.”

The AMA spends at least $7 million a year running the RUC, according to its own estimates, and that includes maintaining about six full-time staff members. For that, it gets a very good return on investment. The first boon is that, in order to be on the RUC, specialty societies must become dues-paying members. At a time when the AMA has struggled against being overshadowed by specialty societies, controlling the RUC prevents what might otherwise be a rapid exodus of membership. As one RUC member told me bluntly, “No one cares about AMA. They care about the RUC.” And that’s a lucky break for the AMA. In 2012, dues collection actually increased by 3 percent, topping out at $38.6 million for the year. Cha-ching.

The second boon for the AMA is that by controlling the RUC, it controls much of the source code that our health care system uses to operate. Every single one of those roughly 9,000 medical services and procedures has its own five-digit code, known as current procedural terminology (CPT), and the AMA owns them all. That means that anyone—physicians, labs, hospitals, you name it—who wants to bill Medicare, Medicaid, or a private insurance company has to purchase either AMA books and products, or products from other software companies that pay AMA royalties and licensing fees to use the CPT codes. According to its annual report, in 2012 the AMA made $83.1 million in “royalties and credentialing products,” a large chunk of which comes from licensing CPT. Again: cha-ching.

And that’s just the monetary stuff. The third boon—the real power curve—is the fact that the AMA’s control of the RUC makes it indispensible to everyone and everything in a $2.7 trillion health care industry. That includes specialty societies, primary care organizations, and medical device and pharmaceutical companies—all of whom have something big to gain or lose from the RUC’s decisions.

The AMA cannot be unaware of this staggering power. Still, its official line about the RUC is that it’s simply doing the U.S. government a favor—offering its professional recommendations free of charge. Chaired by Dr. Barbara Levy, who is also the vice president of health policy at the American Congress of Obstetricians and Gynecologists, the RUC is simply a gathering of volunteer experts who jettison their personal interests and behave “like the Supreme Court” on behalf of the public good, according to the AMA.

But in talking to a half-dozen current and former RUC members, including both generalists and specialists, the image of the committee that emerges is less a gathering of angels, cloaked by some Rawlsian Veil of Ignorance, and more akin to a health care-themed Game of Thrones. Several RUC members I spoke to mentioned that the chairwoman often reminds the committee to “Put your RUC hat on,” meaning: “Don’t think from your society’s standpoint.” But everyone I spoke to said that specialty societies on the RUC form coalitions and alliances. Two doctors told me that “personal loyalties” play a major role in determining the way that RUC members vote. “There’s no denying it’s a highly, highly, highly politicized process,” a RUC member told me.

Here’s how the process works. Every time a new procedure comes along, a special committee at the AMA called the CPT Editorial Panel decides whether or not it needs to create a new CPT code for it. The need for a new code is sometimes tied to a new device—a valve or pump or robot that, if it is to be used, requires that doctors perform a new procedure.

Importantly, it’s not the panel’s job to weigh in on whether a new procedure is more effective or cost-efficient than a traditional method. The Food and Drug Administration has to approve a new device for the panel to consider it, but other than that the panel’s job is limited. It simply decides if a new procedure is sufficiently different from existing procedures already in the CPT; if it is, then it is assigned a CPT code, and then sent off to the RUC to be assigned a relative value unit.

When either updating an old RVU or coming up with a new one, the RUC members spend most of their time debating something called “work units”—a slippery currency that combines how much time, training, technical skill, physical and mental effort, and stress are required of a doctor when performing a certain procedure or service. For example, according to the 2013 RUC database, “freezing off” a suspicious-looking lesion or freckle, known in the medical parlance as a “destruction,” has been assigned 1.22 work units; inserting a single-valve cardiac stent, 33.75.

By many accounts, the resulting debates are often spectacularly absurd. The RUC’s database features page upon page describing what exactly a doctor does when performing each procedure. How many minutes must a doctor spend waiting for a patient to get dressed or undressed? How much time does it take to scrub in, or wait around? To read a chart? Each of these questions can bring sometimes hours of haggling at the meetings.

And then there’s the even more slippery idea of how much “mental effort” or “stress” a given procedure requires. How stressful is it to, say, perform a surgery that requires a doctor to stop a patient’s heart? And, since all of these values are relative to one another, is that level of stress greater or less than having an office visit with, say, an emotionally disturbed teenager suffering from multiple illnesses?

It’s at this point that most people—both AMA representatives and critics of it—are in agreement: at best, this is a deeply imperfect system, mired by necessity in the minutiae of doctors’ actions. But while RUC supporters argue that it’s simply the best we’ve got, critics contend that by taking an already imperfect system and handing it over to precisely those groups with the biggest material interests at stake, we’re making it even worse.

Coming up with the exact number, down to the hundredth decimal point, illustrating the “work units” for a given procedure is an admittedly thankless task. But when the RUC does it, it relies to a large degree on the testimony of—who else?—the most affected specialty society on the RUC. For instance, the American College of Cardiology will give a presentation arguing for the precise amount of time and effort required to perform a cardiac stent; the urologists weigh in on how long a catheter procedure should take. The RUC’s argument here is that the most affected specialty society knows the most about how much work, time, and stress go into the procedures its members perform.

But, of course, that specialty society also has the most to gain by inflating that value. For one, it’s in that society’s direct interest to get its members paid as much as possible. For another, the most affected specialty society often receives a good chunk of its funding from pharmaceutical and medical device companies—companies that also have a direct stake in the RUC’s proceedings. When the RUC offers up generous reimbursement rates for a specific procedure, doctors generally do it more often, and that means they use more of certain drugs and devices, too. It’s a positive feedback loop—and everyone knows it.

And then there’s the fact that much of the “data” these affected specialty societies trot out in front of the RUC would not pass the laugh test in a high school stats class. After all, these specialist societies get their data from surveys of their own membership—a group of people who stand to gain directly and materially from making a procedure seem as difficult, time-consuming, and stressful as possible. And respondents can’t exactly plead ignorance. They know darn well how the results of those polls will be used, and in case they forget, the surveys are printed with a reminder: your response is “important to you and other physicians because these values determine the rate at which Medicare and other payers reimburse for procedures,” according to a 2010 Wall Street Journal article.

What’s more, RUC rules require as few as thirty survey responses—a meager sample size, even if everyone involved weren’t both self-selected and personally invested in the results. “You wouldn’t use the results of thirty surveys to determine anything, much less billions in taxpayer cash,” a former adviser to the RUC told me.

There’s good reason to take into account the experience of those doctors who perform the procedure in question, said John Goodson, a primary care physician and associate professor at Harvard Medical School who has written about the RUC, “but if the process of assigning values to physician services is to be trusted, then the profession should hold itself to the same high, evidence-based standards that it does in other domains.”

Another flaw in methodology comes from the fact that the RUC often relies on records from teaching hospitals in determining how long an operation takes, even though teaching hospitals often have longer surgery times than nonteaching hospitals. A 2006 study by the nonprofit health care research firm RTI International compared the amount of time the RUC suggested for sixty surgeries to data from 148 hospitals’ actual surgery logs. The RUC’s estimated times were often longer—sometimes by up to two hours.

Perhaps the most damning aspect of the RUC’s methodology, however, is that, while its members often spend quite literally hours debating if a certain procedure takes three minutes or just two, the RUC never so much as flicks at the question of how much—or even whether—a procedure actually benefits patients. This failure, which is part of a broader flaw in federal health care policy, is enormously damaging to the practice of American medicine. Among other things, it means that many patients wind up undergoing expensive procedures for which more effective and less costly alternatives are available.

The AMA’s main defense against the charge that the RUC skews health care spending toward specialists’ costliest procedures is that the system is self-policing. The members are working within a fixed budget, the AMA says, so they keep each other in check: if the RUC votes to raise the RVU of one procedure, it has to account for that increase by decreasing RVUs of other procedures elsewhere. And that’s true—as far as it goes. The process does indeed involve much squabbling among specialist societies, and RUC representatives do sometimes end up voting to lower codes that would positively affect their own societies. “There’s a certain calculation that happens, and people definitely vote against themselves,” a former RUC member told me.

But this inter-society bargaining occurs in a context in which there’s already a baked-in directional bias toward increasing the value of technical procedures, which are updated regularly and constantly fine-tuned, rather than cognitive or diagnostic services, which are mostly left alone. It also occurs in a context in which one side is politically weaker than the other. The most important cleavage within the RUC is between specialist doctors, who make the bulk of their money billing for procedures, and primary care doctors, who generate most of their income from office visits. While the primary care docs make up roughly 40 percent of physicians nationwide, they have only 14 percent of the votes on the RUC. Primary care physicians now have four rotating seats on the committee—up from just two seats a few years ago—out of a total of twenty-nine voting seats. (Of the thirty-one-doctor panel, two permanent seats are nonvoting positions.) Since a vote passes with a two-thirds majority, their political clout is extremely limited.

In 2005, this baked-in two-faction system erupted into a full-blown war during a RUC meeting when the two representatives from primary care threatened to leave the committee if it did not increase compensation for office visits, according to people who were present at the time. Powerful specialty societies, who didn’t want to see the amount of the pie remaining to pay for procedures decreased, vehemently opposed the idea.

Dr. Tom Felger, a former director of the American Academy of Family Physicians who was on the RUC at the time, told me that the American College of Surgeons had even created a spreadsheet, which they shared with other surgical specialties, illustrating exactly how much the RUC could increase the value of the office-visit CPT codes without affecting surgeons’ income. “They had done the math. They knew the facts,” said Felger, who represented the AAFP at RUC meetings for a decade. “When I saw it, I thought, ‘Wow-ee, this is it—now that’s collusion.’ ”

In 2007, the RUC did finally vote to increase the RVUs for office visits, redistributing roughly $4 billion from different procedures to do so. But that was only a modest counter to the broader directionality of the RUC, which spends the vast majority of its time reviewing, updating—and often increasing—the RVUs for specific, technical procedures that make specialists the most money. Because of the direct relationship between what Medicare pays and what private insurers pay, that has the result of driving up health care spending in America—a dynamic that will continue as long as specialists dominate the committee.

And despite the RUC’s vote to increase office-visit codes, the large payment gap between primary care doctors and specialists still exists. In 2012, radiologists and orthopedists made on average nearly twice as much ($315,000) as pediatricians ($156,000), while family doctors and those specializing in diabetes and endocrinology made nearly $140,000 less than urologists. “If … a primary care doctor is making a fraction of what an orthopedist is making, then that distorts the health care system in a whole variety of different ways,” said Vladeck, the former head of the CMS under Clinton. “You really have to think about what that’s doing down the line.”

One effect is that fewer young doctors choose to go into primary care. Another is that existing primary care docs cram more and more patients into their schedules to make up cost on volume and, as a result, have only a few minutes to consult with each one (see Candice Chen, “A Day in the Life of a Primary Care Doctor,” page 42). “If you run a practice and have bills to pay—that’s going to weigh on you,” says Kavita Patel, a primary care internist at Johns Hopkins Medicine and former health care adviser at the White House. “I see twenty-eight patients in a day. I spend seven to eight minutes with a patient. That’s unrealistic—it’s crazy.”

The good news is that there’s been some incremental progress in the past few years. For example, a more empirical system is now in place for selecting the CPT codes that the RUC reviews every year. The CMS has also cracked down on certain types of redundant billing. “We’ve reduced payments for high-cost imaging quite significantly,” Jonathan Blum, the current director of the CMS, told me. “And we’ve eliminated payment codes we thought were overvalued, contrary to recommendations of the RUC.”

The CMS touts that in the last couple of years it has accepted only 60 percent of the RUC’s recommended RVUs—down from an average of about 90 percent over the past twenty years. (For technical reasons, it’s fair to say that the 60 percent number is somewhat exaggerated, but it is still a step in the right direction.)

The Affordable Care Act also takes some incremental steps toward reforming the payment system. It requires that the CMS create new “mechanisms” for establishing the physician fee schedule, which can include increasing its own in-house data collection and analysis to correct, corroborate, or refute the RUC’s recommendations, especially for inputs that are more easily measured empirically, like determining how long on average a given surgery takes. To comply, the CMS recently commissioned two reports from the RAND Corporation and the Urban Institute to advise the agency on how best to do that.

The CMS, in cooperation with the AMA, is also considering rolling out new codes that may make it easier for primary care doctors to bill for services for which they weren’t previously compensated. This year, for example, they introduced two so-called transitional care management (TCM) codes that will allow doctors to bill Medicare for the time they spend helping patients transition from an in-patient setting to another community or their homes.

Yet while some of these incremental changes have been supported by the AMA and the powerful specialty societies (which, indeed, have nothing to lose from, say, TCM codes), other attempts at reform have been met with fierce push back—from organized letter campaigns to intense lobbying—and it is not clear if they will survive.

“CMS is in a no-win situation,” says Vladeck. “They’ve got extremely powerful forces making extraordinary amounts of money, and if CMS tries to change that, it’s really easy for the providers to say, ‘This is going to impair access,’ or ‘This is going to hamper care,’ even if there’s zero reality to that claim. People like doctors and nurses, and they don’t like government bureaucrats.”

Even if these incremental steps remain in place, some critics argue they are akin to frosting on a rotten cake. “You can make these tweaks,” says Brian Klepper, a health care analyst and principal at WeCare, a primary care clinic and medical management firm, “but what you’re doing is ignoring the fact that this system is fundamentally insane. It’s so corrupt and collusive, it’s not something that can be incrementally fixed.”

Long term, there are two basic options to really solving the problems caused by the RUC. The first is to take the process away from the control of the AMA and put it in the hands of a well-resourced group of experts under the auspices of the federal government. This might take the form of a panel of doctors employed by the government, or of an advisory committee of representatives of different medical societies but with greater representation of primary care doctors. While the latter set-up would hardly eliminate all conflicts of interest and political horse trading, such a committee would at least have to meet federal requirements for disclosure of all conflicts of interest. It would also be required to publish minutes from the meetings, data from any surveys used, and so forth. That would be a big improvement over the current, closed-door policy at the RUC, which, because it’s convened by a private entity, the AMA, enjoys First Amendment freedom from federal disclosure rules.

This option, however, is politically tricky. “The AMA and these medical specialty societies have power, and they’re not wild about seeing that power diluted,” said Zeke Emanuel, a former special adviser on health policy to the Office of Management and Budget and the National Economic Council, and an oncologist. “So yeah, if you ask the sober policy community, ‘Should we do this?’ their opinion is yes. But when it comes to this, the sober policy community has almost never held sway.”

In 2011, Washington Democratic Congressman Jim McDermott proposed a bill that would have furnished the CMS with resources to assemble an independent council of advisers. It was met with a strongly worded letter from the American College of Surgeons the day it was proposed and died in committee that afternoon.

Some reformers point to a provision in Obamacare that might allow for an end run around Congress. The law creates a new entity, the Independent Payment Advisory Board, which, if Medicare costs outstrip the Consumer Price Index, will have the power to cut or change Medicare provider payments unilaterally. Its decisions can be overturned by Congress only if lawmakers pass alternative cost-cutting measures of equal size. Statutorily, IPAB could create a government-run equivalent of the RUC. Whether it will ever get a chance to exercise that power, however, is an open question: IPAB is a major political target for both Republicans who are demanding its immediate abolition and some Democrats who enjoy close ties to the medical drug and device industry.

The second option to solving the RUC problem would be to get Medicare out of the business of funding fee-for-service medicine. Reformers have been complaining for years that paying providers per procedure creates incentives for gaming and overuse that are difficult, if not impossible, to overcome. Under Obamacare, the CMS is already taking modest steps away from fee-for-service billing by expanding experiments in “bundled payments,” whereby providers are paid a lump sum to take care of patients with certain conditions, like diabetes or heart disease. The AMA, aware of the growing backlash in Washington against fee-for-service, has endorsed some of Medicare’s bundling initiatives.

But we need to go much further. It’s no coincidence that numerous studies have found that the best-quality and lowest-cost health care in America can be found in systems like Veterans Affairs and Utah’s Intermountain Healthcare where doctors are on salary and paid for keeping their patients well, not according to a fee-for-service system. As this magazine has argued (see Phillip Longman, “The Cure”), the federal government should set a certain date at which Medicare will pay only for health services provided by integrated systems.

Such a move would be fiercely resisted by organized medicine, and specialist societies in particular. But it would be the surest way to control the nation’s health care costs while improving health outcomes. And it would have a delightful side benefit: with fee-for-service eliminated, there would be no need to have thirty-one doctors sit in a ballroom in Chicago and centrally plan the pricing minutia of thousands of medical services and procedures. The RUC, in other words, would be made obsolete.

The post Special Deal appeared first on Washington Monthly.

I’m a primary care pediatrician in a clinic in Southeast Washington, D.C., that provides health care to a largely poor, urban, and underserved community. On Monday mornings, I look forward to going to work. I’m excited to see my patients—the babies, children, teens, and families I’ve watched grow up—and face the challenge of figuring out how best to help. I started working in this community during my residency training almost twelve years ago, and I’ve stayed here ever since.

As much as I love my work, however, my days are stressful and hectic and there is never, ever enough time. I start the day by looking at my schedule, which is typically booked full with patients scheduled every fifteen minutes, and the anxiety begins. My 8:30 a.m. appointment shows up at 8:44—just within our fifteen-minute late policy. By the time this family checks in and is in a room, it’s well after 9:00, and my later appointments have started to arrive. I feel the pressure of people waiting, but when I go into that first room, I can’t bring myself to rush this parent who’s worried about her child. I sit down, quiet my anxiety, and listen to what the parent has to say. Meanwhile, I’m trying to find out, what were the results of the emergency room tests? What were the results of the tests we ordered last time? What did the specialist do? I ask these questions, knowing that time is ticking.

If all of my scheduled patients show up, I spend the morning running from room to room and my lunch hour becomes fifteen minutes. If no one else is in the hallway after I leave a room, I run. The couple of seconds I save probably don’t make a real difference to a waiting family, but it’s all I can do. I apologize frequently to families for running late. Some families are forgiving; some aren’t. I feel bad that my patients have to wait, and, being human, I feel worse when they’re upset with me. By the end of the day, I’m physically and emotionally exhausted.

Some observers might make the obvious suggestion—stop scheduling appointments every fifteen minutes. But in the U.S. health care system, the only way to make more is to do more. In my clinic, those extra visits pay for important patient services, like a care manager, social work, and mental health and dental care. They also pay the salaries of the staff members who are needed to keep the clinic open five days a week.

Compared to other sectors of the health care system, primary care is disadvantaged. Primary care services are generally compensated less than other specialties, so even when a primary care doctor can see more patients, he or she still can’t earn as much as, say, a cardiologist or a surgeon. Primary care doctors make one-third the average income of orthopedic surgeons, according to the Medical Group Management Association. But a bigger problem is that this payment difference means primary care practices can’t hire the additional staff or make the investments that will allow doctors to focus on doctoring and not on the million little administrative tasks that come along with providing health care.

In my case, these administrative tasks often mean a day that is filled with frustration and less time for patients. There’s the very long automated recording when I call an insurance company to see why they rejected paying for someone’s medication. There’s the time spent on hold while waiting for a specialist to discuss a patient’s case. Electronic health records have helped in many ways, but our system always seems to run too slowly. When I open a new window on my computer to order lab tests or send a prescription, the pause is just long enough to remind me that people are waiting, but it’s not enough time to do anything else.

Given that primary care doctors are caught between the time pressure of seeing as many patients as possible and keeping up with paperwork—and are less well paid than their colleagues in specialized medicine—I’m not surprised that fewer and fewer medical students are choosing to go into primary care. It shouldn’t be this way. On those rare days when I have the space to spend more time with families and do the things needed to provide the best care, I go home knowing I have the best job in the world. I go home remembering the little victories, like keeping a patient with asthma from having to go to the emergency room; the feel-good moments, like the toddler who runs down the hall to give me a knee-level hug; and, above all, the joy of knowing that a child I’m treating will survive, will be healthy, and will be happy again.

The post A Day in the Life of a Primary Care Doctor appeared first on Washington Monthly.

For many Americans, the economy is still a cold and hard place. Wages are down, job numbers are barely creeping up, and the latest asset bubble drifts high out of the reach of most folks. About the only hot business around is the rivalry to identify a root cause for our woes. Even as Democrats and the GOP continue to argue the value of stimulus, two new schools of thought have shot into fashion. Importantly, both focus on the role of technology. Strangely, they do so from diametrically opposed points of view.

One is led by MIT professors Erik Brynjolfsson and Andrew McAfee, who proudly write in the Luddite tradition. The problem, they say, is too-rapid automation. In short, robots are taking our jobs. The other viewpoint, epitomized by the writings of economists Robert Gordon and Tyler Cowen, says no, the real problem is that we have entered a “great stagnation.” The digital revolution has reached maturity, and no other transformational technology is in sight.

Both groups muster an abundance of evidence. It hardly needs saying that we live in an era in which millions of workers have been displaced by technology. Less obvious to some, but also demonstrably true, is that we live in an era in which the pace of technological progress has stagnated in many key realms. Where, for instance, is the “century of biology” we were promised only a few years ago? And that once-vaunted pharmaceutical “pipeline” looks awfully dry these days.

But what if both camps are right about the effects they observe and wrong about the causes? What begins to make sense of this odd picture is a problem that previous generations of Americans also had to confront—a concentration of economic control that enables a few corporate bosses to manipulate technological advance entirely outside of any open and competitive marketplace. Put another way, what can explain both of these problems is that the masters of America’s biggest technological corporations increasingly enjoy the power to speed the rollout of technologies that favor capital and to slow those that disfavor their own private interests.

Back in the 1930s, America suffered from a similar set of ills, and the government took direct aim. Specifically, starting in the second half of the New Deal, Franklin Delano Roosevelt’s administration combined stepped-up antitrust enforcement with the forced licensing of key patents held by monopolistic enterprises. Today, few people know this history, but the policy laid the groundwork for the long era of prosperity and technological progress that followed, including the birth of Silicon Valley.

Indeed, when the late industrial historian Alfred Chandler Jr. set out to research his second-to-last book, Inventing the Electronic Century, he came to a conclusion that surprised even him. What was most responsible for America’s astounding technological advance in the twentieth century? It was, Chandler wrote in 2001, the men and women of the Roosevelt administration’s antitrust division. They were the “gods,” he wrote, who “set the stage” for the information revolution. Follow where Chandler points, and we may yet recover the key to restoring broad prosperity, along with the ability to devise the technological tools we need to fix many of our most pressing problems.

Our first challenge is simply to recognize how few companies now govern our technological economy. A good starting example is the chemical and biotech giant Monsanto. Here is a corporation that wields almost complete control over the basic genetic traits of key crops, including corn and soy; that over the last decade has buttressed that power by spending upward of $12 billion to buy direct competitors such as Dekalb Genetics and Delta and Pine Land as well as at least thirty companies that breed and retail its seeds; and that has brought at least 145 lawsuits against small farmers to enforce those rights.

Or consider the business software giant Oracle. Its CEO, Larry Ellison, once said that acquiring another company was “a confession that there’s a failure to innovate.” Then in 2004 Ellison began to gobble up precisely those competitors most likely to force Oracle to innovate. This included PeopleSoft, Siebel, Sun Microsystems, and more than eighty other firms.

The story is not much different at Google, which has vacuumed up more than 120 former competitors, along with their products, patents, and, often, their scientists and engineers. If you think of Google as an innovative company, remember that it was the smaller companies it swallowed that actually developed most of its key components. These include YouTube, DoubleClick, and the ITA airline reservation system, as well as ten search companies that no longer compete with Google because Google now owns them. Much the same is true of Intel, Corning, Pfizer, and Microsoft. These giants don’t merely set standards for certain formats of semiconductors, glass, pharmaceuticals, and software. Their mastery over patents and markets empowers them to block or buy most any newcomer that might threaten their sovereignty. What technologies are developed, and how and where they are developed, is increasingly up to these small clubs of executives alone.

Such private dominance over whole precincts of applied science does not lack for defenders. In academia, an entire industry has emerged to preach the gospel of Joseph Schumpeter, the Austrian economist who in 1942 wrote an eloquent defense of the monopolist as the prime mover of innovation. He claimed that monopoly is of social value because of “the protection it … secures for long range planning.” A good example of a modern-day Schumpeterian is Michael Mandel, the former chief economist at BusinessWeek. Noting that society faces “enormous challenges” in remaking our energy, health, and other sectors, Mandel concluded in a recent paper that “only large firms have the staying power and scale” to “implement systemic innovations.”

What’s odd is the almost complete lack of attention to this roll-up of control over our system of industrial science, especially given the public’s fascination with the last high-stakes antitrust suit against a tech goliath. This came in 1998, when the Justice Department charged Microsoft with leveraging its monopoly over operating systems to capture control over lines of business such as browsers. The case resulted in a court order to break Microsoft in two, which the Bush administration later set aside. It also resulted in controls over Microsoft’s actions that, many argue, cleared the way for the initial emergence of companies like Google.

Gary Reback, an antitrust lawyer who took part in the case against Microsoft, sums up the current policy: “In information technology we have no antitrust enforcement today, and I don’t expect any enforcement for at least the next four years.” Worse, in realms ranging from drugs to genetically modified food, the longer the government allows big companies to swallow smaller ones, the harder it becomes to restart the processes of innovation. As antitrust lawyer Robert Litan has observed, “Mergers in high-tech markets should face an extra degree of scrutiny.” The “relative sluggishness of the judicial process,” he says, can make it very hard to “unscramble” a deal after the fact.

The debate over the relationship between monopoly and innovation goes back at least as far as the Industrial Revolution. Indeed, striking the right balance was a preoccupation of the Founders, as evidenced by their concern with patent monopolies. Thomas Jefferson, who served on the first U.S. Patent Commission, rejected the idea that a citizen had any “right” to monopolize control over a technology. Ideas, Jefferson wrote, “cannot, in nature, be a subject of property.” But, to give the inventor a chance to perfect his conception and grow it to scale, Jefferson believed that some ideas are “worth … the embarrassment of an exclusive patent.” Jefferson emphasized, however, that officials must always be chary in granting such privilege.

Nevertheless, problems soon emerged. By the mid-nineteenth century, American financiers had figured out how to use patent monopolies not merely to hobble rival innovators but also to erect corporate empires; by the turn of the twentieth century, they had largely perfected the art. One of the more notable instances saw J. P. Morgan grab control of the electrical patents of Thomas Edison, George Westinghouse, and Nikola Tesla, and then use the resulting “pool” to control the entire electrical industry. One lawyer of that era even penned a primer for businessmen. “Patents are the best and most effective means of controlling competition,” he wrote. Sometimes, he added, patents “give absolute command of the market, enabling the owner to name the price without regard to cost of production.” The first coherent reactions against such abuse of patents also date to this time. In 1900, political scientist Jeremiah Jenks proposed using antitrust law to compel giant companies to license their patents.

During the Progressive Era, the country passed its first antitrust legislation, but enforcement proved weak and never tackled the problem of patent monopoly. This remained true through Roosevelt’s first term. Indeed, during the first two years of the New Deal, FDR largely suspended antitrust enforcement. But following the economic and political failure of the National Industrial Recovery Act, Roosevelt reversed course. In a 1938 message to Congress, FDR said he would use antitrust policy to unleash the “vibrant energies” of entrepreneurs and thereby bring a “new vitality” to America.

The first step was not to dispatch a mob of hillbillies with broad axes. Rather, it was to join Congress in launching the Temporary National Economic Committee (TNEC) to investigate—empirically—how big companies concentrated and used power. The result was the most extensive study of monopoly in the history of America, and a series of shocking revelations. One was the detailed account of how the glass companies Hartford-Empire and Owens-Illinois had managed to capture and hold a 100 percent monopoly over the business of making bottles in America.

As a summary of the TNEC put it, Hartford-Empire had “demonstrated how a corporation might rise to a position of power and monopoly, not through efficiency or through managerial skill, but by manipulating privileges granted under the patent laws.” Once there, Hartford-Empire maintained a “control over production and prices more complete than that exercised by most public utility commissions.”

U.S. patent policy, the summary concluded, promoted two contradictory processes: “One is creative, the other, restrictive; one encourages or rewards inventiveness, while the other fosters monopoly; one promotes production, the other fosters predation.” The overall balance, however, favored the suppression of better ideas. “The patent system permits powerful units or combinations to destroy small competitors by endless litigation or by threats of litigation, regardless of the merits of the small producer’s case or of his product.”

Based largely on these revelations, the Roosevelt administration began to establish the foundations of a competition policy that would remain in effect for two generations. The main architect was Wyoming-born lawyer Thurman Arnold. During the early days of the New Deal, Arnold had been skeptical of antitrust enforcement. But when he was named to head the TNEC inquiry into patents and saw how companies like Hartford-Empire operated, his thinking on the issue changed completely.

Roosevelt named him to run the Antitrust Division of the Department of Justice (DOJ) in 1938; by 1942, Arnold had boosted the staff from eighteen to nearly 600. He also launched a slew of new cases, bringing ninety-two in 1940 compared to just eleven in 1938. And he established clear strategic goals. Arnold agreed with Jeffersonians like Louis Brandeis that the central aim of
anti-monopoly law is to disperse political power. He also believed that competition was best for technological advance, and here he made his greatest mark.

There were three main components to the overarching competition strategy that emerged in the 1930s in the complex dialog between the Roosevelt administration and Congress. One was an acceptance that some industries, like electricity, telephones, and gasworks, were natural monopolies and hence should be regulated by the public. Second was the belief that in areas of the economy that did not require high degrees of scientific knowledge—such as retail, farming, and banking—the government should promote as wide a distribution of power and opportunity as possible. Hence the anti-chain store legislation of the time.

The third component, created largely by Arnold and his team, was a coherent approach to regulating industrial corporations engaged in the art of applying science to mass production.

Well into the 1930s, giant companies like AT&T and DuPont were investing in research, sometimes extravagantly. But their dominance over their markets meant they—like Hartford-Empire—often had little incentive to introduce superior technologies when doing so threatened to cannibalize their existing product lines or otherwise diminish their profits. Arnold tackled this challenge first by insisting that all such companies compete at least to some degree. This led the DOJ to adopt a general policy of aiming to have at least three or four firms engaged in every industrial activity. (One example is the government’s 1945 decision to force Alcoa to share its 100 percent aluminum monopoly with Kaiser and Reynolds.)

Arnold then combined this policy with an entirely new approach to patents. The TNEC had recommended that any patent held by a dominant firm be made “available for use by anyone who may desire its use,” that all licenses be entirely “unrestricted,” and that suits for infringement be all but prohibited. As one writer put it, the goal was to treat the patent monopolies of dominant companies as “a public utility.”

Innovation by Acquisition? The graphs below depict some but not all of the major high-tech companies absorbed in recent years by Google, Oracle, and Monsanto.

Under Arnold’s leadership, in 1941 the DOJ and the Federal Trade Commission (FTC) began to apply a variant of this policy. The government’s general approach was to start by bringing an antitrust suit against a firm that had captured undue control of some sector of the economy. It would then accept a settlement (in the form of a consent decree) by which the corporation promised to share its basic technologies with all comers, for free.

Until the Ronald Reagan administration killed the policy, the U.S. government applied this model to most technologically dominant large corporations in the nation. In the process they forced the people who controlled these companies to spill perhaps upward of 100,000 technological “source codes” into the world. A study done in 1961 counted 107 judgments just between 1941 and 1959, which resulted in the compulsory licensing of 40,000 to 50,000 patents.

One result was the greatest dissemination of industrial knowledge in human history. The world was treated to the secrets behind the televisions of RCA, the light bulbs of General Electric, the cellophane and nylon of DuPont, the titanium of National Lead, and the shoemaking technologies of United Shoe Machinery, among many others.

Another result was a new balance of power in the political economy of technology. By using antitrust law to trump patent law, Arnold and his team largely solved the traditional dilemmas of patent law. The big companies were less free to use patents to protect their bastions. The small firms, precisely because their size exempted them from antitrust oversight, could still fully exploit patent monopoly. Without breaking a single big industrial company, Arnold and his team helped foster a world in which engineers and scientists—no matter how small the company they worked for—could go about their work safe from predation, albeit not competition.

To get a sense of how Arnold’s team liberated the ingenuity of America’s citizens, consider what took place after the DOJ brought an antitrust suit against AT&T in 1949. By the late 1940s, AT&T had become notorious for its failure to integrate the most recent ideas of its subsidiary, Bell Labs, into the telephone system it controlled. The FTC, for instance, had cited the monopoly for sitting on such ready-for-market innovations as automatic dialing, office switchboards, and new handsets.

Even before settling the case, AT&T began licensing out key patents it controlled. One was for an obscure device called the “electronic transistor.” At the time, transistors were seen merely as a potential competitor to existing vacuum tube technology, and AT&T wasn’t much interested in disrupting its existing business lines by developing them. In 1952, AT&T licensed the technology for a small fee to thirty-five companies, twenty-five from the United States and ten from abroad.

Today, of course, transistors are the bedrock of all computer technology. The path to practical application was blazed not by AT&T or any other big firm; as business historian David Mowery has written, “the more aggressive pioneers in the application of the new transistor technology were smaller firms that had not produced vacuum tubes.” One of the smallest, Texas Instruments, introduced the first commercially viable transistor in 1954, just three years after its founding. Other early drivers were Motorola and Fairchild.

Consider, also, what happened inside the big, science-based industrial corporations after they were forced to compete with the fruits of their own scientists’ labors. In his close study of DuPont, business historian David Hounshell writes that “a particularly virulent attack” by the DOJ in the 1940s led executives to conclude that DuPont’s “generation-old strategy of growth through acquisition was no longer politically feasible,” and, further, “that the corporation’s growth would have to be based almost exclusively on the fruits of research.” Pointing to DuPont’s subsequent investments in R&D, Hounshell concluded that Arnold’s policy, although not necessarily best for DuPont’s short-term profits, “was good for the scientific community” at large.

We see much the same pattern in copier technology. Here the key action was a 1975 consent decree between the FTC and Xerox. In 1972, Xerox had been able to use patents to block Litton and IBM from entering the plain paper copier market. But the new agreement opened the market to new competitors and spurred Xerox to redouble its own development efforts. “The transition period” after the consent decree, Stanford economist Timothy Bresnahan has written, “saw a great deal of innovative activity from entrants and Xerox.” Faced with new competitors on all sides, he adds, “Xerox introduced new products in all segments.”

We also see this pattern in the software industry. In January 1969 the DOJ filed suit against IBM, charging the giant with retarding the growth of data-processing companies. In direct response to the suit, IBM decided to “unbundle” its hardware, software, and services. As then CEO Thomas Watson Jr. wrote, to “mollify” the Justice Department IBM abandoned its old marketing practice, by which it would “lump everything together in a single price—hardware, software, engineering help, maintenance, and even training sessions.”

One result, as Alfred Chandler observed, was to open up a market for “companies [including the Computer Sciences Corporation and Applied Data Research] hoping to sell independent software applications.” The other was to spur IBM to new and greater feats of science and engineering. In the years after the suit, Watson writes, IBM “prospered—which made the antitrust laws easier for me to accept.”

Now consider, in contrast, what happened within the walls of the giant science-based industrial corporations after the Reagan administration abandoned most of Arnold’s approach to regulating competition. We see a sudden collapse of investment by giant firms left to govern entire realms of technology as they alone determined.

In the 1980s and ’90s, General Electric was run by Jack Welch, widely recognized as one of the brightest CEOs of the time. Almost as soon as the Reagan administration overturned Arnold’s antitrust regime, Welch embarked on what he called his “No. 1 and No. 2 strategy.” First was a campaign of buying up and selling off business units in order to insulate GE from competition in every industrial sector in which it operated. Second was a shift from a reliance on R&D to drive profitability to a reliance on exploiting Welch’s newly forged corporate power. The bottom line? In 1981, GE was the fourth-biggest U.S. industrial firm and one of the top spenders on research. By 1993, GE had fallen to seventeenth in spending on R&D but had become the most profitable big company in America.

For a more recent example, there’s Pfizer. Here the buying binge did not begin until 1999, but once it started executives pursued it with abandon. Over the next ten years they grabbed Warner-Lambert, Pharmacia, and many smaller companies. The culmination came in 2009 when they seized Wyeth. The executives cut 19,000 jobs. They also cut R&D by a phenomenal 40 percent, from $11.3 billion at the two companies to about $6.5 billion. The former president of Pfizer Global Research, John LaMattina, summed up the results in Nature. “Although mergers and acquisitions in the pharmaceutical industry might have had a reasonable short-term business rationale,” LaMattina wrote, “their impact on the R&D of the organizations involved has been devastating.”

The American public has a fundamental interest in empowering our scientists and engineers to bring forth what is truly new and better, and in empowering ourselves—as a community and as individuals—to adopt these ideas at the pace and on a path that we alone choose. Why then have we almost entirely ignored, since the case against Microsoft, the role competition policy must play in promoting citizen-friendly technological advance?

The most obvious answer is money. In his 1942 defense of monopolists, Schumpeter wrote that dominant firms use their outsized profits to develop and introduce new technologies. In the real world, many goliaths invest their hoards in advertising old technologies, purchasing friendly treatment from Congress and the White House, and hiring “experts” at think tanks and universities to make their case with sponsored research.

The giants have also invested liberally in a powerful, but specious, political argument—that the “global” nature of competition today makes bigness necessary. They use this argument to justify more concentrated corporate power. The economist Michael Mandel distilled this idea in a recent paper. “In order to capture the fruits of innovation,” he wrote, “U.S. companies have to have the resources to stand against foreign competition, much of which may be state supported.” They also use this argument to justify greater control over intellectual property. The 1994 Uruguay Round trade deal, for instance, enabled these giants to reinforce patent and copyright protections not just in developing nations but also here at home, such as by extending patent terms from seventeen to twenty years.

Given how effective this “global competition” argument continues to be, even among sophisticated intellectuals, it merits a detailed response. The first point to consider is simple: the idea entirely ignores all historical evidence. Under the system Arnold pioneered, the American economy prevailed over and ultimately vanquished two rival economic systems, those of National Socialism and, later, Soviet Communism. America became the “Arsenal of Democracy” during World War II even as the Justice Department was busy slapping domestic monopolies with antitrust suits. In the 1950s and ’60s, while American prosperity was putting the lie to Soviet Communism, we were deploying a competition policy that today’s libertarians conflate with “command and control” but that was really the exact opposite.

Today, of course, global trade has vastly expanded. But that makes the idea that U.S. citizens must allow domestic monopolies to concentrate power so as to help “our” companies compete with “their” companies only that much less valid. For one, such arguments contradict the intent and existing structure of the interdependent international industrial system built with such care in the years after World War II.

The American architects of this system assumed that industrial integration with countries like Japan would make it all but impossible for the Free World’s industrialized nations to engage in armed aggression against one another. This strategy was so successful that it provided the argument for the subsequent extension of this system of “free trade” to countries like India and China in the mid-1990s.

The architects of the system also believed that such integration would provide an important economic by-product, namely more competition for big U.S. corporations—and, by extension, more rapid technological advance. Forcing companies like General Motors and RCA to compete with companies like Toyota and Panasonic, so the thinking went, was a great way to supplement antitrust enforcement, not an excuse to abandon it.

The architects of the system were completely confident that the U.S. government could—and would—use trade law to police the international system. One of the best examples of such enforcement took place in the mid-1980s, when Japanese electronics corporations including Hitachi and NEC made a play to capture control over key components of the personal computer, such as DRAM memory chips. The U.S. government responded by applying tariffs and quotas to Japanese-made components. The goal was not to bring the activity home to America but to spread it more widely. And, in fact, the action gave a huge boost to manufacturers in places like South Korea and Singapore.

Today, viewing corporations as national champions that need to be favored with expanded monopoly power is a form of protectionism and extremely dangerous. It leads to less innovation and to a loss of public control over how technology is deployed and for whose benefit. Worse, it distracts us from the challenge of working with citizens of other nations to ensure that our international system—which is, for all intents, now a form of global industrial “commons”—is structured to ensure its safe operation and resiliency at all times. The most important goal? The distribution of physical risk in the system, via the safe distribution of the production capacity we rely on for our foods, drugs, electronics, and other vital supplies. Which is, at bottom, just another way of saying we need a coherent competition policy.

So what technological gems lie hidden inside today’s giant corporations? Which vaults of patents should we crack open first? The fact is, we don’t know which ideas will prove most useful to us, over time. Those that now seem most promising might not pan out. Others, less glittery in their infancy, might yield wonders. The only way to find out is to drag the ideas into the light, and let the public pick through them and play with them just as we did in the golden age of American prosperity.

Today, we are being herded in a very different direction. A century ago, America’s lords of industry boasted of their power right in the names of their industrial estates; there was Standard Oil, Standard Distilling, Standard Rope and Twine. Today’s corporate chieftains often as not choose names that lend an aura of smallness, even cuteness, to the imperial enterprise. But it’s not hard to identify which corporations could be renamed Standard Operating System, Standard Semiconductor, Standard Enterprise Software, Standard Storage, and Standard Search.

The problem is not standardization per se. Some standardization is necessary in almost every technological system: think electrical sockets, doorframes, railroads, and television broadcasting. But too rigid a standardization, or standards setting left in the wrong hands, can be stifling. As the editors of Engineering magazine explained the conundrum a century ago, the challenge is “to suppress the folly of individualism which prefers sliding down a rope to using the standardized staircase, and yet not suppress the benefactor of standards who can evolve the escalator.”

That’s why it matters whether a standard is open or closed. And why it matters whether decisions about how and what to standardize are made by a democratic community or by a single private corporation operating in the name of a few individuals.

Today, in almost every key technological sector in America—including electronics, software, pharmaceuticals, medical devices, and the Internet—standardization is determined and enforced by private actors for private profit. The result is not merely to leave the decision about what technologies to deploy and under what terms in the hands of private corporate governments; it is also to force all of our scientists and engineers to goose-step down particular technological pathways.

Do nothing, and we will get the future they want, as fast as they want it, at the price they set.

The post Estates of Mind appeared first on Washington Monthly.

Shortly before noon on Wednesday, March 6, Rand Paul, the fifty-year-old senator from Kentucky, took the floor of the Senate. “I rise today to begin to filibuster John Brennan’s nomination for the CIA,” Paul said. “I will speak until I can no longer speak. I will speak as long as it takes, until the alarm is sounded from coast to coast that our Constitution is important, that your rights to trial by jury are precious, that no American should be killed by a drone on American soil without first being charged with a crime, without first being found to be guilty by a court. That Americans could be killed in a café in San Francisco or in a restaurant in Houston or at their home in Bowling Green, Kentucky, is an abomination.”

Ever since 2011, when two Predator drones in the Yemeni sky assassinated Anwar al-Awlaki, a jihadist cleric born in New Mexico, critics have alleged that the Obama administration, by not releasing evidence of the cleric’s guilt, had violated the due process rights of a U.S. citizen. Beginning this January, Paul sent letters to the White House requesting information about the Central Intelligence Agency’s (CIA)drone program, including whether the administration had the authority to launch a drone strike against an American on U.S. soil. But he had not been satisfied with the Justice Department’s response: that although the president had no intention of ever carrying out such a strike, it was possible to imagine a situation, like Pearl Harbor or 9/11, where he might have no other choice.

As the hours of the filibuster wore on, Paul steadily earned the attention of the public and the support of his Tea Party compatriots in the Senate. Mike Lee of Utah and Ted Cruz of Texas joined in, and then so did Jerry Moran of Kansas. Even Marco Rubio, who as a member of the Senate Select Committee on Intelligence had voted in favor of Brennan, lent his support to Paul, eating up time by quoting Wiz Khalifa and Jay-Z. Well after midnight, Paul wrapped up, saying, “There are some limits to filibustering, and I am going to have to go take care of one of those here.” In just twelve hours and fifty-two minutes, the junior senator from Kentucky had gone national.

Even though Paul had found an eye-catching way to attack the Obama administration, not everyone in the Republican Party approved of his choice of cudgel. “Calm down, Senator,” huffed the editorial page of the Wall Street Journal. Lindsey Graham brought to the Senate floor a sign comparing the number of Americans killed on U.S. soil by al-Qaeda (2,958) and those killed there by drones (zero). John McCain labeled Paul and his congressional allies “wacko birds.” To these critics, Paul’s protest was absurd, implying that the U.S. government might start hunting Americans with drones just for the fun of it. In June, after Paul called the just-leaked news of the National Security Agency’s (NSA) digital surveillance program “an extraordinary invasion of privacy,” McCain questioned his credibility. McCain noted that just before the April 15 Boston Bombings, Paul had rejected the idea that America was a battlefield in the war on terrorism.

John Tate, who heads the Campaign for Liberty, a grassroots lobbying group founded by Rand Paul’s father, Ron, dismissed the party’s foreign policy establishment as nervous about new competition. “Why would they be reacting so strongly and forcefully and negatively if they weren’t scared?” he asked. But the Paul phenomenon is largely the party’s own doing, the consequence of the GOP’s hawkish wing having long ago displaced its moderate one. For decades, moderates ruled the party’s foreign policy establishment, from President Dwight Eisenhower, who was unafraid to issue nuclear threats to end the Korean War yet inveighed against the military-industrial complex, to President George H. W. Bush, who called for a “new world order” yet resisted the temptation to depose Saddam Hussein in the final days of the Persian Gulf War.

As the GOP turned right on domestic issues, however, the moderates got squeezed out. (Their last elected ally, Senator Richard Lugar, lost his Indiana primary to a Tea Party-backed candidate in 2012.) Taking their place after 9/11 was a new group of Republican foreign policy hands: the neoconservatives, idealists who saw the application of U.S. military power as the answer to many of the world’s problems. Yet as their project ran aground in Iraq and Afghanistan, they lost the trust of the American public. Strangely, though, neoconservatism never lost its grip on Republican politicians. During the 2012 Republican presidential primary, the candidates tried to outdo each other on keeping troops in Afghanistan and confronting Iran.

With a war-weary public concerned more about unemployment and debt than foreign affairs, the Republican elite’s hawkish consensus has created an opening for someone offering a more restrained alternative, and Paul has seized the opportunity. More than any other Republican politician in recent memory, he is challenging the party’s foreign policy elite. Where most Republicans have called for military intervention, Paul has advocated noninterference; where they have defended increases in military spending, he has proposed cuts.

His message of prioritizing nation building at home is reverberating so deeply, in fact, that Paul is being treated as a viable 2016 presidential candidate. And he is acting like one, filling his schedule with stops in states with early primaries and starting his own leadership political action committee. In other words, by making himself impossible to ignore, Paul is forcing a conversation that the Republican Party doesn’t want to have—and with an interlocutor much of it considers to be a foreign policy lightweight.

Just four years ago, Paul was removing cataracts and performing corneal transplants in southern Kentucky. “I don’t think that as a physician in Bowling Green practicing ophthalmology I was really carrying around a foreign policy,” he said to me one Wednesday afternoon in May. We were speaking in his Senate office, a hushed space decorated with equestrian prints. With his tired eyes and permanent bedhead, Paul looked like the sleep-deprived collegiate swimmer he once was. Before coming to Washington, his involvement in politics had been limited to campaigning on behalf of his father, and founding a group that graded state legislators on taxes. In 2009, when Senate Minority Leader Mitch McConnell shoved his Kentucky counterpart Jim Bunning from his seat, Paul leaped into the race to succeed him.

McConnell and the Republican establishment had a different successor in mind: Trey Grayson, Kentucky’s secretary of state, the Harvard-educated son of a banker. Paul was, however, the clear choice of the newly formed Tea Party movement. Even though the race centered on economic issues, the Grayson campaign, backed by internal polls of likely Republican voters showing 75-25 splits in its favor on national security positions, sought to make foreign policy an issue. “When his father ran for president in 2008, for the vast majority of Republican voters his foreign policy views made him a nonstarter. So we thought, ‘Wow, here’s his son,’” Grayson told me. “We’re going to assert that he has similar views, even when it’s not clear on specific issues whether he’s in fact exactly the same … and that will disqualify him in the minds of voters.”

The campaign seized on comments Paul had made about sending prisoners from Guantánamo Bay back to the battlefield—just another issue on which Paul, as his opponents put it, was “too kooky for Kentucky.” In a debate broadcast on Kentucky Educational Television, Grayson demanded that Paul explain why he was in favor of allowing detainees to return to war zones. “And don’t talk about Chinese Uighurs,” Grayson warned. (Paul had claimed that his comments about release were made in reference to the Uighur prisoners the Bush administration had already decided to free, marking perhaps the first time the plight of Chinese Muslims had figured in Kentucky politics.) Paul weathered the debate well, making Grayson’s footnoted attacks look desperate.

During the campaign, Paul tapped into his father’s national fund-raising network, gathering small pledges from libertarian donors across the country. Among them were the millions of listeners to the radio show hosted by Alex Jones, America’s most prominent conspiracy theorist; they were so eager to contribute that once when Paul was on the air, they crashed his Web site. In one 2009 appearance, Jones asked Paul if he thought the new world order was going to succeed. Paul replied, “Thirty years ago, nobody thought there’d be one currency in Europe. Right now, most people don’t think there could be one currency in our [continent], and yet the talk of the amero is out there.” The what? Paul seemed to be referring to a short-lived uproar that started when conspiracy theorists encountered images of a fictional unified North American currency created by a designer of novelty coins.

Grayson, by contrast, lined up endorsements from the GOP establishment, including Dick Cheney and Rudy Giuliani, both of whom implied that Paul was soft on terrorism. But their support, Grayson told me, “played right into Rand’s hands. The voters didn’t care so much about the foreign policy stuff, and they saw the establishment trying to protect one of its own.” Paul won the primary by twenty-three points and cruised through the general election.

Paul was sworn into the Senate in January 2011, and he wasted no time in proving his Tea Party credentials. That same month, he introduced legislation to cut $500 billion over the eight months left in that fiscal year. His budget for the next fiscal year eliminated the Departments of Education, Energy, Housing and Urban Development, and Commerce. It froze foreign aid, scaled back defense spending, and privatized the Smithsonian Institution. The Senate rejected it 90 to 7.

Paul’s budget constituted early proof that his thinking on foreign policy deviated from the party line. Just as Washington should stop fostering dependency through generous entitlement programs at home, he argued, it also needs to stop subsidizing the security of governments in Europe, Asia, and the Middle East—foreign welfare queens that can afford to pay for their own needs. In practice, that would mean closing down some U.S. military bases and shrinking the number of troops stationed at others. “The neocons want to characterize this as ‘Oh, he wants to disengage, he doesn’t want to be involved anywhere,’” Paul told me, but he said that overstates his position. “If Germany wants to have their joint base with us and we want to have it, we could do it. Maybe we do it with, instead of fifty thousand troops, five thousand troops.” In South Korea, he said, U.S. forces could leave as part of a deal in which North Korea agreed to abandon its nuclear program and allowed inspections to verify that it had done so.

When Obama directed the U.S. military to enforce a no-fly zone in Libya in March 2011, the emerging split on foreign policy within the Republican side of the Senate spilled out into the open. John McCain took to Fox News Sunday to defend the intervention as necessary to prevent a slaughter in Benghazi and support democracy after the Arab Spring. Invoking the United States’s “unique moral responsibilities,” Marco Rubio endorsed the campaign and urged the administration to openly embrace the goal of removing Libyan leader Muammar Qaddafi from power.

Paul, meanwhile, recorded a video response to Obama’s address on Libya, condemning the president for failing to seek approval from Congress “before hastily involving ourselves in yet another Middle Eastern conflict.” Along with Senators Mike Lee, Jim DeMint, Ron Johnson, Tom Coburn, and John Cornyn, all of whom lean to the right within the GOP, he sent a letter to Obama challenging the White House to comply with the War Powers Resolution. The law, passed in 1973 over the veto of Richard Nixon and in response to the Vietnam War, requires presidents to obtain congressional authorization for military campaigns lasting longer than sixty days, but no president since has accepted its constitutionality.

Paul’s opposition to the Libya campaign went beyond questions of procedure. “In Libya, unless there’s something that I don’t know that wasn’t reported in the media, I’m not sure what our national security interest was,” he told me. “I’m a little skeptical, because the neoconservatives in my party the year before wanted to fund Qaddafi and sell arms to Qaddafi.” Paul was referring to a 2009 meeting, revealed in the WikiLeaks cables, in which Senators John McCain, Joe Lieberman, Lindsey Graham, and Susan Collins discussed the sale of military equipment with the Libyan government. “The next year they want to send boots on the ground and can’t get in there quick enough to topple Qaddafi,” Paul said. While McCain and others had not called for ground troops, Paul’s point remains: “The only thing that seems to be consistent in their position is being involved.”

In February 2012, after Egypt charged nineteen American nongovernmental organization workers with illegally funding pro-democracy groups and prevented six from leaving the country, Paul found a peg on which he could hang his long-standing opposition to foreign assistance, and he proposed an amendment to cut off all U.S. aid to Egypt until the Americans were freed. “Dependency often leads to indolence, lethargy, a sense of entitlement, and ultimately to a state of insolence,” he said on the floor of the Senate. “Egypt has been receiving welfare from the United States for nearly forty years.” The measure failed, but the Egyptian government allowed the NGO workers to leave, and Paul took credit for playing the bad-cop role. He later introduced a bill proposing that the government end all aid to Egypt, Libya, and Pakistan; it failed 81 to 10.

Notably absent from that list was Israel. Ron Paul never got along with the pro-Israel crowd. (The Republican Jewish Coalition, for example, did not invite him to a presidential candidates’ forum in 2011.) Fearing that the son had inherited the father’s views, supporters of Israel rallied around Trey Grayson during the 2010 primary.

After Paul won, their fears appeared to be confirmed. In September 2012, Paul was the Senate’s sole “nay” vote on a nonbinding resolution endorsing Israeli Prime Minister Benjamin Netanyahu’s preferred redline for military action: Iran’s development of a nuclear weapons capability. (The Obama administration has said it will support military action only if Iran actually develops nuclear weapons.) He has refused to rule out the option of containing a nuclear Iran, for fear that doing so will commit the United States to war if Iran were to go nuclear despite the international community’s best efforts.

But aside from his stance on Iran, Paul has gone out of his way to woo the pro-Israel crowd, distancing himself from his father on the topic. “He pretty much threw his father under the bus, very early on, to try to make it clear that he didn’t share all of his father’s views,” said one Republican foreign policy adviser who met with Paul privately. Another adviser who has spoken with Paul privately told me that Paul criticized his father’s stance on Israel, pointing out that Ron Paul’s opposition to Israel’s settlement policies was inconsistent with his stated preference for the United States to mind its own business. “He had clearly thought through where his father’s foreign policy broke down,” the adviser said.

This past January, Paul traveled to Israel, effectively making public the sentiment he had conveyed in private. He had just received a seat on the Senate Foreign Relations Committee, and he spent the first part of his trip meeting with politicians including Netanyahu, Israeli President Shimon Peres, and Palestinian President Mahmoud Abbas. He spoke at a lunch hosted by the American Israel Public Affairs Committee and told an audience at a free market think tank in Jerusalem that he favored only a “gradual” reduction of U.S. aid to Israel.

The trip was designed not only to reassure the pro-Israel crowd but also to win over Christian supporters. For seven days, Paul and his wife, Kelley, rolled around the Holy Land on a bus full of American evangelical leaders. The fifty-three-person tour was organized by David Lane, a born-again political activist from California. Owing to their belief that the second coming of Jesus requires a state for God’s chosen people, American evangelicals have a special attachment to Israel. “It’s the Abrahamic covenant,” Lane explained. “God said to Abraham, ‘I’m going to give you the land and that’s my word, that’s my covenant.’ And so there’s never going to be peace because if you go over there, all the key places of the Jews, the Muslims have put a mosque on top of it.”

Paul and the others bathed in the Dead Sea and held a church service on a boat in the Sea of Galilee. They visited the Mount of Beatitudes, the site of the Sermon on the Mount; the Garden of Gethsemane, where Jesus prayed before his crucifixion; the Mount of Olives, from which he ascended into heaven; and the ruins of Megiddo, where Armageddon is supposed to take place. “What happened to Rand Paul was spiritual,” Lane said. Afterward, Lane said, Paul sent him a handwritten note confiding that his first night home, he woke up in a dream singing the hymn “How Great Thou Art.”

If the trip to Israel was the first step of Paul’s move to make himself more acceptable to the conservative mainstream, the second took the form of a speech he gave at the Heritage Foundation, the conservative think tank led by former Senator Jim DeMint, who had endorsed Paul in the primary. Branding himself a “realist,” Paul urged “a foreign policy that is reluctant” but not isolationist. Indeed, “there are times, such as existed in Afghanistan with the bin Laden terrorist camps, that do require intervention.” Paul’s advisers had also approached the American Enterprise Institute and the Council on Foreign Relations as possible venues, but in part because Paul was not interested in holding a question-and-answer session, he ended up at Heritage. And so, with Paul taking no questions after the thirty-minute speech was over, attendees started eating lunch at 11:30 in the morning.

In making the case for restraint, Paul invoked the diplomat George Kennan, quoting liberally from a biography written by the Yale historian John Lewis Gaddis. Kennan was a foreign policy realist who was most famous for drafting the United States’s containment policy, a path that avoided both appeasement and war. Yet he also believed that grand strategy belonged in the hands of unelected wise men, making him an odd hero for a Tea Party populist. When I pointed out this seeming contradiction to Paul, he said that after reading the Kennan biography, “you kind of thought of him as a snob and an elitist.” (Gaddis, reached by telephone in New Haven, responded that Kennan “was certainly an elitist. I don’t think he was a snob.”) But citing Kennan allowed Paul to claim the threadbare mantle of Republicans’ favorite dead president, Ronald Reagan. As Paul explained, in attempting to contain the Soviet Union through limited means Reagan was arguably the most Kennanesque of any Cold War president.

Not everyone, however, bought Paul’s portrait of a restrained Reagan. The day after the speech, Robert Kagan spent an entire Washington Post column criticizing it, pointing out that Reagan ramped up military spending, armed rebels around the world, and attacked Grenada and Libya. “Well, you didn’t see us in a major land war with Iraq,” Paul retorted to me. “You didn’t see us in a twelve-year war that we’ve been involved with in Afghanistan.” He had a point. In negotiating with Soviet leader Mikhail Gorbachev, Reagan overruled the neoconservatives within his administration who were pushing for a harder line, and every military action he authorized was indirect or small-scale. “When it comes to using force, Reagan was very, very cautious, and he did not like to expose our people to unnecessary danger,” said Jack Matlock, one of Reagan’s foreign policy advisers.

On the other hand, Reagan was more of an internationalist; he was willing to bind the United States into arms-reduction deals with the Soviets. When Paul was asked just after his election whether he would vote in favor of the New START Treaty, an agreement between the United States and Russia on joint nuclear weapons reductions, he said, “It doesn’t sound like I’m probably going to be in favor of that.” The Senate ended up ratifying the treaty before he was sworn in. “The fact that twenty-six senators, all Republicans, voted against the New START Treaty must have sent Reagan twirling in his grave,” Matlock said.

Paul’s self-proclaimed realism also fits uneasily with his libertarianism. Traditionally, realpolitik is the school favored by statists—people like Otto von Bismarck and Henry Kissinger—who believe that grand strategy is best left to a strong executive. Paul’s opposition to drones reveals this contradiction most. The CIA’s drone program allows the United States to fight terrorism by joystick from Nevada, without having to engage in the messy business of nation building. As the foreign policy commentator and former Ron Paul adviser Leon Hadar told me, one would think that drones would be “the weapon that realists would fall in love with.” Yet for Paul, they represent the very embodiment of unchecked government power.

In fixating on the possibility that the federal government could use a drone to kill a U.S. citizen on U.S. soil, Paul made it look like his opposition to drones owed more to conservative chain emails than to studied Human Rights Watch reports. Reasonable critics have questioned the Obama administration’s drone policy over the secrecy surrounding the targeting process and the possibility that collateral damage from strikes helps terrorist recruitment. (Both were problems Obama attempted to address in his speech at National Defense University in May.) The idea that a Hellfire missile could interrupt a barbecue, however, does not top their list of concerns. When I suggested to John Tate that the filibuster had to be symbolic, he said it probably was—but only partly so. “There’s a certain segment of the people that aren’t so sure about what you said, that we’re not going to do drone strikes on American soil,” he said.

Speaking to me in his office, Paul argued that the drone program’s lack of geographical limits means that the same problems it poses in, say, Yemen could affect the United States too. “We have circumstances overseas where you and I are talking, and they think you’re a terrorist, and they blow us both up,” he said, trying to lend some immediacy to a hypothetical scenario. While the two of us may be terrorists, he continued, the only person who gets to see the evidence is the president. “He flips through flash cards, and they do a Power-Point, and he decides who he’s going to kill,” Paul said. He added, “Let’s say you are a bad person and you may be plotting. Maybe it is a good thing to kill you. But then”—he began gesturing successively to the three silent staffers beside us—“Moira sits in your chair next, and we kill her, and then Rachel sits in your chair, and then Sergio sits in your chair. Is there an end to it?”

As his imagined bloodbath demonstrated, Paul’s anti-drone crusade pivots between principled opposition to executive power and fantastical scenes of robotic doom. John McCain told me that Paul’s filibuster proved so popular because “it feeds into the conspiracy theories of Americans—the government, the black helicopters going around taking unilateral actions that can trample on individual liberties.”

Yet as out-there as the filibuster may have been, it received the support of the thirteen sitting GOP senators (and one Democrat, Ron Wyden) who formally joined it. McCain said that upon seeing his fellow Republicans flock to the floor, he was “both entertained and dismayed, because it certainly showed, one, the herd instinct around here, but second of all, the influence and inordinate fear of primary challenges.” For Republicans with foreign policy views like McCain’s, it’s bad enough that a noninterventionist coalition is forming around Paul, Cruz, and Lee; what’s worse is that members of their own faction have to pay obeisance to it.

For many in the Republican foreign policy establishment, Paul’s positions are naive, even dangerous. His floating of the idea that the United States might be willing to live with a nuclear Iran—a stance that puts Paul more in line with realist scholars of international relations than the Republican base—startles those who believe that such a state would upset the delicate balance of power in the Middle East and threaten Israel. Clifford May, the president of the Foundation for Defense of Democracies, said that containment “is an option that should be considered, but having been considered, it should be rejected because there is no way to contain a nuclear jihadist Iran.”

Paul’s proposals to sever foreign aid, meanwhile, have been met with allegations that he just doesn’t get it. Military assistance, the argument runs, buys the United States influence abroad and promotes stability where it is needed most. “Rand Paul is one nice fellow, but I bet you he’s never talked with CIA Director General Petraeus about what would happen if we cut our aid off to Pakistan,” Lindsey Graham said last year.

Most of Paul’s 2012 book, Government Bullies, is dedicated to singling out federal regulators—Environmental Protection Agency officials who arrest a homeowner for spreading topsoil, Department of Agriculture administrators who levy multimillion-dollar fines on a teenage rabbit breeder, and so on. But in a chapter on “foreign bullies,” Paul recounts his crusade against aid to Egypt. “I do not have forty years of foreign policy experience,” he writes. “But I do know that if you want [to] take on a bully, you can’t be meek. You don’t pull punches, but swing as hard as you can, preferably with a blunt object.”

Swinging at Egypt, however, would seem to send exactly the wrong message to the new government: that while a military dictatorship can receive billions of unconditional dollars from the United States for thirty years, as soon as it is replaced with an electoral democracy the funding will dry up. Cutting off aid would also disempower one of the few stabilizing forces in the chaotic country. “I’m not sure what exactly we would achieve by doing that,” said Richard Fontaine, a former McCain adviser who is now president of the Center for a New American Security.

While the Republican foreign policy establishment dismisses the substance of Paul’s views, it recognizes their appeal. In March, the American Enterprise Institute, admitting that “fiscal constraints, weariness with war and isolationism are eroding the American will to lead,” launched the American Internationalism Project, led by former Senators Joe Lieberman and Jon Kyl. Dan Senor, who advised Mitt Romney on foreign policy during his 2012 campaign, has begun organizing a network of donors to back internationalist candidates in Republican congressional primaries.

Even as the neoconservatives are busy trying to stamp out Paul’s brand of foreign policy, however, Paul is engaging in a concerted outreach to them. After Paul won his primary, he spoke with a group of GOP foreign policy hands at a meeting organized by the Foreign Policy Initiative that included Senor, Bill Kristol, Jamie Fly, and Tom Donnelly. Senor met with Paul again before the Israel trip, and the two discussed Senor’s book on the Israeli economy. Elliott Abrams, a former George W. Bush administration official who is now a fellow at the Council on Foreign Relations, has met with Paul twice, forty-five minutes each time, talking mostly about the Middle East. He found Paul willing to listen and argue. There are two possible explanations for Paul’s discussions with neoconservatives, Abrams said. “One is purely political—that is, like the trip to Israel, it is a part of creating a better image of himself as someone who listens to everyone and who is just seeking as many opinions as he can get. The other theory is that he’s actually interested in seeing what we think.”

By putting out feelers to the foreign policy establishment, Paul is fueling chatter about his presidential ambitions—speculation he openly embraces. Part of this effort involves distancing himself from his father. During the presidential debates of 2007, Ron Paul, spasmodic in voice and animated in eyebrow, alienated voters with his argument that 9/11 was backlash against the United States’s meddling in the Middle East. “Ron saw himself as a truth teller,” said a senior Republican aide with ties to Rand Paul. “Rand sees things a little differently. Rand believes that the best way to effect change is to win and then be able to make policy.” In April, the elder Paul founded the Ron Paul Institute for Peace and Prosperity and named Slobodan Milosevic apologists and 9/11 truthers to its board. Rand did not attend the think tank’s opening.

There is plenty more distancing left to do. This May, the National Association for Gun Rights, a group that sits to the right of the National Rifle Association, sent a fund-raising letter under Paul’s name raising alarm about the Obama administration’s support for the United Nations Arms Trade Treaty, which would supposedly allow UN bureaucrats to confiscate Americans’ guns. “I don’t know about you,” the letter said, “but watching anti-American globalists plot against our Constitution makes me sick.” The allegation played to populist suspicions about international institutions. (As Paul’s long-shot primary opponent Gurley Martin said during one debate to much applause, the UN needed to be “sent back to France or wherever in the hell it came from.”) But it was wholly untrue: the treaty in question explicitly affirms the right for countries to set their own domestic gun policies.

In June, Paul issued a call to arms concerning the NSA’s electronic surveillance program. As he had done before, Paul bypassed the measured criticism he could have summoned and instead embraced the paranoid style. “How long until these spying capabilities suffer some ‘mission creep’ and they start using the GPS feature in your phone to track whether or not you go to gun shows?” he asked in a mass email. The dispatch requested that supporters join Paul’s class-action lawsuit against the federal government (something legal experts say has no chance of succeeding) and that they donate to his leadership PAC.

The domestic market for American activism abroad is soft. Part of the fault for that lies with the economic recession. At a time of high unemployment, ambitious programs of international engagement are a tough sell. Take foreign aid, which by definition has no domestic constituency. According to one 2010 poll, Americans on average believe that their government spends 27 percent of its budget on international assistance but should spend 13 percent; the actual fraction is 1 percent. “Foreign aid—just those two words have taken on a negative connotation with a lot of our Republican base,” McCain told me.

But neoconservatives cannot heap all the blame for the erosion of their foreign policy monopoly on the economy. “One word, two syllables: it’s Iraq more than anything else,” the conservative Washington Post columnist George Will said when I asked what explained the growing popularity of Paul’s foreign policy. In Iraq, the Bush administration attempted to transform the Middle East unilaterally and cheaply. When the experiment failed—when it became clear that the reformation of Iraq could only be had at great cost, if at all—the contradictions in the administration’s worldview were laid bare. To a lesser extent, this was true in Afghanistan, too, where achieving even the limited goal of denying al-Qaeda a safe haven has proved frustratingly elusive. “Conservatives have been eloquent and correct for forty years on how hard it is to fix Cleveland,” Will said. “They seemed to neglect what they knew about Cleveland when it turned to Afghanistan.”

With Iraq having “thoroughly shattered the Republican Party’s brand on foreign policy,” as the Cato Institute scholar Christopher Preble put it, some Republicans began searching for alternatives to the neoconservative ideology that had dominated their party’s thinking. In another era, they would have bumped into something called the Republican realist, a category that last had influence during the George H. W. Bush administration in the figures of Colin Powell, James Baker, and Brent Scowcroft.

But sometime in the 1990s, that species began to go extinct. After Bush lost his reelection, the realists never could transcend technocracy to achieve real political influence, and never could offer a message that competed with that of the neoconservatives. Today, Republican realists face the added disadvantage of having a president from the opposite party who, generally speaking, has adopted just the type of limited foreign policy they prescribe. Agreeing with the incumbent Democrat gets you nowhere in the Republican Party.

And so the non-neoconservative Republicans are left with Paul, who, in the words of the conservative New York Times columnist Ross Douthat, “can sometimes sound like a libertarian purist, sometimes like a realist in the Brent Scowcroft mode and sometimes like—well, like a man who was an ophthalmologist in Bowling Green, Ky., just a few short years ago.” Paul’s perceived extremism has prevented the old-school realists from claiming him as their own. As one former official who identifies as a realist told me, “While some (but not all, to say the least) of what Rand Paul says makes sense, he is much too outside the mainstream on all sorts of economic, domestic, and foreign policy questions to be the heir to Bush 41, Ford, Nixon, Eisenhower, etc.” The isolationist wing of the GOP is long gone, so it is impossible to know what they would make of Paul, but, Trey Grayson said, “Robert Taft wouldn’t be hanging around the equivalent of Alex Jones.”

Republican foreign policy experts are quick to question Paul’s credentials—anonymously, at least. One Capitol Hill staffer I talked to said, “I have yet to see any evidence that this guy’s anything more than someone who’s read up on a handful of issues as opposed to someone who’s traveled widely and thought deeply about the world.” Whereas Rubio has added Jamie Fly, the former director of the Foreign Policy Initiative, to his team, Paul has made no equivalent national security hire. On foreign policy, Paul listens to a group of political advisers that includes Doug Stafford, his former chief of staff who now works on his reelection campaign; Trygve Olson, a consultant who has worked on democracy promotion efforts in eastern Europe and who described himself to me as “a political guy who ended up doing a lot of foreign policy”; and Jack Hunter, a radio talk show host now working for Paul who calls himself “the southern avenger.” “I think this is a work in progress,” Elliott Abrams said of Paul’s foreign policy.

Nonetheless, as his ideological opponents readily admit, Paul is a skilled politician with a viable future. Yet he is popular not only because he is young, savvy, and articulate but also because he has exploited a long-standing gap between American citizens and their political leaders on foreign policy. When pollsters from Rasmussen asked likely voters this January, “Should the United States be the world’s policeman?” only 11 percent answered yes. No wonder Paul’s message of restraint has found such a warm reception.

The brashest of Paul’s positions—the immediate cutting off of aid, the major downsizing of military bases, the imposition of significant congressional authority—will likely never become U.S. foreign policy. But his effect on the rhetorical landscape could prove more lasting. Paul, George Will said, has “expanded the range of what is discussable.” The challenge he poses to advocates of military intervention is particularly potent, and particularly useful at a time when Washington is debating our intervention in Syria.

On the day Paul and I spoke, Rasmussen polled likely voters about the conflict in Syria. Seventy-three percent thought the United States should stay out. The Senate, meanwhile, was coming to its own consensus on Syria. The chair of the Foreign Relations Committee, Democratic Senator Robert Menendez, had just introduced legislation that would provide arms and training to the opposition, and McCain and Democratic Senator Carl Levin would soon take to the Senate floor and demand missile strikes against Bashar al-Assad’s forces. Rubio had staked out his position on Syria well before, arguing for stronger actions against the regime back in 2011.

Paul was skeptical. He wondered which side the rebels were on, what would happen to Syria’s two million Christians, and whether a post-Assad state would be any better than the one that preceded it. “I’m not saying it’s not America’s problem; I’m just saying I’m not sure what the solution is, and I’m not sure anybody knows,” he said. “People who say they know, I think, are being presumptuous.” Two days later, Paul was off to Cedar Rapids, Iowa, to speak before a sold-out crowd at the GOP’s Lincoln Day Dinner. The Iowa caucuses were more than two and a half years away, but Paul was already polling well among Iowans. He was leading Rubio by nineteen points.

The post The Education of Rand Paul appeared first on Washington Monthly.

For more than a decade, Loma International Business Group, Inc., operated out of the seventh floor of the elegant stone building in downtown Baltimore known as “Baltimore’s First Skyscraper.” Loma’s owners, Manuel and Lola Alban, seemed to fit in well with the lawyers, accountants, and government officials who also had offices in the building. Manuel Alban advertised himself as an attorney, and the couple purported to offer legal services to immigrants, particularly from Honduras and El Salvador, who were looking for help in dealing with their immigration status. Over the course of a decade, the Albans filed immigration paperwork for more than 600 clients, charging each hundreds of dollars for their work.

In June 2011, a federal judge shut down Loma for deceptive practices. According to a complaint filed by the Federal Trade Commission (FTC), Manuel Alban was not an attorney, nor were the Albans authorized to provide immigration services, as they claimed. Moreover, more than half of the immigration applications they filed were rejected or denied, often because they filed the wrong form or failed to pay a fee. Collectively, the Albans bilked their clients of tens of thousands of dollars.

The Albans succeeded by using word-of-mouth advertising and preying on their clients’ vulnerability. “Since most consumers have limited English skills,” said the FTC’s complaint, “they place their trust in the Albans to select, prepare, and file the necessary English language immigration forms.”

They also succeeded by exploiting the Byzantine complexity of the immigration system, which is too intimidating for most laypeople to navigate on their own. Jackie Vimo of the New York Immigration Coalition, a nonprofit advocacy group, calls immigration law “second only to the tax code for complexity.” She says her group “strongly advises against” clients applying for an immigration benefit on their own, because the stakes for immigrants are so high. Says immigration lawyer Rachel Van Wormer, “You put the wrong things on your form, and you could be deportable.”

Talk of immigration reform is moving closer to reality, and the legislation that emerges from Congress will determine whether the treacherous path that immigrants already face becomes more dangerous still. While politicians jockey to craft a “tough” bill that piles on hurdles and paperwork for immigrants, unscrupulous entrepreneurs like the Albans are likely salivating over the opportunities.

Immigration advocates already report an uptick in profiteering. Even though legislation has yet to be passed—and even when it has been passed, it will likely take months for the government to issue regulations governing the process—fraudsters are already claiming that visas are available and that a waiting list is being developed. “The ink isn’t even close to dry, and people are creating the false impression that people should start signing up now,” says the New York Immigration Coalition’s Vimo.

In fact, the biggest potential beneficiaries of reform might not be the eleven million undocumented immigrants eager for legal status. Instead, the winners might be waiting in the shadows: an army of “storefront coyotes”—a variation on the notorious profiteers who charge thousands of dollars to smuggle desperate immigrants across the border.

While recent opinion polls show that the majority of Americans support giving illegal immigrants a path to legal status, Americans also want that path to be “earned.” A 2013 poll by the Public Religion Research Institute found, for example, that 63 percent of Americans support a path to citizenship for illegal immigrants “provided they meet certain requirements.” Spelling out those requirements has been central to the current politics of reform, particularly for conservative proponents who feel the only way to pass reform is to mollify the hard right with a restrictive and tortuous path to legal status.

In the March 2013 proposal by the Senate’s bipartisan “Gang of Eight,” for example, the bill summary made it painfully clear that this proposal was no amnesty. After meeting preconditions on border security, “undocumented immigrants will be able to come forward, must submit to and pass background checks, be fingerprinted, pay $2,000 in fines, pay taxes, prove gainful employment, prove they’ve had a physical presence in the U.S. since before 2012 and going to the back of the line, among other criteria. Criminals and those who don’t meet these criteria will be deported.” Moreover, the proposal set an absurdly short timetable—one year—for all immigrants seeking legal status to file their paperwork.

Nevertheless, the first markup of the Senate bill before the Senate Judiciary Committee drew dozens of amendments from senators seeking to make the bill even tougher. Utah Republican Senator Orrin Hatch, for example, filed twenty-four proposed amendments, including one to collect DNA samples from every immigrant seeking legality. Because proponents of reform feel they must bow to pressure that immigrants “earn” legal status, whatever new legislation emerges will likely make an already tortured path to citizenship even more complex.

Ever since Ronald Reagan signed the Immigration Reform and Control Act of 1986, the so-called “amnesty” law that legalized 2.7 million undocumented immigrants, Washington, under pressure from an angry public, has passed ever more draconian restrictions on immigrants, legal as well as illegal. First came the Illegal Immigration Reform and Immigration Responsibility Act of 1996, which banned new immigrants with green cards from receiving government benefits such as Social Security, increased border security and penalties for immigration fraud, and dramatically expanded the list of deportable offenses. Then, after the 9/11 attacks, Congress passed a slew of measures tightening immigration, including the Homeland Security Act of 2002, which created the Department of Homeland Security and put immigration in its purview; the USA PATRIOT Act, which made it easier to deport suspected terrorists; and the REAL ID Act, which made claiming asylum tougher and made driver’s licenses unavailable to undocumented immigrants.

In theory, despite all these new laws the immigration process remains fairly simple: you apply for a visa, become a “lawful permanent resident” (that is, you get a “green card”), and then you apply for citizenship. But in practice, the process has become impossibly protracted. According to the Migration Policy Institute, immigrants from countries where the demand to immigrate is high, such as the Philippines, have waited as long as twenty-four years just for their initial visa.

There are multiple channels to a green card, depending on whether you’re coming to America because of a job, because you have family members who are U.S. citizens or lawful permanent residents, or because you are a refugee from political or physical persecution in your home country. Each channel requires its own set of forms, a myriad of supporting documents and the potential involvement of multiple federal agencies (particularly if something goes wrong): the U.S. Citizenship and Immigration Services (USCIS) to handle the initial application; Immigration and Customs Enforcement to handle any deportation proceedings; and the Department of Justice to handle appeals in the immigration courts if an application is denied or a deportation is contested. Some cases also involve the Customs and Border Protection agency. Each agency, as well as the courts, is also constantly churning out case law, policy memos, and regulations that practitioners must keep up with. A mistake anywhere along the way can lead to deportation; in 2012, Barack Obama’s administration deported a record 409,849 immigrants.

Immigration lawyer Jie Li tells of a client who had taken it upon himself to fill out the green card application for his foreign-born wife. Despite what should have been a straightforward process, the client—who was, ironically, a USCIS employee—committed a paperwork error that triggered deportation proceedings. JoJo Annobil, the lead immigration attorney for the New York Legal Aid Society, describes the current regime as “zero tolerance.” “Every mistake is magnified,” he says. He cites, for example, a client who was a legal resident, the spouse of a U.S. citizen, and the father of three American-born children. Before coming to Annobil, this client had tried to file his paperwork himself, but accidentally sent his forms to the wrong address, thereby missing a crucial deadline—enough to trigger deportation proceedings.

Trying to navigate these treacherous bureaucratic waters on one’s own is madness. But finding capable and honest professional assistance is itself a crapshoot. The market for immigration services is strewn with rip-offs, such as Web sites that charge people for forms that can be downloaded for free from the USCIS. One such site of dubious value is www.us-immigration.com, which mimics a government site and justifies charging for forms with the offer of 24/7 phone advice and “personalized instructions.” The site’s owner, American Immigration Center, Inc., has received enough complaints to earn an F grade from the Better Business Bureau.

Drive through a Latino neighborhood and you’re likely to see signs for “notarios publicos,” immigration consultants who are not lawyers and operate in a legal gray area. While the clerical act of filling out forms is not technically the unauthorized practice of law, offering advice on how to complete a form—or even just making those decisions on someone’s behalf—crosses the legal line. Even if a notario doesn’t blatantly advertise him- or herself as an attorney, as Manuel Alban did, he or she may still be offering unauthorized legal advice.

Notarios also deliberately compound the confusion for consumers by using that title. In many Latin American countries, a notario publico is a respected designation for lawyers (unlike the term “notary public” in the United States, which indicates someone who is legally qualified only to witness signatures). In Mexico, earning the title of notario publico requires passing a special test, having a clean criminal record, and being over the age of twenty-five. Though not every notario in the U.S. is a scam artist, when it comes to immigration law bad advice can be extremely dangerous for unsuspecting clients. “Maybe [the notarios] are ill-intentioned or they’re just ill-informed, but either way you’re left holding the bag,” says Cori Alonso-Yoder, an immigration attorney with the Washington, D.C., nonprofit Ayuda.

Authorities have made some efforts in recent years to step up enforcement against fraud. In 2011, the FTC, the Department of Homeland Security, and the Department of Justice jointly launched the National Initiative to Combat Immigration Services Scams to crack down on notarios and immigration services fraud. The American Immigration Lawyers Association, the specialty bar association for immigration attorneys, also began an effort called Stop Notario Fraud to help educate consumers and encourage them to report suspected fraud.

Nevertheless, enforcement has been relatively weak. The FTC’s case against Loma, for example, was one of merely sixteen federal actions brought against immigration service providers between 2008 and 2011. A major reason for the tepid enforcement is that undocumented immigrants are often reluctant to draw official (and potentially negative) attention to themselves by reporting a crime. In fact, some victims of irresponsible and fraudulent notarios may never get the chance to come forward because the notarios’ errors trigger deportation proceedings. (According to Valeria Treves of the advocacy group New Immigrant Community Empowerment (NICE), this is a tactic notarios explicitly use: they file for immigration benefits that people clearly aren’t eligible to receive, charging fees for each application; their client never gets a visa; and the mistake draws the notice of immigration authorities, who may begin deportation proceedings. Meanwhile, the notario in question escapes scot-free because the client might be too busy fighting deportation proceedings to file a complaint against the notario.)

Moreover, because the FTC doesn’t pursue cases on behalf of individuals, merely filing a complaint doesn’t help a would-be immigrant get his money back—a further disincentive to complain. Even if they wanted to complain, victims of fraudulent notarios are often so financially drained by their experience that they can’t pursue restitution on their own, says immigration lawyer Li.

As a result of all these factors, only 716 complaints were filed against immigration services providers in 2012, according to the FTC’s Consumer Sentinel Network Data Book. That’s four more than the number of complaints filed against modeling agencies (712), and a couple hundred fewer than were filed against funeral homes (936).

Even if all the notarios were shut down and every visa seeker were assigned a credentialed immigration attorney, the difficulty of finding reliable advice and assistance would persist. Part of the problem is that immigration law is both very complex and poorly paid. The result is that it’s not a high-demand specialty for young law school graduates. “The immigration bar has a bad reputation because there are a lot of bad immigration lawyers out there,” says George Washington University immigration law professor Alberto Benitez.

This problem is compounded by the fact that immigration lawyers often have to earn their paychecks on volume, because most of their clients aren’t rich. “Their bread and butter is doing as many cases as they possibly can,” says Benitez.

“You’re not going to make it otherwise.” Like doctors paid by the number of patients they see and the number of tests they order, immigration lawyers have an incentive to take as many clients as they can—and to file as many applications as they can, even if the clients are unlikely to benefit.

While many excellent private immigration lawyers are out there, the most reliable source of quality assistance is from immigration services nonprofits. But these organizations are crushed by overwhelming demand. Alonso-Yoder’s Ayuda, for example, is one of just 765 nonprofits nationwide that provide free or low-cost legal help to immigrants. One of the three immigration attorneys on staff, Alonso-Yoder works in a windowless office in the Takoma Park neighborhood of D.C., handling about sixty to seventy cases at a time. Her small clinic typically sees twenty new clients a week for consultations, many of whom she turns away due to lack of capacity. The immigration law clinic at George Washington University, directed by law professor Benitez and staffed with the help of law students, faces far more demand than it can handle. In March, the clinic stopped taking new clients for 2013.

The current immigration legal services market, then, is riddled with fraud, under-regulated, and chronically lacking in competent professionals. Now imagine what will happen if Washington passes an immigration bill that sends eleven million new customers with far more technically demanding cases into this system.

The most obvious way to protect immigrants from falling victim to fraud or errors is to recognize the tremendous complexity of the existing structure. Congress should resist the urge to pile on even more onerous requirements in an effort to show how “tough” the new regime will be. But politically, it’s hard to see how that will happen. Already, a sizeable percentage of hard-right conservatives have favored a system that will encourage “self-deportation”—specifically, making requirements so onerous that immigrants choose to leave rather than try to make it through the process. According to the Public Religion Research Institute’s survey, 56 percent of Americans who identify with the Tea Party favor self-deportation, although a majority of Americans overall do not.

Since any immigration bill that gets through Congress will also likely contain legalization requirements far more draconian than what most Americans consider reasonable, can anything be done to make the path toward legal status less perilous for prospective citizens?

The answer is yes. The current Gang of Eight plan, for example, calls for “initial entry, adjustment, and citizenship assistance grants” for nonprofits that provide immigration services. These would help organizations like Ayuda expand their staff and increase the number of clients they can take on. The plan also mandates the creation of the public-private United States Citizenship Foundation to help administer these grants and collect best practices for delivering immigration services.

While these provisions lack the specific commitment of resources to make them real, the inclusion of proposals such as these in the final bill could go a long way toward helping immigrants meet the law’s onerous requirements while avoiding scammers. Congress could go further by eliminating the ban, imposed in 1996, on federally funded “legal services corporations”—such as the Legal Aid Society—from assisting undocumented clients. Given that a principal objective of immigration reform is to bring undocumented immigrants into legal status, this restriction is counterproductive.

A second step is to facilitate tougher enforcement against unscrupulous providers, including notarios. Ayuda’s Alonso-Yoder, for example, is encouraging increased reporting of fraud by helping more victims get restitution. Her group has launched a new effort called Eradicate Notario Deceit, which will provide low-cost legal representation to notario victims who want their money back. In addition to encouraging more reporting, suing notarios will put them on notice that they can no longer act with impunity.

The Gang of Eight plan also includes a provision requiring anyone who helps prepare an immigration form to sign it, just as tax preparers are currently required to sign the returns they work on. That requirement could help make providers more accountable for bad service and bring fraudulent and incompetent ones to the attention of authorities.

A final step is to improve the overall quality of immigration attorneys. One way to do that is to encourage the creation of a special accreditation or certification by private or state bar associations, equivalent to a Good Housekeeping Seal of Approval. This would require no statutory change by Congress, but it would help excellent lawyers distinguish themselves and would raise the prestige of immigration law more generally, which could attract more aspiring attorneys to the profession.

The passage of immigration reform could be a tremendous victory for all immigrants, not just the eleven million undocumented immigrants currently living in the shadows. But the current debate also carries the seeds of a potential tragedy—the creation of a system that is so complex, so onerous, and so likely to lead to the exploitation of immigrants that it might be more merciful not to pass any reform legislation at all.

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The March on Washington:
Jobs, Freedom, and the
Forgotten History of
Civil Rights
by William P. Jones
Norton, 320 pp.

Many were shocked by the brazen attempt by Beck, the man who famously called the first black president a racist who has “a deep-seated hatred for white people or the white culture,” to transform the March on Washington into what he wanted it to be. But however cynical Beck’s rally on the forty-seventh anniversary of the March on Washington was, it was not out of line with the general way that the march has been used and remembered in the half century since it took place. William P. Jones’s new book, The March on Washington: Jobs, Freedom, and the Forgotten History of Civil Rights, is timed to coincide with the fiftieth anniversary of the march, and attempts to reclaim both the march itself and the radical history of civil rights.

Where critics of Beck’s rally focused on the way that Beck’s vision differed from King’s, Jones’s book does much to displace King from the center of the civil rights narrative. Though King’s famous “Dream” speech has become the hallmark of the march, it was not representative of the day’s events or demands. Where King’s speech was optimistic and vague (“So we have come to cash this check—a check that will give us upon demand the riches of freedom and the security of justice”), the march had specific radical demands that had been debated for decades by the organizers.

The idea for a march on Washington came in 1941 from an anonymous black woman who shouted to A. Philip Randolph during a mass meeting in Chicago that “we ought to throw 50,000 Negroes around the White House, bring them from all over the country, in jalopies, in trains, and any way they can get there … and keep them there until we can get some action from the White House.” This woman was responding to the tension between President Franklin Delano Roosevelt’s attempts to rally Americans for the defense effort through the repeated invocations of the freedoms Americans enjoy and the reality of the lack of freedoms enjoyed by most African Americans. Her solution—more Occupy than one-day rally—was originally scheduled to take place that year. The 1941 march was intended to show the “mass power” of African Americans in order to achieve liberation from, as she said, “economic, social, and political slavery.”

However, on June 18, 1941, Roosevelt met with Randolph and others from the March on Washington Committee and explained that he believed the march would do more harm than good. One week later (and one week before the march was scheduled to take place), Roosevelt issued an executive order instructing federal agencies to administer their vocational and training programs without discrimination, and created the Fair Employment Practices Committee to enforce the order. Randolph proclaimed victory and declared the march “unnecessary at this time.”

Unfortunately, Roosevelt’s executive order proved ineffectual and ill-enforced, leading many to realize that whatever promises were made, a show of power was necessary. For the following two decades, as local protests and boycotts took place across the South, the idea of a march on Washington remained a missed opportunity and a lingering possibility.

Competing proposals and tactics sought to provide social, political, and economic opportunities to African Americans. Roy Wilkins and the National Association for the Advancement of Colored People (NAACP) believed in litigation and lobbying rather than protest. King’s Southern Christian Leadership Conference (SCLC) and the Student Nonviolent Coordinating Committee (SNCC) focused on nonviolent protests in the South. Whitney Young and the National Urban League focused on a “Marshall Plan for the Negro” to improve housing, education, health care, and employment opportunities. Though the major civil rights organizations agreed on the need to end discriminatory practices and deliver economic opportunities, their competing visions made it unlikely that they would participate in a coordinated protest.

In early 1963, Randolph and several other organizers invited Anna Arnold Hedgeman, who had been involved in the first iteration of the March on Washington, to help plan “a March on Washington for Jobs.” Hedgeman tried to enlist the support of the NAACP and the Urban League, but failed. She tried to include Dorothy Height, the president of the National Council of Negro Women, but was rebuffed. She recognized that the SCLC and SNCC were turning their attentions to Washington and set up a meeting between Randolph and King. The result was the decision to march on Washington “for Jobs and Freedom.”

Almost twenty-two years to the day after President Roosevelt met with Randolph and other organizers of the march to offer tepid legislation and advice that a mass protest might harm their cause, President John F. Kennedy met with Randolph and other organizers of the march to explain his support for a moderate civil rights bill and to explain that a march might harm their cause. This time, the organizers held their ground and explained that the march would take place.

The March on Washington grew out of a clear-eyed understanding of the problems facing African Americans, and presented a discrete list of demands, including a comprehensive and effective civil rights law that would guarantee access to public accommodations, “decent housing, adequate and integrated education, and the right to vote.” The demands also included federal withholding of funding from any discriminatory program, desegregation of all schools by the year’s end, enforcement of the Fourteenth Amendment by reducing congressional representation from states where citizens were disenfranchised, barring discrimination in housing projects that received federal funding, and granting the attorney general the authority to issue injunctions when any constitutional right was violated. The demands also included a “massive federal program to train and place all unemployed workers—Negro and white—on meaningful and dignified jobs at decent wages,” raising the minimum wage to allow all Americans a decent standard of living, extending the Fair Labor Standards Act to domestic service and other excluded sectors, and creating a federal Fair Employment Practices Act that would bar discrimination from all levels of government, as well as by employers, contractors, employment agencies, and trade unions.

The speeches at the March on Washington captured the radical demands of participants. Randolph spoke of the “civil rights revolution,” and declared that “the sanctity of private property takes second place to the sanctity of the human personality.” Randolph explained the dangers of “profit-geared automation,” and insisted that schools and education be properly funded. His radical vision demanded “new forms of social planning, to create full employment, and to put automation at the service of human needs.”

The SNCC chairman, John Lewis, explained that “we are involved in a serious social revolution.” He articulated explicit demands and time frames, stating,

If we do not get meaningful legislation out of this Congress, the time will come when we will not confine our marching to Washington. We will march through the South; through the streets of Jackson, through the streets of Danville, through the streets of Cambridge, through the streets of Birmingham. But we will march with the spirit of love and with the spirit of dignity that we have shown here today. By the force of our demands, our determination, and our numbers, we shall splinter the segregated South into a thousand pieces and put them together in the image of God and democracy.

King’s speech was among the last of the day, and sought to reinvigorate weary travelers and marchers; however, it was “the least representative or attentive to the specific demands of the mobilization.” In a strange bit of irony, it is King’s speech that has come to embody the tenor and goals of the March on Washington.

Jones thoroughly recovers the radical reality of the events leading up to the march, as well as the march itself, and exposes the important question of how such a radical event was so quickly remembered as a model of moderation. Jones does not attempt to answer this question, but his book does contain hints and guideposts for a fuller analysis. Was it because the violence and disorder that was expected never materialized? Or was it that many of the social and economic demands of the march never came to fruition? Jones’s book shows that it is not only Glenn Beck and the Tea Party participants who incorrectly remember the March on Washington. It is also the critics who repeatedly forget to include the march’s slogan: “for Jobs and Freedom.”

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Improbable Scholars:
The Rebirth of a Great
American School System
and a Strategy for
America’s Schools
by David L. Kirp
Oxford University Press, 262 pp.

Kirp quickly falls in love with the children he studies, a group that includes many undocumented students who face difficult home lives. “Be my father!” one boy, Joaquin, cries out one day, a reminder that Joaquin’s father has been gone for two years. Another boy, Andres, calls out, “Be my father.” Writes Kirp, “That’s harder for me to hear because Andres is in fact living with his father.” And when Kirp goes to Paris for Thanksgiving, a boy named Tomás asks, “Can you return? Do you have papers?”—an indication of the fragile lives these children are living.

Nationally, high-poverty schools are twenty-two times less likely to be high achieving than middle-class schools. That was generally the case with the Union City school district, which ranked next to last in the state in 1989, Kirp notes, sparking the mordant response, “Thank God for Camden!”

But today the situation could hardly be more different. Union City students, overwhelmingly low income and Latino, score at roughly the New Jersey average in reading and math from third grade through high school—this in a state where scores are consistently among the very best in the nation. The graduation rate is 89.4 percent, compared with about 70 percent nationally. Union City High School, according to the American Institutes for Research, ranks among the top 12 percent nationally, and sends students to top colleges.

What happened to turn around an entire high-poverty district like Union City? Generous funding, for one thing. Union City is the beneficiary of a series of New Jersey Supreme Court rulings, including one in 2011 that decreed that the state would have to rescind budget cuts and spend an extra $500 million in impoverished school districts. Among the extras this money bought was a high-quality preschool program. Beginning at age three, students in New Jersey’s high-poverty school districts are entitled to receive free preschool, six hours a day and 245 days a year, taught by teachers with college degrees in small classes. Although the program is not compulsory, about 90 percent of Union City children participate.

Many high-poverty New Jersey districts got this extra funding but continue to fail, while Union City students have flourished. Trenton, for example, embraced what Kirp calls “the Great Leader Theory,” hoping that superstar principals would jump-start individual schools, but has had little success. Union City, instead, pursued system-wide reform, with a number of key elements. The district adopted a consistent curriculum across classrooms, with a relentless focus on early reading and expanding the vocabulary of students. Tests are used as diagnostic tools, rather than to punish, and every new teacher gets a mentor.

In a district where students come from a number of foreign countries, the Union City schools also do the important work of instilling a strong sense of American identity. At an end-of-year school ceremony, children hoist flags from more than fifty countries, says Kirp. A roar goes up for the Dominican Republic flag, but the “longest, loudest cheer is heard when the flag of the United States, their new homeland, is unfurled.”

Kirp is emphatic in noting that Union City achieved its success by hewing to fundamentals. There are no charter schools in Union City. And while teacher’s unions have come under fire for much of what ails public education, Kirp says, Union City’s teachers are part of a strong union, as are other teachers in New Jersey’s highly ranked schools.

Of course, Union City schools are not immune from national education policy. Kirp is concerned that the No Child Left Behind Act causes teachers to skip interesting lessons like plant experiments because science is not among the tested subjects in elementary school. He also worries when teachers provide extra learning sessions only for the “cusp” kids—those just within reach of passing the tests.

To his credit, Kirp does not join the militant anti-testing crowd. “High-stakes exams contributed to making Union City’s schools better,” he writes; if used properly, to identify areas for student improvement, “testing can be a force for good, especially for the have-less kids on whom schools have too often given up.” Unlike many state tests, New Jersey’s assessments measure students’ critical thinking skills rather than just their ability to memorize material. “Teaching to this kind of test means readying students to become problem-solvers,” notes Kirp.

Skeptics will likely ask whether Union City’s success can be replicated in high-poverty districts elsewhere, given the district’s relatively small size. Likewise, as Kirp points out, sociologist Anthony Bryk has found that Latino schools are often an exception to the “straight-line connection between poor neighborhoods and failing schools.” Trust levels are higher in Latino schools, Bryk found, and “Latino neighborhoods tend to have significantly more social capital and neighborhood organizations” than other poor neighborhoods. Would Union City’s programs work with African American students, who continue to bear the legacy of the nation’s most egregious forms of discrimination?

Yes, says Kirp, in places like Montgomery County, Maryland, outside of Washington, D.C., for example, which educates ten times as many students as Union City. Montgomery County, which includes wealthy white areas alongside more diverse and low-income communities, has devoted extra funds to lower-income “red zone” schools than to the wealthier “green zone” schools—for such interventions as reduced class size and extended learning time. The approach has worked. Kirp writes, “In 2003, only half the district’s black and Hispanic fifth graders passed the state’s reading test; by 2011, 90% did.”

Significant as Montgomery County’s “red zone” approach has been, Kirp fails to discuss a far more effective educational strategy employed by the county. Under an inclusionary zoning initiative, public housing units are made available to low-income families throughout Montgomery County, in the affluent green zone as well as the working-class red zone. An important 2010 Century Foundation report by RAND Corporation’s Heather Schwartz found that low-income elementary school students whose families were randomly assigned to housing units in the green zone and attended green zone schools had far more significant achievement gains than those assigned to red zone neighborhoods and schools—even though students in the latter group were showered with extra financial resources and did pretty well.

The omission of integration strategies is surprising, because in other contexts Kirp has written powerfully about the benefits of housing and school integration. In a 2012 New York Times article, for example, Kirp wrote, “The experience of an integrated education made all the difference in the lives of black children—and in the lives of their children as well.” Given legal constraints on using race in student assignment imposed by the Supreme Court, more than eighty school districts now pursue integration by socioeconomic status, an approach that not only raises student achievement but also allows low-income students access to the kind of middle-class social networks that are powerful determinants of employment.

Despite this lapse, Kirp is to be credited with providing critical balance to our education debates. While much ink has appropriately been spilled on the success of the Knowledge Is Power Program (KIPP) charter schools, Union City has done something in many ways even more impressive: taking low-income children who happen to live in a jurisdiction and helping them make dramatic achievement gains. (The one time KIPP tried to take over a regular public school population, in Denver, Colorado, it failed.)

Like the KIPP approach, the Union City strategy involves large amounts of money, which makes it less attractive to policymakers than getting tough with teachers and their elected union representatives. But as Improbable Scholars makes clear, the success in Union City suggests that money spent on effective educational strategies is likely to pay substantial dividends for years to come.

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The Smartest Kids
in the World: And How
They Got That Way
by Amanda Ripley
Simon & Schuster, 320 pp.

Education’s role in the global economic race has spurred more recent expeditions. Introduced by the Paris-based Organisation for Economic Co-operation and Development (OECD) in 2000 to compare students’ critical thinking skills in industrialized nations, the Program for International Student Assessment—known as PISA—revealed that American students were average or below average in reading, math, and science among nearly three dozen competitor countries. The United States has relinquished its vaunted position as the world’s leading education pipeline, slipping from first to eleventh place in the percentage of young adults with high school diplomas. As higher education ballooned from twenty-four million to 136 million students worldwide between 1970 and 2005, the proportion of the world’s students attending U.S. colleges and universities decreased from 29 percent to 13 percent. (China’s share of worldwide enrollment rose from 0.1 percent to 21 percent—even though only 5 percent of the Chinese population has a college degree.)

Enter journalist Amanda Ripley and her new book, The Smartest Kids in the World: And How They Got That Way, as she follows three American exchange students to high schools in three of the top-scoring PISA countries: Finland, South Korea, and Poland. While her attempt to see deeply into those educational systems from the perspectives of students may fall a bit short—how well equipped are students to analyze the educational systems they’re in for a relatively short time?—Ripley’s well-woven tale of educational history, policy, and culture in the three countries and the lessons she draws for the United States are timely on two big topics: academic standards and teacher quality.

Three years ago, in the face of mounting evidence that the George W. Bush-era No Child Left Behind Act (NCLB) inadvertently led to lower expectations for many students, the nation’s governors and the states’ top education bureaucrats worked with teachers and subject specialists to hammer out new, tougher Common Core State Standards in math and literacy, now adopted by forty-five states and the District of Columbia. These same standards are currently under attack from both the left and the right as unfair to disadvantaged students, an assault on local sovereignty, and a lot more—even as majorities of American students say that their courses aren’t challenging enough.

Ripley reports that “rigor”—clear and high expectations shared by students and adults—is what drives the successful education systems in the three nations she studied, where standards are national and mandatory, as they are in most industrialized nations. Indeed, Poland, fairly new to the standards game, introduced them in the late 1990s and then leapfrogged the U.S. and other nations up the PISA ladder, despite higher-than-average levels of youth poverty than its OECD peers. Indeed, Ripley concludes, it is America’s lack of high, shared expectations for students that is “the most glaring problem with America’s fragmented [education] system.”

Ripley’s three students are shocked by the intensity of the commitment to education in other countries. One, from an affluent Minneapolis suburb where he’s studying a rigorous International Baccalaureate curriculum, is blown away by the fact that his South Korean high school classmates go to school, do test prep in the afternoon, eat dinner at school, and then head to after-school tutoring academies called hagwons, often not arriving home until midnight. “Study police” cruise Seoul and other cities, sometimes breaking into back rooms in the middle of the night, busting up cram sessions. “Korean kids essentially went to school twice every week day,” Ripley writes. For less-affluent parents, helping their children stay in the round-the-clock educational race is typically their biggest family priority.

Ripley makes clear that student testing is at the heart of the strong Finnish, South Korean, and Polish systems—not NCLB-style tests designed to hold educators accountable for student performance, but demanding national tests that students must pass to graduate from high school and get into the best universities. Other nations are relentlessly standards driven in ways that the American education system simply isn’t. In Finland, the university matriculation exams extend over three weeks and fifty hours. In South Korea, students spend two years preparing for an entrance exam for the nation’s top three colleges. Only 2 percent are admitted.

The “smartest kids in the world” take school seriously because school is serious in the highest-achieving countries. To them and to everyone they know, learning matters. Foreign students studying in America report overwhelmingly that academics are easier here and that their teachers’ expectations are surprisingly low. It’s hard to imagine the U.S. opening the country’s stock exchanges an hour late to free up the roads for students traveling to testing sites on the annual national testing day, or grounding planes that day to remove the distraction of jet noise, as happens in South Korea. In all three countries, sports are done outside of school, through clubs. School is about schoolwork.

As Ripley rightly points out, the intensity of education in countries like South Korea puts immense stress on students, and some collapse under its weight. But in Finland, the top PISA performer, students actually have more room to breathe, but there’s no less commitment to rigor or hard work. Nor is rigorous learning just for top students. Tracking—the practice of sorting students into classes by ability ubiquitous in the U.S.—was virtually unheard of in the countries Ripley studied. In Poland, “even diesel mechanics needed to know geometry and the basics of physics. In top-performing countries, rigor is synonymous with educational equity.”

One of Ripley’s exchange students, an Oklahoma student bored by her own high school, was so perplexed by her Finnish classmates’ conscientiousness that she asked them bluntly, “Why do you guys care so much?” The answer, Ripley concludes, has as much to do with psychology, or philosophy, as policy: “[P]erformance was mostly a project of hard work—not God-given talent.” (Likewise, Ripley says, the South Koreans are profoundly influenced by the Confucian belief that the only path to true understanding comes from long and careful study.)

And in Finland, the notion that all students can work their way to high standards allows educators to move close to half the country’s students into and—importantly—out of special education classes at some point in their educational careers without stigma. In contrast, many American educators believe ability is fixed: students are either smart and capable of reaching high standards, or they’re not.

Because of its commitment to transforming its teaching profession in recent decades, Finland has become something of a mecca for American reformers. One hundred percent of teacher candidates rank in the top quarter of their high school classes, and teacher training is concentrated in a few high-quality universities. Admissions standards for the education programs are high. Master’s degrees are required for all teachers, and educators make competitive, professional wages. As a result, Finland now attracts its best and brightest into public school classrooms, where it gives them wide latitude over their work.

That Finland has created such a high-performing teaching profession holds out the hope that we can make teaching much more than the pink-collar work it has been in this country. But some of Finland’s teacher reforms are going to be tougher to transfer to American public education than reformers—and Ripley—suggest. “[U.S.] education colleges should only be allowed to admit students with SAT scores in the top third of the national distribution or lose government funding and accreditation,” she suggests.

Yet it’s one thing to concentrate education programs on eight campuses in a tiny country like Finland, but quite another to transform the more than 2,000 teacher preparation programs that are spread across the U.S., especially since many generate substantial enrollment-driven revenues for their parent institutions. The Finnish national government also pays every prospective teacher’s tuition (and every other college student’s tuition), and supports them during yearlong residencies with mentor teachers, another expensive proposition.

Still, Ripley’s reporting leads her, and us, to valuable insights into today’s standards debate. She doesn’t pretend to know how to build a cultural commitment to educational rigor and the belief in the value of hard work that propels other countries to achieve it. But Ripley helps us see clearly that shifting philosophical gears—making drive rather than talent the cornerstone of our educational system—is a key to achieving our academic aspirations.

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That is, in many ways, the story of Richard M. Daley. Eldest son of the legendary Chicago mayor and political boss, Daley entered politics at an early age surrounded by doubters who considered him an inarticulate, unsophisticated mediocrity, incapable of maintaining the family legacy. The disparaging comments continued through his first two decades in Illinois public office and did not disappear even during the early stages of his mayoralty, which began in 1989. “There are smarter people than me,” Daley once told a reporter. “I know that. I’ve met a lot of them. I don’t say too much. I just listen and try to figure out where they’re coming from.”

First Son: The Biography of
Richard M. Daley
by Keith Koeneman
University of Chicago Press, 392 pp.

But when he retired in 2011 after twenty-two years as mayor, Daley could genuinely be said to have had the last laugh. He had exercised power about as nimbly as his father had, turned Chicago into a laboratory for new ideas in urban management, and guided the city’s transformation from a large but inward-looking midwestern metropolis to a place with legitimate global aspirations.

The odyssey of Richard M. Daley is laid out with scrupulous detail in First Son, a new biography by Keith Koeneman that takes Daley from his initial political venture as a state constitutional convention delegate to the final moments of his tenure on the fifth floor of city hall. The book wanders from its subject at times, and the prose is less than dazzling. But it is a valuable book, admirably fair and balanced, and vastly informative about four colorful and highly eventful decades in the life of America’s third-largest metropolis.

Chicago is, for all of its attractions, a deeply flawed city, and Daley accumulated a long list of disappointments to go with his successes. Early in his tenure, he attracted national attention by taking personal control of the city’s school system, but it was only marginally better when he left office than when he started out. The crime rate, and especially the murder rate, remained frighteningly high, fueled by a horrendous gang problem in the poorest neighborhoods. And while Daley prided himself, with some justification, on his skills as a financial manager, he left a heavy load of debt for his successor, Rahm Emanuel.

But all of this must, in the end, be measured against some developments more visible to the naked eye: the glittering downtown that hosts a cavalcade of visitors from virtually everywhere in the world, turning Michigan Avenue on a June Friday night into a promenade equal to what the brightest global cities have to offer; the boom in central-city residential life, which has converted once-dull avenues downtown into thriving corridors for the upwardly mobile and the affluent; the second wind of old working-class neighborhoods close to the center, blighted just a few years ago, as walkable enclaves of the Millennial generation.

Daley did not create the inner-city comeback, but it is fair to conclude that his development policies and sensitivity to Chicago’s physical character made possible changes that other cities are still laboring to emulate. Anyone who sees the visual evidence of Chicago’s more successful neighborhoods is likely to ponder the career of Richard M. Daley and ask: What if he did make a few mistakes?

Of course, Daley’s critics, of whom there are many, are likely to respond that there were more than a few, and they were more than mistakes. These people will argue that he was nearly as much of an autocrat as his father, becoming increasingly impervious to outside criticism as he grew older and more deeply ensconced in office.

To detractors, the most tangible evidence of autocratic mischief was his unilateral order to demolish Meigs Field, an in-town airport for private planes highly valued by much of the city’s business elite. Meigs Field was destroyed in the dead of night in 2002, in order, Daley said, to create a park. Opponents said it was destroyed so Daley could prove his ultimate political control to anyone who doubted it.

It was episodes like the Meigs Field debacle that led to muttering about Daley as a not-so-benign dictator, pursuing the path set out by his father a few decades before. But those particular comparisons don’t quite work. The elder Daley presided over a city divided uneasily by black and white, but he owned the meek loyalties of a political organization in which the white politicians were beholden to him and the black machine aldermen were willing to accept virtual table scraps of patronage in exchange for the votes that kept him in office.

The younger Daley never had a situation like that. He succeeded a pair of African American mayors, came in with the city’s black community highly suspicious of him, and faced a political environment in which unified black opposition might threaten his mayoralty at any time.

Richard M. Daley’s ability to work in this environment stands as perhaps his single most impressive political attribute. He saw the changing demographics of the city, with Hispanics drawing closer to their current one-third of the population, and reasoned that with sufficient Hispanic support he would never have to worry about a black challenger. He offered patronage and political assistance to Hispanic community leaders, and soon converted himself into a majority mayor rather than a minority mayor fighting to hang on.

But Daley cultivated other constituencies that were not part of his father’s world. Soon after taking office in 1989, he served as grand marshal of the annual gay and lesbian pride parade. “I think it is important,” he said, “for me to show my support of the gay community.” Daley’s conspicuous environmentalism—symbolized by his successful determination to place a “green roof” on top of city hall, won over many of the “lakefront liberals” who had constituted the only organized political bloc that had opposed his father. “Talk about a tree person!” Daley once boasted to reporters. “Right here! I’m a tree hugger.”

The early years represented Daley at his innovative best. In addition to taking personal charge of the city’s school system and promoting numerous teaching and management experiments—a bold and valuable move, if a less than triumphant one—the mayor reorganized the slothful and patronage-ridden Chicago Park District, kept finances in good shape, personally supervised construction of the wildly successful Millennium Park along the downtown lakefront, and launched a widely copied series of cultural initiatives with his energetic and creative cultural affairs commissioner, Lois Weisberg.

Daley also led the city into a wide range of experiments in privatization, taking numerous city services and facilities out of public management, a step his father would no doubt have disdained. Foremost among these moves was the decision to sell off the Chicago Skyway, a troubled eight-mile toll road, for $1.8 billion. But nearly every annual budget through the 1990s included the privatization of one government function or another.

When scandals emerged in the Chicago Housing Authority, resulting in the temporary transfer of the city’s housing programs to the federal government, Daley responded with the “Plan for Transformation,” which featured the privatization of all housing management as well as the demolition of fifty dysfunctional public housing towers and the construction of new low-rise mixed-income developments to replace them. By the early years of the new century, nearly all the infamous towers were down, although many of the new projects remained to be built.

Koeneman makes a distinction between the mayor’s widely praised early terms and the later ones, in which he was more autocratic, more impulsive, and less attuned to management detail. Whatever one thinks of this thesis, it is undeniable that the last few years served to tarnish at least a little bit of Daley’s legacy.

For one thing, there were clear signs that the old tradition of shady political dealings had not faded away completely. Patronage ran up to and beyond the level of cronyism. The most egregious example was the Hired Truck Program scandal, in which it was disclosed that the city, as Koeneman tells it, “spent $40 million a year to pay private trucking companies to do little or no work.” Some of these companies were run by close political allies of Daley’s, as was the program itself. “I am embarrassed,” Daley said when the scandal broke. “I’m angry, and I’m disappointed because I feel I’ve let the people down.”

Beyond the evidence of graft that came uncomfortably close to him, Daley suffered serious public policy setbacks in the closing years. An expensive and broadly supported bid to bring the 2016 Olympics to Chicago was shot down in embarrassing fashion by the International Olympic Committee. City finances gradually deteriorated, in part a result of the Great Recession but also a consequence, as Koeneman points out, of a still-bloated city workforce and extravagant public pension commitments. By 2009, Chicago was running a large deficit.

Perhaps worst of all, in the public’s mind, was Daley’s last big privatization venture, the decision to lease the city’s 36,000 parking meters to a private company for seventy-five years in return for $1.2 billion. It was an effort to help with the financial problems, but it led to a dramatic increase in parking charges. An inspector general brought in to assess the situation concluded that Daley should have asked for at least a billion dollars more in payments, or else the city should have held on to the meters, raised rates, and kept all the money for itself.

Chronicling the series of late-career setbacks Daley suffered, Koeneman writes that the mayor “appeared more and more like a prize fighter past his prime, a once-great champion who had stayed in the ring for one fight too many.” But when it comes to measuring the entire twenty-two years, Koeneman ends up, albeit a little nervously, on the positive side. “The passage of time,” he says, “would likely lead to history’s judgment that Daley’s achievements had outweighed his mistakes.” The volume as a whole bears that judgment out.

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