BREAKOUT: A Strategy for Winning
and Governing for 2013-2017
The Current Situation
The Left broadly
speaking--President Obama, most of the news media, left-wing interest
groups, Democrats--believes it sees an opportunity to create a wave
election similar to those of 1994, 2006, 2010 and retake majority
control of the House of Representatives.
Their goal is to describe
the Republican Party as an unacceptably radical party and defeat
individual candidates by suppressing Republican turnout, driving
independents away from Republicans and maximizing turnout of the
Democratic base. In particular, efforts to control spending in Medicare
and Medicaid and to reduce or eliminate funding for left wing
activities will consistently be described as radical and unacceptable.
Reading the polls after the recent government shutdown, the Left
believes (mistakenly, I think) that this model is now even more likely
to succeed.
Those same polls also reveal extraordinary opportunity for
Republicans. The fact is that Americans are fed up with Washington, not
just with Republicans. They believe America is on the wrong track, and
President Obama's approval rating is now among lowest of his presidency.
While Republicans are
currently on defense, the failures and costs of Obamacare, the
continuing weak economy in jobs and take-home pay, growing government
debt, and inevitable failures of bureaucratic big government will only
make it more obvious that Washington and the bureaucracy is hopelessly
broken. And the Democrats have very publicly reaffirmed themselves as
the party of big government bureaucracy, most recently with the launch
of Obamacare.
Republicans could respond
to these failures of government by becoming the Party of Austerity. But
the Party of Austerity can rapidly reduce its supporters as people are
told what the austerity means for them personally. Policies of pain
almost never work in the absence of a large crisis. They might also play
into the Democrat caricature of Republicans as radical and
unacceptable.
There is a different
strategy, however, which could dramatically unlock the current policy
gridlock in Washington and create a new conversation in which Americans
find the Republican Party to once again be the party of hope and
opportunity (as it was in the Reagan years and in the 1994 Contract with
America campaign).
An Historic Opportunity
The dramatic breakthroughs in science, technology, and
entrepreneurship are creating new policy opportunities for a better
future with a better economy, more take-home pay, better health, more
learning, greater national security, a better, smaller, modernized
government, and a balanced federal budget.
In Washington insider terms
this sounds like a fantasy or an impossibility. In the dynamic world
outside Washington all of these capabilities are increasingly obvious
but outside the political news media, the political language, and the
thinking of politicians and their staffs and their consultants.
This historic opportunity
requires a very substantial change in the thinking and behavior of
Republicans and there will be enormous resistance to the change (see
quotes in appendix at end of paper for thinking about real change).
A key Republican goal should be to have 80% of all communications for
the next four years be positive about exciting breakthroughs, exciting
opportunities, and a better future for virtually all Americans.
Nothing would do more to
defeat the Left's current strategy than a positive Republican Party
focused on opportunities for the future.
Offering Americans a Better Future
Our premise is that new science, technology, and entrepreneurship can lead to:
- A rapidly growing economy with more jobs, more take home pay and more economic opportunity
- A new system of better learning at lower cost for your entire lifetime
- A dramatic improvement in health outcomes and reduced costs leading to longer lives, greater independence for the elderly, and a dramatic increase in high value jobs marketing American health innovations throughout the world
- A modernized government that is much less expensive, more effective, and more reliable and accountable
- A better environment through sound science, entrepreneurship, and focused problem solving
- A stronger, leaner, less wasteful national security system
- A balanced budget within a decade through a combination of:
- greater economic growth
- more government revenues from a larger economy and from royalties from energy and other natural resources
- dramatic modernization of government to reduce waste and eliminate fraud
- breakthroughs in health dramatically lowering the cost of health care
- returning power to the states and to the people.
Budget Conference Strategy
Republicans in the Budget
Conference should focus first on economic growth, second on increased
revenue through increased energy royalties, third on modernizing
government to reduce fraud and theft, and fourth on dramatic
opportunities for better health outcomes at lower costs.
A tax increase for entitlement cuts agreement is a pain-pain
agreement and can't possibly achieve our goals or be supported by the
American people.
There is no democracy in our lifetime that has sustained an austerity-led reform program.
We need a new model of budget breakthroughs and this formula creates a new focus on a positive, opportunity-oriented future.
What we are proposing is to replace the argument of more versus less with an argument of better future versus failed present.
Today we have Republicans
who want more savings and less taxes versus Democrats who want less
savings and more taxes. Neither side is arguing for rethinking the
fundamentals, learning from non-Washington developments, and modernizing
government systems and policies.
Better future versus failed present would be a profound change in the very nature of the national debate.
It will require an equally
profound change in the Congressional Budget Office (CBO). CBO is today
incapable of measuring the impact of modernizing systems and adopting
new technologies in government. Today CBO is a major "Prison Guard of
the Past," blocking modernity and keeping budget talks in sterile and
self-defeating strait jackets.
The budget talks cannot allow the petty bureaucrats of CBO to reject
everything happening in the rest of America and score only obsolete
models of static and inherently false formulas.
Breakthrough Examples as Proof of the Real Opportunities for Dramatic Improvement in Public Policy
These examples can be extended dramatically. They are designed to
create a sense of how widespread the breakthroughs are and why Breakout as a concept is largely a matter of transferring what is already happening outside Washington into public policy in Washington.
Each of these examples could lead to hearings, legislation, town hall meetings, and a variety of positive activities.
1. Theranos is a
breakthrough biotech company which may save $61 billion in Medicare and
$96.1 billion in Medicaid over the next decade. Its new technology
conducts a battery of up to 1,000 common medical tests very
inexpensively and from just one drop of blood. It has pledged
that each of its tests will cost less than half of the Medicare rate.
Today there are 64,980 price controls for medical tests in Medicare.
Retail prices for tests are trade secrets so it is impossible to know
what Theranos could save for federal employees, Tricare, Veterans
Administration, etc. Just holding hearings and accelerating the rate of
adoption would save tens of billions. The technology is already in use
in a handful of pharmacies and will soon be available at Walgreens
nationwide. You can see the menu/prices of tests here (this alone is
revolutionary): http://www.theranos.com/test-menu?ref=for_providers
See Breakout Introduction, Chapters 3 and 11 for more on cost-saving health breakthroughs.
2. Booz and Co. have
estimated that insurance administrative costs can be driven down from
around $29 per member per month to around $5 per member per month. An 80
percent reduction in administrative costs would save substantial
amounts in government health programs. The Federal Employee Health
Benefits Program would save about $10 billion over the decade by moving
to an Administrative Services Only (ASO) plan. Connecticut has moved
Medicaid to an ASO plan and saved $41 million in 2012 and expects to save $80 million this year.
3. Moving from the broken
“Fee for Service” model in Medicare to the ASO model would save close to
$300 billion over the coming decade, according to UnitedHealth Center
for Health Reform and Modernization. Those savings estimates assume a 5
year phase in. By the end of the decade, savings would be 5 percent of
total Medicare spending.
4. A vastly more powerful
step toward dramatic reduction in costs would be requiring that citizens
and payers have the right to simple transparency in price and quality.
Today the insurance companies insist that they own the data even for the
plans that are self-insured. Medical device companies want a tax break
but refuse to release price and quality information, claiming they are
trade secrets. No single change would do more to reduce costs and
accelerate innovation than insisting on a real market with real price
and quality information. The savings could literally be several hundred
billion dollars every year.
5. Two states (Florida and Texas) have initiated four year degrees
for a total cost of $10,000. If every state adopted this program what
would the impact be on the student loan program and its projected costs?
6. The revolution in online
learning is accelerating. Kahn Academy has had 283 million views on
YouTube and its website has six million students visit each month.
Kaplan is developing very sophisticated real time feedback systems to
maximize the effectiveness of online learning. Duolingo teaches six
foreign languages for free and has over 10 million users. Udacity has
signed a contract with Georgia Tech to produce a Master's degree in
Computer Science for $7,000 (the residential degree costs $70,000 so
Udacity is reaching its goal of reducing tuition by 90%). The
implications of online learning for pre-school through adult learning
have barely been considered. It has enormous power to change the world dramatically.
For more see Breakout Chapter 2.
7. Attaching online
learning to unemployment compensation would create a dramatic new worker
training program at virtually no cost. The 2012 federal-state spending
of $94 billion to people to do nothing could be transformed into an
enormous job training and skill development program (see Khan Academy's
and Udacity's amazing free offerings as an example). It would be a major
step towards rebuilding the middle class by rebuilding the knowledge
base needed to succeed. For more see Breakout Chapter 10.
8. Achieving normal commercial standards of competence would save billions. One study
by the IBM Center for Business of Government estimated $100 billion a
year in saved costs by adopting commercial business practices in
government operations. This process by modernizing the civil service,
the procurement regulations, and the information systems to the norms of
a modern multinational corporation would save tens of billions a year
and improve performance. The fiascos of the F-35 fighter overruns and
the Obamacare rollout collapse should provide more than enough incentive
to profoundly modernize the management and information systems and cut
through a 130 year old civil service model that is fossilized. Applying
continuous improvement systems like Lean Six Sigma could save hundreds of billions over a few years.
For more see Breakout Chapter 9.
9. STOP PAYING THE CROOKS.
This is capitalized because it is so much money it is outrageous, and
yet Washington is determined to ignore it. In 2009 Jim Frogue wrote a book
by this title outlining for Medicare and Medicaid alone how big the
fraud problem is. The estimate at that time was that Medicare and
Medicaid combined, as paper based bureaucratic systems, had fraud in the
range of $70 to $120 billion a year paid to crooks. That is more than
$1 trillion dollars over a decade. Nothing systemic has been done.
American Express, Visa, and MasterCard among others have very serious
systems for stopping fraud. The fraud and theft are not simply Medicare
and Medicaid. Earned Income Tax Credit false payments are in the 25%
range because of IRS mismanagement and incompetence. That is an estimated $12 to $15 billion a year--or
$132 billion over the last decade to be precise. Food Stamp fraud and
mispayments have skyrocketed as the program has grown dramatically
larger. Even the government's own website
on accuracy lists high error rate programs amounting to about $100
billion a year ($1 trillion over a decade not counting the interest on
the debt it would accrue).
For more see Breakout Chapter 8.
10. Dramatically greater
revenues can be generated without a tax increase by opening up
government lands to oil and gas and mineral development and opening up
offshore opportunities to develop oil and gas fields. This makes sense
for national security and jobs reasons. It also makes sense for
government revenue reasons. Scott Noble of Noble Royalties has
commissioned studies which estimate that government opportunities in oil
and gas would lead to a $5 trillion increase in the economy over thirty
years, a $780 billion increase in royalties to the government and a $1
trillion dollar increase in tax revenue from a bigger energy industry.
In other words a sound American energy policy
would add $1.78 trillion in government revenue and create hundreds of
thousands of jobs while improving our national security and energy
independence.
For more see Breakout Chapters 4 and 5.
11. Even more revenue
increases would come from a dramatically bigger economy. The number one
goal of the current budget negotiations should be to restart the
economic dynamism of small businesses and baby businesses (the former
are designed to remain relatively small, the latter are launched in the
hopes they will grow). The Small Business Committee should bring in
small business and entrepreneurial witnesses (including the
self-employed) and identify every unnecessary burdensome regulation
which slows down job creation and business creation. Today red tape is
often a bigger hindrance than taxes in creating jobs. A Small Business
Independence Act should be developed with the goal of reducing by 80% or
more the regulatory burden on entrepreneurs and small business owners.
That would substantially accelerate job growth.
12. Regenerative Medicine
is one of the greatest areas of breakthrough in improving human health
and creating very high value American jobs, as well as in permanently
curing many of the most common and most expensive medical problems. The
field is currently crippled by the Food and Drug Administration which
requires that regenerative technologies meet the demands of two
regulatory paths simultaneously. This means it is almost impossible to
bring the technology to market, since it's hard enough to meet the
requirements of ONE regulatory track. This is an area where lives can be
saved and improved, costs can be reduced, and high value American jobs
can be created.
For more see Breakout Introduction, Chapters 3 and 11
13. Self-driving cars will be a reality within a few years. They have
enormous implications for infrastructure development, safety, and a
host of other aspects of life. The regulatory hurdles to their adoption,
however, are quite significant. We should have extensive hearings on
how to accelerate this development and how it will improve our lives.
For more see Breakout Chapter 6.
Conclusion
There are an extraordinary number of opportunities to improve
lives, create jobs, increase government revenue without taxes, balance
the federal budget and improve services while lowering costs.
We should be committed to an intense period of becoming the advocates of a Breakout which can move us far beyond the current policy gridlock.
With positive, optimistic
ideas that will improve people's lives, we can re-engage the American
people in their own self-government and their political process.
We can reach out to the "Pioneers of the Future" who are actually developing the ideas that will change our lives.
We can bring together the "Champions of the Future" who know that this will lead to better lives and who want to help implement the developments of the Pioneers.
We will inevitably be
attacked and opposed by the "Prison Guards of the Past" who oppose the
changes that may make America better but may harm their interests or
privileges. Some of those "Prison Guards" will be entrenched in the
Republican Party. Remember that the future has publicists but the past
has lobbyists, and sometimes the future doesn’t even have a publicist.
Finally, many Americans
today are "Prisoners of the Past" not because they are trapped but
because in their own minds they can't imagine a new and better world.
Our job is in part to reach them with a message of hope and a program of
real opportunity that liberates them from the past and draws them into
an exciting and fulfilling future.
For more details, see my new book Breakout.
Appendix:
Key Principles for Real Change
Prime Minister Margaret Thatcher: "First you win the argument, then you win the vote."
Albert Einstein
(attributed): “The definition of insanity is doing the same thing over
and over again and expecting different results".
President (and General of
the Armies) Dwight David Eisenhower: "Whenever I run into a problem I
can’t solve, I always make it bigger. I can never solve it by trying to
make it smaller, but if I make it big enough I can begin to see the
outlines of a solution.”
President Abraham Lincoln
Message to Congress December 1, 1862: "The dogmas of the quiet past,
are inadequate to the stormy present. The occasion is piled high with
difficulty, and we must rise -- with the occasion. As our case is new,
so we must think anew, and act anew. We must disenthrall ourselves, and
then we shall save our country."
Following these principles will lead America to a dramatically better and more desirable future.
Your Friend,
Newt
Newt
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