Saturday, August 29, 2009
Lies, Damned Lies, and Health Care Polls
Jim Lindgren illustrates why so much of the polling on health care reform is terrible. Even outfits like NBC are asking questions which highlight only the nice sounding bits of the reform proposals:
Now I am going to tell you more about the health care plan that President Obama supports and please tell me whether you would favor or oppose it.
The plan requires that health insurance companies cover people with pre-existing medical conditions. It also requires all but the smallest employers to provide health coverage for their employees, or pay a percentage of their payroll to help fund coverage for the uninsured. Families and individuals with lower- and middle- incomes would receive tax credits to help them afford insurance coverage. Some of the funding for this plan would come from raising taxes on wealthier Americans.
I'm surprised it only got 53% in favor. ...
ABC, NBC Won't Air Ad Critical of Obama's Health Care Plan
The refusal by ABC and NBC to run a national ad critical of President Obama's health care reform plan is raising questions from the group behind the spot -- particularly in light of ABC's health care special aired in prime time last June and hosted at the White House.
The 33-second ad by the League of American Voters, which features a neurosurgeon who warns that a government-run health care system will lead to the rationing of procedures and medicine, began airing two weeks ago on local affiliates of ABC, NBC, FOX and CBS. On a national level, however, ABC and NBC have refused to run the spot in its present form.
"It's a powerful ad," said Bob Adams, executive director of the League of American Voters, a national nonprofit group with 15,000 members who advocate individual liberty and government accountability. "It tells the truth and it really highlights one of the biggest vulnerabilities and problems with this proposed legislation, which is it rations health care and disproportionately will decimate the quality of health care for seniors."...
Vive Le French Care?
Call it the grass-is-greener syndrome. Advocates of national health care, acknowledging the flaws in ObamaCare yet despising the current U.S. system that has the best medicines, the best medical equipment and the shortest waiting lists, have turned their eyes lovingly to places like France.
As City Journal contributing editor Guy Sorman notes, the French would also love to have the low-cost, high-service system some Americans gush about. Unfortunately, they don't. France's system isn't that cheap and is financed by high taxes on labor that have heavy economic consequences.
Sorman notes that a Frenchman making a monthly salary of 3,000 euros has 350 of them deducted for health insurance. Then the employer throws in an additional 1,200 euros. This raises the cost of labor to prohibitive levels and puts a brake on economic growth. This helps explain why French unemployment hovers around 10%.
France imposes an additional tax levy to cover the constant deficits that national health insurance runs.
The French Parliament raises this levy, which applies to all forms of income, every year. Altogether, Sorman writes, "25% of French national income goes toward what's called Social Security, which includes health care and basic retirement pensions for all."
Drugs developed in America at enormous expense do cost less in France, which decides what drugs are to be used and at what prices. American patients in effect subsidize the French, who take the same pills at half the price because American pharmaceutical companies don't want to lose the French market....
Japanese, Koreans gain most from cash for clunkers
Japanese and South Korean automakers registered the biggest market share gains in the U.S. government's "cash for clunkers" program that ended this week with bankruptcy related inventory shortages hurting General Motors Co GM.UL and Chrysler.
Toyota Motor Corp (7203.T) Honda Motor Co Ltd (7267.T), Nissan Motor Co Ltd (7201.T), Hyundai Motor Co (005380.KS) capitalized on the program's goal of pushing consumers away from gas guzzling sport utilities and pickups, to more efficient cars and trucks, preliminary sales figures showed on Wednesday.
Overseas manufacturers dominate in car sales, while U.S. companies have been stronger in the light truck segment. Cars outsold trucks 2-1 under the "clunker" initiative.
Ford Motor Co (F.N) was the only domestic manufacturer to hold its own in market share compared with its performance so far this year, while GM slipped and Chrysler stumbled noticeably....
Involuntary Associations and National Service
Unlike some European systems of the past two centuries, the American tradition is for individuals to form their own diverse communities and for each community to govern itself to the extent possible. Universal national service seems to reverse the direction of this relationship: its goal is to use the government to transform people to fit within the government’s vision of what’s important and how one should serve. Senator Barack Obama makes that government direction clear, promising us that his administration “will direct that service to our most pressing national challenges,” eschewing the traditional American approach of having the government take its direction from the diverse choices of its people....
...Mandatory community service sucks in much that is private and diverse and spits out an excessively homogenized version of the good, a version that would come with a government seal of approval.
It’s probably not an accident that many American groups who tend to favor greater government largesse are relatively stingy in their own donations to charity. Nor do I think it an accident that Americans are the most generous people in the world, while the few European countries that have universal military or community service have populations that fall far short of America’s in donating their time and money to the less fortunate. For charity work to be truly transformative in a positive way, perhaps it must be truly voluntary. That coerced service can be transformative without endangering freedom is even more improbable....
Lying for Health Care Reform - LBJ's Example for Today's Democrats
...We believe, after looking at the evidence, my co-author [David Blumenthal] and I, that if the true cost of Medicare had been known — if Johnson hadn't basically hidden them — the program would never have passed. America's second-most beloved program would never have happened, if we had had genuine cost estimates....
...A further concern is that initial cost estimates of federal health programs are usually very optimistic. When Medicare was launched in 1965, Part A was projected to cost $9 billion by 1990, but ended up costing $67 billion. When Medicaid’s special hospitals subsidy was added in 1987, it was supposed to cost $100 million annually, but it already cost $11 billion by 1992. When Medicare’s home care benefit was added in 1988, it was projected to cost $4 billion in 1993, but ended up costing $10 billion. Or consider that when Massachusetts Commonwealth Care was put into place in 2006, it was expected to cost about $725 million annually, but the expected cost for 2009 is now almost $1 billion.
...The NPR segment was intriguingly titled, "Democrats Could Learn From LBJ's Medicare Push." I have no doubt that many Democrats who are pushing health care reform, especially the government-run insurance option, know that their cost projections are wildly underestimated. But like LBJ, contemporary Democrats don't care because they also know that once their health reform programs are enacted they will be almost impossible to kill. Enacting government health care is more important than telling their constituents the truth about what it will cost them. Plus ça change, plus c'est la même chose! ...
Subprime Lenders Getting U.S. Subsidies, Report Says
Many of the lenders eligible to receive billions of dollars from the government's massive foreclosure prevention program helped fuel the housing crisis by issuing risky subprime loans, according to a report to be issued Wednesday by the Center for Public Integrity.
Under the $75 billion program, called Making Home Affordable, lenders are eligible for taxpayer subsidies to lower the mortgage payments of distressed borrowers. Of the top 25 participants in the program, at least 21 specialized in servicing or originating subprime loans, according to the center, a nonprofit investigative reporting group funded largely by charitable foundations.
Much "of this money is going directly to the same financial institutions that helped create the sub-prime mortgage mess in the first place," Bill Buzenberg, executive director of the center, said in a statement. ...
Payday For Unions
Buried on page 65 of the 1,017 pages of HR 3200, the House's health care reform bill, and in a Senate bill as well, stands a $10 billion entitlement to keep pensions for unions like United Auto Workers as shiny and gold-plated as the day Detroit executives signed off on them.
Steelworkers, municipal employees, teachers and other union retirees will benefit from what the bills call "Reinsurance Programs for Retirees." The $10 billion cash infusion is intended to refinance Voluntary Employee Beneficiary Associations (VEBA) insurance to continue coverage for unions' early retirees in restructurings.
It's nothing but another bailout for union-bankrupted industries that can't sustain their contracts. In most of the private sector, companies cut back. They pay for what they buy. They scrimp.
Unions are different. When things get bad, they want taxpayers to pay. And they demonize corporate profits. When profits are a dirty word, one man's wealth is another man's loss, and creating value is no longer recognized as a means of earning money.
It's no surprise that bailouts are the result.
But there's a problem with all this largesse — the poor and middle class who don't get these fat pensions end up paying for them anyway. Back in February, President Obama praised unions for their "sacrifices" in the auto bailouts. We've yet to see taxpayers praised or thanked for their "sacrifices" in bailing out unions.
Unions gave $52 million to elect Democrats in the last election. The link between bailouts and campaign cash couldn't be clearer....
Woman accused of threatening bomb-plot informant
A Texas woman faces trial this month in Austin on charges she threatened to kill a government informant who infiltrated an Austin-based group that planned to bomb the Republican National Convention in St. Paul, Minn., last fall....
Medicare First!
...Think about this for a moment. Medicare is a huge, single-payer, government-run program. It ought to provide the perfect environment for experimentation. If more-efficient government management can slash health-care costs by addressing all these problems, why not start with Medicare? Let's see what "better management" looks like applied to Medicare before we roll it out to the rest of the country.
This is not a completely cynical suggestion. Medicare is, for instance, a logical place to start to design better electronic records systems and the incentives to use them. But you do have to wonder why a report that claims that Medicare is wasting 30 percent of its spending thinks it's making a case for making the rest of the health care system more like Medicare. ...
Health plan covers assisted suicide but not new cancer treatment
Barbara Wagner has one wish - for more time.
"I'm not ready, I'm not ready to die," the Springfield woman said. "I've got things I'd still like to do."
Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.
Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.
"I told them, I said, 'Who do you guys think you are?' You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?' " Wagner said....
Myths and Facts about Obamacare
Last week NBC News released a poll showing that while 36% of Americans believed President Barack Obama’s health care plan was a “good idea,” 42% of Americans believed it was a “bad idea.” NBC’s explanation for this inconvenient truth? “[M]isperceptions about the president’s plans for reform … that nonpartisan fact-checkers say are untrue.” Specifically NBC found that 55% of Americans believed Obamacare “will give health insurance coverage to illegal immigrants,” 54% believed it “will lead to a government takeover of the health care system,” 50% believed it “will use taxpayer dollars to pay for women to have abortions,” and 45% believed it “will allow the government to make decisions about when to stop providing medical care to the elderly.”
The President has since copied NBC’s diagnosis, devoting his Saturday Weekly Address to debunking these “phony claims.” The problem for NBC News, and the White House, is that every one of these concerns has rock solid foundation in fact....
...These are just some of the very real fears Americans have about Obamacare. And as we have decisively demonstrated, all have sound basis in fact. But they do not even touch on another very real fear Americans have about Obamacare: the cost. This Friday, the Obama administration leaked news that they will be forced to raise their 10-year budget deficit forecast to about nine trillion dollars, up about two trillion from the previous forecast. Considering that all best estimates point to at least a $1 trillion price tag for Obamacare, it is a wonder just 42% of Americans believe Obamacare is a “bad idea.”
Incompetent Government
Do the NYTimes editors read their own paper? If they do, you’d think they'd see foolishness of their arguments for more government. Today's front page wails that the President has fewer than half his top appointees “in place advancing his agenda."
Obama does not have his own people enacting programs central to his mission. He is trying to fix the financial markets but does not have an assistant treasury secretary for financial markets. He is spending more money on transportation than anyone since Dwight D. Eisenhower but does not have his own inspector general watching how the dollars are used. He is fighting two wars but does not have an Army secretary.
Does it occur to the editors that a government incapable of appointing people within 8 months should not try to "fix" financial markets?...
Why Most (Sucessful) Politicians Value Staying in Power More than the Public Good
...One might still ask why the power-seekers tend to predominate over those who place a higher value on the public good. The key explanation is selection effects. A politician willing to do anything to take and hold on to power will have a crucial edge over an opponent who imperils his chances of getting elected in order to advance the public interest. The former type is likely to prevail over the latter far more often than not. This is especially true in a political environment where most voters are often ignorant and irrational about government and public policy. Candidates have strong incentives to pander to this ignorance and exploit it in order to win elections. Those unwilling to exploit public ignorance because they place the public interest above political success are likely to be at a serious disadvantage relative to their less scrupulous opponents. Thus, politicianswho value power above other objectives are more likely to get into office and stay there. As economist Frank Knight wrote back in the 1930s, "[t]he probability of the people in power being individuals who would dislike the possession and exercise of power is on a level with the probability that an extremely tender-hearted person would get the job of whipping master in a slave plantation."...
Small Government Caused Our Current Problems?
...So, there you have it in plain English. To repeat: “small government nearly ruined the global economy last fall.” Cohan spares us any evidence that we actually had a small government at any time during the past twenty-five years. I would be especially interested in such evidence, inasmuch as I have written a number of articles and books brimming with evidence that in fact the governments of this country at every level were growing in size, scope, and power during those years.
Like Cohan, those who continually blame insufficient regulation for our present plight offer little or no evidence, relying instead on the implicit assumption that if only the regulations had been much stricter, the bankers and other business-sector malefactors never would have perpetrated their evil deeds. This faith in the regulators is touching, to be sure, but it is also extremely naïve. We now have—and long have had—miles of regulations on the books and legions of regulators at work in scores of government agencies. What specific power did they lack? And had they been given even greater powers, budgets, and staffs, what enchantment would have transformed these ostensible guardians into smart, dogged champions of the public interest, rather than the time-serving drones and co-conspirators with the regulated firms that they have always been?
Somehow, no matter how many regulations are created and how many regulators are put on the government payroll, when these rules and enforcement agents fail to prevent a disaster, many people’s response is to propose that the government write more regulations and hire more regulators. If these advocates of expanded government intervention had been in New Orleans as it was being submerged under floodwaters in the wake of Hurricane Katrina, they no doubt would have proposed that the Corps of Engineers dynamite the remaining levies—to prove that they favored “doing something.”...
Report: CIA Used Power Drills, Guns, Threats Against Children
CIA officers used power drills, mock executions and threats against children in often futile attempts to break high-value al Qaeda targets, according to portions of a 2004 report by the CIA inspector general that was made public today.
"We now have a document that the world can read that shows in excruciating and disgusting detail that the United States violated its own beliefs and turned to the dark side when it didn't have to," said Richard Clarke, a former national security official and now an ABC News consultant. ...
THE REAL REASON AMERICANS ARE ANGRY
... "The crazy tree blooms in every moment of liberal ascendancy," historian Rick Perlstein proclaimed in the Washington Post.
While the commentariat's condescension is almost comical, the whole evil-or-stupid explanation misses the elephant in Obama's room: Americans of all stripes, it turns out, aren't very keen about the government barging into their lives.
An ABC/Washington Post poll from June showed people preferred "smaller government with fewer services" over "larger government with more services" by 54% to 41%, up from 50%-45% a year earlier (independents were even more pronounced, at 61%-35%). A Rasmussen poll from April showed that 77% of Americans preferred a "free market" economy over a "government managed" economy, up seven percentage points from just last December. A July CBS poll found that 52% of Americans think that Obama is trying to do "too much."...
...Consistently, 60% or more of Americans have opposed the ongoing federal takeover of the domestic automobile industry. And for good reason, too, beyond the crazy economics of throwing good taxpayer money after bad private failure. TARP money was expressly earmarked by Congress for financial institutions, not auto (or any other kind of) manufacturers, which makes the Detroit bailout not only imprudent but illegal...
How Government Created the Financial Crisis
Many are calling for a 9/11-type commission to investigate the financial crisis. Any such investigation should not rule out government itself as a major culprit. My research shows that government actions and interventions -- not any inherent failure or instability of the private economy -- caused, prolonged and dramatically worsened the crisis.
The classic explanation of financial crises is that they are caused by excesses -- frequently monetary excesses -- which lead to a boom and an inevitable bust. This crisis was no different: A housing boom followed by a bust led to defaults, the implosion of mortgages and mortgage-related securities at financial institutions, and resulting financial turmoil.
Monetary excesses were the main cause of the boom. The Fed held its target interest rate, especially in 2003-2005, well below known monetary guidelines that say what good policy should be based on historical experience. Keeping interest rates on the track that worked well in the past two decades, rather than keeping rates so low, would have prevented the boom and the bust. Researchers at the Organization for Economic Cooperation and Development have provided corroborating evidence from other countries: The greater the degree of monetary excess in a country, the larger was the housing boom....
Auto Dealers Paid for Just 2 Percent of 'Clunkers' Claims, Congressman Says
The federal government has only reimbursed auto dealers for 2 percent of the claims they've submitted through the popular "cash for clunkers" program, a Pennsylvania congressman said, calling on the Obama administration to help speed up the process. ...
Social Security crunch coming fast
...The story begins: "In Washington these days, the only topics of discussion seem to be how many trillions to throw at health care and the recession, and whom on Wall Street to pillory next. But watch out. Lurking just below the surface is a bailout candidate that may soon emerge like the great white shark in 'Jaws': Social Security.
"Perhaps as early as this year, Social Security, at $680 billion the nation's biggest social program, will be transformed from an operation that's helped finance the rest of the government for 25 years into a cash drain that will need money from the Treasury. In other words, a bailout."
As I've already noted, there is no money in the Social Security Trust Fund -- just IOUs from the government to itself. What is liable to spark debate and grab headlines is that instead of producing its biggest surplus ever in 2009-10, the trust fund could start running deficits in the next year, primarily because the weak economy is generating less tax revenue.
That's years earlier than expected. Social Security wasn't supposed to go into the red until around 2015.
Past projections were for a cash-flow surplus of about $87 billion this year and $88 billion next year. But new projections show those figures may drop to around $18 billion or $19 billion, which could easily go negative. And once the red ink starts spilling (a temporary bounce into the black in the next couple of years notwithstanding), that deficit will grow for the next 20 or so years unless something is done to halt it....
...In other words, the government spent it. Throughout all those years in the 1980s and 1990s, when folks worried about the budget deficit, it was reported to be lower than it would have been had the Social Security Trust Fund's money not been going into government coffers, thereby reducing the size of the deficit. Also untenable is the projected worker-to-retiree ratio, which will jump from 30 Social Security recipients per 100 workers in 1990 to 46 per 100 in the next 20 years.
And Social Security funding isn't the only time bomb. Sloan notes that "when it comes to problems, Medicare makes Social Security look like a walk in the park, even though at about $510 billion this year, it's far smaller. Not only are Medicare's financial woes much larger than Social Security's, but they're also much more complicated. . . . Medicare is more convoluted, because the health-care system is much more complex than Social Security. Which, when you think about it, involves only money."...
Overhauling health-care system tops agenda at annual meeting of Canada's doctors
SASKATOON — The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.
Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.
"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.
"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."...
Goodbye to Health Care Privacy
When the government takes over the health care system, bureaucrats will want to know whether you have a government-mandated health insurance policy when getting care. If you don’t, you’ll face a penalty.
Cornell law school professor William A. Jacobson writes that under both the House and Senate plans, the IRS will serve as the enforcer of the rules against individual taxpayers. Doctors will have to report to the IRS the names, addresses, Social Security numbers and coverage periods of their patients....
Sunday, August 16, 2009
Democratic health care vs. democracy
...Yet none of this logically implies a single-payer system. There are excellent alternative reforms that would rely on dynamic competitive markets coupled with means-tested assistance for those who can't afford proper care. Most Americans can afford to buy their own insurance and health care. Shouldn't the government focus narrowly on those who can't? Why create a universal food program when you can just give the poor food stamps?
"A program for the poor is a poor program," as an architect of our Social Security system put it. How can we be sure that taxpayers will vote to finance adequate care for those who have no option other than the government safety net? A right to health care seems to imply a guarantee. But the American public, which includes many who deny that there is a right to health care, cannot be counted on to guarantee it. The closest thing to a guarantee, then, is a universal, one-size-fits-all program that gives everyone an incentive to ensure that benefits are a fitting size.
The fact that American voters have repeatedly resisted a move to any system of universal health care underscores for many liberals the danger of leaving the protection of basic rights to the discretion of the democratic public. And so, in one of the profound ironies of American politics, even the Democratic Party abjures the fundamental democratic responsibility of honest persuasion when it comes to nailing down its contested vision of our basic rights.
Nobody gets to start from scratch. And that means sometimes things that shouldn't be on the table are on it. If so, how do we take them off? Not by lying to one another. The worth of trust and cost of mutual hostility are too high. Our democratic burden is to help others see what we think we see. And if we fail, we keep trying. We might try this sometime. Maybe, then, we could find a way to trust one another enough to create a health-care system that really delivers for everybody. Until then, we'll get the system we deserve.
Democracy and the Grounds of Distrust
...It requires an amazing kind of selective amnesia to think that there is “no evidence’ that the U.S. government is “capable of madness.” The government of the United States invaded Iraq and its agents have killed many tens of thousands people on the basis of the fact that some Saudis trained in Afganistan flew planes into the World Trade Center, plus some lies. Torture, extraordinary rendition, indefinite detention, etc. I call that madness. Of course, Ezra means the other parts of government concerned with domestic affairs. But not the parts that break into peoples’ houses and destroy their lives for selling contraband herbs, or that subject us constantly to mendacious propaganda about drugs. Our government — and by extension our fellow citizens — is capable of terrible things and proves it every single day. Is it really possible to love government so much, to invest so much hope in its benevolent efficacy, that we grow blind to its evident capacity for evil? Anyway, there must be some parts of the government that are not capable of madness. Ezra invites us to think about those when considering health care reform. Will you accept?...
Healthy debate
There's a growing movement at town hall meetings and online to make sure members of Congress read the entire health care reform bill before they vote on it, and to make it available to the public at least 72 hours before a vote.
"Read the bill" is typically another way of saying "not so fast," but there's no denying the idea's appeal. Too many bills have been rushed to a vote in Congress with too little time for scrutiny.
There's just one hitch: You could read the entire health bill and still not have a very good idea of how the plan would work. Legislative language is notoriously, necessarily murky. Take the opening lines of one of the bill's most controversial sections, the one about voluntary "end of life" counseling:
"SEC. 1233. ADVANCE CARE PLANNING CONSULTATION. (a) Medicare. — (1) IN GENERAL. — Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended — (A) in subsection (s)(2) — (i) by striking 'and' at the end of subparagraph (DD); (ii) by adding 'and' at the end of subparagraph (EE); and (iii) adding at the end the following new subparagraph: '(FF) advance care planning consultation (as defined in subsection (hhh)(1) … "
Got that? Most members of Congress and most Americans could read all 1,017 pages of the House bill (to be fair, much of it isn't quite this opaque) and come away with a confused picture about what it all means....
Saturday, August 15, 2009
Quote of the Day: Nobel Prize Winning Economist Thomas Schelling
In an interview with the Atlantic in July, Nobel Prize winning economist Thomas Schelling was quoted:
I sometimes wish that we could have, over the next five or ten years, a lot of horrid things happening — you know, like tornadoes in the Midwest and so forth — that would get people very concerned about climate change....
Health Care: A Lesson in Practical Philosophy
...I suspect that Holbo, and many of my interlocutors, are made intensely uncomfortable by the idea that their root assumption--that they are on the side of reducing human suffering and lengthening lifespans--might be wrong. There are a bunch of ways you can deal with this disturbing possibility. You can scream at me. You can posit a highly speculative world in which government and academia suddenly, and for no apparent reason, get a lot better a inventing devices and mass-market drugs than they have so far proven. You can claim, falsely, that government and academia already do all the work producing useful drugs. You can assume that slashing pharma profits 80% will have no impact on their behavior, or at least, only change the behavior you want to change.
Or you can bite the bullet and say, we should save lives now at the expense of lives later. There's philisophic justification for that choice. But that opens up a whole can of worms about things like global warming. It helps if you phrase it aggressively: "How dare you suggest that someone should suffer now when we can treat them, so that someone who's not even born yet can live?" and don't think much about the equally inflammatory alternative formulation: "How dare you suggest that billions and billions of people suffer and die for the sake of a few uninsured Americans right now?" Geometric progressions are a bitch. So is figuring out the right discount rate for the lives of future world citizens, as William Nordhaus and Nicholas Stern can attest....
...
I'll close by returning to the practical question. If my objection is just "practical", he says, then why don't I include the good that could be done by a national health care program if it worked? Well, I have. I've acknowledged that at least some people would have to be better off under such a system (and others worse off, and I can't begin to calculate which group is larger) But as I said at the beginning, geometric progressions are a bitch. If the innovation spurred by the private sector could save 1% of the people who currently die each year, the number of people we'd be killing along with the private sector would necessarily be hugely larger than the number of people we'd save by implementing such insurance, since the most grotesquely exaggerated estimates released by interest groups pin the latter figure at around 0.8% of deaths in America (a much smaller number than the number who are estimated to be killed by access to the system--nosocomial infections and treatment side effects). That's even before you consider the people in other countries who would be saved by these advances. When I talk about the utilitarian calculus of weighing the good of current uninsured against the good to people who are currently, and in the future, untreatable without further innovation....
Pelosi’s New House Un-American Activities Committee
...In the black-and-white films I loved as a child, the good guy Americans were always contrasted with the foreign, un-American guys—complete with identifying scars—slapping their prisoners to make them talk. So why is the Obama administration fighting in courts in San Francisco, Washington and London “to keep an official veil of secrecy over the treatment of a former prisoner who says he was tortured at Guantanamo Bay,” and why is Secretary of State Hillary Clinton threatening “to limit U.S. intelligence-sharing with Great Britain if the [British high] court disclosed details of [his] treatment in Guantanamo”? (See details here.) And of course Pelosi herself has successfully obfuscated the record on her knowledge of and complicity in the use of torture during the Bush administration....
...“The American Way” used to be that those who worked hard, were honest, and served their fellow man did well, and those who didn’t went broke. Now, those who work hard and save lose their shirts in a government-fueled trainwreck and get taxed to bail out those who took on risky ventures and paid themselves fancy bonuses to boot. Meanwhile, government bail-out programs like TARP can’t account for the billions appropriated to them, big banks-formerly-known-as-investment banks are making even greater record profits, and the average Joe playing by the rules is out of luck. Who’s responsible for this un-American state of affairs and how do we get our money back?...
Wanted: Obama healthcare reform volunteers willing to be paid $15 an hour
It seems that, despite all the media attention lavished on e-mail appeals to his supporters, not everyone pushing for President Obama's embattled healthcare reform plan these warm August days is an idealistic volunteer in it for the sake of helping move the country forward and gaining medical attention for millions of uninsured Americans.
The website's large-type headline announces: "Work to Pass Obama's Healthcare Plan and Get Paid to Do it! $10-15 hr!"
It's a web ad on Craigslist: "You can work for change. Join motivated staff around the country working to make change happen. You can make great friends and money along the way. Earn $400-$600 a week."...
Thousands of surgeries may be cut in Metro Vancouver, leaked paper reveals
Vancouver patients needing neurosurgery, treatment for vascular diseases and other medically necessary procedures can expect to wait longer for care, NDP health critic Adrian Dix said Monday.
Dix said a Vancouver Coastal Health Authority document shows it is considering chopping more than 6,000 surgeries in an effort to make up for a dramatic budgetary shortfall that could reach $200 million....
US deficit forecast to be four times last year’s record
To put some context on a new estimate that puts this year’s federal deficit at $1.8 trillion, consider this: That amount had never been spent by the federal government in a single year until 2000, let alone borrowed.
That’s right. As the decade began, the US government spent $1.8 trillion in a year for the first time. Now it’s poised to spend that much in excess of its tax revenues.
The Treasury released the latest figures Wednesday, showing spending of about $3 trillion in the past 10 months, and revenues of only $1.74 trillion.
With two months to go in the fiscal calendar, the Obama administration is projecting that the imbalance will end up totaling $1.84 trillion, more than four times last year’s record-high. ...
The Health Insurers Have Already Won
As the health reform fight shifts this month from a vacationing Washington to congressional districts and local airwaves around the country, much more of the battle than most people realize is already over. The likely victors are insurance giants such as UnitedHealth Group (UNH), Aetna (AET), and WellPoint (WLP). The carriers have succeeded in redefining the terms of the reform debate to such a degree that no matter what specifics emerge in the voluminous bill Congress may send to President Obama this fall, the insurance industry will emerge more profitable. Health reform could come with a $1 trillion price tag over the next decade, and it may complicate matters for some large employers. But insurance CEOs ought to be smiling. ...
...The industry has already accomplished its main goal of at least curbing, and maybe blocking altogether, any new publicly administered insurance program that could grab market share from the corporations that dominate the business. UnitedHealth has distinguished itself by more deftly and aggressively feeding sophisticated pricing and actuarial data to information-starved congressional staff members. With its rivals, the carrier has also achieved a secondary aim of constraining the new benefits that will become available to tens of millions of people who are currently uninsured. That will make the new customers more lucrative to the industry. ...
...UnitedHealth's relationship with Democratic Senator Mark R. Warner of Virginia illustrates the industry's subtle role. Elected last fall, Warner, a former governor of his state and a wealthy ex-businessman, received a choice assignment as the Senate Democrats' liaison to business. The rookie senator landed in the center of a high-visibility political drama—and in a position to earn the gratitude of a health insurance industry that has donated more than $19 million to federal candidates since 2007, 56% of which has gone to Democrats. ...
...In August 2007, the company hired Sommer, who previously headed global lobbying for Goldman Sachs (GS). He quickly built a new Washington team of former congressional aides and other K Street operatives. One key acquisition: Cory Alexander, former chief of staff for House Majority Leader Steny Hoyer (D-Md.), an influential moderate Democrat. Alexander had been lobbying for the huge mortgage financier Fannie Mae (FNM). Today, Sommer directs a team of nearly 50 people from UnitedHealth's spacious Washington office on Pennsylvania Avenue, equidistant between the Capitol and White House. The company spent more than $3.4 million on in-house and outside lobbying in the first half of 2009.
Sommer has retained such influential outsiders as Tom Daschle, the former Democratic Senate Leader who now works for the large law and lobbying firm Alston & Bird. Daschle, a liberal from South Dakota, dropped out of the running to be Obama's Secretary of Health & Human Services after disclosures that he failed to pay taxes on perks given to him by a private client. He advised UnitedHealth in 2007 and 2008 and resumed that role this year. Daschle personally advocates a government-run competitor to private insurers. But he sells his expertise to UnitedHealth, which opposes any such public insurance plan. Among the services Daschle offers are tips on the personalities and policy proclivities of members of Congress he has known for decades. ...
...What people in Washington tend not to discuss, at least on the record, is the open secret that insurers are minimizing their forecasts of the eventual windfall they will enjoy from expanded coverage for Americans. UnitedHealth has given certain key members of Congress details about its finances and tax liability—both historical numbers and figures projected under various cost-sharing scenarios. But some on Capitol Hill are skeptical. "The bottom line," says an aide to the Senate Finance Committee, "is that health reform would lead to increased revenues and profits [for the insurance industry]. ... There will be [added] costs [to the companies], but we're not sure the revenues and profits will be as low as they say." ...
Civil Rights Commission Criticizes Obama Health-Care Plan’s Racially-Discriminatory Affirmative Action
The U.S. Commission on Civil Rights says Obama’s health-care plan is racially discriminatory. The House health-care bill backed by Obama is filled with “sections that factor in race when awarding billions in contracts, scholarships and grants” and give “preferential treatment to minority students for scholarships.” Taxpayers of all races will end up paying more because of these arbitrary racial preferences. The Civil Rights Commission has concluded that this racial discrimination is unjustified, and that it will neither “reduce health care disparities among racial and ethnic groups,” nor “improve health care in underserved areas.”
Earlier, I wrote about other provisions backed by Obama that would mandate affirmative action in health care to promote “cultural competence” — whatever that means — and fund left-wing community organizers. “ObamaCare” also contains preferences for illegal aliens, who are exempt from its taxes and penalties, but can access its benefits due to lack of eligibility verification safeguards. The safeguards were blocked by liberal lawmakers allied with Obama....
Healthcare Reform That's Hard to Swallow (Los Angeles Times)
...However, the climate for drug development is deteriorating. Research and development investments per new drug introduction approximately doubled between the early 1980s and early 1990s, and only about three in 10 drugs approved by the Food and Drug Administration for marketing recoup their development costs.
President Obama has made it clear that he intends to eke out huge cost savings at drug companies' expense: "You've heard that as a consequence of our efforts at reform, the pharmaceutical industry has already said they're willing to put $80 billion on the table," and he added: "We might be able to get $100 billion out or more."...
...The stimulus bill has already set aside $1.1 billion to figure out how to distinguish the blue pills from the red ones, and reform legislation is expected to pour more money into these attempts to measure "comparative effectiveness."
But this approach ignores the futility of such one-size-fits-all prescribing of medicines. For many classes of drugs -- among them statins, anti-hypertensives, pain-relievers and antipsychotic medicines -- the selection of the appropriate drug among many possibilities requires a delicate balancing of effectiveness and acceptable side effects in each patient. Under Obama-care, you don't want to be one of those people who might really need the more expensive red pill.
Once the cheap blue pill has been anointed as the one eligible for federal reimbursement, there will be little incentive for companies to pour millions of dollars into developing a new generation of drugs that might in fact prove to be better -- but perhaps only for a small subset of patients....
Tuesday, August 11, 2009
Democracy and the Grounds of Distrust
...It requires an amazing kind of selective amnesia to think that there is “no evidence’ that the U.S. government is “capable of madness.” The government of the United States invaded Iraq and its agents have killed many tens of thousands people on the basis of the fact that some Saudis trained in Afganistan flew planes into the World Trade Center, plus some lies. Torture, extraordinary rendition, indefinite detention, etc. I call that madness. Of course, Ezra means the other parts of government concerned with domestic affairs. But not the parts that break into peoples’ houses and destroy their lives for selling contraband herbs, or that subject us constantly to mendacious propaganda about drugs. Our government — and by extension our fellow citizens — is capable of terrible things and proves it every single day. Is it really possible to love government so much, to invest so much hope in its benevolent efficacy, that we grow blind to its evident capacity for evil? Anyway, there must be some parts of the government that are not capable of madness. Ezra invites us to think about those when considering health care reform. Will you accept?
I suspect Ezra thinks that his side of the debate has done nothing to engender distrust. But that would be wrong. The reason I wrote a whole paper about the “noble lies” underpinning the American Social Security system is precisely that our system did and does violate the spirit of transparency and openness needed for good-faith democratic deliberation. And, as I argued last month in my column for The Week, the demonstrated willingness of Democrats, both politician and wonk, to dissemble about whether or not they’re trying to set in motion a chain reaction toward a single-payer system practically demands distrust....
Undue Influence
...Enter Section 1233 of the health-care bill drafted in the Democratic-led House, which would pay doctors to give Medicare patients end-of-life counseling every five years -- or sooner if the patient gets a terminal diagnosis.
On the far right, this is being portrayed as a plan to force everyone over 65 to sign his or her own death warrant. That's rubbish. Federal law already bars Medicare from paying for services "the purpose of which is to cause, or assist in causing," suicide, euthanasia or mercy killing. Nothing in Section 1233 would change that.
Still, I was not reassured to read in an Aug. 1 Post article that "Democratic strategists" are "hesitant to give extra attention to the issue by refuting the inaccuracies, but they worry that it will further agitate already-skeptical seniors."
If Section 1233 is innocuous, why would "strategists" want to tip-toe around the subject?
Perhaps because, at least as I read it, Section 1233 is not totally innocuous. ...
...Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?
Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren't quite "purely voluntary," as Rep. Sander M. Levin (D-Mich.) asserts. To me, "purely voluntary" means "not unless the patient requests one." Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that's an incentive to insist.
Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit "formulation" of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would "place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign," I don't think he's being realistic. ...
Deceptive Obama Health-Care Plan Worsens the Status Quo, Explodes Costs, Say Washington Post Columnists
The Washington Post endorsed Obama — indeed, it hasn’t endorsed a Republican for president since 1952 — but a lot of Washington Post columnists are not enthusiastic about his health-care plan, which is costly, obsolete, deceptive, and harmful.
Obama’s plan would just aggravate the status quo and increase skyrocketing health-care costs, says veteran editorialist Robert J. Samuelson: “One of the bewildering ironies of the health-care debate is that President Obama claims to be attacking the status quo when he’s actually embracing it. . .While denouncing skyrocketing health spending, he would increase it.”
Earlier, Samuelson noted that various aspects of Obama’s health-care plan were “naive, hypocritical” and “simply dishonest.”
Elderly people would be subjected to worrisome undue influence regarding end-of-life decisions, says Charles Lane, a liberal editorialist.
Obama’s plan ignores basic, obvious reforms of the health-care system needed to stem skyrocketing costs and provide health-care security, says Charles Krauthammer — such as a more efficient, less litigious way to decide medical malpractice cases, which wealthy, liberal trial lawyers oppose....
...In the New York Times, economist Tyler Cowan calls Obama’s plan “voodoo economics.”...
The Next Fannie Mae
Much to their dismay, Americans learned last year that they “owned” Fannie Mae and Freddie Mac. Well, meet their cousin, Ginnie Mae or the Government National Mortgage Association, which will soon join them as a trillion-dollar packager of subprime mortgages. Taxpayers own Ginnie too.
Only last week, Ginnie announced that it issued a monthly record of $43 billion in mortgage-backed securities in June. Ginnie Mae President Joseph Murin sounded almost giddy as he cheered this “phenomenal growth.” Ginnie Mae’s mortgage exposure is expected to top $1 trillion by the end of next year—or far more than double the dollar amount of 2007. (See the nearby table.) Earlier this summer, Reuters quoted Anthony Medici of the Housing Department’s Inspector General’s office as saying, “Who would have predicted that Ginnie Mae and Fannie Mae would have swapped positions” in loan volume?
Ginnie’s mission is to bundle, guarantee and then sell mortgages insured by the Federal Housing Administration, which is Uncle Sam’s home mortgage shop. Ginnie’s growth is a by-product of the FHA’s spectacular growth. The FHA now insures $560 billion of mortgages—quadruple the amount in 2006. Among the FHA, Ginnie, Fannie and Freddie, nearly nine of every 10 new mortgages in America now carry a federal taxpayer guarantee.
Herein lies the problem. The FHA’s standard insurance program today is notoriously lax. It backs low downpayment loans, to buyers who often have below-average to poor credit ratings, and with almost no oversight to protect against fraud. Sound familiar? This is called subprime lending—the same financial roulette that busted Fannie, Freddie and large mortgage houses like Countrywide Financial.
On June 18, HUD’s Inspector General issued a scathing report on the FHA’s lax insurance practices. It found that the FHA’s default rate has grown to 7%, which is about double the level considered safe and sound for lenders, and that 13% of these loans are delinquent by more than 30 days. The FHA’s reserve fund was found to have fallen in half, to 3% from 6.4% in 2007—meaning it now has a 33 to 1 leverage ratio, which is into Bear Stearns territory. The IG says the FHA may need a “Congressional appropriation intervention to make up the shortfall.”...
...Then there is the booming refinancing program that Congress has approved to move into the FHA hundreds of thousands of borrowers who can’t pay their mortgage, including many with subprime and other exotic loans. HUD just announced that starting this week the FHA will refinance troubled mortgages by reducing up to 30% of the principal under the Home Affordable Modification Program. This program is intended to reduce foreclosures, but someone has to pick up the multibillion-dollar cost of the 30% loan forgiveness. That will be taxpayers.
In some cases, these owners are so overdue in their payments, and housing prices have fallen so dramatically, that the borrowers have a negative 25% equity in the home and they are still eligible for an FHA refi. We also know from other government and private loan modification programs that a borrower who has defaulted on the mortgage once is at very high risk (25%-50%) of defaulting again. ...
Monday, August 10, 2009
Hate Crime in St. Louis: Obama Backers Beat Up Black Critic of Health-Care “Reform,” Use Racial Slurs
Kenneth Gladney, a black critic of Obama’s health-care plan, was beaten, kicked, and called racist names by members of the SEIU, a corrupt and powerful left-wing union that backs Obama’s plan, leaving him wheelchair-bound and too weak to speak. This hate crime took place at a St. Louis “town hall” meeting. SEIU members are bused in to town hall meetings called by liberal lawmakers in order to create the illusion of grassroots support, and intimidate would-be critics.
To curry favor with the corrupt SEIU, the Obama Administration has betrayed union workers by gutting federal regulations that help uncover corruption by union leaders and their misuse of union members’ dues....
...The Obama Administration has a glaring double standard when it comes to hate crimes. It has turned a blind eye to hate-crimes committed by liberals, such as voter intimidation in Philadelphia by black panthers who included a Democratic official and Obama poll-watcher. Yet it has advocated reprosecuting in federal court other people found innocent of hate crimes in state court, taking advantage of a loophole in constitutional protections against double jeopardy.
Feds’ grip on health care system could strangle biotechs
As lawmakers debate the future of the nation’s health care system, some Maryland biotechnology executives fear federal legislation could cut off the cash supply for startup life sciences companies.
Health reform shaping in Washington could mean that some drug companies would lose their exclusive licenses in less time than it would take to recoup the cost of developing new drugs. Another issue in the health reform debate is whether the government would set prices for some drugs and diagnostic treatments. Venture capitalists would think twice about investing in a new treatment if it can’t be sold at market prices, biotech entrepreneurs say....
Sunday, August 09, 2009
Obama discovers that health reform is a hard sell
...If Obama has his way, his health care plan will be funded by his Treasury chief who did not pay his taxes, overseen by his Surgeon General who is obese, signed by a president who smokes and financed by a country that is just about broke. What possibly could go wrong?...
Trucks win in Cash for Clunkers game
NEW YORK (CNNMoney.com) -- What are people trading their clunkers in for? It depends on who you ask.
The government's results showed small cars as the top choice for shoppers looking for Cash for Clunker deals. But an independent analysis by Edmunds.com disputed those results, and showed that two full-size trucks and a small crossover SUV were actually among the top-ten buys.
The discrepancy is a result of the methods used. Edmunds.com uses traditional sales measurements, tallying sales by make and model. The government uses a more arcane measurement method that subdivides models according to engine and transmission types, counting them as separate models.
For example, the Ford Escape is available in six different versions including two- and four-wheel drive and hybrid versions. The government counts each version as a different vehicle using guidelines from the Environmental Protection Agency. Only the front wheel drive, non-hybrid version made the government's top ten list.
The Ford Escape crossover SUV, instead of being the seventh-most popular vehicle under the program, as the government ranked it, was actually the best seller, according to Edmunds.com. The government pegged the Ford Focus as the top seller. ...
Saturday, August 08, 2009
A French Revelation, or The Burning Bush
Incredibly, President George W. Bush told French President Jacques Chirac in early 2003 that Iraq must be invaded to thwart Gog and Magog, the Bible’s satanic agents of the Apocalypse.
Honest. This isn’t a joke. The president of the United States, in a top-secret phone call to a major European ally, asked for French troops to join American soldiers in attacking Iraq as a mission from God.
Now out of office, Chirac recounts that the American leader appealed to their “common faith” (Christianity) and told him: “Gog and Magog are at work in the Middle East…. The biblical prophecies are being fulfilled…. This confrontation is willed by God, who wants to use this conflict to erase his people’s enemies before a New Age begins.”
This bizarre episode occurred while the White House was assembling its “coalition of the willing” to unleash the Iraq invasion. Chirac says he was boggled by Bush’s call and “wondered how someone could be so superficial and fanatical in their beliefs.”
After the 2003 call, the puzzled French leader didn’t comply with Bush’s request. Instead, his staff asked Thomas Romer, a theologian at the University of Lausanne, to analyze the weird appeal. Dr. Romer explained that the Old Testament book of Ezekiel contains two chapters (38 and 39) in which God rages against Gog and Magog, sinister and mysterious forces menacing Israel. Jehovah vows to smite them savagely, to “turn thee back, and put hooks into thy jaws,” and slaughter them ruthlessly. In the New Testament, the mystical book of Revelation envisions Gog and Magog gathering nations for battle, “and fire came down from God out of heaven, and devoured them.”
In 2007, Dr. Romer recounted Bush’s strange behavior in Lausanne University’s review, Allez Savoir. A French-language Swiss newspaper, Le Matin Dimanche, printed a sarcastic account titled: “When President George W. Bush Saw the Prophesies of the Bible Coming to Pass.” France’s La Liberte likewise spoofed it under the headline “A Small Scoop on Bush, Chirac, God, Gog and Magog.” But other news media missed the amazing report.
Subsequently, ex-President Chirac confirmed the nutty event in a long interview with French journalist Jean-Claude Maurice, who tells the tale in his new book, Si Vous le Répétez, Je Démentirai (If You Repeat it, I Will Deny), released in March by the publisher Plon....
The Market Doesn’t Ration Health Care
...To see that the market does not ration one need only see that “the market” doesn’t do anything. To talk as if it does things is to reify the market — worse, it is to anthropomorphize the market, ascribing to it attributes — purposes, plans, and actions — that only human beings possess. We may also see this as another instance of literalizing a metaphor, which, as Thomas Szasz has so often warned, is fraught with peril.
I’m not saying that economists don’t realize this diction is a metaphor. Of course they do, and there’s no harm in using this shorthand among those who understand it as such. The problem, as I see it, is that the general public doesn’t fully grasp the metaphorical nature of these statements. For the sake of public understanding, free-market advocates should not welcome a debate in which they begin by saying, “Our method of rationing is better than your method of rationing.”
Better to respond to the interventionists this way: The market does not ration or allocate. The market does not do anything. It has no purposes or objectives. It is simply a legal framework in which people do things with their justly acquired property and their time in order to pursue their own purposes....
...It is true that as a result of market exchanges, goods and resources change hands and (except for land) locations. But in no sense is this rationing or allocation. The resulting arrangement of resources is simply a product of many transactions. Of course, people’s choices of what and what not to buy and sell at which prices create an arrangement of goods and resources that tends to be intelligible in terms of consumers’ subjective priorities. But that does not warrant calling the process rationing or allocation....
France Fights Universal Care's High Cost
...France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.
In recent months, France imposed American-style "co-pays" on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. "A hospital doesn't need to be money-losing to provide good-quality treatment," President Nicolas Sarkozy thundered in a recent speech to doctors.
And service cuts -- such as the closure of a maternity ward near Ms. Cuccarolo's home -- are prompting complaints from patients, doctors and nurses that care is being rationed. That concern echos worries among some Americans that the U.S. changes could lead to rationing.
The French system's fragile solvency shows how tough it is to provide universal coverage while controlling costs, the professed twin goals of President Barack Obama's proposed overhaul....
...Despite the structural differences between the U.S. and French systems, both face similar root problems: rising drug costs, aging populations and growing unemployment, albeit for slightly different reasons. In the U.S., being unemployed means you might lose your coverage; in France, it means less tax money flowing into Assurance Maladie's coffers.
France faces a major obstacle to its reforms: French people consider access to health care a societal right, and any effort to cut coverage can lead to a big fight.
For instance, in France, people with long-term diseases get 100% coverage (similar to, say, Medicare for patients with end-stage kidney diseases). The government proposed trimming coverage not directly related to a patient's primary illness -- a sore throat for someone with diabetes, for example. The proposal created such public outcry that French Health Minister Roselyne Bachelot later said the 100% coverage rule was "set in stone."...
...Since the 1970s, almost all successive French health ministers have tried to reduce expenses, but mostly managed to push through only minor cost cuts....
...In the U.S., hospitals are paid for each individual procedure. This system, called fee-for-service, is suspected of contributing to runaway costs because it doesn't give hospitals an incentive to limit the number of tests or procedures.
Ironically, France is actually in the midst of shifting to a fee-for-service system for its state-run hospitals. The hope is that it will be easier for the government to track if the money is being spent efficiently, compared with the old system of simply giving hospitals an annual lump-sum payment....
...Yet even the smallest budget moves are proving controversial. Local residents are up in arms over a cost-cutting measure that makes patients pay €1.10 an hour to park at the hospital. "It's a scandal," says retired local Communist politician Gérard Eude. "It goes against the very idea of universal health care."
‘You Are Terrifying Us’
We have entered uncharted territory in the fight over national health care. There’s a new tone in the debate, and it’s ugly. At the moment the Democrats are looking like something they haven’t looked like in years, and that is: desperate.
They must know at this point they should not have pushed a national health-care plan. A Democratic operative the other day called it “Hillary’s revenge.” When Mrs. Clinton started losing to Barack Obama in the primaries 18 months ago, she began to give new and sharper emphasis to her health-care plan. Mr. Obama responded by talking about his health-care vision. He won. Now he would push what he had been forced to highlight: Health care would be a priority initiative. The net result is falling support for his leadership on the issue, falling personal polls, and the angry town-hall meetings that have electrified YouTube.
In his first five months in office, Mr. Obama had racked up big wins—the stimulus, children’s health insurance, House approval of cap-and-trade. But he stayed too long at the hot table. All the Democrats in Washington did. They overinterpreted the meaning of the 2008 election, and didn’t fully take into account how the great recession changed the national mood and atmosphere.
And so the shock on the faces of Congressmen who’ve faced the grillings back home. And really, their shock is the first thing you see in the videos. They had no idea how people were feeling. Their 2008 win left them thinking an election that had been shaped by anti-Bush, anti-Republican, and pro-change feeling was really a mandate without context; they thought that in the middle of a historic recession featuring horrific deficits, they could assume support for the invention of a huge new entitlement carrying huge new costs.
The passions of the protesters, on the other hand, are not a surprise. They hired a man to represent them in Washington. They give him a big office, a huge staff and the power to tell people what to do. They give him a car and a driver, sometimes a security detail, and a special pin showing he’s a congressman. And all they ask in return is that he see to their interests and not terrify them too much. Really, that’s all people ask. Expectations are very low. What the protesters are saying is, “You are terrifying us.” ...
Ken McIntyre: Associated Press outsourcing to Leftist nonprofits is a bad idea
...Earlier this month, the 163-year-old news cooperative announced it would distribute "watchdog and investigative journalismÓ penned not by its own staff or that of member papers, but by four outside groups: the Center for Investigative Reporting in Barkeley, Calif.; New York-based ProPublica; and two D.C. outfits, the Center for Public Integrity (CPI) and the Investigative Reporting Workshop at American University.
AP, itself a not-for-profit enterprise, identified the four organizations as "civic-minded nonprofits. They also all have decidedly liberal sponsors. A cursory glance at the "independentÓ news shops reveals their reliance on left-tilting patrons such as the Knight Foundation and leftist donors such as financier Herbert Sandler and currency speculator George Soros.
Sandler and his wife, Marion, founders of ProPublica, are generous givers to Democratic candidates and left-wing causes including the Center for American Progress and ACORN, the ethically-challenged radical action group. Soros, an early backer of CPI as well as the radical MoveOn.org, poured tens of millions into attacks on President George W. Bush...
Inventor Dean Kamen Says Healthcare Debate "Backward Looking"
...Well, I mean the whole supposition that "We have a crisis in healthcare." Our healthcare system has seen some of the greatest achievements of the human intellect since we started recording history: We're developing incredible devices and implantables to improve the quantity and quality of people's lives. We're developing pharmaceuticals that alleviate the need for surgery and eliminate the volatile effects of diseases. We're making the surgeries that are necessary ever less invasive. You can get a stent through your femoral artery all the way up into your heart and fix a blockage without surgery. I'd say, if we have a crisis, it's the embarrassment of riches. Nobody wants to deal with the fact that we're no longer in a world where you can simply give everybody all the healthcare that is available.
Each side of this debate has created the boogieman and monsters, like "We don't want let this program to come into existence because that will mean rationing." Well, I hate to tell you the news but as soon as medicine started being able to do incredible things that are very expensive, we started rationing. The reason 100 years ago everyone could afford their healthcare is because healthcare was a doctor giving you some elixir and telling you you'll be fine. And if it was a cold you would be fine. And if it turns out it was consumption; it was tuberculosis; it was lung cancer—you could still sit there. He'd give you some sympathy, and you'd die. Either way, it's pretty cheap.
We now live in a world where technology has triumphed, in many ways, over death. The problem with that is that it's enormously expensive. And big pharmaceutical giants and big medical products companies have stopped working on stuff that could be extraordinary because they know they won't be reimbursed, according to the common standards. We're not only rationing today; we're rationing our future. ...
...Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free.
Whatever the marketplace, if talented people are given resources they're going to keep driving us to having better, simpler, cheaper solutions to problems. And, by the way, if they come up with a better solution but it can't be cheaper—which, in the beginning, most things aren't—nobody says you have to buy it. If you think this new drug is too expensive, it's not a good deal, we have a crisis, buy the old one. It's a generic now. It's cheap.
You can't look at the problem and say, "I want them to do more, better, faster miracles—and not invest in research, not invest in development, and have those miracles delivered to me free." It's unrealistic. And people know that about most things. They do. Nobody expects that just because they've made computers better they're going to give them to you free. ...
...
Last year what did we spend in the United States on soft drinks? $121 billion. Nearly half of what we spend on all of our pharmaceuticals, on soft drinks. I'm not against soft drinks—I think you ought to buy all the soft drinks you want.
Last year what did we spend supporting professional sports? $409 billion.
Now if somebody in this country wants to explain to me that we ought to be spending about twice as much supporting sports as on all of our pharmaceuticals, then stop spending. You don't like that drug? You don't want to cure this disease? Don't buy it. But don't make villains out of people so that we can turn what is a real social responsibility issue into a political debate. ...
...Well, it would kill us if we look at the 30-year actuarial data based on our 19th century confidence in technology. But I'm sure in 1920 if you asked actuaries to say what percentage of our GDP are we going to spend taking care of people with polio, they'd say: "They get polio, it goes to their lungs, they sit in iron lung machines, they could live a whole lifetime with three people watching over them. We can't support them all."
But what did it cost to deal with everybody with polio? Oh, $2 apiece. We gave them the Salk vaccine. But in the 1920s Salk wasn't around yet. ...
THE NATIONALIZATION OF YOUR BODY
Health care is a game-changer. The permanent game-changer. The pendulum will swing, and one day, despite their best efforts, the Republicans will return to power, and, in the right circumstances, the bailouts and cap-&-trade and Government Motors and much of the rest can be reversed. But the government annexation of health care will prove impossible to roll back. It alters the relationship between the citizen and the state and, once that transformation is effected, you can click your ruby slippers all you want but you’ll never get back to Kansas....
...But it will make a lot of other things worse. Government-directed health care is a profound assault on the concept of citizenship. It deforms national politics very quickly, and ensures that henceforth elections are always fought on the left’s terms. I find it hard to believe President Obama and his chums haven’t looked at Canada and Europe and concluded that health care is the fastest way to a permanent left-of-center political culture. He doesn’t say that, of course. He says his objective is to “control costs”. Which is the one thing that won’t happen. Even now, health care costs rise far faster under Medicare than in the private sector. ...
...So elections dwindle down to a sterile argument over how to “improve” the system: The left-of-center party usually pledges to throw money at it. The right-of-center party is less enthusiastic about that, which generally makes it suspect on the issue, so it settles on some formulation to the effect that it can “deliver” better “services” more “efficiently”. In other words, the only viable rationale for the right becomes its claim to be able to run the leftist state more smoothly than the left. Every footling reform with any whiff of the private sector about it has the ranks of the great and the good lining up on TV to drone the indestructible cliché that “the NHS is the envy of the world.” Years ago, in The Daily Telegraph, I wrote that I’d seen a fair bit of the world and had never met anybody who envied the NHS, although presumably there must be a Bhutanese yak farmer up country somewhere who’d be impressed by it. A couple of days later, Mr Sonam Chhoki, a Bhutanese gentleman, wrote to the paper to say that, while not a yak farmer himself, he came from good yak farming stock and, after a bit of grumbling about my outmoded ethnic stereotyping, declared that he certainly didn’t envy the NHS. His British parents-in-law “have had to wait more than two years for operations, after being turned away several times for lack of hospital beds. However basic the Bhutanese health service is, it has not yet come to this sorry state.”...
...In a nanny state, big government becomes a kind of religion: the church as state. Tommy Douglas, the driving force between Canadian health care, tops polls of all-time greatest Canadians. In Britain, after the Tube bombings, Gordon Brown began mulling over the creation of what he called a “British equivalent of the US Fourth of July”, a new national holiday to bolster British identity. The Labour Party think-tank, the Fabian Society, and proposed that the new “British Day” should be July 5th, the day the National Health Service was created. Because the essence of contemporary British identity is waiting two years for a hip operation....
To Lower Costs, Mass. May Restructure Doctor Pay
Massachusetts is proud of its landmark 3-year-old health insurance law. It has brought the state's proportion of uninsured down from around 10 percent in 2005 to only 2.6 percent — the lowest in the nation.
But the achievement is in jeopardy. Massachusetts has the highest health costs in the country.
"The critical point is whether or not we can begin to do something about cost control," says Dolores Mitchell, who heads a state commission that buys coverage for 310,000 government workers and their families. "We've just got to do it."...
...But some worry "global payment" sounds suspiciously like the managed care "capitated" HMO plans of the 1990s. Those plans were also based on paying health care providers a fixed amount per patient....
Geithner Vents at Regulators as Overhaul Stumbles
WASHINGTON -- Treasury Secretary Timothy Geithner blasted top U.S. financial regulators in an expletive-laced critique last Friday as frustration grows over the Obama administration's faltering plan to overhaul U.S. financial regulation, according to people familiar with the meeting.
The proposed regulatory revamp is one of President Barack Obama's top domestic priorities. But since it was unveiled in June, the plan has been criticized by the financial-services industry, as well as by financial regulators wary of encroachment on their turf....
Government Employment Up or Down?
The New York Times editorialized today about the supposed “brutalizing” effects of state and local government spending cuts. They claim that “most states also have cut their public workforces.”
Yet USA Today reporter Dennis Cauchon takes a look at the actual data, and he finds that state and local governments added 12,000 workers in the latest quarter, while the private sector cut 1.3 million jobs.
Thus, it appears that “brutal” restructuring is going on in the private sector, but not in the government sector. ...
Morning Bell: The People Spreading “Disinformation” About Obamacare
...The President has explicitly said that the public option will not eliminate private insurance. He told the American Medical Association on June 15th: “What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system…So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this - they are not telling the truth.” So the President SAYS the public option will not lead to single payer health care … but a number of prominent people are saying the exact opposite:
* Rep. Jan Schakowsky (D-IL) at a Health Care for America Now rally: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single-payer. My single-payer friends, he was right. The man was right.”
* Rep. Barney Frank (D-MA) told Single Payer Action: “I think that if we get a good public option it could lead to single-payer and that is the best way to reach single-payer. Saying you’ll do nothing till you get single-payer is a sure way never to get it. … I think the best way we’re going to get single-payer, the only way, is to have a public option and demonstrate the strength of its power.”
* Washington Post blogger Ezra Klein at the Democratic National Convention last year: “They have a sneaky strategy, the point of which is to put in place something that over time the natural incentives within its own market will move it to single-payer.”
* Noble Prize winning New York Times columnist Paul Krugman: “[T]he only reason not to do [single-payer] is that politically it’s hard to do in one step…You’d have to convince people completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan, that may evolve into single-payer.”...
Obamacare Is Called a Trojan Horse for a Reason
...Schakowsky tells her Health Care for America Now audience: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single-payer. My single-payer friends, he was right. The man was right.”...
...Frank tells a member of Single Payer Action: “I think that if we get a good public option it could lead to single-payer and that is the best way to reach single-payer. Saying you’ll do nothing till you get single-payer is a sure way never to get it. … I think the best way we’re going to get single-payer, the only way, is to have a public option and demonstrate the strength of its power.”...
...Klein tells his netroots audience: “They have a sneaky strategy, the point of which is to put in place something that over time the natural incentives within its own market will move it to single-payer.”...
...Krugman tells his audience: “[T]he only reason not to do [single-payer] is that politically it’s hard to do in one step…You’d have to convince people to completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan, that may evolve into single-payer, but you can do it politically…”...
‘Cash for Clunkers,’ By the Numbers
...He added that the average annual income of those who bought cars with their rebates was $57,700, just under the $61,000 for all new car buyers these days. That suggests that consumers with the lowest incomes who, in theory, need the rebates most, are not benefiting from the program.
One of the problems, Mr. Spinella said, is that even a $4,500 rebate may not be enough to persuade consumers to turn in their cars, particularly if they are unable to borrow from cautious auto dealers.
“Some of the folks who drive a beater all the time are unlikely to get a new car loan,” he said. “That’s one of the problems with the program.”
The WTO Subsidies Rules and “Cash for Clunkers”
The government’s new “cash for clunkers” program has been wildly successful. Under the program, consumers may receive up to $4,500 towards the purchase of a new, more fuel-efficient vehicle. What is surprising is the impact this it is having on consumer spending patterns regarding domestic vs. imported vehicles. According to press reports, more than 70% of the clunkers that were traded-in were domestic. Moreover, as reported here, consumers are showing a preference for imported cars when they purchase under the program, with Toyota (17%) and Honda (14%) leading the way. The top ten sellers under the program are Ford Focus, Honda Civic, Toyota Corolla, Toyota Prius, Ford Escape, Toyota Camry, Dodge Caliber, Hyundai Elantra, Honda Fit, and Chevy Cobalt. In other words, six of the top ten sellers are foreign cars (although the Camry is built at home and abroad).
Cash for Clunkers is one of the few government subsidy programs that I am aware of that clearly has the de facto effect of promoting imported over domestic goods. ...
Cash for Clunkers Falls Flat
Only in Washington could a program that is spending money 13 times faster than was planned be labeled a "success." The "cash-for-clunkers" program ground to a halt last week because in less than a week, a program that was supposed to last until November 1, had spent the entire $1 billion allocated to it. Let's just hope that the government takeover of the rest of the health care industry doesn't result in similar "success."...
...The Obama administration also got the program's costs all wrong. The money was spent so quickly that it lasted less than a week-- just 8 percent of the time that it was supposed to last. If the government gets the health care numbers this wrong, one can only imagine the damage to the deficit....
Sahara Desert Greening Due to Climate Change?
Desertification, drought, and despair—that's what global warming has in store for much of Africa. Or so we hear.
Emerging evidence is painting a very different scenario, one in which rising temperatures could benefit millions of Africans in the driest parts of the continent.
Scientists are now seeing signals that the Sahara desert and surrounding regions are greening due to increasing rainfall.
If sustained, these rains could revitalize drought-ravaged regions, reclaiming them for farming communities.
This desert-shrinking trend is supported by climate models, which predict a return to conditions that turned the Sahara into a lush savanna some 12,000 years ago. ...
New Detainee Site In U.S. Considered
The administration is considering whether to transfer some detainees at the military prison at Guantanamo Bay, Cuba, to a facility in the United States that would contain courtrooms to hold federal criminal trials and military commissions to prosecute terrorism suspects, administration officials said Sunday.
The maximum-security facility would be jointly run by the departments of Defense, Justice and Homeland Security, with each assuming responsibility for different sets of inmates. Officials said such a facility could also house prisoners held in indefinite detention and those cleared for release but who have no country willing to accept them. Those convicted in federal court or military commissions could serve their terms there. ...
...The administration has signaled that some Guantanamo Bay detainees will be tried in federal court and some in military commissions. It also said that there may be a third category of prisoners who are deemed too dangerous to release but who cannot be tried because of a lack of evidence or the need to protect intelligence material. ...
California's Reckoning -- and Ours
...Here's the national lesson. There's a collision between high and rising demands for government services and the capacity of the economy to produce the income and tax revenue to pay for those demands. That's true of California, where poor immigrants and their children have increased pressures for more government services. It's also true of the nation, where an aging population raises Social Security and Medicare spending. California is leading the transformation of politics into a form of collective torture: pay more (higher taxes), get less (lower services).
Make no mistake: The spending cuts and tax increases the state enacted to bridge its budget deficits are not cosmetic. In February, the Legislature agreed to a penny increase in the state sales tax, bringing the total -- including local sales taxes -- to about nine cents or more. Top income tax rates, already among the highest in the country, were raised. So were motor vehicle registration fees. Spending cuts approved in February and July are deep. Together, the cuts equal almost 30 percent of the general revenue fund and will affect schools, prisons, colleges and welfare.
The state's liberal establishment is in mourning. "Reversing 40 years of progress" is how Jean Ross of the California Budget Project, a liberal research and advocacy group, put it in one blog. Some welfare benefits will be cut by half. California's student-teacher ratio, now about a third above the national average, will probably go even higher. The University of California system lost 20 percent of its state payments. It's raising tuition and student fees 9.3 percent, imposing salary reductions of 4 to 10 percent on more than 100,000 workers, and delaying faculty hires.
National parallels again seem apparent. Federal budget deficits -- reflecting the urge to spend and not tax -- predate the recession and, as baby boomers retire, will survive any recovery. Amazingly, the Obama administration would worsen the long-term outlook by expanding federal health insurance coverage. There's much mushy thinking about how we'll muddle through. ...
Why Most Journalists Are Democrats: A View from the Soviet Socialist Trenches
... What I found was so much propaganda about the wonders of Soviet Socialist Mankind and the horrors of Western Democracy that the people exposed to it might as well have had electrodes implanted to control their thoughts. There were no governmental checks and balances and nothing even close to a free press—so positions of power were filled by nasty sorts who kept good people in fear for their lives if they didn’t think the right thoughts. Soviet Socialism, as it turned out, was a perverse system that killed motivation even as it made fear as natural as breathing.
Why wasn’t this widely reported in the Western press?
As it turns out, the preponderance of journalists are Democrats. And socialism, with its idyllic, “progressive” programs, has formed an increasingly important role in Democratic policies. Who wants to investigate a possible dark side of your own party’s plank?
We’ll get to that. First—why are most journalists Democrats?...
...Most journalists take a number of psychology, sociology, political science, and humanities courses during their early years in college. Unfortunately, these courses have long served as ideological training programs—ignoring biological sources of self-serving, corrupt, and criminal behavior for a number of reasons, including lack of scientific training; postmodern, antiscience bias; and well-intentioned, facts-be-damned desire to have their students view the world from an egalitarian perspective. Instead, these disciplines ram home the idea that troubled behavior can be fixed through expensive socialist programs that, coincidentally, provide employment opportunities for graduates of the social sciences. Modern neuroscience is showing how flawed many of these policies have been—structural differences in the brains of psychopaths, for example, help explain why remedial programs simply helped them become better at conning people.
Academics in the social sciences tend to give short shrift to the dramatic failures and corruption within US educational system or unions. (Think here of the Detroit Public School system, or the National Education Association, whose former officers have written: “The NEA has been the single biggest obstacle to education reform in this country. We know because we worked for the NEA.”) Instead, because of their ideological biases, professors often emphasize that corporations are the bad guys, while unions and the government—at least the type of government that supports higher paychecks for social science professors and jobs for their students—are good. This type of teaching makes the Democratic Party and its increasingly socialist ideals seem naturally desirable, and criticism about how those ideals will supposedly be met less likely. (How many social scientists predicted that the billions spent on busing and the Projects would worsen the situations they were meant to solve, as ultimately happened?) It’s no wonder that journalists enter the profession as Democrats, then keep their beliefs intact through all-too-common tendencies to conform. ...
...This also ignores journalism’s own issues with greed and corruption—most despicably with Walter Duranty, who covered the Soviet Union for the New York Times and won the Pulitzer Prize in 1932 for a series of stories that uncritically backed Stalinist propaganda, denied the Ukrainian famine, and defended Stalin's infamous trials. Duranty lived lavishly in Stalin’s good graces. (Meanwhile, the Times has never returned the Pulitzer.) More recently, the New York Times’ fraudulent reporter Jayson Blair received a mid-six figure advance for his memoirs—even the most egregious reporters can make big bucks and become media darlings....
...If you’re a journalist, want to help people and want to tell the truth, what truth are you going to tell? Why, the truth you think helps people, of course! ...
Leave Swiss Banks Alone
...But for us here in Switzerland, our financial privacy laws are a foundation for individual dignity and basic property rights.
Unfortunately, the confidentiality that is the hallmark of Swiss banking is coming under increasing pressure. The global economic crisis has led some governments to intensify efforts to seek tax revenue abroad — and Switzerland, which accounts for nearly 30 percent of all offshore private wealth, is a natural target. ...
...Until recently, the Swiss government had steadfastly insisted on Swiss sovereignty and refused to provide assistance to other governments in cases of tax evasion — that is, cases in which a taxpayer failed to declare income, either intentionally or unintentionally. While tax fraud is considered a crime here, tax evasion is not (though it can be subject to fines).
This Swiss peculiarity of considering tax evasion as a mere administrative offense has a long history. We think government exists to serve us, not the other way around. We understand that we have to pay taxes — and we do, with numerous studies showing that the Swiss are extraordinarily honest about paying what we owe — but we do not think it is the government’s role to intrude on our privacy and wrench them from us.
This attitude goes back to Switzerland’s founding in the 13th century. The original Swiss communities’ resentment of what they saw as the Hapsburgs’ oppressive taxes helped push them to claim their independence in 1291.
Today, Swiss citizens continue to vote on any tax increases in referendums (and sometimes even accept them). These healthy curbs on government contrast with the Orwellian concept of the “transparent citizen” whose every act is known to government. We see our system as a social pact between citizens and the state.
Swiss privacy laws help preserve basic property rights. Bank secrecy was introduced in 1934, most notably to protect the identities and assets of Jews in Nazi Germany. ...
Subscribe to:
Posts (Atom)