2009/07/22

Governor Jindals' health care proposal

The Republican Governor of Louisiana, Bobby Jindal, proposed the following for a national health-care policy:

Insurance reform. Congress should establish simple guidelines to make policies more portable, with more coverage for pre-existing conditions. Reinsurance, high-risk pools, and other mechanisms can reduce the dangers of adverse risk selection and the incentive to avoid covering the sick. Individuals should also be able to keep insurance as they change jobs or states.

Problem: The failure to provide "more coverage for pre-existing conditions" is not, as the computer guys say, a bug, but a feature of private, for-profit health insurance. It's an inherent, built-in tendency that no "guidelines" will ever eliminate from the picture. It is in the financial interests of these companies to not pay claims. Nothing will ever "fix" that as asking them to ignore that fact is to ask private, capitalist companies to disregard their very nature.

Consumer choice guided by transparency. We need a system where individuals choose an integrated plan that adopts the best disease-management practices, as opposed to fragmented care.

If it were in the financial interest of private, for-profit companies to provide such transparency, they've had decades to provide it. If there is no such transparency currently being provided, there's very probably a good (financial) reason why not. It's very highly likely that even if such transparency is mandated, companies will find ways around it, thereby making phone-book size regulations inevitable. BTW, the Blue Dog Democrats are no better on the issue than Republicans are. Again, their reasons are mostly financial.

Aligned consumer interests. Consumers should be financially invested in better health decisions through health-savings accounts, lower premiums and reduced cost sharing.

Lower costs are precisely what's being offered by the Democrats.

A new study from the Commonwealth Fund finds that the public option could save the country $265 billion. The same study found that Grassley's favored approach--allowing insurance companies to maintain their near-monopoly status--would cost the country $32 billion.

In short, Jindal is offering absolutely nothing that even begins to address the problems caused by overreliance on private, for-profit health care insurance. What are his critiques of the Democratic approach?

Second, the Democrats disingenuously argue their reforms will not diminish the quality of our health care even as government involvement in the delivery of that health care increases massively. For all of us who have seen the Federal Emergency Management Agency’s response to hurricanes, this contention is laughable on its face.

Keep in mind that in August 2005 when Hurricane Katrina hit New Orleans, the Presidency, the Senate and the House were all in Republican hands. Louisiana Governor Kathleen Blanco declared a State of Emergency on Friday, 26 August. President Bush was fully and properly informed by the Governor on Saturday, 27 August that Federal assistance was required. The hurricane struck late on the night of Sunday, 28 August.

8PM CDT [Monday 29 Aug]— GOV. BLANCO AGAIN REQUESTS ASSISTANCE FROM BUSH: “Mr. President, we need your help. We need everything you’ve got.” [Newsweek]
LATE PM — BUSH GOES TO BED WITHOUT ACTING ON BLANCO’S REQUESTS [Newsweek]

New Orleans was not submerged because "government" was inherently incapable of action. It was submerged because the government was in the hands of people who didn't believe they were responsible for assisting their fellow citizens in a crisis.

Far better examples for Jindal to use to look at how the government would handle health care would be to look at institutions like the VA Hospitals (I stayed in two VA Hospitals in 2000 and was satisfied with their services) and the Post Office (The number of letters that I didn't receive despite their being properly addressed, I can count on one hand).

Republican Representative Michele Bachmann agrees with Jindal's first point, that

If a so-called public option is part of health-care reform, the Lewin Group study estimates over 100 million Americans may leave private plans for government-run health care.

See above, where I explain that private, for-profit companies will inherently and by definition, always seek to pay out as few claims as they can possibly get away with. A government plan will not have that incentive. Note Bachmann's reasoning as to why a government plan will be less expensive:

...because the taxpayer-subsidized plan will be 30 to 40 percent cheaper.

Not because the government can make it cheaper, as Jindal claims it will unfairly do, but it will just be inherently cheaper as the government pays their senior people far less than executives at private companies make and the government doesn't have to pay for advertising or any other type of competition with other providers.

In short, Jindal makes an extremely unconvincing case for maintaining private, for-profit health insurance. I recommend "single-payer" and believe that "public option" would be a reasonably satisfactory substitute, at least for now.

2009/07/20

MyBO has health care canvassing materials

I just went on to the MyBO site to congratulate our President. He pretty much knew that Republicans were not on his side in the health care debate, but it also looks like he realizes that the Blue Dog Democrats are not on his side either. From a healthcare roundtable at Children’s National Medical Center:
Now, there are some in this town who are content to perpetuate the status quo, are in fact fighting reform on behalf of powerful special interests. There are others who recognize the problem, but believe — or perhaps, hope — that we can put off the hard work of insurance reform for another day, another year, another decade.
Just the other day, one Republican senator said — and I’m quoting him now — “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.” Think about that. This isn’t about me. This isn’t about politics. This is about a health care system that is breaking America’s families, breaking America’s businesses, and breaking America’s economy.
And we can’t afford the politics of delay and defeat when it comes to health care. Not this time. Not now. There are too many lives and livelihoods at stake. There are too many families who will be crushed if insurance premiums continue to rise three times as fast as wages. There are too many businesses that will be forced to shed workers, scale back benefits, or drop coverage unless we get spiraling health care costs under control.
The MyBO site has a walking campaign option and a calling campaign option. As I’ve never really liked calling (I can do it in a group, but have zero desire to do it by myself), I chose the walking option.

2009/07/17

Stimulus funds

Kind of amusing to read Eric Cantor's (House Minority Whip R-VA) criticisms of the stimulus bill.

"….A stimulus bill should have an immediate economic impact and create real, long-term jobs, and this stimulus bill has clearly not created jobs or fixed our economy."

Okay, and what "shovel ready" projects did the Republican Party offer back when the stimulus bill was being debated? They didn't. They offered tax cuts. What do tax cuts do? Well, President Bush gave America $1.3 trillion in tax cuts in 2001 and the recession continued until early 2003.

CNN even feels obliged to do a bit of due diligence and points out that:

"Last week, House Minority Leader John Boehner found himself in the DNC's sights: Democrats released a tough Web video blasting him for saying the stimulus hadn't delivered for his state.
" 'In fact, millions in recovery act funds have been committed to dozens of projects creating jobs for people right here in Ohio,' the narrator said in the DNC video. '…Now John Boehner is using baseless attacks to mislead the public about the success of the Recovery Act.' "

Which leaves Cantor with a score of zero out of two. Later,


"Cantor spokesman Brad Dayspring called the stimulus a 'bad deal' and a 'misguided …pork-barrel bill.' "

Okay, what does a "pork-barrel" bill do? That's right, it calls for spending money. Something that's ordinarily bad, but in times of recession, is a very good thing.

Again, Cantor scores a zero.

2009/07/16

The hearings on Judge Sonia Sotomayor's nomination to the Supreme Court

Something very puzzling about the hearings concerning the Supreme Court nomination of Judge Sonia Sotomayor. Republican questioners and of course, following along like puppy dogs, great chunks of the traditional media, seem to be very deeply interested in a statement that Judge Sotomayor made outside the courtroom eight years ago. Supreme Court nomination hearings normally concern what the nominee has said in their legal decisions, not on their outside speeches. The press corps felt obliged to an absolute rock-bottom bare minimum of due diligence and to state:

White House aides said the comment was being taken out of context, and predicted it wouldn't put the nomination off course.

But they've determinedly avoided going any further. The public has been left in the dark as to what the complete context of her "wise Latina" remark was. For the record:

When Sotomayor asserted, "I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn't lived that life," she was specifically discussing the importance of judicial diversity in determining race and sex discrimination cases.

What she was not doing was making a general, sweeping statement about how a "wise Latina" would make better decisions in all cases.

It's also been noted that WaPo reporter Chris Cillizza has been writing "Winners and Losers" lists for the hearings, but gee, wow, amazingly enough (See "following along like puppy dogs" comment above) all of his "Losers" so far seem to consist entirely of Democrats. It's also been noted that Fox News saw fit to allocate 55 minutes on July 15th covering the remarks of two Republican Senators, but the remarks of six Democratic Senators warranted only 30 minutes of coverage.

Not that the larger political picture has been bad for Democrats. A Latino group decided to make Rush Limbaugh the issue and to pit his statements against those of Republican Congresspeople representing heavily Latino districts in Florida. In a Daily Kos Weekly State of the Nation Poll for July 6th thru the 9th (Daily Kos is what Bill O'Reilly calls a "far left...Web site, a vicious enterprise" so readers should keep that in mind and should apply the proper skepticism) the Latino regard for Republican Congresspeople is 5% favorable to 80% unfavorable, so Republicans can pretty much write off the Latino vote for the next few election cycles at least.

The blogger Christy Hardin Smith of firedoglake.com has been liveblogging the hearings, summarizing and paraphrasing what the participants say as opposed to doing a straight transcript. Her first entry is here. Another firedoglake blogger, Marcy Wheeler or "Emptywheel," tag-teams on the liveblogging and contributed a piece looking specifically at Sotomayor's answers on two important Supreme Court cases, Youngstown (Concerning Presidential powers versus those of Congress) and Korematsu ("Yeah, it's okay to put 100,000 Japanese-Americans behind barbed wire for the duration of World War II").

I'm troubled because rather than framing the question in terms, first and foremost, of Youngstown and a congressional limit on executive power, or of a warrant, she framed in in the same terms Yoo used to "authorize" it--with a very expansive view of what constitutes a "reasonable" search. It makes me worried that Sotyomayor would suggest that wiretapping a group like al-Haramain might be considered reasonable, even in spite of the restrictions that clearly limit doing so in FISA.
That said, when pressed (and Feingold did have to press her) she did ultimately agree that Youngstown would govern such cases.
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Now, Charlie Savage analyzed what I assume to be the same 2003 speech Feingold mentioned and concluded (with some reservations) that Sotomayor's statements--arguing for a particularized suspicion of illegality--auger well for her approach to civil liberties. I still have a somewhat queasy stomach about her immediate invocation of unreasonable search in this context. Others--including Kagro X, who actually has one of those fancy JD things and good judgment to boot, aren't so worried. Hopefully, I'm just being paranoid.
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I was very heartened by Sotomayor's response to Feingold's question about Korematsu and not judging from fear.

So Sotomayor gets a qualified approval on two important cases.

Absolutely marvelous photo of Senators Lindsey Graham and Jon Kyl as Graham questions Sotomayor (Completely irrelevant, but from the same site, Presidents Obama and Bush as they pitched the first ball in July 2009 and April 2009, respectively).


Democrats.Senate.Gov is also providing live feeds and video highlights to the hearings.

2009/07/14

Limbaugh vs Sotomayor

Rush Limbaugh reacts to an ad run by a Latino group

"Now, the Democrats want to make this all about Sotomayor versus me. We have a spot, a new ad run by a liberal Latina organization called 'Presente Action.'
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"So Russ Feingold, a couple of words that Sonia Sotomayor said taken out of context. You mean like Macaca? George Allen saying Macaca? We heard about that for weeks and months as the Washington Post and the Democrats sought to destroy Allen."

Well, yes, liberals did indeed run George Allen's words against him because George Allen "also had confederate flags and hangman's nooses in his office." Allen was deeply and seriously racist and fully deserved to be denied office for that reason. Judge Sonia Sotomayor made her "wise Latina" comment once and if one looks at the whole speech, it's quite clear that she was trying to make a very specific, limited point.

But what I thought was really hilarious was what the ad says about how the Republican Party relates to Limbaugh

"That's Republican leader Rush Limbaugh calling Judge Sotomayor a racist and a bigot. It's insulting to all Latinos and Americans. We asked Republican Congressman Adam Putnam if he would denounce Limbaugh's words. He refused to reply. Let's put a stop to the hate. Call Congressman Putnam today at 863-534-353 and tell him to condemn this language."

This puts a lot of Republicans into a very difficult position. They can either denounce a man that many dittoheads consider to be a hero or they can maintain credibility with the rest of America's citizens.

2009/07/08

Assessment of President Obama

I think with this description of the detention powers that the Obama Administration claims it has, I can definitely say that, as an Obama supporter, I'm definitely of the "Cafeteria Catholic" variety. I think some of the stuff our President has done has been wonderful, specifically his Iran policies, his administration's attitude towards Missile Defense and his economic stimulus policies, but I have absolutely no respect whatsoever for his War on Terrorism policies (Yeah, he's retired that term, but has kept the substance of those policies). Even a right-winger who supports Obama's WOT policies

... policies of indefinite detention and denial of due process...

is uncomfortable with the idea of keeping prisoners locked up even after they're declared innocent of all charges

...there is something Orwellian about this administration's attempt to have it both ways -- to get the credit for putting detainees on trial only to disregard the outcome if they don't like the verdict.

In the same post, the NPR Ombudsman demonstrates that, while discussing the question of the torture of prisoners, she suffers from complete and utter obliviousness. Essentially, the US is "good" and can therefore never perform any act as unequivocally awful as torture. Our enemies and countries we're not interested in defending are all "bad" and so are perfectly capable of committing the terrible, morally indefensible act of torture. Is torture a bad thing? Wel-l-l-l, that depends on who's doing it.

I agree with this assessment that these administration statements on the stimulus are puzzling, especially because they're so completely unnecessary

In other news, in answer to a question about whether the stimulus was adequate, Biden also said that everyone had misread how bad the economy was back in January, which I think is nonsense. Everyone knew that the economy was in very, very deep trouble. It was politics that made the stimulus inadequate, not imperfect knowledge.

I understand why he would say it, but I don't think it rings true considering all the talk about the "worst economy since the Great Depression" at the time. Plus, I think it's a weak play. They knew that even the best stimulus would take time to kick in --- they said so then --- so they should just stick to their guns. "No one could have predicted" excuses are lame in most cases, but especially lame in this one.

Seems to me the stimulus policies are good, but the administration appears to be defending the Blue Dog Democrats who weakened the stimulus by bellyaching about the cost and stripping it of many needed billions of dollars. It's especially a source for grim humor that Republicans are whining and crying about how long the stimulus is taking to work. Remember that virtually no Republicans voted for it, so it's not like they can claim any credit for it if it does work.

Obama's policies on health care? Good grief, don't ask! With his Chief of Staff Rahm Emanuel going all wobbly on whether he supports the "public option" (American citizens prefer Single Payer, but Public Option is a reasonable substitute). So I'm not sure I can put any faith into that team on their major domestic priority.

Update: The Inky ran a piece today (July 10th - Page A7) on the Obama Administration defending how the Presidential administrations briefed/briefs Congresspeople on what the intel agencies are up to. As the blogger emptywheel points out, the current briefings to Congress are a hopelessly broken mess that require deep and serious reforms.

In order to maintain proper separation of powers and to ensure that intel operations are legal and effective, the briefings must be seriously reformed.