Good Afternoon! Happy Martin Luther King Day!!
I’ve been spending the morning getting back up to speed on Health Care Economics which is something I never enjoy but never seem to be unable to avoid. The facts on the ground never change much. What we know about single payer and third party payer systems remains pretty much the same. The only thing that seems to change is the hostility in this country on the subject. I keep having to dredge up the same information over and over with the new twists.
Well, here I go again …
There are three articles that BB sent me this morning that sum up the situation nicely. I’m going to start with those and then finish up by reviewing the mini-case of the failed single payer case in the state of Vermont. I’m not doing this because I don’t think single payer health insurance is a good deal ceteris paribus. It obviously works in other countries. As the Republicans remind us daily, we are not other countries. Theoretically, it provides superior risk sharing and economies of scale on cost. So, my theoretical economist side loves it. My living in America with everything that’s already standing and Republicans who thwart everything at every turn except tax cuts for the wealthy and wars side has a different train of thought.
Yes, it’s time to heal those suffering badly from Berns. I’m going to be in good company because the public wonks are with me on both accounts. We yearn for a simpler, cheaper, more efficient way of paying and getting health care. But, we know the difference between brainstorming and an actionable policy. I’m cursed with a heart longing for idealism but a brain that reins the damn thing in. Bernie Sanders plan really isn’t a plan. It’s a lofty goal.
Here’s Ezra Klein writing for VOX stating ‘Bernie Sanders’s single-payer plan isn’t a plan at all: Sanders’s long-awaited health care plan is, by turns, vague and unrealistic.‘ You should read these links fully if you can manage the time.
Sanders calls his plan Medicare-for-All. But it actually has nothing to do with Medicare. He’s not simply expanding Medicare coverage to the broader population — he makes that clear when he says his plan means “no more copays, no more deductibles”; Medicare includes copays and deductibles. The list of what Sanders’s plan would cover far exceeds what Medicare offers, suggesting, more or less, that pretty much everything will be covered, under all circumstances.
Bernie’s plan will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments. Patients will be able to choose a health care provider without worrying about whether that provider is in-network and will be able to get the care they need without having to read any fine print or trying to figure out how they can afford the out-of-pocket costs.
Sanders goes on to say that his plan means “no more fighting with insurance companies when they fail to pay for charges.”
To be generous, it’s possible that Sanders is just being cynical in his wording, and what he means is that, under his plan, individuals have to fight with the government rather than private insurers when their claims are denied.
But the implication to most people, I think, is that claim denials will be a thing of the past — a statement that belies the fights patients have every day with public insurers like Medicare and Medicaid, to say nothing of the fights that go on in the Canadian, German, or British health-care systems.
What makes that so irresponsible is that it stands in flagrant contradiction to the way single-payer plans actually work — and the way Sanders’s plan will have to work if its numbers are going to add up.
Behind Sanders’s calculations, both for how much his plan will cost and how much Americans will benefit, lurk extremely optimistic promises about how much money single-payer will save. And those promises can only come true if the government starts saying no quite a lot — in ways that will make people very, very angry.
“They assumed $10 trillion in health-care savings over ten years,” says Larry Levitt, vice president at the Kaiser Family Foundation. “That’s tremendously aggressive cost containment, even after you take the administrative savings into account.”
The real way single-payer systems save money isn’t through cutting administrative costs. It’s through cutting reimbursements to doctors, hospitals, drug companies, and device companies. And Sanders’s gestures towards this truth in his plan, saying that “the government will finally have the ability to stand up to drug companies and negotiate fair prices for the American people collectively.”
But to get those savings, the government needs to be willing to say no when doctors, hospitals, drug companies, and device companies refuse to meet their prices, and that means the government needs to be willing to say no to people who want those treatments. If the government can’t do that — if Sanders is going to stick to the spirit of “no more fighting with insurance companies when they fail to pay for charges” — then it won’t be able to control costs.
Put it this way: for all the talk about being honest and upfront, even Sanders ended up delivering mostly smoke and mirrors — or as Ezra Klein says, puppies and rainbows. Despite imposing large middle-class taxes, his “gesture toward a future plan”, as Ezra puts it, relies on the assumption of huge cost savings. If you like, it involves a huge magic asterisk.
Now, it’s true that single-payer systems in other advanced countries are much cheaper than our health care system. And some of that could be replicated via lower administrative costs and the generally lower prices Medicare pays. But to get costs down to, say, Canadian levels, we’d need to do what they do: say no to patients, telling them that they can’t always have the treatment they want.
Saying no has two cost-saving effects: it saves money directly, and it also greatly enhances the government’s bargaining power, because it can say, for example, to drug producers that if they charge too much they won’t be in the formulary.
But it’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.
And Sanders isn’t coming clean on that — he’s promising Medicaid-like costs while also promising no rationing. The reason, of course, is that being realistic either about the costs or about what the system would really be like would make it a political loser. But that’s the point: single-payer just isn’t a political possibility starting from here. It’s just a distraction from the real issues.
The deal is this. We have entire systems, institutions, and agents that have been functioning under multiple plans for quite some time. This includes Medicaid, Medicare, SCHIP, the VA, and a myriad of private health insurance plans. You just don’t wave a magic wand and expect that all to unwind costlessly and seamlessly. You also don’t expect all those folks to be thrilled about it either or to seamlessly transfer their efforts and resources to a new system. It takes big money and time to do that. We’re not operating from scratch here.
That also doesn’t take into account politics. Yes. POLITICS. Remember when we first got the ACA and how the majority of Dems and Republicans voted for a single payer plan when the Dems controlled Congress? Remember how the ACA should work if SCOTUS hadn’t let so many states opt out of the system? Yes, Virginia, there is no Santa Claus.
Dear Bernie Sanders-supporting Friends: Sanders is nice enough. He’s got some good ideas. But, no, I do not think he’s got what it takes to be President. He operates out there in gadfly paradise. Or, as Michel Cohen writes it: ‘Bernie Sanders doesn’t get how politics works’.
Now for my deeper impression of the debate: even with his rising poll numbers in Iowa and New Hampshire, I find it increasingly difficult to take Sanders seriously as a presidential candidate.
Maybe it’s the fact that he’s 74, would be the oldest man to ever become president, and yet couldn’t be bothered to release his medical records until a Clinton surrogate attacked him for it.
Maybe it’s that Sanders finds a way to answer virtually every question by turning it back to another predictable and one-dimensional attack on Wall Street and big money.
Maybe it’s that he gets away with proposing unrealistic policy ideas that have little chance of being passed even by Democrats in Congress, let alone Republicans, and then gets praised for being authentic. Sunday night Sanders finally released his single-payer health care plan, which is all of eight pages and provides little detail on how he’ll implement a complete restructuring of the US health care system. That’s at least an improvement over his plan for breaking up the banks, which is four pages and just as short on detail.
Maybe it’s that every time he answers a question on foreign policy and national security, it’s blindingly apparent that not only does he not understand foreign policy and national security, he simply doesn’t care to know more. I mean, only Bernie Sanders could answer a question about instability Middle East by pivoting to an attack on wealthy nations like Saudi Arabia, which he repeatedly says has to play a greater role in the civil war in Syria, as if no one on his staff could bother to tell him that Saudi Arabia is already playing an important role in the civil war in Syria.
It’s all that and something else — Sanders really does have a singularly naive and simple-minded understanding of American politics. He genuinely seems to believe — and I know this because he repeatedly yelled it at me during the debate — that money is the root of all evil in politics and that if you get the big money out, great things will happen. Sanders said that “a handful of billionaires . . . control economic and political life of this country.” He argued that Republicans and Democrats don’t “hate each other.” He called that a “mythology.” Instead, he said, the “real issue is that Congress is owned by big money and refuses to do what the American people want them to do.”
I’m sorry, but that is a maddeningly simplistic — and wrong — explanation of how American politics works.
Take single-payer health care, which Sanders claims has been difficult to enact because of a corrupt campaign finance system that allows the “pharmaceutical industry” and private insurance companies to spend millions in “campaign contributions and lobbying.”
On the one hand, Sanders is right — those are powerful interests. But so are doctors and hospitals, who’d pay a huge price if single payer became law; so are Republicans, who fought tooth and nail to defeat Obamacare and would do the same for a single-payer plan; so are Democrats, who couldn’t even support a public option for Obamacare and are unlikely to support single payer; so are Americans, who may not be inclined to support another restructuring of the health care system — a few years after the last one. It’s not just about money; it’s also about a political system constructed and reinforced to block the kind of massive reform Sanders is advocating. Money is important, but it’s not even close to the whole story.
How someone who’s been in Washington as long as Sanders can believe that all that stands between doing “what the American people want [Congress] to do” is something as simple as reforming campaign finance is stunning. Sanders, who brags the NRA gives him a D- rating, is the same politician who supported legislation giving gun manufacturers immunity from civil lawsuits and voted against the Brady Bill. Why? Perhaps it is because Sanders comes from a state that has few gun control laws and lots of gun owners. Yes red-state senators who oppose gun control receive contributions from the NRA. They also have constituents who oppose gun control measures and vote on the issue — like Bernie Sanders. It’s as if in Sanders’ mind, parochialism, ideology, or politics plays no role . . . in politics.
So, yes, we have the ACA (Obamacare) which is a “kludge” to borrow a turn of phrase from Krugman. If we could start from scratch then single payer health insurance would be infinitely cheaper and better. But, that’s not the way it is.
Krugman admits that Obamacare is far from perfect, an awkward, imperfect solution that does not work for everyone. But he thinks it would be a mistake for Democrats to expend political capital refighting the battle that gave them their biggest victory in decades. Here’s how he lays out his case:
If we could start from scratch, many, perhaps most, health economists would recommend single-payer, a Medicare-type program covering everyone. But single-payer wasn’t a politically feasible goal in America, for three big reasons that aren’t going away.
First, like it or not, incumbent players have a lot of power. Private insurers played a major part in killing health reform in the early 1990s, so this time around reformers went for a system that preserved their role and gave them plenty of new business.
Second, single-payer would require a lot of additional tax revenue — and we would be talking about taxes on the middle class, not just the wealthy. It’s true that higher taxes would be offset by a sharp reduction or even elimination of private insurance premiums, but it would be difficult to make that case to the broad public, especially given the chorus of misinformation you know would dominate the airwaves.
Finally, and I suspect most important, switching to single-payer would impose a lot of disruption on tens of millions of families who currently have good coverage through their employers. You might say that they would end up just as well off, and it might well be true for most people — although not those with especially good policies. But getting voters to believe that would be a very steep climb.
Bottom line for Krugman is that single-payer ain’t gonna happen. Like it or not, the fact that Obamacare did not disrupt the millions of Americans who get health insurance through their employers gives it a leg up. Then there is the fact that taxes would have to be raised on the middle class to pay for it, as even Sanders acknowledges. And even though the middle class would not doubt save even more on their health insurance premiums, Krugman comes down on the side that higher taxes on them would not fly politically.
I’d like to add something to all of this. It’s frequently nice to have test cases for policy change. Massachusetts was the test case for ChaffeeCare/DoleCare/RomneyCare/ObamaCare. It wasn’t perfect but it worked.
According to a new analysis, health care reform in Massachusetts, popularly known as “Romneycare,” didn’t cause hospital use or costs to increase, even as it drove down the number of people without health insurance.
Implemented by the state in 2006, and signed by then-Gov. Mitt Romney, the reform is looked at as a model for the Affordable Care Act, also known as “Obamacare,” the sweeping and controversial health care law that Republican lawmakers in the House tried to repeal for the 37th time Thursday.
Amresh Hanchate, an economist with the Veterans Affairs Boston Healthcare System and lead author of the study, which he presented Thursday at an American Heart Association conference, says that the results of the study were surprising.
When it was implemented, about 8.4 percent of Massachusetts citizens were uninsured; by 2010, just 3 percent were uninsured. Uninsured rates fell most among minorities: In 2006, 15 percent of African-Americans were uninsured, in 2010, that rate was at 3.4 percent. Uninsured rates for Hispanics in the state fell from 20 percent to 9.2 percent during the same period.
Similarly encouraging news is found on the ACA even though it was seriously hampered by the SCOTUS ruling that allowed many states to opt out of the medicaid expansion and hosting local exchanges. We have one state that tried to have single payer. It failed. The state was Vermont. Sanders was asked about it during the debate. He dodged the question by referring it to the state’s governor. Well, there’s a lot of information out there on it. I’ll start with NEJM.
On December 17, 2014, Vermont Governor Peter Shumlin publicly ended his administration’s 4-year initiative to develop, enact, and implement a single-payer health care system in his state. The effort would have established a government-financed system, called Green Mountain Care, to provide universal coverage, replacing most private health insurance in Vermont. For Americans who prefer more ambitious health care reform than that offered by the Affordable Care Act (ACA), Shumlin’s announcement was a major disappointment. Was his decision based on economic or political considerations? Will it damage the viability of a single-payer approach in other states or at the federal level?
Shumlin’s exploration of a single-payer health care system, which included three assessments by different expert groups, was among the most exhaustive ever conducted in the United States. A 2011 study led by Harvard health economist William Hsiao provided optimistic projections: immediate systemwide savings of 8 to 12% and an additional 12 to 14% over time, or more than $2 billion over 10 years, and requirements for new payroll taxes of 9.4% for employers and new income taxes of 3.1% for individuals to replace health insurance premiums (see table) Financial Estimates from Three Projections for a Vermont Single-Payer Health Plan.).
Two years later, a study by the University of Massachusetts Medical School and Wakely Consulting projected savings of just 1.5% over 3 years.2 Finally, a 2014 study by Shumlin’s staff and consultants predicted 1.6% savings over 5 years and foresaw required new taxes of 11.5% for employers and up to 9.5% for individuals. The governor cited these last projections in withdrawing his plan: “I have learned that the limitations of state-based financing, the limitations of federal law, the limitations of our tax capacity, and the sensitivity of our economy make that unwise and untenable at this time . . . . The risk of economic shock is too high,” Shumlin concluded.
Two factors explain most of the decline in the plan’s financial prospects. First, the anticipated federal revenues from Medicaid and the ACA declined dramatically. Second, Shumlin’s policy choices significantly increased the total projected cost of Green Mountain Care: raising the actuarial value of coverage — the expected portion of medical costs covered by a plan rather than by out-of-pocket spending — from 87% to 94%, providing coverage to nonresidents working in Vermont, and eliminating current state taxes on medical providers. Still, even Shumlin’s projections indicated that the plan would reduce Vermont’s overall health spending and lower costs for the 90% of Vermont families with household incomes under $150,000. Despite differing projections, all three studies showed that single payer was economically feasible.
In reality, the Vermont plan was abandoned because of legitimate political considerations. Shumlin was first elected governor in 2010 promising a single-payer system. But in the 2014 election, his Republican opponent campaigned against single payer. Shumlin won the popular vote by a single-percentage-point margin, 46% to 45%, which sent the election to the Democratic-controlled House of Representatives; though the House reelected him easily in January, a clear public mandate for his health care agenda was nowhere in evidence.
Here’s some slightly less academic explanations. This one comes from the Boston Globe.
Vermont took Obamacare a step further. In 2011, Shumlin proudly signed a bill to establish a publicly financed, single-payer system. The law required Shumlin to submit a detailed financial plan by 2013.
Shumlin missed the deadline, raising fears among supporters and critics alike that single-payer health care would cost much more than anticipated. Those fears were realized on Dec. 17, when Shumlin, two years late and just a month from narrowly winning reelection, released the financial analysis.
The numbers were stunning. To implement single-payer, the analysis showed, it would cost $4.3 billion in 2017, with Vermont taxpayers picking up $2.6 billion and the federal government covering the rest. To put the figures into perspective, Vermont’s entire fiscal 2015 budget, including both state and federal funds, is about $4.9 billion.
Shumlin’s office estimated the state would need to impose new personal income taxes of up to 9.5 percent, on top of current rates that range from 3.55 to 8.95 percent. Businesses would be hit with an 11.5 percent payroll tax, on top of 7.65 percent payroll taxes employer pay for Social Security and Medicare.
And even those tax increases might not have been enough. The governor’s office estimated the Green Mountain Care program would run deficits of $82 million by 2020 and $146 million in 2021. Shumlin said he feared the tax increases would harm businesses and the economy.
Okay, this is VERMONT, folks. Now, try doing that in Louisiana and Kansas or try getting their elected officials in the District to buy off on it.
So, a lot of children just really like believing in Santa Claus and it doesn’t take much to get them to continue their buy-in. Then there was Doctor Daughter who figured out it was her Dad and me at an extremely tender age after careful empirical study then asked me if that was the case. Of course, I said yes rather than try to lead her on like my parents did me for the sake of my sister. I just told her to go along if other kids believed and their parents hadn’t told them the truth yet. She did so like a little Nixonian co-conspirator.
I will not lie to you. Ceteris paribus. I prefer Single Payer Health Insurance. Ceteris paribus. Bernie Sanders has some really nice ideas.
I have never been one of those theoretical researchers. All of my stuff is empirical. I live in the land of empirical evidence. Yes, folks socialized medicine works just fine in the UK and is fairly cheap and folks get turned away for stuff that would probably piss the average American off. Yes, single payer health or a government option works great in Switzerland and other places. But, this is a country where it appears that our options will be Hillary Clinton or Donald Trump.
Spare me the Santa Claus mythos or the Senator Gadfly mythos.
Sorry this is so long, but as you can see, I had a lot to say and prove. I vote we try to improve on the ACA and for Hillary. Just sayin’.
Mea culpas go to any one whose work I over quoted. I love fair use but I also loved what you wrote. I quoted and cited you. Just sayin’.
What’s on your reading and blogging list today?
Massachusetts Governor Deval Patrick appeared on Meet the Press this morning. I haven’t seen the whole program; but from what I’ve read about it along with what Patrick has said about Mitt Romney in other interviews, I think he’s getting it just right. Here’s what he said on MTP, according to The Boston Globe:
Patrick, a co-chairman of Obama’s reelection campaign, said the presumptive Republican presidential nominee had a poor record of job growth as governor, repeating the familiar statistic that Massachusetts ranked 47th in the nation in that category when Romney was in office.
But, Patrick said, that “doesn’t mean he was a failure as governor.”
Really? What specifically did Romney do well as governor? Why he signed the nation’s first universal health care law and pushed for the individual mandate that citizens must purchase health insurance. Patrick knows full well that Romney doesn’t want to be praised for that accomplishment. Every Obama surrogate should hammering health care achievement home, again and again. Back to the Globe article:
Host David Gregory asked the governor to respond to former President Bill Clinton’s statement Thursday that “there’s no question that in terms of getting up and going to the office and basically performing the essential functions of the office, the man who has been governor and had a sterling business career crosses the qualification threshold.”
Gregory suggested Clinton’s remarks undercut one of Obama’s major arguments.
“It undercuts the spin on the argument that the president has made,” Patrick replied. “The president has never attacked Bain. It’s not about Bain. It’s never been. Bain’s a fine company.”
Really? What’s it about then?
“He had a terrific career creating wealth,” Patrick said. “There is very little evidence that, either in the public or the private sector, he’s had a terrific career creating jobs.”
The corporate media is comparing Patrick’s approach to what Cory Booker said previously on MTP. But I think they’re wrong. More Obama surrogates should follow Patrick’s lead. Sure, Bain is a terrific company and Romney deserves credit for his role in building the business. But at Bain and as governor, Romney didn’t create jobs. But, hey…he led the way to socialized medicine in Massicusetts! Isn’t that great?
Here’s an opinion piece that Patrick wrote for CNN a couple of days ago. In it he spells out a very clear argument against Romney as POTUS. Of course he leads with Romney’s failure to create jobs in the state. Everyone knows by now that Massachusetts ranked 47th among the states in job creation.
and that was in relatively good economic times. Real wages declined (while rising across the nation). Instead of helping workers and small businesses adjust to changes in the global economy, Romney cut critical work force training programs and millions in economic development funds. Instead of promoting Massachusetts to attract jobs, he used the state as a punchline on the national Republican political circuit.
When Patrick took office he had to clean up Romney’s messes.
He left behind a bureaucracy whose work force grew during his term, an unsustainable public pension system and a culture of poor accountability throughout state government.
Young people and jobs were leaving our state. Our roads and bridges were crumbling, and his Republican predecessors’ poor oversight of the infamous Big Dig project in downtown Boston resulted in billions of dollars of cost overruns, substandard workmanship and debilitating debt that he made no effort to remedy.
In the face of budget challenges, what did Romney do? He raised nearly every fee and surcharge that didn’t bear the title “tax” and cut funding for the schools. In a state where education is our calling card, Romney was responsible for the second largest per pupil cut in education funding in America during his second year in office.
Sure Romney’s a nice guy, Patrick says, and he was very successful in business. But in his only time in office Romney failed to create jobs or stimulate the economy. Why did this happen?
Romney sincerely believes that people are better off on their own: on their own to deal with their unemployment; with under-resourced public schools and no way to pay for college; with neglected infrastructure; with a job market that needs skills they didn’t have. He does not fundamentally believe that government should help people help themselves. And he has a record as governor of Massachusetts to demonstrate how much damage his leadership does to people, their families and our future.
Finally, here’s a recent interview that Patrick did with John King in which he makes similar arguments.
I think the Obama campaign should have their other surrogates emulate Deval Patrick’s approach–call it hitting Romney with a velvet glove that has a steel lining. You don’t have to yell and scream to get your message across. Patrick is calm, cool, and collected. He’s not “nauseated” by attacks on Bain or private equity, like Corey Booker. He doesn’t call Romney’s career at Bain “sterling,” like Bill Clinton did. He explains why Romney’s career at Bain is irrelevant to job creation, while his time as Governor is. And he strongly praises the one achievement Romney doesn’t want to talk about: health care reform.
I don’t know if this can all be boiled down to a 30-second sound byte, but Deval Patrick is coming pretty close with this:
“He had a terrific career creating wealth,” Patrick said. “There is very little evidence that, either in the public or the private sector, he’s had a terrific career creating jobs.”
The Obama campaign should keep Patrick front and center, hammering home the message that Romney knows nothing about job creation–and in fact really doesn’t care about it–but he sure deserves all the credit in the world for leading his state to universal health care.
What is it about Elizabeth Warren that makes Republicans foam at the mouth and turn apoplectic? Surely her tenure as a presidential adviser and creator of the Consumer Financial Protection Bureau brought her into direct fire and criticism for anyone singing the corporate/banker tune. Though the Bureau was presumably a joint venture with Treasury, it soon became apparent that Timothy Geithner was a less than enthusiastic partner in Warren’s brainchild, an agency to protect consumer interests from confusing, often unfair financial contracts.
To many in the public, Elizabeth Warren was and has been a vocal advocate of the 99% before the 99ers were a twinkle in anyone’s eye. She had famously said she would fight for the Bureau’s legitimacy and was willing to leave “blood and teeth on the floor” to make that happen. That attitude and her frank support for middle-class, every-day concerns made her wildly popular in the public arena.
Well, that was then and this is now. Warren would not receive a permanent position to head the Bureau she created and breathed into life. That would have entailed a fight from this Administration, something for which President Obama has shown little talent or willingness.
Instead, as we all know Elizabeth Warren is running for the US Senate in Massachusetts, the seat held by Ted Kennedy for nearly 47 years, now occupied by Scott Brown, who was swept into office primarily over Obama’s botched healthcare plan.
I suspect that the GOP’s real problem with Ms. Warren is she did not go quietly into that good night, otherwise known as: back off and shut up. Not only is she running for the Senate but she’s giving talking tours, explaining the current financial crisis and serving up some very inconvenient truths about what Bush’s eight-year stint of failed economic policy actually did to the country. Remember? Cut taxes; run two, hideously expensive, unfunded wars; and create a Medicare drug program out of thin air and magic money.
Ms. Warren’s unforgiveable sin is simply this:. Tell the truth. Not only that, but then suggest the rich have an obligation to pay their fair share, to give back to the society that made their success possible. Known as pay it forward. And if you’re going to go to Hell, why not go out in true glory? Warren went on to suggest that no one who has become rich did it all on their own. Her statements went viral.
Republican and Libertarian heads exploded in short order. Blasphemy must be punished, they screamed. Bring the woman to heel.
The new Republican assault is as predictable as it is laughable. Elizabeth Warren is now charged with a ‘collectivist agenda.’ She is an enemy of free enterprise, a threat to capitalism [which needs redefining because as I recall Banana Republic economies are hardly free, nor dedicated to capitalism]. And so we come to the rather pathetic campaign ad that declares Ms. Warren is calling for violence, the overthrow of the State itself.
She is the Woman Who Would Throw Rocks.
Personally? I hope her aim is deadly.
I found this article at the CSM that highlights that we actually had a Do-a-Lot congress this year and it has a nifty self test on political knowledge in 2010 you may want to take. They highlighted six big laws that were passed this year. All of them were definitely steps in the correct direction even though they had flaws that will have to be worked out. I’m not sure I’d consider all of them great successes but when you look back on the list, you’re sure to find something naughty and nice.
Here’s there intro to the list.
The post-election lame-duck session – typically a mopping-up operation to get out of town – also made history, passing key pieces of legislation, often with greater input from Republicans than had earlier been the case. People can argue the merits of what Congress did, but it’s hard to quibble with the scope of the undertaking. Here are six of this Congress’s major accomplishments, in the order in which they were approved.
Here are their list of “six big achievements”.
1. American Recovery & Reinvestment Act
The $819 billion economic stimulus package, signed into law February 2009 less than a month after Barack Obama became president, is the largest stand-alone spending bill in US history. It included tax cuts, as well as new spending for public works, education, clean energy, technology, and health care.
2. Patient Protection and Affordable Care Act
Congress battled for a year to pass health-care reform, which was finally a done deal March 23, 2010. The law mandates that all Americans obtain health insurance coverage, and it sets up entities called health exchanges to provide people with affordable options.
3. Financial regulatory reform
Known officially as the Dodd-Frank Wall Street Reform and Consumer Protection Act, the new law is the most significant regulatory overhaul of the financial system since the Depression ended in the 1930s. Signed into law in July 2010, it aims to end bailouts forced on taxpayers by financial institutions deemed “too big to fail” and to protect consumers. Included in the legislation is a powerful, independent consumer-protection bureau, an early-warning system for financial groups deemed too big to fail, new oversight of credit agencies, and lower fees on debit-card charges. It also directs much of the $600 trillion over-the-counter derivatives trade through clearinghouses and exchanges.
4. Big tax-cut extension, plus new stimulus
Congress averted the largest tax increase in American history by voting in December to extend the Bush-era tax cuts for two years, including for the highest-income households.
5. Repeal of ‘don’t ask, don’t tell’
Fulfilling campaign pledges of the last two Democratic presidents, Obama on Dec. 22 signed a law that repeals a 17-year ban on gay men and women serving openly in the US armed services.
6. New nuclear arms pact with Russia
The new Strategic Arms Reduction Treaty (START) with Russia reduces the US and Russian arsenals of deployed strategic nuclear warheads to 1,550 apiece within seven years. The Senate ratified the treaty Dec. 22 by a vote of 71 to 26.
Okay, I’ll put it to you!
Naughty or Nice list?
See, even JuJu the Christmas Cat wants in on the project!!! (I guess my youngest daughter still hasn’t gotten through the doll phase yet.)
That’s a quote from the incoming Speaker of the House, John Boehner. From The New York Times:
In a speech to the Right to Life Committee in June, Mr. Boehner explained the roots of his beliefs.
“I grew up in a small house in Cincinnati with a big family, 11 brothers and sisters,” Mr. Boehner said. “My parents sent all 12 of us to Catholic schools.” At those schools, he said, “we learned about deeper values, and respect for life was at the top of that list.”
Except as far as I can tell, the only form of life that Boeher holds sacred is fetuses. He seemingly has no objection to lives being lost during pointless wars, he voted against stem cell research which would help people with deadly diseases, and I would be very surprised if he doesn’t support capital punishment. Boehner apparently doesn’t value women’s lives very much, since he voted against equal pay for women.
Because of his deep “respect for life,” Boehner strongly supports the goals of the new chairman of the Energy and Commerce Subcommittee on Health, Rep. Joe Pitts (R-PA), whose committee “has jurisdiction over private health insurance, Medicaid and much of Medicare, as well as the Food and Drug Administration and the National Institutes of Health,”
Pitts primary goal is to repeal Obama’s health care reform law.
Short of that goal, Mr. Pitts said he was determined to ban federal subsidy payments to any health insurance plans that include coverage of abortion — a benefit now offered by many private health plans.
Under the new law, the federal government is expected to spend more than $450 billion in subsidies to help low- and middle-income people buy insurance from 2014 to 2019.
When Congress was writing the law, Representative Bart Stupak, Democrat of Michigan, led efforts to restrict the use of federal money for insurance plans covering abortion. Mr. Pitts, though less well known, was the chief Republican co-author of the “Stupak amendment.”
From his powerful new perch, Mr. Pitts said he would try again to impose those restrictions.
“The new health care law is riddled with loopholes that allow taxpayer subsidies for coverage that includes abortion,” Mr. Pitts said.
In its current form, the Obama health care law allows health plans to cover abortions, but no federal money can be used to pay for them. To make sure not a single cent of taxpayer money gets used in that way, patients must write two separate checks–one for health coverage and one completely out-of-pocket for abortion coverage. Furthermore, insurance companies have to keep the money in separate back accounts! In addition President Obama, the great progressive, issued an executive order to make it absolutely clear that no federal funds can be used to pay for abortions.
But none of that was good enough for Joe Pitts. He wants to make sure that no plan that makes abortion coverage available can receive subsidies under the new law. In effect this would ban abortion, since the few doctors who still perform the procedure aren’t likely to keep doing so if they aren’t covered by insurance. Frankly, I think the current rules will probably lead to this result, but Joe Pitts and John Boehner want to make absolutely sure. Because they care so very deeply about human life.
God, I’m so sick of Republicans. If only we could have gotten a Democrat into the White House in 2008, maybe Democrats would still control Congress.
Good Morning!! The long holiday weekend is officially over. Of course the big story is still the latest Wikileaks release.
This McClatchy story at the Miami Herald points out that despite hysterical warnings from U.S. officials there is “no evidence that WikiLeaks releases have hurt anyone”
American officials in recent days have warned repeatedly that the release of documents by WikiLeaks could put people’s lives in danger.
But despite similar warnings before the previous two releases of classified U.S. intelligence reports by the website, U.S. officials concede that they have no evidence to date that the documents led to anyone’s death.
Before Sunday’s release, news organizations given access to the documents and WikiLeaks took the greatest care to date to ensure no one would be put in danger. In statements accompanying stories about the documents, several newspapers said they voluntarily withheld information and that they cooperated with the State Department and the Obama administration to ensure nothing released could endanger lives or national security.
The newspapers “established lists in common of people to protect, notably in countries ruled by dictators, controlled by criminals or at war,” according to an account by Le Monde, a French newspaper that was among the five news organizations that were given access to the documents. “All the identities of people the journalists believed would be threatened were redacted,” the newspaper said in what would be an unusual act of self censorship by journalists toward government documents.
I see no reason to believe this release will be any different. Yes, there will be embarrassment for various world leaders–so what? We have a right to know what our government is doing. I say more power to whistleblowers the world over.
The New York Times posted an exchange of letters between Julian Assange and the U.S. government. The letter show that Wikileaks was very open to withholding information if it would really cause harm to anyone.
In other news, Claire McCaskill is attempting to distance herself from Obama, now that he’s no longer seen as the messiah. Will wonders never cease? You’d think McCaskill would go down with the ship, but I guess she’d rather hang onto her job in the Senate than continue her worshipful attitude toward the President.
Appearing on “Fox News Sunday,” McCaskill said that she’d voted against the president on cap-and-trade, the second round of cash-for-clunkers, comprehensive immigration reform and every omnibus bill.
McCaskill said she’d also sometimes disagreed with Obama when he was a senator.
“My record of independence, frankly, stretches back for a long period of time,” she said.
When asked to name an issue where Obama had fallen short, the senator said his move into healthcare legislation at a time when he should have been focusing on job creation was “very difficult,” and therefore economic issues “didn’t get the attention they needed.”
The Obots continue to drop like flies. It would be nice if Nancy Pelosi would get the message and start standing up for Democratic principles for a change.
I’m not sure what to think about this next story. The DHS and ICE have summarily shut down more than 70 websites. Supposedly these sites were involved in counterfeiting products or encouraging theft of intellectual property, but what is the recourse for a site that is wrongly shut down?
From the Wall Street Journal: Website Closures Escalate U.S. War on Piracy
A federal crackdown that shut more than 70 websites last week is the latest sign of an escalating war against counterfeit and pirated products, using legal tactics that may be closely scrutinized by civil-liberties groups.
Domain names of the affected sites—which offered such diverse goods as scarves, golf gear and rap music—were seized by U.S. Immigration and Customs Enforcement, part of the Department of Homeland Security, under court-approved warrants.
This is controversial because civil actions are generally used in piracy cases.
ICE’s latest crackdown is based on procedures used in criminal cases, including seizing domains and assets of suspect websites without prior notification of their owners, lawyers tracking the case said.
“It’s time to stop playing games,” said Chris Castle, a Los Angeles attorney who has represented copyright holders as well as technology companies involved in digital music.
Here a two different reactions to the government shutting down websites.
From Stephen J. Vaughn-Nichols at ZDnet: The Rise of Web Censorship
Back in 1964, U.S. Supreme Court Justice Potter Stewart of famously wrote on what was, and wasn’t “hard-core pornography” that, “I know it when I see it.” Today, free speech on the Web is impeded by far more restrictions than just what is, or isn’t, pornographic. On the Web in 2010, even the appearance of enabling file-sharing of copyright materials seems to be enough for the Department of Homeland Security’s Immigration and Customs Enforcement (ICE) to shut down Web-sites without notice.
But here’s the problem, according to Vaughn-Nichols:
I have no use for sites that traffic in counterfeit goods such as fake autographed sports jerseys or designer purses. I do, on the other hand, worry when a site like Torrent-Finder is shut down.
You see, Torrent-Finder, which is back up under a new domain name, Torrent-Finder.info doesn’t host Torrent file or even BitTorrent file trackers. It’s just a search engine dedicated to file torrents such as movies, TV shows, or software programs. You can find the same file torrents with Google if you know what you’re doing. Torrent-Finder, and sites like it, just makes specific kinds of file searches easier.
I think its fine for the government to try to block the sales of fake LeBron James Miami Heat jerseys and the like. It’s when we start moving into the murkier land of intellectual property and the “right” to block searches, that I start getting worried.
From Elliot’s blog, which is devoted to “domain name investing news and tips”: Why I Am Not Worried About Domain Name Seizures
I will preface this by saying that I don’t like the idea of the government acting as judge and juror, while not seeming to give the website and/or domain name owners the opportunity to defend their actions. It’s scary that the government can simply take over some websites at it’s whim without the owner’s chance to defend his or her actions.
However, if the companies that own the websites are or were doing something illegal while violating the rights of people in the US (whom ICE is responsible to protect), this seizure is not such a huge deal as some might make it out to be….
Eventually, these website operates should have their day in court, but taking away their platform is a way to temporarily stop them from doing what the government believes is an illegal act (although it seems pretty simple to move to another domain name). I don’t know where to draw the line when it comes to seizures such as this, but if a company happens to be brazenly flouting the law, I am not opposed to government intervention. If these website operators are in the right, then they will certainly have their day in court.
I don’t know, this whole thing makes me uneasy, especially with the TSA being permitted to violate the 4th amendment rights of airline passengers. To me this feels like an attempt to begin censoring the internet.
Here’s an interesting story on possible effects on the health care law if Congress makes serious attempts to cut the deficit: Deficit battle threatens job-based health care
Budget proposals from leaders in both parties have urged shrinking or eliminating tax breaks that help make employer health insurance the leading source of coverage in the nation and a middle-class mainstay.
The idea isn’t to just raise revenue, economists say, but finally to turn Americans into frugal health care consumers by having them face the full costs of their medical decisions.
Such a re-engineering was rejected by Democrats only a few months ago, at the height of the health care overhaul debate. But Washington has changed, with Republicans back in power and widespread fears that the burden of government debt may drag down the economy.
Death panels, anyone?
The South Carolina Republican, a proponent of the law banning openly gay service in the armed forces, said definitively that there was no support for repeal on the Republican side of the aisle. He called for an additional study to determine whether the military itself favored overturning the 17-year-old legislation.
“This is a political promise made by Senator Obama when he was running for president,” said Graham, during an appearance on Fox News Sunday. “There is no groundswell of opposition to Don’t Ask, Don’t Tell coming from our military. This is all politics. I don’t believe there is anywhere near the votes to repeal Don’t Ask, Don’t Tell. On the Republican side, I think we will be united in the lame duck [session] and the study I would be looking for is asking military members: Should it be repealed, not how to implement it once you as a politician decide to repeal it. So I think in a lame duck setting Don’t Ask, Don’t Tell is not going anywhere.”
Please, someone, snap some pics of Lindsey Graham next time he hits a gay bar. I wonder what his pals McCain and Lieberman would say then?
According to interviews with the Daily Beast, the Taliban is laughing at the U.S., Britain, and NATO, because they negotiated with a fake Taliban leader for months.
Taliban commanders in Afghanistan reacted with amusement this weekend to news of an impostor who, by claiming he was a senior Taliban leader, managed to fool NATO officials and get invited to high-level peace talks.
The man pretending to be insurgent leader Mullah Akhtar Muhammad Mansour was in fact a shopkeeper from Quetta in Western Pakistan, they said.
“Imagine,” Mohammad Hafiz, a senior Taliban commander, told The Daily Beast, “if a shopkeeper from Quetta can make a fool of them and keep them engaged in talks for months, how do they believe they can defeat the Taliban?”
Hafiz, himself a close aide to the insurgent leader Mansour, said Taliban commanders were laughing at the fact that American and British officials could be so easily deceived. But he and other insurgent leaders denied the shopkeeper was a plant; in fact, they said, they wouldn’t mind finding him and having a chat.
That is pretty pathetic. It’s time to get out of Afghanistan. Iraq too.
What stories are you following today?
And guess what… it isn’t you and me. Here’s the front page story from August 6th, 2009.
All this back and forth on rw/lw blogs about whose grass roots are nuttier or meaner or better organized is cute, but while this debate on how many wingers can fit on the tip of a town hall meeting goes on, the real health care anti-reform is happening on K Street. The circus only stops you from looking at the men behind the curtain. Not one teabagger or ACORN rent-a-protester or you or the rest of us are part of the real conversation. Shouldn’t our focus be on why the Health Insurance is happy about what’s going on? Uh, maybe while you’re all throwing memes at each other, some one should be watching the pile of money on the floor that’s disappearing before our very eyes? The Democrats have the votes to make this pass. BUT, wtf are they passing? You really think this is an obsequious foot in the door?
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.
Executives from UnitedHealth certainly showed no signs of worry on the mid-July day that Senate Democrats proposed to help pay for reform with a new tax on the insurance industry. Instead, UnitedHealth parked a shiny 18-wheeler outfitted with high-tech medical gear near the Capitol and invited members of Congress aboard. Inside the mobile diagnostic center, which enables doctors to examine distant patients via satellite television, Representative Jim Matheson didn’t disguise his wonderment. “Fascinating, fascinating,” said the Democrat from Utah. “Amazing.”
Okay, did you take a deep breath long enough to read that highlighted line? Do you realize that all we’re doing with the current format is giving these guys new customers to fleece with their 30% mark-up? Is that a good deal? That’s worth a symbolic vote for single payer and an inkle of a public option? A few more folks in 2013 join the fleecing of the ill while it’s paid for by throwing children off SCHIP and removing benefits from Medicare? Are liberals really fighting for THAT? Are conservatives thinking THAT’s socialism?
What fresh hell is this?