Month: December 2009 Page 3 of 5
And maybe I’m being unfair, but I don’t seem to see the same degree of soul-searching on the other side. Too much of what I read seems to come from people who haven’t really faced up to what it will mean for progressive hopes — not to mention America’s uninsured — if health care reform crashes and burns, yet again.
What it will mean is not forcing people who can’t afford insurance to buy insurance they can’t, well, afford. And bad insurance at that.
I think the Raven nails it when it writes:
I’m struck, in reading the support for the disastrous Senate “health” “care” bill, how much it depends on the idea than an improvement on the average level of US health care is acceptable, even though it means that huge numbers of people will be ruined, and some will die. And I think I’m starting to see a pattern: among liberals the academics and the people with secure jobs support it (even Krugman, sigh), and the people like Ian Welsh who’ve actually been poor, or who know people who’ve been poor, oppose it. It’s easy, when dealing with numbers, to forget that each click on the counter signifies a whole life: hopes and fears and dreams. I want us to remember.
A whole life and all its fears and dreams. How many will be destroyed by this bill? I won’t pretend that politics shouldn’t be about doing the most good for the most people, but sometimes the price in destroyed lives is too high for marginal improvement in other people’s lives. (See reduced consumer costs in exchange for making people unemployed, aka: “free” trade.)
Yes.
Nate Silver has some questions for those who want the health care bill to die. Since many of these questions are common ones, here are answers.
1. Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?
a. Over the medium term, how many other opportunities will exist to force people to spend money they don’t have on insurance that doesn’t have a cap on expenses and in some cases only has a 70% actuarial value? 100 billion in subsidies doesn’t mean squat if they come tied to an expense people can’t afford, making them buy insurance which is not particularly useful.
2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?
No. Even at 300% or 401% (sbusidies cutting off at 400%), there are people who will be forced into bankruptcy by this bill. Repeat after me, no cap on expenses, and inadequate cost controls.
3. Where is the evidence that the plan, as constructed, would substantially increase insurance industry profit margins, particularly when it is funded in part via a tax on insurers?
Stock values of pharma, insurance companies and healthcare companies in general are up, that’s because the market thinks the plan will increase their profits. Where is the evidence that forcing 30 million people to buy a product with actuarial values as low as 70% wouldn’t increase profits?
4. Why are some of the same people who are criticizing the bill’s lack of cost control also criticizing the inclusion of the excise tax, which is one of the few cost control mechanisms to have survived the process?
5. Why are some of the same people who are criticizing the bill’s lack of cost control also criticizing the inclusion of the individual mandate, which is key to controlling premiums in the individual market?
Because the mandate, as noted above, will force people who can’t afford insurance to buy bad insurance. Also, if you take a look at Massachussets, where they have a mandate, you will find little evidence that a mandate has controlled costs. A mandate by itself is not sufficient to control costs, all it does is set up a company shop. Absent hard regulation of the sort of the US has proven very bad at enforcing (see Crisis, Financial) a mandate is just a looting license.
6. Would concerns about the political downside to the individual mandate in fact substantially be altered if a public plan were included among the choices? Might not the Republican talking point become: “forcing you to buy government-run insurance?”
Not if it were a robust public option which reduced costs. Good policy makes people happy. And no one would be forced to buy the public option anyway, it’s an option. Only one of many choices.
7. Roughly how many people would in fact meet ALL of the following criteria: (i) in the individual insurance market, and not eligible for Medicaid or Medicare; (ii) consider the insurance to be a bad deal, even after substantial government subsidies; (iii) are not knowingly gaming the system by waiting to buy insurance until they become sick; (iv) are not exempt from the individual mandate penalty because of low income status or other exemptions carved out by the bill?
How many people are going bankrupt a year now? Well, in the first 9 months of the year, 1,046,449. Average that out for the year, and assume we hit something over 1.3 million. Now, how many MORE people would go bankrupt if they were forced to spend money they don’t have on insurance they can’t afford, which has no caps on expenditures and when things were getting tight couldn’t dump that insurance?
8. How many years is it likely to be before Democrats again have (i) at least as many non-Blue Dog seats in the Congress as they do now, and (ii) a President in the White House who would not veto an ambitious health care bill?
They already have a president in the Whitehouse who doesn’t want an ambitious health care bill and has worked hard to make sure there isn’t one. Here’s my question for you. Given cost realities, which no, this bill doesn’t address, how many years will it be before it will be even more clear that something has to be done? But in any case, pushing through a bill which is worse than the status quo is not a victory, so this question is a non-sequitur.
9. If the idea is to wait for a complete meltdown of the health care system, how likely is it that our country will respond to such a crisis in a rational fashion? How have we tended to respond to such crises in the past?
Well, in the Great Depression the US responded quite well. Of course, there’s a 50/50 chance that instead of getting an FDR you may get something much worse, but again, passing a bad bill now isn’t superior to passing no bill at all, so this is a non-question.
10. Where is the evidence that the public option is particularly important to base voters and/or swing voters (rather than activists), as compared with other aspects of health care reform?
Well, the public option has regularly polled as popular, and in the meantime 40% of democratic voters are currently stating that they are so demoralized they are thinking of staying home in 2010. We can’t know how much of that is related to this lousy healthcare plan, but given that healthcare has dominated the news from DC for, oh, 6 months, I think it would be surprising if it wasn’t a huge factor.
11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?
I don’t know, and neither do you. What I do know is that doing something bad is worse than doing nothing at all.
12. What is the approximate likelihood that a plan passed through reconciliation would be better, on balance, from a policy perspective, than a bill passed through regular order but without a public option?
Very high, since it is 3 or 4 Senators who keep blackmailing out the better parts of the bills, and reconciliation needs only 51 votes.
13. What is the likely extent of political fallout that might result from an attempt to use the reconciliation process?
Well, Bush used it to pass tax cuts for the rich, and no one seemed to care much. Granted Democrats aren’t allowed to do what Republicans do. Probably you’d have a hard time passing anything till the next election that didn’t require reconciliation, or which you didn’t stick in a miltiary funding bill. But so what? Getting through one really good bill, and with reconciliation you could put through a bill with a real public option, not the watered down House version, would be worth it. Except, of course, that the President doesn’t want a good bill. But, again, this is a bad bill.
14. How certain is it that a plan passed through reconciliation would in fact receive 51 votes (when some Democrats would might have objections to the use of the process)?
Not completely certain. But again, if it fails, I don’t care. This bill is bad, if it dies, it dies. Better no bill, than a bad bill.
15. Are there any compromises or concessions not having to do with the provision of publicly-run health programs that could still be achieved through progressive pressure?
Can’t think of anything significant offhand.
16. What are the chances that improvements can be made around the margins of the plan — possibly including a public option — between 2011 and the bill’s implementation in 2014?
Since indications are that Democrats will lose seats in 2010, not much.
17. What are the potential upsides and downsides to using the 2010 midterms as a referendum on the public option, with the goal of achieving a ‘mandate’ for a public option that could be inserted via reconciliation?
Can’t be done. The Democratic party is not willing to run on it, and progressives cannot run on it alone. Again, there is no indication the President wanted a public option, certainly none that he pushed for it any meaningful way.
18. Was the public option ever an attainable near-term political goal?
Yes. The President wants a bill very badly. If Progressive legislators were willing to walk, they would have bargaining leverage.
19. How many of the arguments that you might be making against the bill would you still be making if a public option were included (but in fact have little to do with the public option)?
Frankly the House public option was already so weak that the bill was already dead to me. Reconciliation is only useful if it offers a chance to get a better public option than the House public option.
20. How many of the arguments that you might be making against the bill are being made out of anger, frustration, or a desire to ring Joe Lieberman by his scruffy, no-good, backstabbing neck?
I have been against this bill for a couple months now. Any frustration I have is only because the bill is so bad it needs to die.
The news in the last few days has continued the drumbeat of demoralizing events which started in the Bush administration, and with only a few hiccups has continued through the Obama administration. It is clear that Obama is, fundamentally, Bush’s 3rd term.
First we have the health care “reform” debacle, where it has been confirmed that the White House pushed Harry Reid to accept Lieberman’s ultimatum, not go to reconciliation. There will be no public option in the Senate bill. There will be no Medicare expansion. There will be no cap on yearly limits. What there will be is a mandate forcing people to buy insurance, some subsidies which can still leave people spending money they can’t afford, and guaranteed issue of lousy plans (Plans where only 70% of the premiums have to be spent on care, for example.) Unless progressive Senators are willing to filibuster, or House progressives are willing to vote against en masse, something very close to the Senate plan is what will pass, because as I noted some time ago, the White House’s bottom line is that something, anything must pass, and conservative Dems are willing to kill the bill to make sure it doesn’t actually threaten health industry profits in any way, shape, or form. (Thus why drug importation, which would cost Pharma money, will be made illegal.)
All of this was completely predictable,. Furthermore the weakness of progressive and liberal legislators, is largely to blame:
Obama and the Democratic leadership’s bottom line is they must pass some bill called “health care reform”. Unless you threaten to take away their bottom line, they will take away anything that isn’t progressives bottom line
This is negotiation 101, and progressive legislators either don’t understand it, or are spineless. As a result they, and Americans, have been rolled yet again. What is depressing about this is that it should be a surprise to no one, but apparently has surprised many.
It is also noteworthy that spending billions on turning brown people into a fine red mist (aka. the Afghan war) is acceptable, but health care (aka. saving actual American lives) is something which can’t cost money. What an interesting, and clearly evil, set of priorities that reveals. I guarantee that real healthcare reform would save more American lives than the entire war on terror—assuming said “war” hasn’t cost more American lives than it’s saved, which is almost certainly the case.
Next we have what Glenn Greenwald is calling the creation of Gitmo North, in which people whom the government judges there is not enough evidence to convict, will be held indefinitely without trial. This is the very definition of tyranny. Any nation which does this is a nation of men, not laws. America has forsaken its fundamental premise and proved its degradation. Yes, this started under Bush, but as Obama embraces this it became a bipartisan project and the new elite consensus. This is now something which has been confirmed as US policy which is extremely unlikely to change no matter who is in power.
Next we have bankers are giving themselves bonuses larger than the entire economy’s GDP growth this year. As Peter Morici notes:
How much is $140 billion?
The U.S. economy grew at a $89 billion annualized rate in the third quarter. That was the first growth since the second quarter of 2008 and came to $22 billion in actual growth in the third quarter.
The bankers, after causing the greatest economic calamity since the Great Depression, are rewarded with six times the growth accomplished so far in the much heralded “economic recovery.”
Meanwhile, seven million families face foreclosure and 25 million Americans can’t find full time work.
To add this sad state, we have the sad spectacle of Obama lecturing the bankers. Meanwhile in Britain, instead of lecturing, the government has imposed a 50% tax on bonuses, and France looks like to follow suite. The British government’s response to threats to move employees out of the country “that’s nice, you do that.”
The fact of the matter, as I’ve long said, is that bankers at the big banks are a net drain on the economy. Their venality and recklessness has wiped out the entire economic gains of the last decade and plunged the economy into its worst crisis since the Great Depression.
Now I’m not surprised they have the gall to pay themselves these bonuses. The entire profits of most large banks in the last expansion were based on open fraud. Of course criminals who have not been punished, but have been rewarded for their crimes are going to continue to steal. What is shocking is that the government is essentially doing nothing. Obama’s pay czar is a sick joke, especially compared to just taxing all bonuses at 50%. Heck, even taxing bonuses at 50% is sad—they should be taxed a good confiscatory 90%. A class of people who caused an economic calamity of this magnitude do not deserve to be paid more than janitors.
Why? Because, as a British study noted, Janitors actually create value. So do homemakers. So do assembly-line workers. Modern bankers, on the other hand, destroy value. They make the economy weaker. That isn’t the way it should be, but when you bail out the banks for trillions and they decrease their lending to businesses and increase their credit card interest rates to as much as 29% it’s clear that all they are is parasites, sucking blood from their hosts.
In a healthy, non-degraded society, none of the behavior listed above would be allowed. Not only would there be confiscatory taxes leveled, there would be massive ongoing criminal investigations into what happened.
In a healthy, non-degraded society, saving American lives by making sure they have health care would be a priority. Especially since the US pays twice as much per person as many countries which get far better results. This would be considered much more important than a war in a far away country, because it would be understood that even if you believe that turning brown people into a fine red mist saves American lives, health care would save more lives. And, done right (aka. single payer) it would even save money. But that was never on the table, and even the limp-wristed compromise of a weak public option was too much for the rich and powerful to tolerate. Americans exist to be looted systematically by their elites, and if they die young and live sick, who cares. They are just sacks of money and the goal of government is to make dipping your hand into that sack as easy as possible for industries which can afford to buy government.
And, last but not least, in a healthy, non-degraded society, the government is not allowed to lock up people indefinitely without trial. If you don’t understand why this is, I can’t explain it to you, any more than it is apparently possible to explain to a plurality of Americans why torturing people is evil, and beyond the pale. The fact that it can’t be explained any more to many Americans, of course, is exactly why it is fair to call this degradation.
Moral and political degradation.
Ok, enough.
Enough, Enough, Enough.
After reading this compilation by Thomas Schaller of various leading “progressives” views on whether the Senate bill should be killed or not, I am beyond disgusted at many of the putrid, spineless, stupid quislings who call themselves progressives.
Just… enough.
Exhibit A:
On MSNBC’s “The Ed Show,” Joan Walsh derides Joe Lieberman but compares progressives who want to kill the entire Senate bill to people who voted for Nader over Al Gore in 2000.
Thank you Joan “lesser evil” Walsh. That election has been trotted out ever since to justify voting for Democrats no matter what they do. It’s good to know that your support is completely unconditional. Of course, perhaps it might have helped if Al Gore and Joe Lieberman had actually fought. Buses full of union members and other demonstrators were willing to go, and Al Gore, the “good man” didn’t want to risk that flaring into violence. So he told them not to roll, and the Supreme Court, seeing that no one gave a damn, gave the election to Bush 5-4. The result was, literally, hundreds of thousands of dead people. Why? Because a good man wasn’t willing to fight. Just like you, a “good woman”, I’m sure. Just like Democratic progressive in Congress. If you won’t fight, and the other side will, the other side will always get what they want. But people like you, who belong to the party of wimps, never understand that, do you?
Exhibit B, Ezra Klein:
And as I spent yesterday arguing, it has a tendency to overshadow the lives in the balance. You can choose your estimate. The Institute of Medicine’s methodology says 22,000 people died in 2006 because they didn’t have health-care coverage. A recent Harvard study found the number nearer to 45,000. Since we talk about the costs of health-care reform over a 10-year period, may as well talk about the lives saved that way, too. And we’re looking, easily, at more than a hundred thousand lives, to say nothing of the people who will be spared bankruptcy, chronic pain, unnecessary impairment, unnecessary caretaking, bereavement, loss of wages, painful surgeries, and so on.
Why people think Ezra is capable of understanding policy has always been beyond me. He can’t, and he never has been able to. The bill will not save all of those lives. What the bill does is force people to buy insurance who don’t have it right now. Force them. The standard shitty insurance (the silver plan) is 70% of actuarial value, which means the company has to spend 70% of premiums on health care. And it’s not capped. So if you get seriously ill, you blow through the cap, and can’t afford the care which would save you life. I don’t know how many people the bill will save, but it’s not 220,000 or 450,000 over ten years. Anyone who thinks it is is incompetent.
Exhibit C, Jonathan Cohn, who writes for the New Republic (which should tell you everything you need to know anyway):
Is health care reform without a public option still worth passing? Unequivocally, unambiguously yes.
The case for is simple and straightforward: 30 million additional people, maybe more, will have health insurance. Many more who have insurance will see their coverage become more stable. The ability of insurers to exclude people based on pre-existing conditions will diminish significantly, if not disappear. And that’s on top of a host of delivery reforms which should, in combination, help make medical care less expensive over time. The bill could be much better, for sure, but to argue that it’s worse than nothing you have to make the case that nothing will somehow lead to more progress in some reasonable frame of time.
30 million more people will be FORCED to buy insurance, which many of them can’t afford. If they could afford insurance, many of them would already have it. What part of FORCED don’t these idiots understand? Let me repeat: Forced, Forced, Forced.
Yes, Jonny, it is worse than nothing, because it will push many of these people over the edge financially in order to give them insurance which is capped, and which, therefore when they get really sick, will not save their life anyway. Not just a moron, but a moral imbecile.
Angela Glover Blackwell, of some group called Policylink is the only person who swings for not killing the bill and gets some bat on the ball:
Politics is the art of the possible. It rarely gives us everything we want — and often it doesn’t even give us what we need. The health-care debate has been a case study in compromise — alternating between hopeful and infuriating and back again.
Oh puke. If someone tells me once more about the art of the possible, instead of the art of the necessary I am going toss my cookies all over them next time I meet them at some conference.
But we are still left with a proposal that takes several important, relatively moderate steps toward a more insured, healthier nation. The protections against rescission and rejections for “pre-existing conditions” should help curb the most egregious abuses of the insurance industry. And subsidies for low-income people will help bring millions of struggling Americans into the health insurance system for the first time.
Ok, that’s at least an argument that makes some sense. I don’t think it’s worth it, because again, the insurance they’re being forced to buy is shitty 70% actuarial value with caps it won’t save their bloody lives, and may well drive them into bankruptcy, because the subsidies are inadequate, but at least she mentions recissions and pre-existing conditions: virtually the only major things the bill does right.
With Progressives Like These…
Who needs Republicans or Conservadems? Honestly, mode one is always, “well, if someone is going to give me one cent, that’s better than no deal no matter what I give up in return!” Plop these fools down in a 3rd world bazaar with $1,000 dollars and they’d be begging for food by the end of their first week.
As Stephanie Taylor says:
When Democratic leaders refuse to fight, they can’t then ask progressives to cave with them. The Progressive Change Campaign Committee is continuing to fight for the best health care bill possible, and we’re intent on holding Democrats’ feet to the fire. But we need to think very seriously about whether there will be a moment when it is clear that the bill does more harm than good–we need to be prepared to kill the bill.
Part of being a great negotiator is being able to walk away. (emphasis mine).
No more Mr. Nice Blogger. The idiots calling for surrender, meekly begging for table scraps, are not due any pretend respect or collegial refusal to call them out for their stupidity and cowardice.
So, Citigroup is being allowed to pay back its TARP money minus billions of taxes they should pay, but also:
Bank regulators including the FDIC and Federal Reserve want to permit a phase-in of capital requirements that rise starting next month under a change approved by the Financial Accounting Standards Board. The rule, passed in May, eliminates some off- balance-sheet trusts, forcing banks to put billions of dollars of assets and liabilities on their books.
If they don’t have enough money to recognize their liabilities, why are they being allowed to pay back their TARP money? (Bear in mind, that it is certain that they have many more liabilities than just these. They are only being forced to recongize some of their liabilities.)
Well:
- TARP needs to be seen to make a profit
- TARP is going to be used by the President for further stimulus. With 40% of Democrats saying they’re going to stay home in 2010, Obama needs a money Congress can’t deny him. The banks give the money back to TARP, and Obama can use it as a slush fund.
- With TARP repaid Citi can pay better bonuses, avoid reorganization and are out from under the government’s thumb.
Citigroup is almost certainly bankrupt, if it were actually forced to bring everything back on balance sheet and value assets at market prices. But hey, job #1 in America is making sure Bankers never face any responsibility for destroying millions of lives while paying themselves billions.
And Job #1 is being taken care of.
When an industry matures you can move it out to the hinterland. That’s what is happening in the US – that’s outsourcing. All these industries are mature – they don’t need to be located in the US anymore – you can stick’em elsewhere. Being in Silicon valley isn’t necessary in semis and tech anymore, the information you gain, the speed and access to the brightest minds in concentration, as well as the small custom suppliers – they aren’t necessary.
When an industry consists of a myriad of small firms they are dependent on each other and geographical proximity is greatly to their advantage. When it narrows down to just a few firms, with a few other firms supplying their services, or with supply chains vertically integrated within the few remaining big firms, they can move to cheaper domains.
Economic cycles in geographic locales that are economically fertile (basically metropolitan regions) operate on a cycle. For a lot of them that cycle involves import replacement. They import goods, then they learn how to make them, then they use the money they saved to buy other things, then they replace them and so on. This is going on very strongly in China right now – and it’s creating a boom; even an overheated economy.
The areas at the leading edge of the economy create new work – new products and services and ideas; they create new things to export that no one else has exported before.
That was a large chunk of the US for a long time.
If you lose that, well, the reason you were so well paid was in part because of it. The economies that fed off of the US had lower GDP per capita.
That’s what’s going on in the US. To move to the next boom, to keep your place in the sun – you have to lead the next revolution; the next time when being close to suppliers and the bright minds and where the action is – to failing to get to market in time being more disastrous than getting to market with a more expensive product.
It’s not hard. The next revolution is the energy revolution. Solar cells, wind, hydrogen fuel cells, passive solar. The technology isn’t mature and that’s good, but it is at the point where with the right incentives, it becomes feasible.
Crisis = danger and opportunity. The rising energy prices, the coming Hubbert’s peak, are not just a crisis – they’re an opportunity.
Take it and you’ve got the next fifteen to twenty years of the US’s economic prosperity.
Let someone else take it and you’ll move off the bleeding edge, move into replacing other people’s exports – or, because your economy can’t really do that because it’s geared to the high expenses of being the leader, find that you can’t even do that and watch an economic slide of startling proportions.
It shouldn’t be a hard choice.
(Originally published at BOPNews back in 2004. Other nations have now moved even farther ahead on energy than the US.)