Stoopid Stuff
Sunday, August 15, 2010
Sunday, September 06, 2009
Going Public
Amidst all the hollering about Obama's plan for health care reform and the "Public Option", it's becoming easy to lose sight of the larger picture. So perhaps a few random thoughts are in order. First, when we discuss the public option, we are NOT talking about "Socialized Medicine", nor are we talking about a "government takeover of health care". We're talking about a government sponsored not-for-profit insurance company. One that will be able to dictate the rates it pays to providers and will serve as an insurer-of-last-resort for people who for whatever reason cannot get private insurance. This is all good. When we talk about health care, our concern is for the health of our citizens, families and their children, not for the profits of private health insurance companies. If they can't find a way to compete, who cares? This isn't manufacturing or retail, this is about the health of Americans.Second, when it comes to health care reform in the US, we need to think in larger terms than just the public option or any other component part. Here's what I mean. When we talk about health care reform, we're really talking about three things:
1. Insurance industry reform.
2. Universal coverage.
3. Health care cost controls.
Industry reform addresses some of the more egregious practices of the private insurance industry, including refusal to cover people with pre-existing conditions, cancelling policies when someone gets sick, capping payments either yearly or lifetime, charging different prices to insure different people, etc. There is pretty universal agreement around these reforms, and along with universal coverage they form the heart of health reform in the US. Universal coverage is simply that. Providing a set of mechanisms whereby everyone in the US can get health coverage. This can be a combination of industry regulation, subsidies and expansion of Medicaid.
The last part of the reform policy structure is cost controls. From a policy standpoint, this is the most critical part, because if nothing is done to control health care costs, it is clear that within a few decades the cost of health care will be untenable, and at that point will require draconian action to avert national bankruptcy. Cost control measures under consideration include employer and individual mandates, tax policy, Medicare reforms and the so-called Public Option. That's right. The public option is nothing but a cost control measure. It isn't necessary for either insurance industry reform nor for universal coverage. It would serve to drive down the cost of health care delivery, and would provide incentives for the health care industry to reduce its administrative and operational costs. One of the oddest things about the whole imaginary "debate" over health policy this year is that the people who position themselves against a Public Option are typically people whose stated opposition to any policy is it's cost. For them to be specifically against a cost control measure, and to so blatantly choose to support industry profits over their own constituents and the national interest is eye opening to say the least.
The third thing that perhaps needs some further exploration is this broad assumption that it's up to Obama how this plays out. What's he going to say, is he going to present a plan, is he willing to drop the public option in negotiations? Look. It's fair to say that without the election of Barack Obama health insurance reform might not be on the table, we might not have as progressive a set of proposals in congress, and a popular and charismatic president can have a powerful effect on public opinion. But this legislation will live or die in the legislature. In the House of Representatives, depending on the structure of the bill, Obama could lose support of the Blue Dogs on the one hand, or the Liberal Caucus on the other. And in the Senate, with it's history of yielding to the demands of Senators from tiny rural states, with it's arcane procedural roadblocks and absolute lack of Democratic Party discipline, there are a multitude of veto points, resulting in a huge bias to retain the status quo.
For me, the public option is desirable, but the industry reforms and universal coverage are what this fight is all about. If we achieve those goals, the cost controls will come. The public option will come, medicare reforms will come, tax policy reform will come. Why? Because they HAVE TO. Because at some point, even a body like the US Senate will be forced by reality to act. So do the good now, and let reality drive the rest. But here's the thing. If you're going to give something up in negotiations, you have to GET something for it. What will the Republicans and Blue dogs agree to in exchange for taking the Public Option off the table? Unfortunately, they very likely feel like they don't need to offer anything, because so far the Obama administration has been negotiating with themselves. Anytime the Republicans or their delusional minions throw a tantrum over some health policy provision, Obama just agrees to scrap it. They have won every point, without argument, without pushback. That SHOULD be the real value of the public option - a hammer with which to drive agreement on the core elements of reform, to gain enough Republican votes in the Senate to prevent a filibuster, and to act as a lightning rod to provide cover for other somewhat less controversial provisions. There is no indication that the Obama administration is prepared to seriously defend ANY provision - indeed, they appear to be happy with any simply passing a piece of legislation, checking the box and moving on, perhaps to immigration. Obama's leadership might make a difference in the outcome - we will see if he's just too craven to take the political risk.
Wednesday, September 02, 2009
See? I TOLD you that you'd miss him when he was gone
Ahh, those pesky unintended consequences. Bet you didn't see this one coming. The Federal Government's Brush Clearer-in-Chief has gone home to build a library and duck Alberto Gonzales' calls, and that damn brush just piles up and piles up until you get something like this. I hope you're satisfied.
Friday, August 28, 2009
It's not that people don't like you, it's just that you're not popular
So in the course of this summer's long hot descent into madness, otherwise generously referred to as a "healthcare debate", we watch with detached fascination as Barack Obama's popularity falls to 50%, showing every likelihood of going lower. But I wonder what's really behind those sagging numbers?In my case, I always tried to be realistic about who and what Barack Obama was. I accepted he was a center-right populist out of the Clinton school, but in spite of his corporatist and interventionist instincts he'd be a vast improvement over the bush/cheney authoritarian kleptocracy, and both America and the world would be vastly better served by an Obama than by a McCain. There were large constituencies that wanted desperately to believe that he was the second coming of FDR, and others that believed he was the antichrist.
I suspect these poll numbers have very little to do with the opposition. The American Political Right has always hated and feared an Obama presidency, and the hardcore 28%ers, the bush/cheney dead-enders, have never endorsed anything he ever did or said. Indeed, they have managed to convince themselves of things he has done and will do that beyond laughable. So all their frantic shrieking and bald-faced lies might have moved a few right-leaning independents back out of his corner, but it can't be that many and he wasn't ever going to be able to sustain their support anyway.
Nope. I think it's me. People like me. Liberals who feel there is a role for government in society, and who believe that spending huge sums on the military and on wars is stupid and wasteful. I began to be disappointed when he squandered opportunities to do some easy, important things. A quicker withdrawal from Iraq, a prompt, fearless closure of Guantanamo Bay, criminal investigations of bush administration lawbreaking, an end to state secrets and national security defenses in trials and lawsuits, there were so many egregious precedents from the previous administration he could and should have rolled back, drawing a bright line between what was acceptable and what was toxic. And he didn't. In every case he hesitated. He equivocated. He tried not to offend, to take small steps that would not draw criticism. He called it bipartisanship, the press called it pragmatism, I saw it as political cowardice.
And now, throughout the most appalling demonstration of what a small band of dishonest ideologues can do to democracy, he has been in the background, careful, fearful, unwilling to draw a line in the sand and say NO! He has sought to appease those who cannot be appeased, he has put process over policy and is clearly trying to build his legacy with a political win, even if the result is horrendous legislation. The right says health care is too expensive, we KNOW it's actually deficit - neutral and he says nothing. The right says any cuts to Medicare are unacceptable and then immediately shrieks that Medicare is bankrupting America, and Obama fails to note the blatant hypocrisy. They say a public option is a trillion dollar boondoggle when it's whole purpose is to control costs. And Obama says it's on the table.
Now, granted, he's the president, and while those foreign policy and defense matters are his to control, it is up to congress to pass health care reform legislation. But it's THE cornerstone of the Obama Agenda, and he needs to come out forcefully and lead. Of course, there's, as they say, the rub. He needs to come out and lead but he might LOSE. And he very clearly is more afraid of losing than he is of implementing bad policy.
All things considered, we should remember we only had two choices in November, and I'm still glad we have Obama instead of John McCain. But any belief or hope I had that he would actually change the way politics are done is gone now. I never thought he could win over the republicans, they are all playing to their regional and local constituencies, and as a result all that remains on the American Right are fringe radicals. But first I hoped he would be something sharply different from George Bush, and he turned out to be very much the same. Then I hoped he would at least use his popularity and majorities in congress to ram through important domestic legislation, and he doesn't seem to have the stomach for that either. Now, as I watch him pointlessly escalate a useless and hopeless war in Afghanistan, I realize that once again, I am drained of hope. I wonder how bad things will have to get before someone has the courage to actually confront the real problems....
Friday, August 21, 2009
Oh for fucks sake!
The bastard is in the last weeks of the process of dying from terminal cancer. He's not anything but a sad, dying human being who did some awful things, but what do you want? Should we try to make him suffer as much as we can? Is that what we are reduced to?"But he didn't show any mercy to his victims on flight 103".
Nope. He sure didn't. Once again, are we going to draw our moral guidance from the worst of our enemies, or shall we look to the best of our heroes? Is it somehow important that, in extremis, we reach down inside ourselves and, in our deepest irreconcilable hated tailor our behavior to the worst of our enemies in hopes of, perhaps, what, frightening them into not fighting us?
What is it we hope to accomplish? Whether this piece of human garbage spends his last days in a cell or or at home, nothing changes. More importantly, it's just not about HIM. How do we see ourselves? What is the bedrock meaning of our society? Do we simply want to ape the worst instincts of our enemies, or should we consider holding ourselves to a higher standard?
This is a conflict with no defined borders, and no functional rules. Isn't it incumbent upon us, if we so desperately want to view ourselves as the "good guys", to try to find a higher moral plane than that which we view as our "enemy"?
Or put another way, if we decide that, in fighting them, we must become them, haven't we already lost?
Interesting Update:
Lt. William Calley has recently apologized publicly for his actions in My Lai in March of 1968. According to AFP:
I find the juxtaposition of the views of a survivor of the My Lai massacre and the insistence of the Pan Am 103 families that Megrahi spend the last weeks of his slow death from terminal cancer in a prison cell to be worth consideration but will leave you to draw your own conclusions...A survivor of mass killings by US troops in the Vietnamese village of My Lai in 1968 has said he welcomed the public apology made by a former officer convicted for his role in the atrocity.
"It's a question of the past and we accept his apologies, although they come too late," Pham Thanh Cong, who saw his mother and brothers killed in the massacre, told the news agency AFP on Saturday.
"However, I prefer that he send his apologies to me in writing or by email."
Pham Thanh Cong, who is the director of a small museum at My Lai, said: "I want him to come back... and see things here.
"Maybe he has now repented for his crimes and his mistakes committed more than 40 years ago."
Wednesday, August 12, 2009
A Thought Experiment
Let's take a moment to consider what the Health Care Reform "debate" would look like if we had an honest, functional press covering it in a responsible way. Imagine if every night a handsome and elegantly coiffed news anchor solemnly recapped the day's events, clearly identifying and differentiating between facts, opinions and lies. How quickly would the debate change if respected news reporting would simply say "Senator X stood up on the floor of the Senate this afternoon and told no less than four outrageous lies." There would be no need to speculate on the Senator's motives nor suggest that there was any agenda behind his lies. It would merely be accurate to take the position that he is either grossly mistaken or lying, and it is not reasonable to assume that someone in that position is ignorant. If the Senator would like to issue a statement that he was not lying, merely uninformed on the issues that would be perfectly acceptable, however any expectation that this might cast him in a better light is likely to result in disappointment.At first there would be outrage. Fox News would condemn the shrill liberal media voices that had the temerity to identify dishonest rhetoric, and to simply report that there is absolutely no truth behind these outrageous statements. I think most of us can remember a nation where it wasn't acceptable to state that the president is a racist who's singular goal is to kill elderly and disabled people. But if every other news outlet stuck to the facts, calling lies lies, opinion opinion, and fact fact, very quickly the nature of the conversation would change. Every time Sarah Palin or Newt Gingrich tried to inspire fear and confusion, a calm, trusted talking head or a respected newspaper would point out that they are lying, that there is NO basis for their frantic pronouncements, and that the facts exist where anyone in the 21st century with an Internet connection can find them.
Soon, the "debate" would narrow. After all, as Ezra Klein points out, there is not a tremendous amount of daylight between the two sides, if you could just get past the insanity:
If we could stop hiding behind fear and lies, if we could make this discussion as truly serious as it ought to be, if we could accept that the American health insurance system is broken and something HAS to be done, something genuine and effective, then we could get to a place where the conversation might lead to something of value.Here are the things that, broadly speaking, legislators agree about: insurance market reforms, including community rating, guaranteed issue, an end to rescission, an end to discrimination based on preexisting conditions, and an individual mandate. Subsidies for low-income Americans. Delivery system reforms. Health insurance exchanges. An expansion of coverage to about 95 percent of legal residents. Prevention and wellness policies. Retaining and strengthening the employer-based insurance market. Creating some kind of incentive for employers to offer, and keep offering, health benefits. Expanding Medicaid to about 133 percent of poverty.
Here are the things that legislators disagree about, but are discussing, and will probably figure out: whether subsidies should reach 300 percent of poverty or 400 percent. Whether there should be an employer mandate or something milder. Whether medium-size employers should be eligible to enroll in the health insurance exchanges. Whether health reform should cost $1 trillion over 10 years or $1.4 trillion over 10 years. Whether it should be paid for through new taxes on the wealthy or a change to existing tax subsidies in the health-care system.
Here are the things legislators don't agree about: whether we should have a public option that is open only to the minority of Americans on the exchanges or a co-op option. How to handle abortion. How to handle geographic disparities in insurance costs.
Here are the things that aren't under consideration but are alive in the public debate: socialized medicine. Euthanasia. Government-driven rationing. Death panels. Illegal immigrants.
Alas, this is a dream. Do I believe the American media is entirely responsible for the embarrassing status of this critical political process? Yes. Yes I do. They alone have the power to turn this into a real conversation, to stop the lies and misinformation that serves no one but the Insurance industry and begin to develop something that serves the people and the nation. That would not just be good faith, that would be patriotic.
In the meantime, we have people in the streets, AMERICANS, demanding their government NOT provide basic health services to the population. How we have arrived here, and how we might find our way back, is beyond me...
The Path to Enacting a Progressive Agenda
Important breaking news. Barack Obama is not a liberal. Just in case you were disappointed by what you've seen from his administration so far, from Gates to Sotomayor to Dennis Ross, you need to recalibrate your thinking. Obama is a Clinton Democrat, a corporate friendly center-right populist with very strong international interventionist instincts. Additionally, he's been somewhat corrupted by the Bush/Cheney administration's Presidential power grab - it's very difficult for people with power to give up any power they already have - so we find Obama with more authoritarian tendencies than we had come to expect.But consider the election of Barack Obama in context. Since 1980 we've had 20 years of Republican presidents. It was Bill Clinton who implemented the tactic of "triangulation", where he essentially moved to the right, co-opting the center while willingly sacrificing both the left- and right-wing bases. After 8 years of Bush/Cheney, there was a huge opportunity in the center once again, with only that hardcore 28% demanding ever more radical right-wing positions from their candidates. But in an election between Barack Obama and John McCain, the more liberal members of the electorate had nowhere to go, so they placed their hopes firmly behind the Democratic candidate. That, coupled with the incessant characterizations of Obama in the press as "liberal", a code word for everything bad in America from black nationalism to communism, resulted in an unrealistic and irrational expectation that Obama would implement a "liberal agenda". Hence all the shock and outrage from the left over his policies.
But there was never any realistic hope that Obama would pursue any truly liberal policy. The Health Care reform legislation he champions is really intended to be the salvation of the American economy, not the American insurance consumer, just as cap and trade is at least an attempt to be an adult and take responsibility for the well being of the planet. America is schizophrenic - the population is overwhelmingly liberal in their viewpoint, but overwhelmingly conservative in their politics. And it's going to take more than 8 disastrous years to expose the failings of these policies and leave them truly discredited. It's going to take something far more catastrophic.
Which leads me to an odd thought. I find myself wondering if we continue to elect center-right populist Democrats and our political system continues to cause them to fail, driving the election of increasingly Right-wing radical fundamentalists, who bring about such disasters that the electorate turns in desperation to another center-right Democrat, America will muddle along a downward path, slouching toward irrelevance, poverty and declining living standards. So maybe what is necessary is a much greater shock to the system. Perhaps the left should just sit back with folded arms and let them elect a Huckabee, a Palin, a Santorum. Maybe before we can begin to run this nation in an effective and compassionate manner the train needs not only to leave the tracks, but explode in a toxic fireball.
Imagine it's the summer of 2010. Unemployment is still high, consumer spending is still down, GDP growth is flat. Health care "reform" turned out to be nothing but a giveaway to the insurance industry, Waxman-Markey died in the Senate, the Immigration reform "debate" turned into a nativist racist horrorshow, and in 2011 Obama had no option but to raise taxes across the board, breaking a campaign promise he never should have made in the first place. The Republicans are successful in painting his first term as a failure, which allows them to claim their policies would have worked. They still insist on unquestioned ideological purity, and at the convention they nominate one of their most ignorant, nativist, war-loving, fear-mongering luminaries.
Whatever the result might be, if the world is not a smoking, radioactive ruin in 2016 it should be the end, for all time, of these lunatic, anti-science, theocratic authoritarians and their angry, violent, irrational followers. It seems to me that a case can at least be made that the best hope America has for a sustainable future over the next 10-25 years is to let them go ahead and break it quickly so we can get on with the job of fixing it.
Thursday, July 30, 2009
The Beer of Fear
Dammit. I'd LOVE to have a beer and chat with Barack Obama. He is, in spite of my concerns about his Presidency, a brilliant and inspiring figure, and one who would offer an interesting insight into the current state of affairs.But as a supporter, a person who believes he is trying in many ways, someone who genuinely wishes him well, I have little or not chance of ever seeing something like that come to pass. In fact, the lesson here is the best way I can hope to have a soul-searching one on one conversation with the most interesting American political figure since John F. Kennedy is to find a way to abuse and mistreat a black man. If I can violate his constitutional rights in a public setting, then deny it was racially motivated, to the point where I can earn the wrath of the President so that he might speak intemperately, then I can hope that the whole thing will blow over as we sit in the garden outside the Oval Office enjoying a Red Stripe and laughing about post-racial America.