Tackling the Cost of Healthcare Reform
In the healthcare debate, everyone seems to agree, at least at a lukewarm level, that universal healthcare is a good thing. While I find the term “socialism” to be an absolute misnomer when applied to a government-backed group package for the uninsured (because strictly speaking it’s only an alternative insurance policy, not a complete takeover of the entire health system), universal coverage will be insanely expensive. The Congressional Budget Office estimates $1 trillion. Where will we find the funds?
In both the California budget and the healthcare debate, something’s got to give. We cannot have the programs without the funds, at least not without overleveraging like irresponsible hedgefund managers. Either taxes must go up, or benefits must come down.
In the healthcare debate, an industry-supported initiative proposes measures to reduce the growth of costs. Apparently not the costs, but the growth of costs:
“The savings would come from standardizing and simplifying all sectors of the health care system; implementing measures to reduce overuse and underuse of health care; investing in effective treatment and prevention; and reducing costs by developing technology and regulatory reforms.” Certainly money will be saved by offering increased preventative care and increasing efficiencies. But it won’t begin to cover the costs of universal healthcare.
So what would?
We could save huge amounts of money and increase coverage by rationing healthcare services to remain within a targeted budget. Translation: maybe terminal cancer patients would be offered fewer options near end-of-life so that more prenatal care could be offered. Would this be devastating? Yes, sometimes it would. But we need to leave behind a mindset that we’re entitled to every ounce of care available when it’s a government administered program. There would still be two tiers: those who could afford to pay privately for extreme measures and those who couldn’t. At least basic healthcare could be had by all.
The Wall Street Journal ran a Democrat-bashing opinion piece entitled How Washington Rations - ObamaCare omen: a case-study in ‘cost-control’. The article argues against a government-funded insurance program by detailing a long description of a “virtual” colonoscopy procedure (a CT scan) which will no longer be covered under Medicare. In an effort to contain costs, Medicare has stopped covering the scanning procedure, though the more invasive traditional colonoscopy is still covered. According to the author, “This is precisely the sort of complexity that the Democrats would prefer to ignore as they try to restructure health care. Led by budget chief Peter Orszag, the White House believes that comparative effectiveness research, which examines clinical evidence to determine what “works best,” will let them cut wasteful or ineffective treatments and thus contain health spending.” Precisely. And everyone will have to stop whining about getting “less than the best.” Unless you’d like to pay for it yourself. Insurance companies, public or private, are not under any obligation to provide services that cost too much for their business plans.
You know what else could cover the costs of universal healthcare for US citizens? Reducing military expenditures ($700 billion per year) and aid to foreign countries (another $34 billion per year). We give billions in aid to Israel (or Pakistan or Albania or Russia) or build more fighter jets ($300 billion) while Americans in poverty go without basic healthcare benefits. Will Obama and the Democratic congress reduce the military budget to reduce the deficits? That remains to be seen. If we are to become a country that spends within its means, we’d better.
Cheney Claims No Connection Between Iraq and al Qaeda, You Silly People
Old Happy Face, Dick Cheney, is reminding us that - duh! - there was never any connection between al Qaeda and Sadam Hussein. Wow, to think we were sharing a public hallucination all that time! Cause I believed it! Every word… that Dick Cheney, er… never said.
First, let me begin to dissect this befuddling illumination by pointing out that every time I see Old Happy Face is on the news, again and again, and NOT Bush, it reinforces the strange intuition many may have shared: that Mr. Bush was never REALLY the president at all! Now that Old Happy Face is trying to clean up his presidential story, it becomes more and more obvious that Bush was faking it the whole time. The whole time! THAT’S WHY HE NEVER KNEW ANY OF THE ANSWERS. HE WASN’T ACTUALLY PRESIDENT. Whew! Glad that’s cleared up.
Moving on to the story of Saddam Hussein and al Qaeda. Here’s the money quote from CNN’s story entitled Cheney: No link between Saddam Hussein, 9/11:
“I do not believe and have never seen any evidence to confirm that [Hussein] was involved in 9/11.”
From the same story:
The former vice president said in 2004 that the evidence was “overwhelming” that al Qaeda had a relationship with Hussein’s regime in Iraq, and that media reports suggesting that the commission investigating the 9/11 attacks reached a contradictory conclusion were “irresponsible.”
“There clearly was a relationship. It’s been testified to. The evidence is overwhelming,” Cheney said at the time.
Condoleeza Rice has backpedaled from asserting that their were “ties going on between al Qaeda and Iraq,” to “No one was arguing that Saddam Hussein somehow had something to do with 9/11.”
Bush’s quotes: From this extensive list from the BBC of Bush’s assertions of a connection bewtween al Qaeda and Sadam Hussein to “No, we’ve had no evidence that Saddam Hussein was involved with September the 11th.” September 17, 2004.
And here we find a quote from McClatchy News Service in which Cheney asserts that waterboarding at Gitmo was worthwhile because it did in fact turn up the OBVIOUS link between al Qaeda and Hussein:
Then-Vice President Dick Cheney, defending the invasion of Iraq , asserted in 2004 that detainees interrogated at the Guantanamo Bay prison camp had revealed that Iraq had trained al Qaida operatives in chemical and biological warfare, an assertion that wasn’t true.
Cheney’s 2004 comments to the now-defunct Rocky Mountain News were largely overlooked at the time. However, they appear to substantiate recent reports that interrogators at Guantanamo and other prison camps were ordered to find evidence of alleged cooperation between al Qaida and the late Iraqi dictator Saddam Hussein — despite CIA reports that there were only sporadic, insignificant contacts between the militant Islamic group and the secular Iraqi dictatorship.
And more from an extensive chronology:
“Vice President Dick Cheney’s repeated trips to CIA headquarters in the run-up to the war for unusual, face-to-face sessions with intelligence analysts poring over Iraqi data. The pressure on the intelligence community to document the administration’s claims that the Iraqi regime had ties to al-Qaida and was pursuing a nuclear weapons capacity was ‘unremitting,’ said former CIA counterterrorism chief Vince Cannistraro, echoing several other intelligence veterans interviewed.” Additionally, CIA officials “charged that the hard-liners in the Defense Department and vice president’s office had ‘pressured’ agency analysts to paint a dire picture of Saddam’s capabilities and intentions.” [Sources: Dallas Morning News, 7/28/03; Newsweek, 7/28/03]
And even more:
Lawrence Wilkerson, chief of staff for then-Secretary of State Colin Powell. In it, Wilkerson wrote that the interrogation program began in April and May of 2002, and then-Vice President Cheney’s office kept close tabs on the questioning. “Its principal priority for intelligence was not aimed at preempting another terrorist attack on the U.S. but discovering a smoking gun linking Iraq and al Qaeda,” Wilkerson wrote in The Washington Note, an online political journal.
So, wow, now I’m confused. Cheney badly needed a connection so that he could, uh… deny there was a connection.
To sum up, Condi Rice, George Bush, Dick Cheney, and a gigantic Senate Intelligence report all say there was never a link between al Qaeda and Sadam Hussein. Oh yeah, and George Tenet says he was pressured to come up with any evidence linking the two so that someone, not these people, but someone elsecould invade Iraq, someone who very badly wanted to.
And not for their oil.
Judge Not Lest Ye Be Judged
There was a time when I thought the worst thing about pro-choice activism was the irrational, and what I thought at the time was extreme and unnecessary, support for late-term abortions. It’s a gruesome scenario, a barbaric practice, and I thought that only horribly selfish people would insist on an abortion that late in the game. I thought these people were making right-wing extremists crazy and threatening the loss of the much more reasonable first-term procedures.
I was wrong. There’s a reason it’s called pro-choice.
I have recently read the painful and tragic accounts of the many couples who chose late-term abortion after learning at the earliest medically possible time that their unborn child, their fetus, had horrible abnormalities. From a 2006 account published in the Boston Globe (worth reading in its entirety):
I don’t remember much from those three days. Walking around with a belly full of broken dreams, it felt like what I would imagine drowning feels like — flailing and suffocating and desperate. Semiconscious. Surrounded by our family, I found myself tortured by our decision, asking over and over, are we doing the right thing? That was the hardest part. Even though I finally understood that pregnancy wasn’t a Gerber commercial, that bringing forth life was intimately wrapped up in death — what with miscarriage and stillbirth — this was actually a choice. Everyone said, of course it’s the right thing to do — even my Catholic father and my Republican father-in-law, neither of whom was ever “pro-choice.” Because suddenly, for them, it wasn’t about religious doctrine or political platforms. It was personal — their son, their daughter, their grandchild. It was flesh and blood, as opposed to abstract ideology, and that changed everything.
Another, from Andrew Sullivan’s Blog:
At 17 weeks gestation our baby had been diagnosed with major heart defects requiring a minimum of three risky open-heart surgeries beginning at birth, and would later require a heart transplant. At 19 weeks we were finally given our amnio results which revealed our baby also had Trisomy 21.
A surgeon at the major teaching hospital where we’d had our fetal echocardiogram informed us that even if our baby somehow survived his palliative surgeries, this latest diagnosis meant he would not ever be eligible for a heart transplant. As we sat talking quietly in our living room, our priest shared with us that he’d spent time at the same hospital where we’d had our fetal echocardiogram and where our son would have had surgery.
He was there to support the family of a three-month-old who was having heart surgery. In the three weeks or so that he tended to this family, he also met 10 other families in the waiting room, each of whom also had young babies undergoing heart surgery. Sadly, within the short space of time our priest was there, every single one of those babies died.
I did go to Wikipedia to find some statistics. They were not encouraging:
In 1987, the Alan Guttmacher Institute collected questionnaires from 1,900 women in the United States who came to clinics to have abortions. Of the 1,900 questioned, 420 had been pregnant for 16 or more weeks. These 420 women were asked to choose among a list of reasons they had not obtained the abortions earlier in their pregnancies. The results were as follows:
* 71% Woman didn’t recognize she was pregnant or misjudged gestation
* 48% Woman found it hard to make arrangements for abortion
* 33% Woman was afraid to tell her partner or parents
* 24% Woman took time to decide to have an abortion
* 8% Woman waited for her relationship to change
* 8% Someone pressured woman not to have abortion
* 6% Something changed after woman became pregnant
* 6% Woman didn’t know timing is important
* 5% Woman didn’t know she could get an abortion
* 2% A fetal problem was diagnosed late in pregnancy
* 11% Other
Of the 420 women who chose to undergo a late-term abortion, the biggest reasons were ignorance and fear. “A fetal problem diagnosed late in pregnancy” accounted for only 2% of the 420, or approximately 8 of the 420 procedures. How is this issue to be dealt with? I am so sad for those who underwent this procedure because they were far more pregnant than they realized (obesity? ignorance or neglect of your own body? lying out of fear?), or because they were afraid of parents, husbands, friends, pastors, ministers, God, or whomever. The solution for all of those people would have been preventative. Birth control should be raining from the skies. Everywhere. So that the “choice” happens before the baby. Preventative.
And for those 2% with fetal abnormalities, I’m sorry I doubted you. I’m now more pro-choice than ever. George Tillman was a man who did a job that no one else wanted to do. He was not a hero, exactly, but a man who stood up for what was legal and in his mind, and the thankful hearts of couples who just wanted to end the pain, ethical. It was so, so wrong that he was shot and killed. I still cannot support late-term abortions when the babies are completely healthy. It seems like it should be possible to word a very specific law to provide for exceptional cases. It would be nice to get to a point where the debate became reasonable so that extremists and murderers ceased to rule the day.
Meet Ray Anderson. He’s got something to teach us.
Ray Anderson spoke at the TED Conference in May. Listen as he describes how his carpet company doubled sales and increased profits while promoting a model for sustainable manufacturing and working toward zero climate impact by 2020. Ray is a humble prophet.
American Sustainability Party
So, right, this is what happens when I start thinking too hard. Bear with me though, because good ideas take some time and a lot of feedback to emerge. I’ve been thinking about an ideal political party. I love the liberty part of Libertarian thinking, i.e., if it doesn’t impose on anyone else’s rights, then it doesn’t need to be illegal. We just went down the wrong path when restricitive laws were passed to “save society money.” This fed into the whole liability as the basis for all social relations. If you aren’t just by me, I’ll sue you and cause you money pain. Hate it! But that’s a bit of a tangent. Liberty and freedom, core values.
I am also deeply committed to the entire concept of sustainability. In fact, we’d do much better to base all of our societal relations on sustainable living. As discussed in past duh pookie posts, traditional economics don’t serve the good of the whole since mainstream economic theory fails to account for externalities, especially unforeseen costs of bad production methods, or just plain insanity like anyone anywhere producing plastic that does not decompose. Permanent garbage, yay! For a real example, antifreeze sells at the gas station for $5.99 a gallon. The price reflects the cost of production and distribution. But, the cost of toxicity to the environment after its use is not accounted for in the original price. This is deeply flawed economics and justifies all kinds of nasty business practices. So, environmentalism would be a core value.
Next, I’m a progressive, so I support the idea of government helping people out. This, to me, is another cost we bear for the good of the whole. Miserable, discontented people lead to instability and disorder. Here’s where my dream party would part with Ayn Rand and the Libertarians. We’d need to provide social services to those unable to help themselves. A critical component would be reasonable, limited social services, not something for nothing, not a free-for-all party. Everyone is capable of performing some kind of community service. Except maybe babies. Okay, no work required from babies!! But some kind of useful participation required from everyone else in order to receive benefits. So, civil service and social service, two more core values.
And the last core value is a little hard to articulate. Community not commercialism might come close. Back to basics. An emphasis on learning, collaborative technologies, humanism. Product obsession replaced with some kind of acknowledgment that we should be humble. A desire to evolve into peaceful, creative, humorous people who live without taking more from the environment that it can give.
Look for the American Sustainability Party on your 2012 ballot. I’m sure it will be just that easy. Anyone wanna join?
Federal Spending: Simon Johnson, Plus Graphs on Stimulus, TARP, Bailouts
Boy, you think you’ve finally got a handle on how much money the federal government is tossing around — and then you take a look at these interactive graphs (Feds to the Rescue and Fiscal Stimulus Map)published in the Atlantic this month in an article entitled, The Fed’s Cash Machine. The graphs are awesome because they do exactly what visual aids are supposed to do: They give you an insight into the scale of the spending meant to pull the economy up from its massive nosedive. Warning: these graphics are upsetting in nature since they may represent the complete leveraging of our children’s and grandchildren’s futures in order to provide the current bankers, CEOs and shareholders with a cushion against their painful mistakes in corporate policy and investment strategies.
For an incisive view of the current US economic situation, I cannot recommend enough Simon Johnson’s Atlantic article entitled, The Quiet Coup. Johnson, a former chief economist for the IMF, lays it bare. In no uncertain terms, Johnson explains:
In its depth and suddenness, the U.S. economic and financial crisis is shockingly reminiscent of moments we have recently seen in emerging markets (and only in emerging markets): South Korea (1997), Malaysia (1998), Russia and Argentina (time and again). In each of those cases, global investors, afraid that the country or its financial sector wouldn’t be able to pay off mountainous debt, suddenly stopped lending. And in each case, that fear became self-fulfilling, as banks that couldn’t roll over their debt did, in fact, become unable to pay. This is precisely what drove Lehman Brothers into bankruptcy on September 15, causing all sources of funding to the U.S. financial sector to dry up overnight. Just as in emerging-market crises, the weakness in the banking system has quickly rippled out into the rest of the economy, causing a severe economic contraction and hardship for millions of people.
But there’s a deeper and more disturbing similarity: elite business interests—financiers, in the case of the U.S.—played a central role in creating the crisis, making ever-larger gambles, with the implicit backing of the government, until the inevitable collapse.
More alarming, they are now using their influence to prevent precisely the sorts of reforms that are needed, and fast, to pull the economy out of its nosedive. The government seems helpless, or unwilling, to act against them.
And:
The conventional wisdom among the elite is still that the current slump “cannot be as bad as the Great Depression.” This view is wrong. What we face now could, in fact, be worse than the Great Depression—because the world is now so much more interconnected and because the banking sector is now so big. We face a synchronized downturn in almost all countries, a weakening of confidence among individuals and firms, and major problems for government finances.
Will Obama become just another protector of the banking industry elites? Will the far Right wake up to the fact that Obama is not the enemy, and maybe Greenspan, Paulsen, and the Federal Reserve are? Tune in for more in the months to come.
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