In the Belly of the Beast: 4/13/11: Mr. President: Why Medicare Isn’t the Problem, It’s the Solution

INDEX (articles follow)

The WikiLeaks News & Views Blog for Wednesday, Day 137

from The Nation Blogs: Media Fix by Greg Mitchell
“POLITICS”

CIVIL LIBERTIES TODAY
“Fascism is the open terrorist dictatorship of the most reactionary sector of monopoly capital”

THE ECONOMY



ENVIRONEMENT








The WikiLeaks News & Views Blog for Wednesday, Day 137

from The Nation Blogs: Media Fix by Greg Mitchell

Greg Mitchell

“POLITICS”

White House cool to re-opening public option debate, even though it is recommended in Simpson-Bowles deficit plan

from AMERICAblog: A great nation deserves the truth by John Aravosis (DC)

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I’m on a White House blogger conference call with a number of senior officials – Dan Pfeiffer, David Plouffe, and Brian Deese – and I got a chance to ask about the public option. The Simpson-Bowles deficit reduction plan recommended a “robust public option.” Basically, what Obama had said he was going to push for during the campaign. In view of the fact that a bipartisan report is now endorsing not just “Obamacare,” but what health care reform was supposed to be, I asked the White House if they’d consider the public option being the table.

I got a longwinded answer from Brian Deese, who works at the National Economic Council and is special assistant to the President for economic policy, restating what the President had already proposed.
So I responded, yes you just reiterated what the President already proposed, but you didn’t answer my question, would you consider the public option being on the table?

I was told that no one is going to set preconditions as to what others may offer in the negotiations, and that was it. In other words, someone else was free to put it on the table during the talks.

It’s pretty clear that the White House has no desire to get anywhere near the public option for a long time coming, which is sad considering Simpson-Bowles just gave them one heck of an entree. How the President isn’t saying “I told you so” when everyone is talking about cutting health care costs. He ought to throw this in the face of every single person who uses the phrase “Obamacare,” of every single Republican who complains about the deficit.

So if Speaker Boehner is interested in a public option, it just might come up in this debate.


A Bad Budget Deal for the People

from PA Editors Blog by Political Affairs
President Obama has struck a deal with the Republicans that is reminiscent of the policies associated with George HW Bush and Bill Clinton, that is, to reduce public spending in major areas while in a less direct way, taxation.
These policies were essentially what was called fiscal conservatism in the pre Reagan era. Under GW Bush, increased military spending for the Gulf War and a recession which reduced general tax revenues saw a significant increase in deficits. Under Clinton, spending cuts and increased taxation, along with the reduction in military spending(very limited but still not insignificant) made possible by the collapse of the Soviet Union, did lead to sharp restrictions on the deficit, even the first budget surplus since the 1950s.
But, while times were generally better than the 1980s or the first decade of the 21st century, the income inequality, increased economic insecurity, and assault of lower income people of the Reagan era was not reversed but continued. Conditions if anything worsened for the bottom 20% of income earners as the federal welfare system was devastated and public sector cutbacks undermined education and vital social services.
Clinton’s policies did not produce “change we can believe in” or change at all. GW Bush’s massive tax cuts for corporations and the wealthy and massive increase in military spending following the 9/11 attacks saw skyrocketing deficits which Clinton’s policies had contained. Earlier, Clinton’s abject failure to reverse deregulation(it actually increased thanks to the Gingrich Congress) played a major role in the collapse of 2008.
Now, is this dejavu all over again? First, given the anarchic nature of capitalist production, no one can seriously estimate what effect these policies will have in a decade, whatever the President, the Republcians or anyone else says about 2023.
We can say that these policies fail completely to address the major problems, i.e., stagnating incomes, high unemployment, crippling consumer debt which limits mass purchasing power.
What should be done?
1. Instead of appeasing the Republicans crackpot scheme to privatize Medicare through a voucher system by calling for Medicare cutbacks, the administration should explain to the public that the costs of health care in other developed countries are around half of what they are in the U.S. thanks to systems of public health care which work like medicare, with the exception of course that a public agency buys prescription drugs at nearly half the cost to Americans.
A Medicare based national health care system and a “single payer” public agency [purchasing prescription drugs rather than cutting Medicare as it is, would sharply reduce spending for health care and make coverage universal.
2. The public sector the President should say, is as necessary to economic well-being as the private sector. And trade unions are necessary in both to protect workers rights, living standards, and purchasing power.
The administration can and should explain to people the necessity of absorbing at least part of the state debts in order to maintain jobs and services and also reduce regressive property taxes and fees, from licenses and highway tolls to college tuition, in order to maintain mass purchasing power and maintain revenues
3. Increasing the taxation of capital (corporations of all kinds) and rewarding those private enterprises which produce high paying quality jobs as against those which export capital and create cheap labor jobs should be the foundation of tax reform.
Explaining to the people the differences between progressive and regressive taxation, making it clear that progressive taxation is associated with high income advanced economies and regressive taxation, which has ballooned in the U.S. over the last three decades, with low income backward or declining economies can be done and in effect must be done if the downward economic spiral is to be halted.

These are three fairly modest proposals in line with what non reactionaries know about modern economies. They are a progressive answer to the Friedmanite “supply side” anti-regulation, anti-tax, anti-public sector ideology and policies that are te source of our crisis. They are not a fiscal conservative answer, which the budget deal is as I see it–fiscal conservatism which under Clinton postponed the worst of the crisis but politically set the stage for its further development under Bush.

The Budget Speech

from Paul Krugman by By PAUL KRUGMAN

Style: I liked the way Obama made a case for government at the beginning. I liked the way he accused Republicans of pessimism, of abandoning a hopeful vision of America. Good that he went after the Ryan plan — and good that he went after the cruelty of that plan. If you ask me, too many percentages. Oh, and whichever speechwriter came up with “win the future” should be sent to count yurts in Outer Mongolia.

Substance: Much better than many of us feared. Hardly any Bowles-Simpson — yay!

The actual plan relies on some discretionary spending cuts, this time including defense — good, although I think too much is being cut from domestic spending. It relies on letting the Bush tax cuts for the rich expire — finally! — plus unspecified reductions in tax expenditures.

The main thing, though, is the strengthened role of and target for the Independent Payment Advisory Board. This can sound like hocus-pocus — but it’s not.

As I understand it, it would force the board to come up with ways to put Medicare on what amounts to a budget — growing no faster than GDP + 0.5 — and would force Congress to specifically overrule those proposed savings. That’s what cost-control looks like! You have people who actually know about health care and health costs setting priorities for spending, within a budget; in effect, you have an institutional setup which forces Medicare to find ways to say no.

And when people start screaming about death panels again, remember: you can always buy whatever health care you want; the question is what taxpayers should pay for. And compare this with a voucher system, in which you have insurance company executives, rather than health-care professionals, deciding which care won’t be paid for.

Overall, way better than the rumors and trial balloons. I can live with this. And whatever the pundits may say, it was much, much more serious than the Ryan “plan”.

Update: I should probably say, I could live with this as an end result. If this becomes the left pole, and the center is halfway between this and Ryan, then no — better to pursue the zero option of just doing nothing and letting the Bush tax cuts as a whole expire.

Update update: I don’t want to step too much on the administration’s selling point, but progressives upset by the claim that there are three dollars of spending cuts for every dollar of tax increases should be aware that there’s a bit of creative labeling going on. As I understand it, they’re counting both interest savings and reductions in “tax expenditures” — subsidies through the tax code — as spending cuts. It’s a much more balanced plan if you look at the balance between revenue increases and non-interest outlays.

Update update update: The Times has a good side-by-side comparison. A world of difference — and Obama made the moral as well as practical case for his version.

 

Mr. President: Why Medicare Isn’t the Problem, It’s the Solution

from Robert Reich

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I hope when he tells America how he aims to tame future budget deficits the President doesn’t accept conventional Washington wisdom that the biggest problem in the federal budget is Medicare (and its poor cousin Medicaid).

Medicare isn’t the problem. It’s the solution.

The real problem is the soaring costs of health care that lie beneath Medicare. They’re costs all of us are bearing in the form of soaring premiums, co-payments, and deductibles.

Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and private healthcare spending is $7,538 per person. That’s almost two and a half times the average of other advanced nations.

Yet the typical American lives 77.9 years – less than the average 79.4 years in other advanced nations. And we have the highest rate of infant mortality of all advanced nations.

Medical costs are soaring because our health-care system is totally screwed up. Doctors and hospitals have every incentive to spend on unnecessary tests, drugs, and procedures.

You have lower back pain? Almost 95% of such cases are best relieved through physical therapy. But doctors and hospitals routinely do expensive MRI’s, and then refer patients to orthopedic surgeons who often do even more costly surgery. Why? There’s not much money in physical therapy.

Your diabetes, asthma, or heart condition is acting up? If you go to the hospital, 20 percent of the time you’re back there within a month. You wouldn’t be nearly as likely to return if a nurse visited you at home to make sure you were taking your medications. This is common practice in other advanced countries. So why don’t nurses do home visits to Americans with acute conditions? Hospitals aren’t paid for it.

America spends $30 billion a year fixing medical errors – the worst rate among advanced countries. Why? Among other reasons because we keep patient records on computers that can’t share the data. Patient records are continuously re-written on pieces of paper, and then re-entered into different computers. That spells error.

Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That’s twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.

A major occupational category at most hospitals is “billing clerk.” A third of nursing hours are devoted to documenting what’s happened so insurers have proof.

Trying to slow the rise in Medicare costs doesn’t deal with any of this. It will just limit the amounts seniors can spend, which means less care. As a practical matter it means more political battles, as seniors – whose clout will grow as boomers are added to the ranks – demand the limits be increased. (If you thought the demagoguery over “death panels” was bad, you ain’t seen nothin’ yet.)

Paul Ryan’s plan – to give seniors vouchers they can cash in with private for-profit insurers — would be even worse. It would funnel money into the hands of for-profit insurers, whose administrative costs are far higher than Medicare.

So what’s the answer? For starters, allow anyone at any age to join Medicare. Medicare’s administrative costs are in the range of 3 percent. That’s well below the 5 to 10 percent costs borne by large companies that self-insure. It’s even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums). And it’s way, way lower than the administrative costs of individual insurance (40 percent). It’s even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

In addition, allow Medicare – and its poor cousin Medicaid – to use their huge bargaining leverage to negotiate lower rates with hospitals, doctors, and pharmaceutical companies. This would help move health care from a fee-for-the-most-costly-service system into one designed to get the highest-quality outcomes most cheaply.

Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year. More Americans would get quality health care, and the long-term budget crisis would be sharply reduced.

Let me say it again: Medicare isn’t the problem. It’s the solution.

 

 

Letting Bush tax cuts expire would solve 75% of deficit over next 5 years, 40% over 20 years

I’m not terribly thrilled about paying more taxes, especially when we know the Republicans will simply take the money and declare a few more wars. But, it is interesting to see how much money we’d save by simply rolling back the Bush tax cuts and returning taxes to where they were during the prosperous Clinton era. NYT:

If Mr. Obama wins re-election, he could simply refuse to sign any budget-busting tax cut for the rich — who, after all, have received much larger pretax raises than any other income group in recent years and have also had their tax rates fall more. Republicans, for their part, could again refuse to pass any partial extension.

And just like that, on Jan. 1, 2013, the Clinton-era tax rates would return.

This change, by itself, would solve about 75 percent of the deficit problem over the next five years. The rest could come from spending cuts, both for social programs and the military.

Over the longer term — 20 years — letting all of the Bush cuts lapse would close only about 40 percent of the budget gap. But 40 percent is a great start.

I had no idea the numbers were that large.

If GOP blocks debt limit increase, another severe recession is the “best case scenario” per Nate Silver. Disaster for Ds and Rs.

In a post two days ago, Nate Silver did an excellent job laying out the consequences of not increasing the debt ceiling, but also explaining why the Republicans are bluffing when they say they won’t vote to raise the debt limit. Interestingly, Nate says that McConnell in the Senate would like nothing better than to have the debt limit increase pass, but to have Dems be the only ones voting for it, that way the GOP can use it as an election issue (so they’re not bluffing about voting against it, just bluffing about letting the debt ceiling increase fail).

Mr. McConnell is discouraging his colleagues from filibustering a vote to increase the federal debt limit because he knows that, if push came to shove, some of his colleagues would almost certainly have to vote yea. He’d rather it pass in a 51-vote environment, where all of the votes could come from Democrats, than in a 60-vote environment, where at least seven Republicans would have to agree to a cloture motion.

Although Mr. McConnell’s remarks were made privately, other prominent Republicans have said as much publicly (including Mr. Boehner, who has said that a failure to raise the debt limit would create a “financial disaster,” and the G.O.P.’s designated budget hawk, Paul Ryan, who has remarked that the debt ceiling must be raised and will be raised.)

That doesn’t sound like much of a negotiating position. How to reconcile it against comments from other Republicans, such as Eric Cantor, that the debt ceiling vote will provide Republicans with “leverage” to extract additional policy compromises from President Obama and the Democrats. The obvious answer is that Republicans are running a bluff.

If the Congress does not vote to increase the debt ceiling — a statutory provision that governs how many of its debts the Treasury is allowed to pay back (but not how many obligations the United States is allowed to incur in the first place) — then the Treasury will first undertake a series of what it terms “extraordinary actions” to buy time. The “extraordinary actions” are not actually all that extraordinary — at least some of them were undertaken prior to six of the seven debt ceiling votes between 1996 and 2007.

But once the Treasury exhausts this authority, the United States would default on its debt for the first time in its history, which could have consequences like the ones that Mr. Boehner has imagined: a severe global financial crisis (possibly larger in magnitude than the one the world began experiencing in 2007 and 2008), and a significant long-term increase in the United States’ borrowing costs, which could cost it its leadership position in the global economy. Another severe recession would probably be about the best-case scenario if that were to occur.

D.C. Mayor Vincent Gray Arrested Protesting Dem-GOP Budget Deal

from Democracy Now! | Healthcare Reform by mail@democracynow.org (Democracy Now!)

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Play_dc_mayorWashington, D.C. Mayor Vincent Gray and several members of the D.C. Council were arrested Monday when they sat down in the middle of a key intersection in the nation’s capital, blocking traffic to protest the federal budget deal between Democrats and Republicans. The proposed budget reimposes a Republican-backed ban on the District spending its own money to provide abortions to low-income women, and on needle exchange programs regarded as crucial to curbing the spread of HIV in D.C.—where the disease is considered an epidemic. We speak to Mayor Gray about why he took to the streets in protest. [includes rush transcript]

CIVIL LIBERTIES TODAY
“Fascism is the open terrorist dictatorship of the most reactionary sector of monopoly capital”

The CIA and Assassinations

from Schneier on Security by Bruce Schneier

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The former CIA general counsel, John A. Rizzo, talks about his agency’s assassination program, which has increased dramatically under the Obama administration:

The hub of activity for the targeted killings is the CIA’s Counterterrorist Center, where lawyers­there are roughly 10 of them, says Rizzo — write a cable asserting that an individual poses a grave threat to the United States. The CIA cables are legalistic and carefully argued, often running up to five pages. Michael Scheuer, who used to be in charge of the CIA’s Osama bin Laden unit, describes “a dossier,” or a “two-page document,” along with “an appendix with supporting information, if anybody wanted to read all of it.” The dossier, he says, “would go to the lawyers, and they would decide. They were very picky.” Sometimes, Scheuer says, the hurdles may have been too high. “Very often this caused a missed opportunity. The whole idea that people got shot because someone has a hunch­I only wish that was true. If it were, there would be a lot more bad guys dead.”Sometimes, as Rizzo recalls, the evidence against an individual would be thin, and high-level lawyers would tell their subordinates, “You guys did not make a case.” “Sometimes the justification would be that the person was thought to be at a meeting,” Rizzo explains. “It was too squishy.” The memo would get kicked back downstairs.

The cables that were “ready for prime time,” as Rizzo puts it, concluded with the following words: “Therefore we request approval for targeting for lethal operation.” There was a space provided for the signature of the general counsel, along with the word “concurred.” Rizzo says he saw about one cable each month, and at any given time there were roughly 30 individuals who were targeted. Many of them ended up dead, but not all: “No. 1 and No. 2 on the hit parade are still out there,” Rizzo says, referring to “you-know-who and [Ayman al-] Zawahiri,” a top Qaeda leader.

And the ACLU Deputy Legal Director on the interview:

What was most remarkable about the interview, though, was not what Rizzo said but that it was Rizzo who said it. For more than six years until his retirement in December 2009, Rizzo was the CIA’s acting general counsel — the agency’s chief lawyer. On his watch the CIA had sought to quash a Freedom of Information Act lawsuit by arguing that national security would be harmed irreparably if the CIA were to acknowledge any detail about the targeted killing program, even the program’s mere existence.Rizzo’s disclosure was long overdue — the American public surely has a right to know that the assassination of terrorism suspects is now official government policy ­ and reflects an opportunistic approach to allegedly sensitive information that has become the norm for senior government officials. Routinely, officials insist to courts that the nation’s security will be compromised if certain facts are revealed but then supply those same facts to trusted reporters.

at Yale University–not in a Muslim country

“In 2008, fraternity members photographed themselves in front of the Yale Women’s Center with a poster reading, “We Love Yale Sluts.” In 2009, a widely e-mailed “preseason scouting report” rated the desirability of about 50 newly arrived freshman women by the number of drinks a man would need in order to have sex with them. And in October, fraternity pledges paraded through a residential quadrangle chanting: “No means yes!” Catherine Sheard, a junior from Canton, N.Y., heard the chants while studying, and reacted the way many students have. “I thought it was really obnoxious and closed the window,” she said. Suddenly, however, these episodes have the campus in a state of high alert. Yale acknowledged last week that the Department of Education’s Office for Civil Rights was investigating a complaint filed by 16 students and recent graduates, accusing the university of violating Title IX, the federal gender-equality law, by failing to eliminate a hostile sexual environment on campus. The complaint alleges a range of acts against women, from taunts to assaults, over seven years….Conor Crawford, a junior from Des Moines, said he had detected a tolerance on campus for crude comments about women that contrasted with a greater deference shown to gay and minority students. “There are a lot of close female friends I have here who have felt threatened,” he said. “You can hear the same language in some all-male suites, with the word ‘bitch’ used a lot and just general objectification.””

Is the FBI Lying to Congress about its Abuses of the “PATRIOT” Act?

from Informed Comment by Juan

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Techdirt asks, “Is the FBI lying to Congress about its abuses of the PATRIOT Act? and answers in the affirmative.

Actually there is plenty of indication in the public record of abuses in the sense of using the act for criminal rather than purely security-related prosecutions and warrantless wiretapping, something the Bureau initially promised never to do.

Former Senator Russ Feingold appears to have seen internal Bureau memos that make it clear that the abuses are even more serious than that, and obviously are sustained.

Power corrupts, and absolute power corrupts absolutely. The case for gutting our Bill of Rights on security grounds is so weak as to be non-existent. Someone please drive a stake through the heart of this tyrannical and unconstitutional Act.

 

THE ECONOMY

ENVIRONEMENT




NUCLEAR POWER

 

Expert: Despite Japanese Gov’t Claims of Decreasing Radiation, Fukushima a “Ticking Time Bomb”

from Democracy Now! | Healthcare Reform by mail@democracynow.org (Democracy Now!)

Play_kakuThe Japanese government is trying to calm fears about radiation levels and food safety in the region around the heavily damaged Fukushima Daiichi nuclear power facility, even as it has raised the severity rating of the crisis to the highest possible level. “Radiation is continuing to leak out of the reactors. The situation is not stable at all,” says Dr. Michio Kaku, professor of theoretical physics at the City University of New York and the City College of New York. “The slightest disturbance could set off a full-scale meltdown at three nuclear power stations, far beyond what we saw at Chernobyl.” [includes rush transcript]

 

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This entry was posted in Background & Analysis, Civil Liberties, Events, Human Rights, Imperialism, Imperialist Interference & Views, Japan, Nuclear Power, Obama, US. Bookmark the permalink.

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