What KIND of health care?

The raging health care debate "debate" is almost entirely devoid of facts, an issue on which I've previously posted. Instead of discussing fact, then, we tend hurl vague accusations, like calling the reformers "communists" (and you've GOT to see this). I "blame" Obama for this lack of specificity, but I realize that the vicious opposition mounted by huge self-interested insurance companies and health care providers might require that he not play all of his cards at this point. But isn't it odd that our politicians aren't at least clarifying the term "health care coverage" when they refer to national health care coverage? Defining this term would make a huge difference to the public reaction to any national plan. Here are two possibilities (though there are others): A) The national plan will offer gold-plated coverage much like the expensive United Health Care coverage I buy for my family through my employer. For the record, the pre-tax cost of this coverage is about $20,000 per year for my family. Is the Obama proposal to provide every citizen with this kind of coverage? If so, I can see why there is massive resentment to the proposal. Many working people can barely afford health insurance coverage at all, and the coverage many people do purchase is not nearly as comprehensive as the expensive coverage I purchase. Of course people who can can only afford to buy their own rudimentary policies will resent that the government might buy gold-plated policies for everyone else, including many highly irresponsible people. B) The national plan will offer a rudimentary coverage only. It will cover x-rays and casts for broken arms, but not heart transplants and expensive drugs that only marginally increase one's chances of surviving an illness. It wouldn't keep people suffering from terminal illness on life support when there is no reasonable chance that they would ever leave the hospital. It would cover only a small subset of the treatments covered by gold-plated policies. It might be akin to the Oregon Plan. I believe that there would be massive resistance to the national coverage described in A) but far less resistance to the coverage described in B). At least Oregon's legislators had the cajunas to specifically state what was covered under their plan and what was not (Oregon's prioritized list is available for all to see). Oregon had the fiscal responsibility to make certain that they could afford the level of health care to which they were committing. Oregon dealt head-on with the accusation that they were "rationing" health care; absolutely they were, just like private plans ration health care only to those who pay those high premiums. Both responsible and irresponsible health care plans "ration" health care. Therefore, it is not a criticism of any health care plan that it "rations" health care. Here are the guiding principles to the Oregon Plan:

In 1987, the Oregon Legislature realized that it had no method for allocating resources for health care that was both effective and accountable. Over the next two years, policy objectives were developed to guide the drafting of legislation to address this problem. These policy objectives included:

• Acknowledgment that the goal is health rather than health services or health insurance • Commitment to a public process with structured public input • Commitment to meet budget constraints by reducing benefits rather than cutting people from coverage or reducing payments to levels below the cost of care • Commitment to use available resources to fund clinically effective treatments of conditions important to Oregonians • Development of explicit health service priorities to guide resource allocation decisions.

Our national conversation regarding health care is so dysfunction on so many levels that it's hard to know where to begin. I'll make only one more point in this post, however. Opponents of current proposals often make accusations that there will be "death panels," indicating that some sick people will be allowed to die. As a nation, we need to grow up and deal with the fact that this happens every day in every hospital in the country: we shouldn't be allocating huge amounts of money to maintain pulses in people who have become living corpses. There are some families who "can't let go" no matter what (e.g., Terry Schiavo), and our national plan needs to have specific guidelines for these situations. In fact, every private insurance plan should have guidelines for determining when further treatment is likely to be futile and a provision for ending coverage at that point. The alternative is to make policies so horrifically expensive that many people can't afford policies that cover tratments likely to make an immediate positive impact on their lives. Only when we put these issues clearly on the table can we begin to have a real conversation.

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Elizabeth Warren faces fierce resistance to regulation of non-bank lenders

Elizabeth Warren is one of my heroes. Barack Obama appointed her to be Chair of the Congressional Oversight Panel created, which was established to oversee the banking bailouts. For many years, Warren has fought tough battles on behalf of consumers. [See the related posts to this post; and here's a video of Warren being interviewed by Jon Stewart that will give you an idea of what she is about (and especially consider Part II)]. Warren is now facing an incredibly tough uphill battle. Her main weapon is common sense. She wants to regulate banks and non-bank lenders, to stop them from defrauding consumers with their fine print, their outlandish fees and their arithmetical hocus-pocus. In a fair fight, her position should easily win the day. But it's not a fair fight, because the financial services industry owns much of Congress. Therefore, Warren has spent much time advocating for the need for a strong Consumer Financial Protection Agency (CFPA). Here's what Warren has to say about the need to regulate non-bank lenders:

There is more that we can do to deal with non-bank lenders, but only if Congress creates a strong CFPA. If we stick with the status quo -- which treats loans differently depending on who issues them and places consumer protection in agencies that consider it an afterthought - we know what will happen because we have seen it happen before. Lenders will continue their tricks and traps business model, the mega-banks will exploit regulatory loopholes, and the non-banks will continue to sell deceptive products. In that world, small banks will need to choose between lowering standards or losing market share, and they will still get too much attention from regulators while the non-banks and big banks get too little. Dangerous loans will destabilize both families and the economy, and we'll all remain at risk for the next trillion-dollar bailout. Regulating the non-banks hasn't been tried in any serious way. The CFPA offers a real chance to level the playing field, to add balance to the system, and to change the consumer lending landscape forever.

Continue ReadingElizabeth Warren faces fierce resistance to regulation of non-bank lenders

Somalia as a libertarian paradise?

Believe it or not, some are claiming that Somalia is doing alright without any elected government, thank you. Somalian have access to fairly good cell phone service and one can hire private bodyguards. Prevalence of AIDS is extremely low compared to many other African countries (though many attribute this to strict Muslim practices regarding sexuality). As this same article points out, however, things are going so "well" that the Somali 2004 presidential election had to be held in Kenya. Consider, also, the BBC's 2009 country profile of Somalia:

Somalia has been without an effective central government since President Siad Barre was overthrown in 1991. Fighting between rival warlords and an inability to deal with famine and disease led to the deaths of up to one million people . . . [Somalia is the] scene of arguably Africa's worst humanitarian crisis: a third of the population is dependent on food aid . . . No effective government since 1991.

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U.S. Supreme Court to decide whether Corporations have the same First Amendment rights as individuals.

On September 4, 2009, Bill Moyers hosted Trevor Potter, president and general counsel of The Campaign Legal Center (and former chairman of the Federal Election Commission), and Floyd Abrams, a First Amendment attorney. You can view the entire discussion here. The topic is whether longstanding federal election laws should be held unconstitutional so that corporations can freely spend unlimited amounts of money (e.g., in the form of movies, books, and other private initiatives) in order to directly affect the outcome of federal political campaigns. The case is Citizens United v. The Federal Election Commission. Many legal commentators are suggesting the Supreme Court has already suggested that it leaning in favor of the corporations on this issue. And we can almost guarantee how Chief Justice John Roberts is going to vote on this issue (and see here). I highly recommend viewing this discussion. I thought that Abrams looked very much like a man who was being paid big money to take position he knew to be reprehensible. On the other hand, Trevor Potter is taking a position that looks out for people like you and me. I realize that powerful corporate interests have already made puppets out of Congress, the SEC, the FDA and many other federal agencies (see these recent examples regarding tobacco legislation and the rejection of the bankruptcy cram-down option). With this as the context, I believe that Citizens United boils down to a simple question: Should our government be at least somewhat run by ordinary people or should corporate money flow even more freely at election time (much more than it flows already), allowing our federal government to be taken over entirely by powerful corporations driven almost entirely by the profit motive? Here are a few excerpts from Moyers’ discussion with Potter and Abrams:

TREVOR POTTER: This is a case about corporate money. If this case is won by the corporation, we will be in the ironic situation where corporations will have no limits on what they can spend in elections and unions still will. So, it's important to remember we're talking about corporations. Corporations exist solely to make money. Amassing economic power. They want, if they could get it out of government, monopolies. They want the ability to defeat their competitors. And if they can use government to do that, they will. Individuals have a whole range of interests. Individuals go to church, they care about religious and social issues, they care about the future of the country. They're voters.

So, they have a range of issues at stake that corporations don't have. Corporations just want to make money. So, if you let the corporation with a privileged economic legal position loose in the political sphere, when we're deciding who to elect, I think you are giving them an enormous advantage over individuals and not a healthy one for our democracy. . . . [C]orporations have a different status. And they ought to be focused on the economic marketplace and not the political marketplace.

FLOYD ABRAMS: You're opening the faucet, so to speak, so that more speech can occur. I don't think it's a can of worms to say that corporations, and it is unions as well, ought to be able to participate in the give and take of the democratic processes in the country. From my perspective, at least, the notion of saying that corporations and unions should be out of the picture either because they're too powerful, or because of the way their money has been created, is so inconsistent with the sort of First Amendment approach that we take in everything else, where we say over and over again, we don't care who the speaker is, we don't care where the speaker's coming from. And speech, we think, is, as a generality, a good thing . . .

BILL MOYERS: But we're not talking about free press issues here. We're talking about the power of an organized economic interest to spend vast sums of money that individuals can't spend . . . Would you disagree with the claim that big business dominates the political discussion today? Whether it's the drug industry or the health insurance industry? Big business is the dominant force in Washington. I mean, I see that as a journalist . . . we're not talking about free press issues here. We're talking about the power of an organized economic interest to spend vast sums of money that individuals can't spend.

It is important to deny powerful profit-seeking organizations the right to skew federal election results even more than they do currently. If the Supreme Court goes the wrong way on this issue, it would even make a mockery out of clean-money initiatives, such as this plan being promoted by Common Cause and this plan by Public Citizen.

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The Right is wrong

My 10 year old daughter came home from school last week, and while she sat with me eating her after-school snack asked me; “Is President Obama a racist?” she said. “No, honey, where’d you hear that?” I said. “Well, [so and so] said that in class to me today and I just wanted to know,” she said. “Did the person tell you where they had heard such a thing, honey?” I asked. “Yeah, [their] grandpa said it,” my daughter replied. “He heard it on TV.” My daughter and I had a discussion on what is racism, its source in ignorance, and how it’s just plain wrong. We also talked about the TV and radio shows which spread intolerance and bigotry for profit and political gain. My daughter’s eyes glazed over a little, and I said; “Thanks for letting me know what’s up with you! Go play with your friends!” Well, I never thought it could happen but, there is obviously no lowest depth of putrid vile chicanery that the far right wing racists will go to block anything that President Obama is up to keep his promise of change in America. Now they’re indoctrinating racism into 10 year old school children.

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