Full Court Press

It was all healthcare all the time on talk radio this morning. On the road this morning I heard some conservative literally spit into his microphone over how crazy it was for something that was supposedly free to actually cost a trillion dollars and how there's a long waiting list for programs - just as there would be once it was enacted for people to see their doctors. He also alluded to the idea that you wouldn't be able to get aspirin.

Pretty crazed stuff, but no doubt straight off the Republican talking points. Emphasize waiting, emphasize cost, emphasize a loss of personal control - all of which happen to be false, but still. Great talking points.

On to NPR where some WellPoint exec is claiming that Medicare is less efficient and innovative than private insurance companies.

Really.

On to the librul station where, without a skipped beat, Big Ed was glad that David Axelrod had finally made a shot over the bow to the Republicans that if they weren't willing to go along with the program then healthcare reform didn't need to be bipartisan.

He read this quote: "Ultimately, this is not about a process, it's about results," David Axelrod, Obama's senior political strategist, said during an interview yesterday in his White House office. "If we're going to get this thing done, obviously time is a- wasting." Both Axelrod and White House Chief of Staff Rahm Emanuel said taking a partisan route to enacting major health-care legislation isn't the president's preferred choice. Yet in separate interviews, each man left that option open.

"We'd like to do it with the votes of members of both parties," Axelrod said. "But the worst result would be to not get health-care reform done."

Paying for it will be the taxes on the wealthy - and it is curious how the Republicans can rail against that and at the same time denounce excessive bonuses - like the ones announced today at Goldman Sachs, where the average employee bonus is nearly $900,000 and top execs will see tens of millions.

Come on. You're not in favor of taxing that?

Fooled a Couple Times

Remember Bush's push to privatize Social Security?

I didn't either -- but this letter-writer did:

Good letter to ed in Mpls Star Trib yesterday:

“We should be glad that our Social Security money wasn’t in the privatized hands of Citibank, Merrill Lynch and the other financial ‘wizards’ as President Bush had so strongly urged.”

Something that needs to be said repeatedly & loudly.

Best Bushenomics article ever

Larry Beinhart's article on Bushenomics at Alternet is well worth a read. Some of his points regarding the looting of our country that's taken place under Bush:

• With privatization, one dollar out of every three for direct military operations in Iraq and Afghanistan goes to private contractors like Halliburton and Blackwater.
• Most the assets of the United States, our collective wealth, could not be sold off in such a direct manner. The administration instead borrowed against them. They cut taxes while continuing to spend lavishly, creating debt. The debt is owed by all of us, the people of the United States.
• As measured by the GDP, the economy grew by 35 percent between 2001 and 2007.
• Job creation: In the first six years of the Clinton administration, 13.7 million jobs were created. In the same period, under Bush, only 3.7 million jobs were created. Barely keeping up with population growth.
• Median income: That's as opposed to average income (If Bill Gates walks into a bar with 10 people, the average income of everyone in the room goes up by $17,5000,000. But the median income just moves up half a notch, from between the fifth and sixth person, to the sixth person's income). From 2001 to 2005, median income, for people under 65, went down $2,000.
• America's businesses: Under Clinton, the Dow Jones went up 324 percent. Bush arrived in 2001. Since then the Dow Jones is up just 10 percent.
• So where is that 35 percent growth in the economy?

• The M3 took off like a rocket after 2001. The Fed stopped publishing the M3 in 2006. (The M1 is basically cash, plus checking and "current" accounts. The M2 adds savings accounts, money market accounts and CDs up to $100,000. The M3 adds in the big CDs, Eurodollar accounts and other large exotics.)
• The administration grew the economy (or at least the amount of money in circulation), without inflation... If [Bushenomics] had created business growth -- actual business, not just financial business -- that would have created jobs. Then there would have been inflationary pressure. If salaries for ordinary people go up, even a little, the total is a big sum. But due to free trade, outsourcing, bad economic policy, policies aimed at keeping wages down, and relentless union busting, good jobs were lost, to be replaced with low-wage jobs, when they were replaced at all.
• Finally, the Fed kept interest rates down. The supply of money was increased. The price of money was kept artificially low.
• With no new boom to invest in, businesses made loans.
• The loans grew into a bubble...
• No job growth, no business growth, no stock market growth, falling median incomes, disappearing pensions and health plans, and the fall of the dollar.
• The real solutions are pretty obvious and pretty simple. First, we have to make a choice: Do we want a sound economy for all of us and a strong America? Or do we want to have a few people of unlimited wealth who use that wealth, among other things, to control the government so that it helps them milk more money from the rest of us?
• In the real world, there are no such things as free markets. In the real world, business people manipulate and conspire to control markets, and governments both control and collude with business, while tax policies and government spending have a major affect on the economy.
• Simply giving money to rich people doesn't work. Bob Novak, the conservative commentator who calls the investor class "the most creative class," is flat out wrong.
• Money has no mind of its own. It has to be directed toward areas that will generate and support business and good jobs at good wages. As it happens, our economic goals are on the same road as the social good.
• The No. 1 target has to be alternative energy.
• The No. 2 target is infrastructure.
• The No. 3 target is health care.
• The No. 4 four target is a balanced budget.
• How can all this be done? Raising taxes. On the wealthy. And on corporations. That's not class warfare. That's simple practicality.

No security in supercapitalism

Begin with Bobby Kennedy's words on the quality of life:

"Too much and too long, we seem to have surrendered community excellence and community values in the mere accumulation of material things. Our gross national product ... if we should judge America by that, counts air pollution and cigarette advertising, and ambulances to clear our highways of carnage. It counts special locks for our doors and the jails for those who break them. It counts the destruction of our redwoods and the loss of our natural wonder in chaotic sprawl. It counts napalm and the cost of a nuclear warhead, and armored cars for police who fight riots in our streets. It counts Whitman's rifle and Speck's knife, and the television programs which glorify violence in order to sell toys to our children. Yet the gross national product does not allow for the health of our children, the quality of their education, or the joy of their play. It does not include the beauty of our poetry or the strength of our marriages; the intelligence of our public debate or the integrity of our public officials. It measures neither our wit nor our courage; neither our wisdom nor our learning; neither our compassion nor our devotion to our country; it measures everything, in short, except that which makes life worthwhile. And it tells us everything about America except why we are proud that we are Americans."

Now go to George Lakoff's essay on neoliberalism — that's Clinton's and Blair's Third Way — at the Rockridge Institute. Lakoff posits that:

In neoliberal thought there is the belief that markets can be effectively regulated to serve those interests, which leads to recommendations for technocratic changes to existing markets as one means to achieve progressive ends. Under the domestic version of neoliberal economics, many progressive moral goals can be achieved through private enterprise as an efficient means to moral ends. Though conservatism sees the market itself as defining moral ends, neoliberalism shares with conservatism the idea that the market can be efficient and serve moral ends. This is why neoliberal thought has no problem with health care solutions that involve profit-maximizing private insurance companies.

The neoliberal emphasis on "systems" often causes a loss of focus upon the progressive morality that lies beneath their political and policy solutions. Specific references to progressive values disappear from their messages. So do references to the government functions of protection and empowerment. Neoliberals may begin with the morality of empathy and responsibility for oneself and others, but their faith and focus soon shifts to the abstract, to complicated systems and intricate public/private solutions. Empathy, the moral force that holds together our democracy and the engine of community, is reduced to sentimentality and shunted aside.

Compare that with Tony Judt's review of Robert Reich's book, Supercapitalism. In that book, Reich himself outlines the problem with "supercapitalism," noting that in 2005 the wealth of the (Wal-Mart founders) Walton family was about the same ($90 billion) as that of the bottom 40 percent of the US population: 120 million.

Inexplicably, Reich doesn't see this as a problem; he finds no basic fault in a system that is wiping out the middle class. Or if he does, he sees it as pointless to complain about it as it would be to complain about the unfairness of aging. It's just there, as far as he's concerned.

Judt differs. And he doesn't believe that "supercapitalism," for which the health insurance industry is in many ways the poster child, will necessarily last — for two reasons, first of which:

this story is not very appealing. It leaves a lot of people out, both at home and abroad; it wreaks havoc with the natural environment; and its consequences are unattractive and uninspiring. Abundance (as Daniel Bell once observed) may be the American substitute for socialism; but as shared social objectives go, shopping remains something of an underachievement. In the early years of the French Revolution the Marquis de Condorcet was dismayed at the prospect of commercial society that was opening before him (as it is opening before us): the idea that "liberty will be no more, in the eyes of an avid nation, than a necessary condition for the security of financial operations." We ought to share his revulsion.

The second source of anxiety is that the never-ending story may not last... [and if so] we might do well to take a second glance at the way our twentieth-century predecessors responded to the political challenges of economic uncertainty. We may discover, as they did, that the universal provision of social services and some restriction upon inequalities of income and wealth are important economic variables in themselves, furnishing the necessary public cohesion and political confidence for a sustained prosperity—and that only the state has the resources and the authority to provide those services and enforce those restrictions in our collective name.

We may find that a healthy democracy, far from being threatened by the regulatory state, actually depends upon it...

Edwards knows the enemy

Michael Moore isn't endorsing anyone, but he likes Edwards:

It's hard to get past the hair, isn't it? But once you do -- and recently I have chosen to try -- you find a man who is out to take on the wealthy and powerful who have made life so miserable for so many. A candidate who says things like this: "I absolutely believe to my soul that this corporate greed and corporate power has an ironclad hold on our democracy." Whoa. We haven't heard anyone talk like that in a while, at least not anyone who is near the top of the polls. I suspect this is why Edwards is doing so well in Iowa, even though he has nowhere near the stash of cash the other two have. He won't take the big checks from the corporate PACs, and he is alone among the top three candidates in agreeing to limit his spending and be publicly funded. He has said, point-blank, that he's going after the drug companies and the oil companies and anyone else who is messing with the American worker. The media clearly find him to be a threat, probably because he will go after their monopolistic power, too. This is Roosevelt/Truman kind of talk...

And he voted for the war. But unlike Senator Clinton, he has stated quite forcefully that he was wrong. And he has remorse...

Edwards is the only one of the three front-runners who has a universal health care plan that will lead to the single-payer kind all other civilized countries have. His plan doesn't go as fast as I would like, but he is the only one who has correctly pointed out that the health insurance companies are the enemy and should not have a seat at the table.

Right.

Headed In The Right Direction?

My mother was dirt poor growing up growing up in North Florida. She got out as fast as she could. Like many other poor Southerners in the 1940s, she headed to Chicago, where she graduated from Mount Sinai Hospital's nursing program.

Not too long ago she mused aloud how her life might have been different if her family hadn't been so poor when she was growing up. The casual observer might think that she'd done OK, poor childhood or not. Indeed, all the Joiner kids were part of the karmic reward of the American dream lifting all boats after World War II. All five siblings made it to the middle class, all but one, in fact, to the upper middle class. My mother and her younger sister married doctors; her older sister became a nurse and married a teacher, and the youngest sister married a city planner. My uncle became an engineer. My own mother never worked outside the home after her first child was born. She lived in a sprawling suburb of big houses on oversize lots and took a nap every afternoon.

But the naps, rather than giving insight into some innate laziness on her part (and there is some of that — in a never-ending rebuke to her own, driven mother), are more a legacy of the malignant effects of poverty. Debilitating, health sapping poverty. The Southern variety. My mother's health was never good, her stamina nonexistent.

The Public Library of Science's journal of Neglected Tropical Diseases has a piece on current U.S. health disparities. It's a reminder of how close the connection is between health and success.

During the early 20th century hookworm was a highly endemic soil-transmitted helminth infection in the American South, and a major cause of severe anemia and malnutrition in the region. Together with malaria, niacin deficiency (pellagra), typhoid fever, ascariasis, trichuriasis, and other conditions common to areas of tropical and subtropical poverty, hookworm helped to foster the concept of the “sick man of the South” or the “lazy Southerner.” The poverty-promoting aspects of these diseases are powerfully illustrated by the recent work of the economist Hoyt Bleakley, who has estimated that because of its impact on child growth and development, school performance, and school attendance, chronic hookworm infection in the American South was responsible for a 43% reduction in future wage-earning.

The writer's conclusion? "There are no excuses for allowing such glaring health disparities to persist in one of the world's wealthiest countries."

Except that, of course, there are plenty of excuses. A couple trillion dollars worth of excuses. Ask a progressive. They'll explain why real health care reform — that is, the proven reform that universal, single-payer health care brings, just isn't feasible.

And as long as that's the progressives' line, it's true. And as long as that's true, our nation will continue heading in the wrong direction, towards a developing world status in health care, education, and the chasm of disparity between rich and poor.

Healthcare dragging down the economy

The Center for Economic and Policy Research has released "The Good, The Bad, and the Ugly: Job Quality in the United States over the Three Most Recent Business Cycles."

Killer title.

"This report finds that the US economy has created fewer good jobs in the 2000s than was the case over comparable periods in the 1980s and 1990s. The report analyzed annual data from the March Current Population Survey for the years 1979 through 2006 and shows that while the current business cycle has seen an increase in the share of jobs that pay at least $17 an hour, this gain has been more than offset by a decrease in the share of jobs that offer employer-provided health insurance (down 3.1 percent points) and pension coverage (down 4.9 percentage points)."

However, we're saved from being a nanny state. Good to look at the bright side, eh. Thanks be to all those Republicans and Dems who've made it possible.

War declared on Sicko

An editorial at Investor's Business Daily on Sicko and healthcare reform lays out a war strategy:

The Hillary Clinton-led forces that tried to socialize medicine in the U.S. 13 years ago are mobilizing for war. Stopping them requires knowing their strategy before the first shot is fired.

Michael Moore's new documentary, Sicko, which opens June 29, has been screened to the press, and it's powerful propaganda.

In it, America is a country where health insurers and hospitals kill people by denying coverage, make obscene profits charging outlandish sums for treatments and drugs, and even dump hapless, gown-clad patients who can't pay their bills on the doorsteps of other hospitals.

Meanwhile, Canada, Britain, France and even Cuba are portrayed as medical fairy wonderlands where doctors, hospitals and medicine are free or cost a pittance. Yet socialism doesn't prevent government-employed physicians from driving Audis or living in million-dollar homes.

Rep. John Conyers, the far-left Michigan Democrat, calls the Sicko release "one of the most important developments in the national debate on our health care crisis since the Clintons attempted to pass universal health care legislation in 1994."

Conyers and Rep. Dennis Kucinich, D-Ohio, are co-authors of legislation to have the government take over the health system and provide "enhanced Medicare for everyone." Sicko producers Harvey and Robert Weinstein have even hired ex-Clinton White House mudslinger Chris Lehane to use the movie as a flash point for organizing political rallies.

Like the bullet that slew Archduke Franz Ferdinand and sparked World War I, Sicko"may one day be looked back on as triggering the great health care war. The next president will likely end that conflict with the momentous decision of replacing our faulty employer-based health insurance system with a reform that empowers one of two interests: the government or patients.

No doubt about the sickness of a current U.S. system that "smothers competition," according to John Goodman, president of the National Center for Policy Analysis.

A Pennsylvania health care agency recently reported that the 60 hospitals performing heart-bypass surgery in that state showed little if any relationship between the price charged for the procedure — from less than $20,000 to nearly $100,000 — and quality of care or mortality rates.

Responding to the findings, Dr. Ronald Paulus, an executive with Geisinger Health System of central Pennsylvania, told the New York Times there's no current financial incentive in the present system for hospitals to provide care leading to better outcomes and lower payments.

Dr. David Gratzer, a Canadian physician, Manhattan Institute senior fellow and author of the new book "The Cure: How Capitalism Can Save Health Care," calls U.S. health care "an accidental system."

... "Federal subsidies enabled managed-care plans to attract customers by offering benefits that other insurers could not," said Regina Herzlinger, a Harvard Business School professor and author of the just-published "Who Killed Health Care?," which makes the case for a new consumer-driven health system.

Herzlinger added that "in its cruelest aspect," the Nixon-Kennedy HMO act "enabled physicians to be paid for not providing health care." The managed-care movement became, as she described it, "the worst kind of business — the kind that injures its customers."

... But is the answer socialism? Many Democrats think so. Chairing a health care panel in Poughkeepsie, N.Y., last month, freshman Rep. John Hall, D-N.Y., a supporter of government-provided single-payer universal coverage, dazzled the audience with a story of how his mother once fell on the steps of a restaurant in the Czech Republic and received a free operation and two free weeks in a hospital....

Herzlinger offers as a model for reform Switzerland's long-standing, market-based, consumer-driven health system. "Individuals in the Swiss system can safely and effectively buy insurance from a large number of competent firms," she said. Universal coverage is required and prices for consumers are not risk-adjusted.

"A sick 60-year-old man pays the same price for insurance as a healthy one," Herzlinger said.

In addition, the Swiss system directly subsidizes the poor. The overall result is that costs and inflation rates are 40% lower as a percentage of the economy than in the U.S....

Interesting. They like the Swiss system, the most expensive system other than our own.

The Swiss generally agree that their system needs major reform — but they've been assaulted by the same barrage of fear-based appeals to scare them off from single-payer that we have. But this is an interesting strategy on the part of the right — to promise a system like Switzerland's, which is indisputably better than ours. It's just not up to par with its neighbors in terms of equity or cost-effectiveness — and does not have better statistics on quality and outcomes.

The only problem with this strategy is that it's hard to imagine the insurance industry money really getting behind it. Switzerland's system depends on regulation that the insurance industry here would never agree to. There are far too many insurance CEO Marie Antoinettes who believe that the peasants can eat cake a while longer — at least until their own own golden parachute comes through.

Sicko's even at Business Week

Sicko's even at Business Week — and with a positive review. Which is as it should be. Our healthcare system is bad for business.

"Anything—including a film—that can bring this issue into the public eye is good for the debate," says heart surgeon Dr. William Plested, president of the American Medical Assn. "So, I'm cheering on Michael Moore, even though I haven't seen the film."

Business Week has a nice trailer for the film there.

Can we reform the system? Or are the cynics right, and it's "unfeasible"? If that's the case, we're in the decline and fall of our democracy. Here's a comment from a recent Washington Post back and forth with Steven Pearlstein:

If you look at wealth inequality from an historical point of view, you will see that countries with a vast difference in the percent of wealth held by the upper 1 percent (say) as compared with the lower 90 percent (say) soon go down the tubes. The reason is that wealth translates into political power, and soon the country is making decisions that benefit the top 1 percent and not the country as a whole. This is discussed in detail in Kevin Phillips' "Wealth and Democracy." Since this is a feedback situation, it tends to happen and has at least started to happen several times in our history. The strength of America has been that just when the trend starts to enter the strong feedback stage, something has happened that redistributes the wealth. The rise of unions and FDR are two such examples. What we have to worry about is that the trend of wealth piling up in the top 1 percent or 0.1 percent is increasing and we see the country taking positions that benefit only the Rich. Two examples are taxing dividends and capital gains at a lower rate and the attempt to abolish the estate tax. I am sure you can come up with many more such examples.

Time to redistribute, wouldn't you say? Or are we too "free market" to save the country?

Employed but losing ground...

The Democrats have been in office for less than two months, and already the New York Times is sugar-coating the worsening economic realities of America's working class.

The Times looks at the latest round of factory closings and sees a glass half full (or, as our Dear Leader would say, "a half-glass-full"). Things are actually not so bad. We're not deindustrializing. The Progressive Policy Institute reports that foreign firms invest billions more in the U.S. than U.S. manufacturers invest abroad. That creates hundreds of thousands of American jobs.

This is pap. The United States doesn't have to "deindustrialize" in order to be in a negative spiral that takes us toward Bangladesh and away from Belgium. Our idolatry of celebrity, aristocracy, and wealth; the growing chasm between rich and poor; the hysteria over "illegals"; the growing acceptance of inequality — we're becoming a smaller and meaner America, even if we do still manufacture a fifth of the world's stuff.

The Times calls for retraining workers as the longterm solution. Pro-free-trade politicians risk a protectionist backlash if they don't heed people's pain.

Just to start, pro-trade politicians have to make sure that a lost factory job does not mean a drastic and lasting decline in living standards, with no access to health insurance and no hope for a college education for that worker’s children. As the tide rises, this country cannot allow millions to drown.

The reality for many Americans is worse than that, both in terms of healthcare and higher education. Those costs have risen far faster than average wages. You don't have to lose your job to see little hope of affording real healthcare coverage or something other than community college for your kids.

Blue ribbons again

The Colorado Blue Ribbon for Health Care Reform met on Tuesday and Wednesday for a retreat and business meeting. The 24 commissioners and three staff people spent about 20 hours together, and understand one another better now.

I’ll be posting this ad nauseum, in part because this group is so typical of opinion leaders across the United States.

There are moderates and conservatives; an advocate for the poor, an advocate for the African-American community, an advocate for the disabled, and an advocate for labor; business and healthcare CEOs and executive directors; and a ranting, aggressive libertarian who leaves everyone else feeling attacked and having to compromise — rightwards from their already tentative, centrist positions. And don't think that those "advocates" balance the group: at least two of the four are centrists.

And they're all pulled relentlessly rightwards.

Here’s an example of how this works.

A couple weeks ago there was an article in the Rocky Mountain News complaining that the generally agreed upon number of 46, 47 million uninsured is vastly inflated.

When the group was going around sharing how they felt, Linda Gorman, the libertarian, offered no vision, but rather her usual tirade against the unfairness of living in community. “The way public programs always work is that they expand into oblivion,” she said.

Then it was Allan Jenson’s turn. Jenson, an independent insurance broker had earlier told me that Americans wouldn’t accept anything other healthcare system than what we have right now because they won’t accept any limitations on what they can buy. He admitted that he knew nothing about France’s system, and the fact that there aren’t limitations there on services, or waiting lists — because the French and most other Western European nations adequately fund their healthcare programs.

On this day Jenson sadly noted that “we live in an era of resource limitations.”

He repeated that the number of uninsured is abused. He doesn’t think Colorado has 780,000 or so. He thinks it’s actually about 200,000.

There were general murmurs of agreement.

Daniel Stenersen, president and CEO of Shalom Park, a long-term care facility and a Democratic appointee, asked the group how much society was going to spend to prolong lives. “How much are we willing to spend on irresponsibility?”

“Then you have this whole notion of a perceived right to service,” Stenersen said. “I’ve struggled with this. Big time. Does a 94-year-old woman have a right to all expenditures that could conceivably be made available to her?”

This is an argument akin to the Right-To-Lifers pulling out the one about the abortions on 8-month, viable fetuses. It's something that doesn't happen. It's taking an extreme and trying to make the law around that vanishingly rare instance.

Barb Yondorf, senior program officer at the Rose Community Foundation, provided a nice counterpoint. She referred to John Rawls’ wonderful framework of helping us judge whether systems are fair or not. Rawls asked us to imagine ourselves parachuting into a society, without knowing whether we’ll be at the top, the middle or the bottom; black or white; disabled or perfectly formed; with a single, alcoholic mother or with a loving and wise extended family.

Would you choose the United States or Belgium?

I'm not sure everyone can usefully use Rawls idea to become more empathetic and objective. You have to squelch the ego that insists you'd overcome anything, and the judgmental attitudes that help many of us blame the poor without remembering all the elements that go into poverty. Rawls' framework doesn't work if you don't have an imagination.

If that's the case, you can continue on believing that wealth should be able to buy anything, no matter what the social and moral cost and that it's all right for the poor to not get anything — even life itself.

No matter what the social or moral cost.

Arrgh. Pirates

Yeah, yeah, it's not going to convince anyone not already convinced. Arrgh.

Still, with this video at the Foundation for Taxpayer and Consumer Rights, the Austin Lounge Lizards expose the health insurance industry's motto:

If you can’t afford to pay my ransom this is what I’ll say;
Yo ho, yo ho, go ahead and die —
I’ve got my share and I don’t care.

Why no single-payer?

Try this rant by Joe DeRayond on Counterpunch out for size:
"The health care system of the United States is hostage to the enormous profits distributed to insurance companies, hospital corporations, and drug purveyors. They swarm over the Congress, plying the legislative system with money, "expertise", and favors. Congressmen leave their seats to take jobs with pharmaceutical companies, as did Jim Greenwood of Bucks County, Pennsylvania, and Billy Tauzin of the 3rd District of Louisiana."
That would probably do it.

That Sense of Rising Panic

A quick check-in with The Center for American Progress's daily Progress Report proved panic-inducing. It's a reminder that everything is connected, and it's all been spiraling downwards for some time now.

Why can't we afford universal healthcare? (Forget for the moment that we can afford it; all we need to do is put a whole new engine in to replace the guzzling, wasteful one we have now.) The Progress Report's lead story is how the Bushies are "giving away tens of billions of taxpayer dollars to oil companies already swimming in cash." Royalties from oil companies when they drill on federal land and in coastal waters are the country's second-largest source of income after taxes.

So is the Bush administration fulfilling its obligation to collect those dollars? Are you kidding? They largely rely on the industry's say-so rather than independent audits. This for an industry that is almost unparalleled in its philosophy of entitlement. The healthcare insurance industry does give them a good run for the money.

Link to Kick the Oil Habit to take action against this outrageous corporate welfare — welfare that helps fund CEO compensation packages only equaled by healthcare insurance execs.

This is just one facet of a cancer that's eating away the American middle class and replacing it with an aristocracy. They tried this once before, and they'll try it again. Wealth and power inexorably, little by little change the rules behind the scenes.

Activist labor unions, together with independent newspapers and Roosevelt saved the middle class in the twentieth century. Today, labor unions are a shadow of what they once were, newspapers are owned by conglomerates, and it's hard to say if a Roosevelt could be elected. Who would you rather have a beer with, Bush or some boring Democratic blue blood who talks without a trace of that reassuring, aw-shucks down-home Southern accent?

Today's health blog news

Kevin Drum comments, without enthusiasm, on Gov. Schwarzenegger plan for California healthcare reform. Drum admits his bias against any plan that cobbles together reforms but keeps the health insurance industry underpinning the system.

Here's his description of the plan:

"Basically, it's an individual mandate (i.e., everyone is required to buy health insurance, the same way everyone who drives is required to buy auto insurance) with state subsidies for those too poor to afford coverage. There's a new tax on doctors and hospitals, and small employers are required to either provide insurance for their employees or else pay a 4% payroll tax. Insurance companies, for their part, are required to offer insurance to everyone, regardless of medical history, age, or occupation (aka "community rating," meaning everyone in a particular community gets the same rate.)"

Drum says that Safeway execs have said it would be cheaper to pay the 4 percent payroll tax than to continue to pay the 7 percent that health insurance costs them.

This is exactly why keeping the insurance industry in the game won't fly. They're too expensive a price to pay just to satisfy ideology.

Read the whole post regarding Schwwarzenegger's plan.

Ezra Klein links to Over My Med Body, which has a list today of 50 conditions that can cause insurers to reject you. Including allergies, bed wetting, breast implants, impotence, working with chemicals, roofing, lumber work, window-washing and war reporting. How does that serve our economy, not to insure those folks?

Klein also has an post about mandated insurance, such as Schwarzenegger proposed for California yesterday. Klein says he's heard criticism that such a system "criminalizes the uninsured," evidently from single-payer advocates, and he notes that single-payer is also mandated insurance. His criticism seems to be that single-payer advocates are complaining about government coercion when single-payer would also coerce: force people to have health insurance via their taxes.

Klein seems to think that as long as government subsidizes the private, for-profit system — up to 400 percent of poverty with Sen. Wyden's proposed plan and up to 300 percent in Massachusetts, that such a system would be fine. The Schwarzenegger proposal only subsidizes up to 250 percent; not enough in Klein's view.

This entire avenue of reform proposes wasting our dollars in order to continue a wasteful system. The problem with mandated insurance as in Massachusetts or Schwarzenegger's proposal isn't the mandate, it's what it's for: subsidizing an inefficient system with poor quality built in because of its fragmented structure. It's going to continue to be a drag on our economy as a whole and on our individual households. But yes, better than what we have now.

Andrew Sullivan provides a great link to Psychology Today Magazine and an article on ideology and fear:

"We tend to believe our political views have evolved by a process of rational thought, as we consider arguments, weigh evidence, and draw conclusions... Among the most potent motivators, it turns out, is fear... The fear of death alone is surprisingly effective in shaping our political decisions—more powerful, often, than thought itself."

This is potent. The powerful pharmaceutical/health insurance/for-profit medical industry counts on it. We on the side of the angels need to do a better job of understanding it.

Health Affairs blog reminds us that New York's Elliot Spitzer also is moving to reform that state's healthcare system. Or not — maybe he's just going to tinker with it, as in Massachusetts and along the lines of Schwarzenegger.

The top 25 articles from 2006 are available online free at Health Affairs until January 19. Go to the blog for that link.

Health Care Renewal has a post from Sunday about MBA-think screwing up all kinds of businesses, with the idea that every business is basically the same.

There's been a lot of news about Home Depot's CEO retiring after six years with a $210 million golden parachute, but Health Care Renewal points out that Pfizer's CEO got an even bigger package after being forced out after Pfizer's stock took an even bigger hit than Home Depots.

"So we see hospitals with fewer nurses, primary care physicians over-worked, under-paid, demoralized, and threatened with replacement by nurses and physicians' assistants, and the hiring of drug representatives not with pharmacology doctorates, but with experience as cheer-leaders. (Meanwhile, we see hospital, managed care, and pharmaceutical executives, many with little previous experience in actually providing health care, clinical research, or making pharmaceuticals, hauling in ever higher compensation.)"

Eat the Rich

There's a great piece in the Jan. 8 New York Magazine about how the hard working American middle class is getting screwed.

In American Roulette, Kurt Anderson leads with two pilots complaining about their CEO's 40 percent raise and the demise of their pension plan. He segues into the 2006 revenues at just Goldman Sachs being larger than the GNPs of two-thirds of the countries on the planet, and he has become a convert to the "anger and disgust about the ongoing breaches of the social contract, an American economic system that seems more and more rigged in favor of the extremely fortunate.

"I know capitalism is all about creative destruction, that the pain of globalization must be endured and flexible labor markets are good; inequality is endemic; life is uncertain and unfair, sure, yeah, of course. We’re all Reaganites now—or at least no longer socialists by instinct. But during the past two decades we’ve not only let economic uncertainty and unfairness grow to grotesque extremes, we’ve also inured ourselves to the spectacle."

What kind of America have we ushered in for our children?

I think about the lines of Leonard Cohen's Suzanne:

"And Jesus was a sailor when he walked upon the water
And he spent a long time watching from his lonely wooden tower
And when he knew for certain only drowning men could see him
He said 'All men will be sailors then until the sea shall free them'"

And it seems to me that today's hard-hearted Christianists who go along with the Social Darwinism of winner-take-all economics must justify their stand by believing that the drowning poor will have no other option than to turn to Jesus.

Thanks to One Good Move for linking to this piece.