Showing posts with label health reform. Show all posts
Showing posts with label health reform. Show all posts

Friday, December 18, 2009

Eugene Robinson's case for passing the Senate bill.

An excerpt from yesterday's Rachel Maddow Show (a show I've seldom seen since I don't have cable [and I probably wouldn't watch these kinds of shows much if I did] but I must say that last night's episode was good television), in which The Washington Post's Eugene Robinson argues that passing this massively flawed bill is better than not passing anything. I agree with nearly every aspect of his analysis:

Thursday, December 17, 2009

Glenn Greenwald: Don't kid yourself; this is the bill Obama wanted all along.

Although I have stated that, lousy as it is, I would prefer that the Senate bill pass -- and although I this is still my position -- I must confess that I have begun to feel increasingly icky about what the bill has lately become. So it goes.

It's an awfully difficult time not to be extremely frustrated by the seeming impotence of the Democratic Party as well as disappointed with Obama. I, for one, never lost sight of the fact that the president is a centrist and a pragmatist and that his attachment to various financial and corporate paymasters is inextricable. It's just that, somehow, I must not have remembered just how far right the putative "center" has become in our corporatist nation state. It's not pretty.

But, more than that, I think I had the feeling that Obama would be able to pull off his role -- precarious and self-contradictory though it may be by definition -- with a bit more...I don't know...panache? I mean, in moments at which he looks like a cynical, calculating servant of corporate interests, he really looks like a cynical, calculating servant of corporate interests. I'm led to wonder why that is. I think it's because of the kinds of posturing that Obama has to do in order to throw bones to the 'progressive' left wing base, while simultaneously keeping the insurance and pharmacological industries happy.

And, as regards this very posturing in application to the matter of a "public option," it looks as if Salon columnist Glenn Greenwald has got Obama's number:
[C]ontrary to Obama's occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it.  From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House -- hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama's campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN).  Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn't pass it.  The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party -- rather than the GOP -- will continue to be the prime recipient of industry largesse. As was painfully predictable all along, the final bill will not have any form of public option, nor will it include the wildly popular expansion of Medicare coverage.  Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this -- the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional "centrists."  Right.  The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives.  The administration is getting the bill which they, more or less, wanted from the start -- the one that is a huge boon to the health insurance and pharmaceutical industry.
Greenwald praises Wisconsin Senator Russ Feingold for pointing this out:
Sen. Russ Feingold (D-Wis.), among the most vocal supporters of the public option, said it would be unfair to blame Lieberman for its apparent demise. Feingold said that responsibility ultimately rests with President Barack Obama and he could have insisted on a higher standard for the legislation.

"This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth," said Feingold. "I think they could have been higher. I certainly think a stronger bill would have been better in every respect."
Seems convincing to me, and if it's true, it isn't all that surprising. But it's still dismaying to see how hamfistedly the Obama administration seems to be in dealing with this stuff. What a mess.....

As matters stand, I still think the bill in its present decimated form is better than no bill and here's why: In almost all of the complaints from the so-called 'progressive' left about this bill, I have not heard a single serious reference to the impact of this law upon poor people. Where are the anti-poverty advocates, and why shouldn't a serious discussion of the problems with his bill include a discussion of poverty? Almost all of the criticism has to do with middle-class concerns and middle-class problems.

Doesn't this bill still help people who can't currently afford ANY health insurance, and shouldn't that be the main priority? Please, if anyone knows more about this angle, fill me in. Nobody seems to be talking about it.

Friday, October 23, 2009

Links: Is Obama finally getting his populist on?

Obama, the Trust-Buster? Obama and congressional Democrats taking on the Insurance Industry? And insisting upon a 'public option'? [DownWithTyrrany]

All of this, plus Obama and the Democrats slashing executive pay for acceptors of TARP money? [The Washington Post]

Contrary to what Washington DC chattering-class idiots might contend, a Democratic, Obama-led Populist Turn is a good thing!!

Wednesday, October 7, 2009

The 'Safeway Solution' to the health care crisis: Pay (the inverse of) what you weigh!!

Let's have a look -- shall we? -- at this weaselly, Scrooge-like robber-baron of the "price-check":


This -- by the way -- is the face of "elite" America. Not the English-lit professors and starving artists.... Not by a long shot.

(Wow: I'm in quite a mood this morning!)

Anyway, this man is Steven Burd, the CEO of Safeway, Inc. And, I'm just joking with all of these ad hominems. For all I know, he's a very nice man who loves his wife and children, etc., etc. Looks like he could use a shave, though.

Steven Burd, a modern-day Captain Of Industry if ever there was one (and there was...that is...there is), has gone public with his innovative -- and I quote -- "market-based solution" to the problem of insuring all Americans while simultaneously lowering costs. His solution is already being used at a Safeway location near you! Here's how he pitched it in an Op-Ed that appeared in The Wall Street Journal -- a once-venerable institution that is now owned, of course, by Captain Of Industry Rupert Murdoch -- last June (emphases mine):
Effective health-care reform must meet two objectives: 1) It must secure coverage for all Americans, and 2) it must dramatically lower the cost of health care. Health-care spending has outpaced the rise in all other consumer spending by nearly a factor of three since 1980, increasing to 18% of GDP in 2009 from 9% of GDP. This disturbing trend will not change regardless of who pays these costs -- government or the private sector -- unless we can find a way to improve the health of our citizens. Failure to do so will make American companies less competitive in the global marketplace, increase taxes, and undermine our economy.

At Safeway we believe that well-designed health-care reform, utilizing market-based solutions, can ultimately reduce our nation's health-care bill by 40%. The key to achieving these savings is health-care plans that reward healthy behavior. As a self-insured employer, Safeway designed just such a plan in 2005 and has made continuous improvements each year. The results have been remarkable. During this four-year period, we have kept our per capita health-care costs flat (that includes both the employee and the employer portion), while most American companies' costs have increased 38% over the same four years.

OK. So: what we're talking about here is a plan that ignores the most pernicious problems of our existing health care non-system. For example, currently, many people have difficulty obtaining health insurance if they suffer from pre-existing conditions. The solution promoted by Safeway's CEO is simply to cease considering it to be a problem! After all, posits this insufferable produce-aisle huckster, it's not considered a problem in the context of auto insurance, so why should it be a problem in the context of health insurance?

Moreover, this 'plan' outright ignores the myriad factors contributing to the skyrocketing cost of health care in our blessed Home Of The Free, and places the blame squarely upon the squishy shoulders of Safeway's nationwide cadre of trailer-trash cashiers: How dare you trailer trash fatty-pantses be born into a family, set of socioeconomic circumstances, culture and genetic disposition that increases one hundred-fold the likeliness that you will be fatty-pants trailer trash??!!:
As with most employers, Safeway's employees pay a portion of their own health care through premiums, co-pays and deductibles. The big difference between Safeway and most employers is that we have pronounced differences in premiums that reflect each covered member's behaviors. Our plan utilizes a provision in the 1996 Health Insurance Portability and Accountability Act that permits employers to differentiate premiums based on behaviors. Currently we are focused on tobacco usage, healthy weight, blood pressure and cholesterol levels.

Safeway's Healthy Measures program is completely voluntary and currently covers 74% of the insured nonunion work force. Employees are tested for the four measures cited above and receive premium discounts off a "base level" premium for each test they pass. Data is collected by outside parties and not shared with company management. If they pass all four tests, annual premiums are reduced $780 for individuals and $1,560 for families. Should they fail any or all tests, they can be tested again in 12 months. If they pass or have made appropriate progress on something like obesity, the company provides a refund equal to the premium differences established at the beginning of the plan year.
Oh, how benevolent of you, you golf-playing, corporate jet-having Übergrocer!
At Safeway, we are building a culture of health and fitness.
Huh. So, that's the goal, is it? I know of someone else who wanted to make this a priority for his entire nation.

Tuesday, September 15, 2009

Wow.

The blog Phuck Politics has brought to our attention the existence of a shocking but intelligently produced and enlightening video document of the so-called "9/12 Tea Party" protests in Washington DC. The video was created by something called New Left Media, and I'm telling you that it's worth watching.

For one thing, it's not just shocking but really really funny.



And also: infuriating. And also: sad.

One of the things that I think makes this video so excellent and informative is its tone and pacing. It has a distinct and consistent editorial voice, but this voice is not intrusive or partisan. Moreover, although ruthlessly candid, it does not go out of its way to mock or condescend to its subjects. This reflects good editorial judgment in that the subjects do a more than adequate job of hanging themselves with their own noose.

An effect of this good editorial judgment is that this piece manages to do more than simply give the viewer a headache. It actually reveals the confusion and ignorance of the vast majority of the protesters. While this doesn't necessarily make them sympathetic characters, it does leave you with a strong sense of the forces/interests that are misleading them and profiting off of their ignorance, their lack of education and their general superstitiousness.

Sure, these rednecks are dumb as rocks, but that's not what I find most frightening. What I find most frightening is that they lack common sense.

Monday, September 14, 2009

Obama: the bargain, the moment of truth and health care.

I've been asked by one of our favorite readers if I might weigh in as to my thoughts on President Obama's health care speech of last Wednesday. Here's my long-winded (but I hope not pedantic or, uh, boring...) reply.

In approaching the health care address, as in approaching all things Obama-related, I divide my assessments into two distinct categories: (1) substantive and (2) operational.

By the first category, I mean, you know, the content: What does it say as a matter of pure policy?, etc., etc. By the second, I refer to the impact and significance that the speech would appear to have operationally, specifically with respect to its embeddedness within salient and underlying political contingencies and discourses.

Some background for my thinking:

Obama differs from other presidents of my lifetime in that he has, in fact, managed to surprise me by occasionally saying something so smart and incisive that it strikes me as something more than simply operational or tactical. In fact, I'm convinced that that's what made Obama appealing to people on the left in the first place: At his best, he offers us much-needed relief from the interminable Samuel Beckett-speak of 20th Century Presidential Personae -- cant that has been particularly excruciating over the course of the previous four presidencies.

Obama speaks and thinks in a way that makes sense to us: It's partly a generational/demographic thing, and it's partly a matter of sheer charisma. It's could even be bollocks: he's got them. (Bollocks are testicles, kiddies.) Not compared to Theodore Roosevelt, maybe, but compared to pretty much any president since JFK. Of course, considering the competition, that's maybe not saying a whole lot...

I remember during the presidential primaries or something, I was explaining to my friend what I thought was actually potentially fresh and worthwhile about Obama, and I phrased it this way:

If you're not going to go out there and actively work to usher in The Revolution, then Obama's your man. In other words: OK, if you want to vote for Kucinich, do it. if you want to vote for Nader, do it. (I did that once and have no regrets.) I applaud you. If you want to start a new, intelligent leftish political movement, then go for it. God knows, we could use something like that. These are worthwhile and commendable projects.

But, I continued, if not -- i.e., if you're going to participate in the political system, warts (of which there are many) and all -- then Obama represents the closest thing to a genuinely progressive force that the political system can in fact, in this moment and time, successfully produce. Vote for Obama, and you'll know that at least you're supporting without a doubt the best thing that our tattered, and bought-and-sold-many-times-over political system can deliver.

Obama was and is NOT Dennis Kucinich. He's not Ralph Nader, and he's not Jimmy Carter. That is part of the point of Obama being Obama: He's not a lost cause and doesn't represent lost causes. He's a winner. He's one of the Beautiful People, with all of the good and bad that comes along with that.

Obama can and does play ball with the big boys. He is and always has been a political realist, and he sold himself to us as a political realist. He beat the Clintons not just because he represented a superior political vision (which he did, by an infinitesimal degree of difference), but because he out-smarted the Clintons.

It wasn't just luck that turned John McCain's campaign into such a disaster: It was the Obama campaign's tactical superiority: Out-flanking your opponent, faking him out, making him sweat over -- and waste money in -- the wrong state at the wrong time, by deliberately sending misleading signals about your own campaign's concerns.

Within a day of the McCain campaign's having trotted out Sarah Palin (as I remarked on that occasion), it dawned upon me: the Republicans are throwing the election.

In retrospect, it seems clear to me that part of the reason this happened is because the Obama campaign forced them into retreating. And: prevailing rhetoric and received wisdom aside, the GOP is still in retreat, if not chaos.

The trouble is that Obama's victory meant -- and means -- that those of us on the left who brought him to office would have to come face-to-face with the limitations of our screwed up and corrupt system, limitations that we didn't really have to face up to in the same way when we were toiling under the tyranny of the Bush/Cheney cabal. With those guys, we could take out our frustration on the other side, for stealing elections. We could decry the stupidity and self-centeredness of the idiots who actually preferred those asshole to Gore or Kerry (not that we loved those guys either...), who at least could speak in complete sentences.

It seems perverse to put it this way, but in Bush/Cheney, we had on our hands a fine distraction that was from the real culprits of the demise of the United States: our nightmare of a de-funded public infrastructure, the menace of neoliberalism and public-private partnerships, a completely unregulated financial sector, masses of political and economic capital concentrated in the hands of fewer and fewer people, the deterioration of the trustworthy news and information (not that we ever had much of that...), the calcification of class, status and racial divisions, a powerful neoconservative lobby, etc., etc., etc....

And so, entirely contrary to the conventional wisdom about Obama being a man who delivers pretty speeches, all form and no substance, for the first time in a long time we have a president who -- for better and, undoubtedly, for worse -- is something more than merely a symbol: He embodies the limited reach of the political left. Or, rather: Obama is the closest thing we have and can have to left-minded president.

And the ugly thing that nobody wants to face up to is that "the left" by this definition -- that is, the left, insofar as the left subsists in the realm of the possible -- is not very damn far left. It is to this phenomenon that I am referring with the titular "moment of truth."

It is this structural limitation that we see embodied in Obama. For a president is more than merely a man: he is a nexus of powerful political and financial interests. Just look at how people become president, what processes make it possible.

Presidents must, of necessity, be products of the status quo. Whether or not they are able (like the aforementioned Teddy Roosevelt and a few others), over the course of their tenure in the Oval Office, to become an active force in transcending or transforming the very status quo that produced them is a function of innumerable factors that lie outside of the control of a single man, and even outside of the control -- contrary to the view favored by conspiracy theorists -- of any single group of interested parties.

In any event, it is the left of -- appallingly -- Tim Geithner and Larry Summers, of Arne Duncan and the Clintons and Gordon Brown and Tony Blair. I mean, that's what passes for the left.

But people who get mad at Obama for this fact -- as we all do -- are wasting their energy, and they are pointing their finger at the wrong person. Obama is exactly what he said he was and exactly what we knew he would be. Even if we didn't know we knew it.

Sometimes it's not an easy thing to digest. Obama's not a hypocrite. To the extent that anyone has expected Obama's political program to be genuinely progressive, she has been kidding herself.

And so, anyway, that brings us back to Wednesday's health care speech. Here's what I thought: Substantively, it contained the inevitable disappointments and a few very positive developments. On the disappointment side, it seemed pretty eager to chuck the so-called "public option," but that was all but sure to happen. And anyway, I'm not all that convinced it makes much of a difference, considering that the government already owns all sorts of stuff that it doesn't own "on paper," like the big banks and the auto industry. So, when it comes down to it, what difference does it make what it's "called"? Now, being the tenacious opponent of neoliberalism that I am, I reserve the right to change my mind on that one, if, let's say, all health care is going to end up being "left to the market to...urm...solve." But even were that the case it wouldn't be anything new: It describes precisely the horrible non- system that we have now. Other substantive disappointments include Obama's continued pandering to senior citizens -- although somewhat less shamelessly than on previous occasions -- and that inevitable fact that Obama had to make a point of declaring a policy of 'fiscal prudence', especially as regards the federal deficit, which was politically a necessary move, but is also as far as I'm concerned completely bogus (like all claims within the bogus field of economics).

Substantively speaking, the best -- or most encouraging -- thing about the speech in my opinion had to do with the fact that it went some way toward framing health insurance reform in moral terms, which, as far as I'm concerned, is the Alpha and Omega of the health care issue. But, hey, that's me.

More important was that the speech was, operationally speaking, a bit of a masterstroke, as far as I'm concerned. As I've mentioned in the past, I'm fairly certain that the whole right-wing circus show of last month -- a.k.a., neo-Nazis at town hall meetings -- was something that the Obama administration and the Dems generally not only welcomed but allowed to crest (and then some!).

In the grand scheme of things, this 'August strategy' has served Obama and the Dems well in that it has:
  1. linked perceptions of any putative 'Republican position' on health care to the handiwork of the Southern Racist Right,

  2. galvanized the Democratic base through its visceral, disgusted reaction to the aforementioned SRR, and

  3. fostered the commonsense presumption among 'mainstream Americans' (read: the upper-middle class suburban people who voted Obama into office in the first place and on whose support his health care agenda turns) that opposition to any moderate-yet-ambitious (read: Obamian) reform measure is identified primarily with people who are 'outside the mainstream' (read: poor, uneducated white trash, with whom upper-middle class suburbanites do not wish to be identified [and who pay their high property taxes for this very reason!]).
Therefore, the reason I think Obama's speech was an operational masterstroke has a great deal to do with its timing. The right-wing cant had escalated marvelously. A healthcare reform opponent performed a Heil Hitler salute in response to an Israeli man's impassioned advocacy of reform. Banners displaying images of Barack Obama with a Hitler mustache superimposed upon his upper-lip. The (hilarious) Barney Frank thing. Anti-reform protesters wielding loaded firearms in the vicinity of the President of the United States.

It had all lingered just long enough at its vomit-inducing stage, and Obama, who has been holding back and eluding the spotlight -- "But, Mr. President: your poll numbers!" -- and at the perfect moment, does a commendable job of delivering what might stand as among the skilled rhetorician's most-impressive-yet feats of oratory:
That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling. It's not a Republican or a Democratic feeling. It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise.

This has always been the history of our progress. In 1935, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism, but the men and women of Congress stood fast, and we are all the better for it. In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress -- Democrats and Republicans -- did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind.

You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter -- that at that point we don't merely lose our capacity to solve big challenges. We lose something essential about ourselves.

That was true then. It remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road -- to defer reform one more year, or one more election, or one more term.

But that is not what the moment calls for. That's not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it's hard. (Applause.) I still believe -- I still believe that we can act when it's hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet history's test.

Because that's who we are. That is our calling. That is our character. Thank you, God bless you, and may God bless the United States of America. (Applause.)
I'm just as cynical as the next man, but I must say, this is some quality stuff.

If nothing else, it makes the Fox News thugs look one-foot-tall.*


________________
* In addition, that is, to sounding -- and being -- dumb.

Friday, September 11, 2009

Analysis of Obama's health care address.

I've been laboring over a couple of posts that will probably never see the light of day because they're too meandering and/or abstruse (even by my usual standards). So that's why I haven't posted anything in a few days. Anyway. So,

Sean Quinn of FiveThirtyEight.com has written a cogent analysis of President Obama's Wednesday night address before a joint session of Congress on the subject of new health care legislation:
My initial reaction to reading and then watching President Obama’s speech last night was that it was a very strong speech, one even more effectively delivered than written. There were two notable “show, don’t tell” moments that I thought were particularly helpful on the President’s behalf.

(AFP OUT) U.S. Vice President Joe Biden (L) and Speaker of the House Rep. Nancy Pelosi (D-CA) (R) applaud as U.S. President Barack Obama addresses a joint session of Congress in the House Chamber of the U.S. Capitol February 24, 2009 in Washington, DC. In his remarks Obama addressed the topics of the struggling U.S. economy, the budget deficit, and health care. (Photo by Pablo Martinez Monsivais-Pool/Getty Images) *** Local Caption *** Barack Obama;Nancy Pelosi;Joe BidenFirst was the high-profile, notorious Joe Wilson moment, a serious breach of decorum (in the U.S.) that served to underscore the exact point Obama had been making: we’d like to have a substantive contribution from Republicans, not the lying – his word – histrionic nihilism we’ve been seeing. Cue Joe Wilson with lying histrionics. Well done, Joe. It pissed people off, made a money-bomb for his opponent Ron Miller, and was similar to the way Dems (although certainly not Republicans) reacted to Sarah Palin’s acid floor speech at the convention on Sept 2, 2008. We saw the few Republicans who were in field offices last year motivated by Palin’s presence on the ticket but not McCain’s; we also saw many more people showing up to Obama offices in part galvanized by opposition to her sneering speech (and overall Palinosity).

The second “show, don’t tell” moment was the one on the issue of tort reform that Republicans hold dear. When Obama mentioned this subject and suggested a practical approach that accounted for across-the-aisle concerns, Republicans cheered. Obama continued, engaged by their cheering, and within his body language and tone of voice it struck me that he seemed to have shifted into live negotiation rather than a one-way speech. Optically, it was a show of good faith that seemed to give truth to his offer of open-doorism. It was a visceral, good guy, higher ground moment.
Read the rest of Quinn's piece here.

And here's a decent reflection in Salon.com.