Salon Funnies

Via Salon.com:

Today's Links

Peter Orszag of the OMB talks with John Dickerson at Slate. I feel compelled to comment on what Mr. Orszag says. He begins right off the bat saying that single-payer is off the table because Medicare is viewed as wasteful and that its important to keep what works now and get rid of the bad. But the baddest of the bad is the rising costs of care. So wouldn't the first thing you would want to fix is the rising costs? What would be the most effective way to do that? A single-payer system fixes that by demolishing the health care industry and going to a system that serves patients, not shareholders. If you look at all the reasons Mr. Orszag says is wrong with the industry, a single-payer system fixes these issues. The bankers have recieved huge sacks of money from the Fed. Let's not let the same thing happen to our health care system.

Robert Reich is right. I'm reading his book right now. It's great, too.

Rolling Stone's latest...

What is logical?

So the Health care debate is really starting to heat up. Last week's crazy news out of the CBO is that the plans being discussed on the hill are all very expensive, costing upwards of a trillion dollars over the next 10 years. There has been a lot of criticism about this report, ranging from the report being rushed, not enough information given to the CBO when they made their report, the report is just plain wrong, etc. That doesn't matter. What matters is that now there is a seed of doubt out there that a public option is a good idea, and opponents to the public option (GOP, AMA, health care execs, etc) are going to use this as ammuinition. The President needs to get a public option enacted. One that isn't crippled. One that can negotiate lower prices. Allows people to import cheaper drugs from Canada. Uses economies of scale to strong-arm companies into lowering prices. Its the only way to get costs under control. I hope that the public option becomes the preferred method that people get healthcare. That it does dramatically lower costs and drive private plans out, because the private plans put the bottom line above all else, and we don't need that in health care.

Robert Reich, and Robert Reich from 5 days ago.
72% of Americans want a public option
Obama's own Dr. wants Medicare for all (single-payer)
Chicago Tribune opinion piece in favor of single-payer
Obama's self-imposed need to compromise could lead to disaster.
One Senator is willing to support single-payer publicly: Senator Kent Conrad (D-North Dakota)
Brad DeLong on how to save 2 Trillion dollars over 10 years in healthcare spending.
The American Prospect does a good job describing what a bad form of the public option could be.

Start your own herb garden!

Live long and Prosper

So Obama pulls another Spock at his news conference today:

QUESTION: Wouldn’t that drive private insurance out of business?

OBAMA: Why would it drive private insurance out of business? If private insurers say that the marketplace provides the best quality health care; if they tell us that they’re offering a good deal, then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.

So the last question and answer in Elizabeth Warren's interview with Frontline is probably one of the great summaries of what has happened during the past year and how we got there.

We've been talking about one tsunami. We haven't talked about credit cards yet. Is there another tsunami coming? ...

In many ways, credit card debt and mortgages were the two things that were the cocaine of the financial services industry. They produced profits beyond your wildest dreams. Boy, why invest in small businesses and construction lines when you can get the profits off those? ... We've watched what happens and the collapse of housing prices, these enormously risky mortgage products that were pushed out there that were promising the high profits, but of course now are going to produce these terrific losses.

And here are the credit cards, kind of the last big profit center for these large financial institutions. And two things are happening simultaneously. They're trying to wring every last dollar they can out of them: Let's raise people's interest rates; let's tack on more fees; let's get tougher on when it is that you're overdue. Push, push, push, get as many dollars as you can, because we're hemorrhaging money over here on the mortgages and everywhere else. ...

Wages have been flat at that point for about a decade. Nobody's making any more money. ... Core expenses -- housing, health insurance, transportation, child care -- have been rising. Families are saving nothing. They're carrying mounting loads of debt in order to bridge the gap between their rising expenses and their flat incomes. They're tapped out. And that's where we are while the boom is still on, while unemployment is low, interest rates are low. The party goes on.

[Then] the housing market declined sharply, which means ordinary Americans, their net worth on paper just is going through the floor, because for most people, there are only two assets that they've got: They've got a house and maybe, if they're lucky, a 401(k). Both of those are going down sharply. Unemployment is going up. Core expenses are not coming down. So the American consumer, the family, the ordinary middle-class folks, they're on their knees financially.

How do we get out of this? They've been the ox that pulled the plow. They've been the consumer. You could count on them. It was safe to invest in retail. It was safe to invest in restaurants. It was safe to invest in anything they might use because they'll always get up and spend and drive this economy.

The fundamentals during the boom showed that that whole underlying economic picture was wrong. It was wrong. It was created through smoke and mirrors, through crazy monetary policy, through permitting financial institutions to keep marketing these credit products and promising profits and throwing them out into this larger marketplace, and these complex instruments and doing trades and bets off them, and pretending that that was wealth, that that was reality.

Well, the party's over. The financial institutions are down for the count. But look around the room. Basic economics of the American family have changed, and that means there's a fundamental reordering here. We can't just jump-start this. We can't just say, "You know, we'll bite our lips, and in another six months we're going to get that same old economy back." ...

We're going to make a series of decisions over the next six months to a year that are going to shape who we are as a people, who we are as a country for the next 50 years. This is our moment. We'll decide this. And what we decide will set who we become. I believe that.

Krugman goes after "centrist" Democrats on Healthcare reform

I like Paul Krugman. A lot. In today's NYT, he goes after the Democrats who want to kill the public option in health care reform. This is one of the gems from his op-ed:

Thus Senator Ben Nelson of Nebraska initially declared that the public option — which, remember, has overwhelming popular support — was a “deal-breaker.” Why? Because he didn’t think private insurers could compete: “At the end of the day, the public plan wins the day.” Um, isn’t the purpose of health care reform to protect American citizens, not insurance companies?
Mr. Nelson softened his stand after reform advocates began a public campaign targeting him for his position on the public option.

Ha! So it looks like activists can sway senators who are bought and paid for by the health care industry. One can only hope. My only disappointment is that he does not call out Mr. Baucus from Montana, who may hold all the keys to getting good reform passed.

UPDATE: Confused about the differences between single-payer and the public option? Look here.

Obama Action Figure

Ok, if you want to get me a present, you can't go wrong with this.

What I listen to

I listen to a few of these podcasts as regularly as I can. All are Excellent.

Today's Links

What happens when the bottom line is priority #1

The Health Reform We Need & Are Not Getting

Frontline this week ran an in-depth story of what happened with the banks last fall.


Robert Reich on the Obama Administration's proposals to reform Wall Street

American War Expeditures in today's dollars. Very cool!

UPDATE: Elizabeth Warren interview from Frontline in its entirety.

Its all connected

Nice to see a Senator's home state paper examine one of it's own. In the article, the paper examine's Senator Baucus' campaign contributions, stating that the Senator has recieved 3.2 million in contributions from the health-care industry from January 2003 to through 2008. Since Baucus chairs the Senate Finance committee, he as a huge influence on the health care reform debate. Specifically, he has said that a single-payer option is off the table. He says this because he is in part owned by the very industry

Supporters of national health insurance are even less optimistic, noting how Baucus, President Obama and leaders in Congress won't even consider their proposal, which they believe would have broad public support.

"I can't think of any reason other than fidelity to your donors, to explain why they would keep us out of the debate," says Dr. Young of the physicians group. "Until we get campaign-finance reform, it will be very difficult to do anything to challenge the status quo (in health care), and the status quo had better be challenged, because it's a very bad status quo."

Boston Globe on Single-Payer

Approaches the subject from the standpoint that women will see a great benefit from such a system. Hard to argue with.

Bill Moyer's Journal and the wage issue

Bill Moyer's casts his gaze on the building debate about income and wage stagnation in this week's Journal.

I want a piece of this

Now THIS is Stimulus.

Why The AMA opposes the Public Option

Why does the AMA oppose a public health option? Maybe this is why.

Great Healthcare reads

Slate
Update on the testimony for Single-payer in front of the House subcommittee hearing.
Health Reform for Beginners, By Ezra Klein of the Washington Post

Why I HATE corporate virus scanners

They are overtly paranoid
They are serious system hogs (hard drive, not cpu)
You can't shut them down

Great Read in the NYT Magazine

This article is fantastic in talking about the inner-workings of Obama's team and their approach to health care.

119 million Americans don't like it, so we need to keep it

So now the argument against a government-run health plan is that a LOT of Americans would prefer that, and if people start using the government plan, then less people would be using private plans. Which apparently is bad. So it is up to our elected Senators to protect us from Democoracy. It's not the government's job to do the will of the people, is the message I am getting here.

Pay for Performance

NPR story on healthcare. Hospital improved care and lowered cost by basing pay on performance, not on the number of tests ordered and surgeries performed. Wow. So it is possible to lower costs and improve care? Really? I didn't think that was possible. (can you detect the sarcasm here?)I can't find the story online anywhere! I'll keep looking for it.

Banks want out of TARP, because TARP is bad. Boo-Hoo! Frakin' banks! First they neeed TARP, are willing to go for it, then when they don't want it, they think they can just walk away? Frak you, banks! They don't want to pay for performance, just like hospitals.

An awesome article on healthcare

UPDATE: Krugman's on the bandwagon.

This post has so many quotable quotes that I can't help myself!

My health is not for sale. Nor is yours. Nor should anyone’s be. As long as insurers are slaves to the bottom line in this country, no reform is possible.

Health insurance cannot be a for-profit enterprise. Period. It must be a not-for-profit enterprise, and that means all facets: pharmacy, hospital, diagnostic, imaging, etc. As soon as profits are the primary motivator, patients become the problem. When patients become the problem, attention is only paid to ways to make them less of a problem, either by cutting back what is insured, how much is insured, or by raising their rates to unaffordable extremes. Right now, all three of these options are in play.

This is a crisis that won’t be eased by tweaking a badly-broken and dysfunctional system. The entire system that must be reshaped into a single payer system and coverage for all. It is a system that must put health at the front of all considerations rather than profits.

Congratulations, Randy

To one of the greatest pitcher to ever play the game, Congratulations! I will never forget '95. Thanks for the fond memories.

Why are we so involved with GM?

I don't know why. American auto companies should have filed for bankruptcy years ago, but the will to do so wasn't there. So now that we've paid over $60 billion for a company that is worth about $1 billion in stock, let's think about why we paid so much...I still can't think of why. Robert Reich has given this some thought. I recommend reading his ideas. Plus, he chose the same theme I did for his blog. Great minds think alike, right? :)

The Deficit

So some aren't too happy about the direction our deficit is going. I'm not happy either, but are things as dire as this?

"Voluntary" Health care reform

So a bunch of the companies that Obama gathered to pledge "voluntary" cost controls a few weeks ago have released their first draft of what their controls and proposals look like. It's so bad as to almost be a joke. There is so much low-hanging fruit here that the lowest peices are already rotting. Only an industry with this much bloat can describe some of these measures as effective. Maybe I'm being a little unfair, but come on.

Some highlights:

1. The Advanced Medical Technology Association accounts represents 90 percent of the medical equipment manufactuerers in the US, a virtual monopoly. They have promised in their second initiative to reduce medical errors and avoidable injuries. So they aren't doing that now? Sounds that that should be a best practice already, but when you represent 90% of the market, you can make your own rules, right?
2. AHIP is proposing to overhaul administrative processess and automate 5 key functions - claims, submissions, eligibility, claim status, payment, and remittance. Sounds great, and they say it will be like when the banks introduced ATMs. But they say the "are not recommending a voluntary effort, but rather that HHS require the adoption of the CAQH Committee on Operating Rules for Information Exchange (CORE)." Meaning that they need to have the Health and Human Services Secretary force them to adopt these rules through CORE. So you have to tell one political appointee make a group representing the healthcare industry force these standards. That still sounds straightforward, but by the time you get anything through a committee it is usually filled with bloat and waste.
3. The American Hospital Association has a lot of vague, progressive-sounding ideas that look good on paper, but they don't provide any concrete numbers to back up their ideas. Plus, they don't list any incentives for hospitals to implement their ideas. It's just a bunch of management speak.
4. The American Medical Association has pretty good ideas and lists out in fairly brief but precise detail what they want to do.
5. The PhRMA, who represents Big Pharma says that they are already in the fight to reducing costs, and studies are showing that costs are already starting to slow. They say that spending for drugs in 2007 was the lowest it was since 1961. Really? Could the Prescription Drug Benefit have anything to do with that? Remember, they claim that spending, not cost is the lowest it's been since 1961. If I'm wrong, I'll eat my shirt. They also claim that the market for drugs in the U.S. will decline by 2% in 2009. Maybe thats because of the recession more than anything else. As more and more seniors see their savings disappear, are they still taking all the drugs they've been given? I hope so. Of course I am in pure speculation mode, but how is that any different from what this report is doing?
6. The SEIU has some good ideas, but it's initiatives are very broad and wide, and seeing how they could implement any of these in the next two to five years seems unlikely

Most of the ideas presented in this paper sound like the initatives that were presented in my companies management meeting today. Very high-level, with very little detail. Maybe these reforms would work, but I don't think they are enough, and I certainly don't trust these companies to live up to whatever promises they gave while Obama had them in a half-nelson in front of reporters a few weeks ago. Even Senator Grassley of the Finance Committee is skeptical.

I’m skeptical that these proposals will add up to anywhere near $2 trillion. In the legislative process, proposals rise or fall based on what [the Congressional Budget Office] says about them, and the same will be true here.

So is there any hope at all, or is this another and potentially bigger FUBAR than the bank bailouts?

Lobbyists Everywhere!!

If you didn't believe me when I said a primary motivation for entertaining lobbyists of our elected officials is the perks after public service, lookey here: Senator Baucus' former chief of staff has been hired by GE to lobby on "Health care reform issues." And it's not just Democrats! A health policy advisor to Republican Chuck Grassley, who is also on the Finance Committee, has been hired by GE for health care lobbying as well.

Baucus keeps his word

When Senator Baucus (D-Montana) ejected advocates from his health care hearing recently, he did say that if the ejected people contacted his office, he would meet with them personally. Well, he is doing just that this week. This isn't a victory for Single-Payer by any means, but it is something.