Costly Public Option

It’s rude to say “I told you so,” but a CBO study has now said that the “public option” will not only not “hold insurance companies accountable” and drive down rates, but will actually charge higher premiums than private insurance. Digby at Hullabaloo says that the CBO “won’t tell you why” and accuses the CBO of “baking” the numbers, but they actually do say why, just as they do with all of the studies they release.

And guess what: it’s in no small part the very same reason that I predicted in “Magic and the Public Option” back on the 20th.

The "public option" is not only being touted as lower cost, but it is now being claimed that it will pay for all of the things that private insurance is refusing to pay for. That being the case, how is it going to charge lower premiums?

And from Ezra Klein in the Washington Post,

"…because the public option is, well, public, it won't want to do the unpopular things that insurers do to save money, like manage care or aggressively review treatments. It also, presumably, won't try to drive out the sick or the unhealthy. That means the public option will spend more, and could, over time, develop a reputation as a good home for bad health risks, which would mean its average premium will increase because its average member will cost more."

So, sorry but, “I told you so.”

Lawrence O’Donnell had two guests on Countdown last night who tried to say that the problem was that Congress was structuring the “public option” such that HHS would negotiate the rates that it would pay to providers and that it would be too small to have adequate negotiating power. There may be some truth in that, but it doesn’t overcome the issue that the CBO described as driving the rates up.

And, of course, no one is talking about the 800-pound gorilla in the room. Those “cost control measures” that the public option won’t be doing? Well, the reform is making many of them illegal for private insurers to do as well, and no one is concerned that without those controls the premiums for health insurance of all types will absolutely have to increase.

The problem is not in the details, here, the problem is fundamental. Congress is trying to reform health care delivery by tinkering around with health insurance regulations and not addressing the health care delivery system itself. There are no details which can make that approach work; whatever they do and however many pages they write trying to do it, it simply is not going to succeed.

It's like trying to make a worn out clunker car with 300,000 miles on it function better by giving it a new paint job. It looks good, but has no practical effect.

Omigod, They Overcounted

I, personally, am astounded that "stimulus jobs" were over-reported. Counters were probably overstimulated by the prostitutes that ACORN set up in business. Or maybe intimidated by ACORN pimps. Maybe it was just ACORN nuts doing the counting.

Excellent Image (with update)

President Obama will soon make a decision regarding additional troops for Afghanistan. I probably will not agree with that decision, but seeing this image will certainly contribute to my respect for that decision.

Update: Saturday, 8:00am
President Obama is certainly not averse to photo ops and, indeed, this may have been one. I suspect, however, that it was not, since photo ops usually involve more than one camera and that camera person usually knows in advance that the President will be there.

The film of which that photo is a screenshot is the only film that is available of the event, and it was scheduled with permission of the family before it was known that the President was going to be coming. That would make it more of a photo coincidence than a photo operation.

Cheerleading Health Care

Paul Krugman has lost his mind. His cheerleading for this tinkering on the edges of our health care delivery system that poses as “health care reform” has reached the point that he now refers to it in his latest column as,

Past efforts to give Americans what citizens of every other advanced nation already have — guaranteed access to essential care — have ended not with a bang, but with a whimper, usually dying in committee without ever making it to a vote.

(emphasis mine) News flash, Paul, this "reform" mandates that all persons must purchase health insurance, and there will still be copays and deductibles; with limits on them, but not one person has claimed that they will be eliminated altogether. That's not what "every other advanced nation already ha[s]" Professor.

To my sure and certain knowledge, in England and in France someone in need of care walks into a health care facility, is treated without any questions of a financial nature and walks out without a bill. Does this piece of legislation give that to Americans, Professor Krugman? Does it give it to all Americans? Even Nancy Pelosi only has the temerity to claim that this 1990-page monstrosity of a bill will cover only 96% of the citizens of this nation, and it covers them by mandating that they purchase insurance.

Please tell me, oh genius with the Nobel prize, how making a deal with drug companies to preserve their prices and profits, making a deal with hospitals to preserve their prices and profits, and then mounting a campaign against insurance companies constitutes any kind of major reform of our health care delivery system.

Regardless of the amount, people in this nation will still have to take money from their food and housing allowance to provide for the purchase of what other developed nations provide at no direct cost, health care. This tinkering that we call reform will still allow people to go bankrupt and lose their homes as a result of illness or accident; something that happens in no other developed nation in the world.

How do 26 million unemployed purchase health insurance, Professor Krugman? All of the tax credits in the world are useless when you have no income to pay income tax on and therefor no income tax to offset the credit against. So how, precisely, do we "guarantee essential care" to those 26 million unemployed and their families, Professor Nobel Prize Winner?

I do not for one minute believe that a bill this massive, 1990 pages, can ever effectively be implemented, let alone enforced. Just the administrative cost of having the people who are affected by this monster read the damned thing will cost more than it could possibly ever save.

Pass the bill if this is the best we can do; it’s pathetic, but it’s better than nothing. But only an idiot would make the claim that this bill puts us on a par with any civilized nation when it comes to health care.

Update: Friday, 12:30pm
You inferred correctly. I do not consider America civilized when it comes to health care. Large corporations profiting from human suffering is barbaric.

Economic Cheerleading

Steve Benen at the Washington Monthly has a post today about how “The Economy Is Coming Back To Life,” cheerleading about the one-quarter increase of a government-created number called the “Gross Domestic Product.” In fairness to Steve, who I read regularly and thoroughly respect, he is not alone is grasping at this straw.

Tell all of that good news about the “economy coming back to life” to the 530,000 people who filed new jobless claims last week, or to the 18.8% of the work force that is unemployed. Tell that to the people who are included in the record number of people whose homes were foreclosed in the same quarter that we're celebrating about. Tell that to the people whose interest rates on credit card balances which were current and being promptly paid was just raised to 30% and more. Tell that to working men and women whose hours and wages are still being reduced. Tell that to holiday retailers who are not hiring seasonal workers this year because the holiday sales forecast is, at best, “flat.”

Pulling future auto sales forward into a single month by means of a one-month subsidy and creating a down-the-road sales slump does not constitute economic growth. Creating a spike in home sales by means of a short term tax credit and low interest rates to artificially drive up prices, using the same methods that created the housing bubble in the first place, does not constitute economic growth. More than 100 banks failed so far this year and many more on the brink is not economic growth.

When I see employment rising significantly and indebtedness decreasing and a major portion of the bad debt written off; when no small banks are failing then I will believe that the economy is improving.

Yes, I know about the “jobs is a trailing indicator” thing. Jobs may be a trailing indicator when unemployment is not improving, but mostly that is a slogan trotted out by politicians to pacify the mob. Even if true, steady state unemployment is not the case here; jobs are still declining, meaning that buying power is declining, home foreclosures are still increasing, and all parts of the real economy are still in a slide.

No, I don’t think the stimulus was a failure, I think it was too small and spent on too many nickel-dime projects. The Great Depression was defeated with things like the Hoover Dam, not with trivia like one-month programs persuading people to buy cars. We are trying to solve big problems with small answers. We have 535 legislators, each of whom wants his own program to get reelected on, so we get 535 trivial projects which create small, temporary local jobs. Even major bills in Congress are nothing more than an amalgamation of small ideas.

We need big thinking, but that requires big people and all of the big people are in history, not in today’s government.

Olbermann Hyperbolizes

To proclaim that Keith Olbermann engaged in hyperbole on his show last night would seem to be a bit inane, wouldn’t it. There are those who might say that I regularly engage in inanity on this blog, but we will disregard them as a mean-spirited minority and move on.

Olbermann went to new heights of hyperbole in last night's segment on “health care reform” when he a) ranted about Obama claiming that “eliminating waste and inefficiency in the health care system could pay for most of the health care package,” b) mentioned critics who claimed that there could not be that much waste and c) declaimed that Obama vastly underestimated how much “could be paid for” by eliminating waste, based on a report from Thompson Reuters.

It’s hard to know where to start dismantling a rant that was so utterly and completely divorced from reality. Not that Olbermann is ever in particularly close contact with reality.

Let’s start with Obama’s claim, which was that eliminating waste and fraud from Medicare would pay for about half of the health care reform package. Medicare. Not from the “health care system,” Keith, from Medicare, which doesn’t even spend $800 billion per year, let alone waste that much.

Next let’s look at where the savings would occur. Since we are talking about the health care reform package spending federal tax dollars, and are talking about the federal budget and the federal deficit, it would seem logical that the savings would have to be in federal spending. Not to our boy Keith Olbermann; any old savings will do.

The report that Olbermann is citing says nothing whatever about Medicare or the federal government, and none of the waste that Olbermann is hooting about is government waste. So how exactly does he think that savings in the private economy is going to pay the cost of a federal program or balance the federal budget? That, it seems, is a trivial detail that Olbermann does not want us to bother with.

Basically Olbermann is talking about this country spending twice as much on health care as any other nation in the developed world, mentioning a health care reform proposal, and then saying, “Oh, look, something shiny.”

Then he brings on a woman from the California Nurses Association to polish up his shiny distraction. She immediately launches a lengthy screed about insurance companies not paying claims, which has nothing to do with the current topic of waste in the health care system but nonetheless draws rave reviews from Olbermann, who loves demonizing insurance companies whatever the current topic may be.

In case you think the CNA is a group of those wonderful caring people beside your bed, think again. It is one of the most powerful labor unions in the state, exceeded only by the California Highway Patrol, which manages to get actual crimes by its members covered up; the prison guards union, which owns the governor and the legislature; and the public workers unions, which not only have pensions higher than their salaries after twenty years, but have wages 40% higher than those in comparable private jobs.

The CNA is a professional and very active political group, campaigning in causes having no bearing on the interests of the workers they represent; for example campaigning actively in favor of the infamous Proposition 8.

Olbermann brings up a Thompson Reuters item that 37% of the waste consists of unneeded treatment, in part to avoid malpractice risk. He goes on to describe his conversations with doctors who said that they were using unneeded treatment basically as a means of pumping up their income, and the CNA representative immediately segues that into a discussion of insurance fraud which Olbermann gleefully joins.

On the Countdown website they have a “Keith bobblehead doll” for sale. Really; I'm not making that up. You can buy one of those on Countdown's website. Or you can watch one every weeknight on MSNBC.

Deadlines

One of the blessings of being an old guy and retired is not having to face deadlines any more; not having clients bugging you with things like, "When are you going to have that done?"

Oops, guess who isn't fully retired.

To keep you amused until I retire again, this could be hard on your tires.

Forseeable Consequences

Part of the problem in the “health care” debate is that so many of the people debating, and offering solutions, know so little about the subject. Case in point is a comment made in response to an article in the Salt Lake City Tribune. The article was about the role of companies which self insure instead of buying health insurance for its employees, and the commenter responded,

The solution to the health care problems (and there are many), in my opinion, would be to relax restrictions that only allow a select number of companies to offer insurance in each state - open the industry up to competition.

The article is worth reading. Many people think their problem is with a health insurance company when it is actually with their own employer, and employers are fighting to keep themselves exempt from the changes in the pending reform.

At any rate, there are no restrictions of the nature that the commenter suggests; they would be an interference of interstate commerce, and would be unconstitutional. What states do is create a set of requirements that insurance companies must meet to do business in their state, and they do that for the purpose of consumer protection, not to restrict competition. Designing policies to meet those policies and becoming certified in a state is an expensive process, so only a few companies decide to do so.

States have done the same thing for auto insurance, and with precisely the same results; auto policies are less flexible and more expensive than need be. Oddly, I don’t hear any major outcry to force auto insurance companies to cease denial of claims, or to quit underpaying claims by using “fair market value” of damaged autos, or to issue insurance at the same costs regardless of prior record, or to remove caps on insurance. Nor do I see demands that we be allowed to “buy auto insurance across state lines.”

Limited availability is the result of something that people asked for. With their constituents clamoring to be protected against substandard and/or deceptive insurance policies, legislators passed legislation that protected consumers but which also reduced availability and made insurance more expensive; a perhaps unintended, but entirely foreseeable result.

I have no doubt that when regulations were first being proposed on car and health insurance there were realists who were saying that such regulation would result in higher prices and reduced availability. They were certainly impugned as being anti-progressive and accused of being on the side of the evil insurance companies.

Those people probably tried to say that they favored regulation but that, in imposing any regulation, we should consider all of the effects of that action and not merely the intended favorable effects, and be guided accordingly. And they were, of course, shouted down because they “were on the side of evil” and were merely trying to prevent the reform from being enacted.

We are proposing regulations now with the best of intention, and are not listening to anyone who suggests that there might be some negative consequences if those regulations are not crafted more carefully. Déjà vu
all over again.

Unintended Consequences

Congress just passed a law regulating credit card fees and rates and, on the face of it at least, protecting consumers. Much of the law goes into effect in February of next year, but part of it becomes effective in the next few weeks. One of the notable changes is that credit card companies may not raise the interest rate on an existing balance.

Citibank just issued notices, as far as anyone can determine it was to all of its card holders, that its interest rate is being raised to 29.99% on existing balances. That’s on all balances, not just ones that are delinquent. Actually, it’s Prime Rate plus 26.74%, which adds to a current rate of 29.99%. If the prime rate changes…

That's why "on the face of it" as to consumer protection. The law doesn't preclude 30% interest rates, doesn't preclude deceptively adjustable rates tied to prime, and didn't preclude massive rate increases to anticipate inception of the law's few restrictions.

Some financial writers are attaching all sorts of dire implications to Citi's move, but I’m siding with those who merely say that it is their decision to beat the new law; to get the higher rate imposed before the law prevents them from doing so. In addition to the consequences for cardholders, there are some unfortunate implications for the overall economy in that move.

Citibank has 92 million cards with $102 billion outstanding balance. The average interest rate charged was 12% on that balance, and raising it increases the monthly payments that cardholders are required to make, increases the interest they owe, and increases their overall debt. My financial calculation is a bit iffy, but I make that an increase in consumer debt, or payment toward debt, of $1.5 billion per month. That is just one credit card company, and not even the largest one.

That means sucking another $1.5 billion per month out of the consumer economy into the financial economy. Another $1.5 billion per month out of Main Street into Wall Street.

How is that going to affect consumer spending and economic recovery?

No Longer About Health Care

The debate was about health care, then it was about health insurance, then it was about health care again. Now it's about none of those things. Now it's just about "The Public Option." Nobody is actually sure what that is, but we need it because it will solve everything including, apparently, the civil war and piracy in Somalia.

Mind Boggling

Nicholas Kristof begins an op-ed column in the New York Times on last Wednesday with this mind-blowing statement,

The United States was born of our ancestors’ nationalistic resentment of a foreign power whose troops we saw as occupiers, not protectors. The British never fathomed our basic grievance — this was our land, not theirs! — so the more they cracked down, the more they empowered the American insurgency.

This is absurd in more than one dimension.

He obviously has not spent much time hanging out, as I have, with people of the Navaho or Hopi nations.

"...our basic grievance — this was our land, not theirs!"   Say what?

In any case, does Kristoff understand that we were a colony, and what a colony is? Foreign power?!  It actually was their land. The English took it away from the Indians and, in the Revolution, we took it away from the English who, at the time, owned it.

Inquiring Minds Want to Know

This is probably a dumb question, and I’m sure Paul Krugman could answer it in seconds, but he probably would just blow it off as not worth answering.

The financial crisis was caused by a collapse the home mortgage market, right? By the discovery that lenders were making home loans to people who could not pay them? Everything went bad when people started defaulting on mortgages and all of the paper that was based on those mortgages was discovered to be worthless.

Home foreclosures hit a new record high in the third quarter of 2009, and the stock market increased 50% to hit 10,000.

So how does an economy that seriously collapsed as a result of bad home mortgages make such an astonishing recovery while home mortgage foreclosures continue to get worse?

Questioned answered: Friday, 11:00am
Actually, foreclosures did not hit a record; they actually declined this year. "Notices of default" were at an all time high and, it turns out, banks are not even issuing those until payments are five months in arrears. They are then holding on to the properties and not foreclosing, creating what is called a "shadow inventory" of bank-owned properties.

Why? Well, if they foreclose they can no longer show the mortgage as an asset. So the answer to my question is that the improvement is because banks are now simply ignoring homeowners' non-payment of mortgages.

Winning Wars

I suspect that very few Americans know that our military forces are currently fighting an insurgency in The Philippine Islands. Although no longer allowed to participate in actual combat, and reduced from the original 1300 landed in 2002, we still have 600 soldiers there for “training and support” in an active counterinsurgency war with no end in sight.

From the New York Times of Sept 25, 2009,

“…despite seven years of joint military missions and American development projects, much of the island outside main towns like Lamitan remains unsafe. Abu Sayyaf members, sheltered by sympathetic residents, continue to operate in the interior’s dense forests, even as the United States recently extended the deployment of troops in the southern Philippines.”

Nick Turse writes in some detail at Tom Dispatch about the American military’s track record at winning wars since World War II, and it is not pretty. He points out that our record is essentially zero since then, achieving at best stalemate and at worst outright defeat every time we engage in full scale armed combat. He disregards Panama and Grenada which, I would concur, do not count as “wars.”

"…50 years later, the U.S. still garrisons the southern part of the Korean peninsula as a result of a stalemate war and a peace as yet unmade. More recently, the American experience has included outright defeat in Vietnam, failures in Laos and Cambodia; debacles in Lebanon and Somalia; a never-ending four-president-long war in Iraq; and almost a decade of wheel-spinning in Afghanistan without any sign of success, no less victory. What could make the limits of American power any clearer?"

This should not be construed to condemn American fighting forces, which are well trained, well equipped and among the very best in the world. Rather it should serve to condemn the misuse and misapplication of the power that is represented by those fighting forces; to say that we are simply trying to use our power in a manner that is not well suited to the application of that particular instrument. We are using a hammer on that which is not a nail.

The discussion omits one war that we did win, and won very convincingly; the Cold War, a war we won by not fighting it. The best use of military power is to have it and not use it. We won the Cold War with the best military slogan ever coined, the one emblazoned on the B-52’s of Strategic Air Command, United States Air Force, “Peace Is Our Profession.”

Messages

Dick Cheney says that President Obama is endangering our troops with all of this indecision on Afghanistan; that he should quit wavering and decide now to send more troops into that war to protect America. I have a message for Dick. The printable version of that message is, "Shut up and go back to your undisclosed location."

I have a message for President Obama too; a totally gratuitous and unnecessary one, but it makes me feel better to express it. "Ignore Dick."

Who's Running America?

In an economy where “too big to fail” has become an epithet, the government nonetheless not only permits, but seems to encourage large firms to swallow smaller firms, creating more “too big to fail” entities in the process and facilitating the reduction of workforces while passing “stimulus” bills to create jobs.

My wife is bemused by my ongoing expectation of logic in government.

Oracle, the world’s largest database software maker, some months ago announced the purchase of Sun Microsystems, which owns MySQL database software. I won’t bore you with the details, but users of the latter database are less than ecstatic about that news, and consider the purchase to be anti-competitive. The US government has no such fears and promptly approved the merger. The European Union, being much less of a corporatist state than the US, said “not so fast” and has put the merger on hold while it studies the issue.

You may recall the EU has also been a bit noncompliant with marching orders issued by Microsoft. It seems the EU has a somewhat different definition of “monopoly” than the US does, and the difference might have to do with bribes campaign contributions. American firms cannot give bribes campaign contributions to European politicians, but they can, and do, to American politicians.

You may also recall that when a European airplane maker won a contract to provide tankers for the Air Force, Congress overturned the award. Seems European firms cannot give bribes campaign contributions to American politicians either, but American firms can and, of course, do.

Now that we have that all straightened out, Sun Microsystems is anticipating that the American government will prevail over the European Union, or they are assuming that Oracle is more powerful than the American government and the European Union combined, which may be the operative assumption. In any case, they have announced the layoff of 3000 workers, who will not be needed once Oracle takes them over.

Congress is considering a bill to extend unemployment benefits again.

Update:9:30am
Forbes, "September Leading Indicators Up 1.0% Vs 0.8% Expected"

Headline at CNNMoney, "Jobless claims dent recovery hopes"

The New Salon

Salon.Com has unveiled its new look. I would comment on it, but I'm waiting for the website to load. It must be quite some "look."

Update
Ah, finally loaded. Meh. Its advertising is still fairly obnoxious, but doesn't put it into the "not worth the effort" category; it's very much worthwhile. I hope they didn't spend a lot of money for the mediocre upgrade, and I hope they find a way to make it load faster.

Are We Full Yet?

There was a brief article in yesterday’s Health Section that people who eat rapidly until they are full are three times more likely to be overweight than those who eat slowly. That actually did not come as news to me, and I happen to know the reason for it, which I’m going to share with you whether you want to know it or not.

Most people think that all messages are carried throughout your body by nerves, but that is not the case. The message that your stomach sends to your brain to tell it that you are full is a chemical message. The chemical is formed in the abdomen, enters the bloodstream and is carried to the brain, where it tells the brain that you should stop eating. If you are eating rapidly, you will have ingested quite a bit of food while the message is in transit.

Eat slowly, with a couple of minutes between bites. You will savor the taste of the food with greater pleasure, and you will gain less weight.

Chris Matthews is an Idiot

Chris Matthews has been fulminating about how worried he is about the situation in Afghanistan. He’s expressed concern about the Taliban overwhelming the Army of Pakistan, taking control of the country and the world facing the problem of having “crazies with nuclear weapons.” He’s “worried about” that happening.

For the past two days he has been dithering about McChrystal’s plan to put small contingents of “our kids” (I assume he means our soldiers and Marines, many of whom are in their forties and fifties) in small outposts out in the boondocks of Afghanistan where the Taliban can pick them off. That would indeed be worrisome if McChrystal were actually planning on doing that. Apparently Matthews can’t read, or he doesn’t know what the term “defending population centers” means.

Yesterday he had Senator Jack Reed, Democrat of Rhode Island, on to expound on the situation in Afghanistan, deferring to his expertise since Reed is a former serviceman. Reed kept referring to what the “Afghanis” need to do in the way of elections and self defense and such, and talking about the “Afghani Army.” He also talked about protecting the “Afghanis” from the Taliban. I assume he was talking about the people of Afghanistan, who are “Afghans,” and not the unit of currency of that nation, which is the “Afghani.” If one is going to pose as an expert on something, one should at least learn the terminology. Chris Matthews, of course, failed to notice that his guest was talking about money rather than people.

Sensible Fire Insurance

Relevant to my last post. If your house burns down and you don’t like the way your insurance company pays off, you should be able to dump them and sign up with a new company. That new company should charge you a lower premium and pay off your losses on the previous fire in a higher amount than the insurance company you just dumped.

That makes sense, right, Senator Wyden?

Magic and the Public Option

I cannot help but feel that I am being sold a bill of goods with this “public option” thing as being a magic bullet to solve the ills that affect our health care system. I’m by no means opposed to a government-run health care plan; the government does many things very well, Medicare among them, so the “public option” doesn’t press any of my buttons on that issue.

I can’t figure out, for one thing, how it is going to get doctors, hospitals and drug companies to charge lower prices, which is absolutely necessary if we are to achieve reform’s stated goal of reducing health care costs. No, wait; that is not the goal of reform. The goal is to “slow the growth of costs,” which is sort of like a football team saying it doesn’t want to do anything but kick field goals. Sounds like the San Diego Chargers.

Negotiation might be a powerful tool but for two problems. First is that the “public option” will initially be too small to wield much in the way of negotiating power. The bigger problem is that the Obama Administration has already cut deals with hospital and pharmaceutical associations that no such negotiations will be included in reform.

The “public option” will be non-profit, which gets rid of an average of 5% of the premium costs. Not bad, but rather less than stunning. Supposedly it won’t need to advertise, but given the amount of advertising the US Postal Service does, I find that questionable. If it doesn’t advertise, how will people know what it is, what plan it offers, or even how to find it? But okay, it won’t advertise.

The "public option" is not only being touted as lower cost, but it is now being claimed that it will pay for all of the things that private insurance is refusing to pay for. That being the case, how is it going to charge lower premiums? Sen. Ron Wyden was on Countdown last night and said that if you are in an employer-provided plan and it refuses to pay for medical care you need, you should be able to drop that plan and enroll in a “public option” that will pay for the things that your employer’s plan is refusing to pay for.

How can the “public option” do that and charge lower premiums?

Insurance companies do not refuse payment for reasons having to do with evil-mindedness; for the reason that they just want you to get sicker and die for the sake of having you get sicker and die because they enjoy people dying. The reasons are economic; the more they pay out, the higher are the premiums they must charge, and the fewer policies they will sell.

So Olbermann and Senator Wyden want me to believe that the “public option” will never refuse payment, will pay all of the bills that private insurance refuses, and will charge lower premiums. I’m not an idiot, and I don’t believe that.

The “public option” is going to eschew cost control methods and maintain lower premiums. And magic ponies will keep everyone in good health.

As I’ve said before, the longer this “debate” goes on, the more it gets dumbed down. We now have boiled it down to two sides screaming meaningless catch phrases at each other; with one side yelling about “death panels” and the other about the “public option.”

Power, PR and Football (updated)

Blogging is certainly difficult when you have no electric power all day, news is limited, and you miss some good football games. Eli Manning got humiliated, and I missed it.

Woke up Sunday morning with no power, and it didn't come back on until 6:30pm. No, it was not related to any weather event; we don't have weather in San Diego. Our weather forecasters go crazy trying to make our weather exciting, but the only imponderable is what time the "marine layer" will burn off and the sun will come out.

I will say this for SDG&E; they handle the public quite well. When I called the service line a recorded voice connected my phone number to my service address and asked if I was calling with respect to that address. When I affirmed that I was another recording informed me that they were aware of the outage, described the nature of the outage, and then said what time power was expected to be restored. When that time came and went with no power I called again and got an update on the time, and at no time did they provide a time which had already passed. After power was restored a live person called to verify that power had come back on. I'm not sure how they could have handled it any better.

Fortunately, the Chargers game is not until tonight. Well, it remains to be seen how fortunate that is; I may wind up wishing it had been played while my power was out.

Meanwhile, Florida is ranked first in the BCS, which shows how bogus the BCS is. Florida barely squeaked past Arkansas Saturday, while The Crimson Tide romped against a stronger opponent. I watched the Florida game, and Florida is not number one.

I did see the end of the Chicago/Atlanta game, and it once more proved to me that the "Cover 2" defense is a mistake anywhere on the field and that using it in the shadow of your own goal is just plain stupid.

Did the Raiders really beat Philadelphia? Really; that's not a misprint?

Update: Tuesday, 8:30am
Um, yes, it would have been better for my power to be out.

Evil Insurance Companies

President Obama is taking a major swing at insurance companies today, as quoted in the New York Times. According to writer Peter Baker,

In unusually harsh terms, Mr. Obama cast insurance companies as obstacles to change interested only in preserving their own “profits and bonuses” and willing to “bend the truth or break it” to stop his drive to remake the nation’s health care system.

He goes on to say of the President’s address,

Rather than trying to curb costs and help patients, he said the industry is busy “figuring out how to avoid covering people. And they’re earning these profits and bonuses while enjoying a privileged exemption from our anti-trust laws, a matter that Congress is rightfully reviewing.”

And I just got a bill from the hospital for a charge of $8,126.63 with no explanation of what procedure it was for, no name of the doctor ordering the procedure, and not even the date on which it was performed. Merely, “Your insurance company has informed us that you are responsible for the stated portion of this expense.”

I called the hospital’s “Patient Financial Services” department and found out that the service was performed on 7/22/09, but they could not tell me the doctor’s name or what the procedure was, and told me to call my insurance company to find out. I told her I was not paying the bill until I received a statement from the hospital with that information.

I did nonetheless research the issue, and the $8,126.63 charge was for a procedure that took a technician just under 20 minutes to perform. So that technician, not physician or registered nurse, is generating more than $24,000 per hour in billing for the hospital.

Billing which insurance companies, and others, pay.

I’m certainly glad we are doing reform to correct the problem with those rapacious insurance companies.

Update: Saturday, 11:30am
A commenter on another blog challenged my assumption that the process was not worth $8,126.63 merely because it only took 20 minutes; that I didn't know what level of skill was required and that the person may have been more skilled than I imagined.

First, my neurologist, who has more than fifteen years of very expensive education and training, charges something like $300 per hour for office visits. Well, I can't be sure what it is, but based on what I pay for office visits, it's certainly less than $1000/hour. That makes it very hard for me to imagine the level of skill and training that would justify $24,000/hour.

But the challenge misses the larger point of my ancedote. Bloviating about how bad the insurance companies are and leaving hospitals, testing labs and drug companies free to charge whatever amouts they want to charge is not solving the problem.

Obama cut a deal with drug companies that in pushing health care reform he would not challenge their pricing. Obama cut a similar deal with the hospitals that he would not challenge their pricing. Obama then prates about "bending the cost curve" and "making health care affordable" by slinging mud at insurance companies.

Olbermann Is An Idiot

Last night Keith Olbermann did a segment remarking on Chuck Grassley babbling about how the individual health insurance mandate might be unconstitutional; that it has never been done before and that it might at least be a tenth amendment (state's rights) issue. "Ever hear of the law requiring people to have car insurance?" Olbermann rejoined smugly.

Well, Keith, baby, a couple of things. First there is no such federal law; that requirement has been established at the state level and has withstood challenge, but is not a federal law, as a guest commenter later pointed out while you tried to pretend you were not listening to him. Second, people could avoid that mandate by not owning a car; that mandate is attached to the car, not to the person, and no such freedom of choice is available with this proposed mandate. Senator Grassley actually has an interesting point, in that the federal government never has mandated individual purchase of anything, so we actually are in new territory.

Sometimes in his haste to make other people look stupid Keith Olbermann steps on his own instrument.

Update: Friday, 8:30am
I don't have any problem with the individual mandate, and suspect it is necessary to make any of the proposals have any semblance of workability. Consensus seems to be that it will withstand challenge. I just think that defending it by comparing it with state laws on auto insurance is stupid.

Krugman Gets Wierd

In his bi-weekly cheerleading for the Obama Administration, Paul Krugman attacks the insurance industry in the New York Times today. It seems he has joined the legion of people who are ignoring prices charged by doctors, hospitals and drug companies and are blaming the insurance companies for everything other than the Lindbergh kidnapping. In part he says this,

One argument was particularly striking: the claim that attempts to limit Medicare spending would lead to higher insurance premiums. In fact, the report assumes that 100 percent of any reduction in Medicare payments to hospitals will translate into higher costs for patients with private insurance.

The only way to justify this claim is to assume that all hospitals are purely charitable institutions, charging as little as they possibly can.

Only members of the NYT can comment on editorials, so I can't ask him what he's talking about, but his conclusion makes no sense to me at all.

If it costs $1000 to treat a Medicare patient and Medicare lowers the payment for that patient from $1000 to $900, where is the hospital going to get that $100 lost dollars from? It's going to increase its "overhead" by that lost $100 and therefor increase the overhead charged to patients with private insurance. Private insurance is charged more by hospitals, and therefor raises premiums. I took business in high school, for heaven's sake.

How does that process translate to the hospital being a "purely charitable institution, charging as little as it possibly can" pray tell?

Even Paul Krugrman is so rabidly defending the indefensible that he is just making shit up, and accusing the insurance companies of lying even when they are clearly just stating the obvious.

Update: Friday, 8:30am
I don't like insurance companies, either. I just think all of this vitriol is ridiculous, and insurance companies are only part of the problem. If a person has multiple injuries in a car crash, you don't save his life by focusing on one injury and ignoring the rest of them.

I just had a hospital bill me $8,126.63 for a process that took one person twenty minutes to perform.

Secretary of State

Chris Matthews suggested yesterday the the real reason for Obama’s Nobel Peace Prize might be his selection of Hillary Clinton as Secretary of State. And that sentence might have more capital letters in it than any that I’ve ever typed in my life.

Every time I see her I am quite taken by how much younger, more vigorous and more cheerful she looks than she did during the campaign, and my esteem for this lady is growing day by day. When he first named her I thought she was a good choice; she has turned out to be, I think, an excellent choice.

Reform, Costs and Premiums

The government mandates certain features on your automobile; seat belts, for instance, air bags, crush panels in the doors, mileage standards, roll bars in the roofs, fuel vapor recycling, and quite a lot of other things most of which are related to consumer safety.

For the government to require health insurance companies to provide certain features, then, is by no means out of line; things like covering pre-existing illnesses, setting caps on copays and deductibles, not placing caps on payments, etc. These, too, after all, are matters relating to consumers.

What the government did not do with the auto industry was mandate all of these features while requiring that manufacturers sell cars at lower prices and, in fact, all of these mandates have increased the price of cars by quite a lot; several thousand dollars per car. But with “health care reform” the government wants to require additional features from health insurance companies while making those companies sell their product at lower prices. When health insurance company representatives point out that these new requirements will raise the price of insurance, just as new safety features raised the price of cars, loud cries of outrage erupt.

An editorial in today’s New York Times addresses the “deep dishonesty” of the insurance industry report, beginning by admitting that the “individual mandate should probably be stronger.” With that little treasure they validated about half of the report. They begin their criticism with,

First, under the legislation, anyone who currently has a policy that turns out to be cheaper than those sold on the exchanges will be allowed to keep it.

What that has to do with the insurance company claim that premiums will rise under the current “reform” proposals is completely beyond me, and nothing that follows makes it any more clear. Further down they declaim,

In a particularly glaring omission, the industry report made no effort to factor in the effect of proposed subsidies that would help millions of people to buy their own insurance on those exchanges.

Again with the exchanges, but the fact that the government is offering subsidies does not refute the claim that premiums will increase; offsetting those premiums with subsidies does not eliminate the increase in the premium. It does eliminate the effect of that increase for those who receive the subsidy, but it doesn’t make a whole lot of sense to take government action to drive up premiums and then use government money to offset that increase, which was caused by government action.

The editorial than describes the proposed tax on high priced policies, never mentioning the President’s promise that “if you like the policy you have, nothing will change.” Or maybe you don’t consider a 40% increase in the price of your health insurance to be a change.

As much as Americans hate the idea of taxes, there is a strong logic to this approach. It is designed to encourage employers and their workers to buy less-expensive plans — and make a more rational calculation of what services they need versus what is “free” because it is covered — and encourage employers to shift compensation more toward higher wages.

So health care reform is now designed to discourage policies that provide outstanding coverage for those who can or want to pay for them, and drive them to more average policies that provide less elaborate care. Employers, paying less for those more moderate plans, will raise your wages instead. Of course they will; and I have some land in Florida that I would like to talk to you about.

Finally, the report makes no mention of the legislation’s efforts to find ways to rein in the relentless spiral of health care delivery costs — the main culprit in today’s spiraling premium costs. In the long run, those reforms should reduce the cost of insurance for everyone.

This is absolutely the first time in the debate that I have seen anyone suggest that the prices charged by doctors, hospitals, clinics, labs and drug companies and paid by insurance companies might have something to do with the high cost of health care, or that the "reform" proposals might be addressing those costs. Obama cut deals with hospitals and drug companies specifically not to address their pricing, so I strongly suspect that this paragraph is disingenuous.

Even if it is not, if these costs are “the main culprit in today’s spiraling premium costs” then why all of the religious fervor regarding the “public option,” which would be paying those same costs? How is this magical “public option” going to “keep the insurance companies honest” and drive down the cost of insurance if it is paying the same prices for the same services that insurance companies are?

To repeat what I have said before, I am not opposed to reform; I strongly favor reform and the more fundamental the reform the better. I know we are not going to get a good bill; Congress has not passed a good bill on anything in many years, and is steadily becoming less and less capable of passing a good bill on this matter or on anything else. We are going to get a bill that is butchered up by the desires of special interests.

But even with that in mind, this is nonsense.

Hailing Reform

Candidate Obama, July 7, 2008, speaking of his plans on health care reform, (emphasis mine)

“I'll also help families who are struggling under the crushing burden of health care costs by passing a plan that brings the typical family's premiums down by $2500 and guarantees coverage to everyone who wants it.”

President Obama, Oct 13, 2009, celebrating passage out of committee of the “health care reform” bill that he favors, (emphasis mine)

“…as the non-partisan Congressional Budget Office has certified, it will slow the growth of health care costs in the long term and it will not add a penny to our deficit.”

In another speech he said that it would both “slow the growth of health care costs” and “bend the cost curve” as if those were two separate things. Actually it doesn’t even address health care costs, as all it deals with is health insurance. It extends insurance to more people but is by no means universal, since it leaves out millions and not just illegal residents. It claims not to increase the deficit, but even the non-partisan CBO admits that premiums will increase under this bill. Apparently they just will increase a bit more slowly than without it.

Note that a diagnostic MRI in the United States costs five times more than it does in other industrialized nations, and this reform bill does not address even peripherally how much imaging labs and hospitals charge for MRI’s. The cost of insurance premiums is dependent, in part, on the amount that insurance companies pay for MRI's received by the people they insure.

You want to reduce the cost of health insurance? Reduce the amount the imaging labs and hospitals charge for an MRI. Does this reform bill even attempt to do that? No.

We are, instead, reducing the cost of health insurance by adding a tax on the insurance companies. In what universe is it sane to suggest that increasing costs to insurance companies is going to result in them lowering their prices?

I’ll tell you what universe comes up with that logic; the universe of the politician that has to raise revenue to provide benefits to voters, but does not have the courage to admit to those voters that there is no such thing as free lunch. Unwilling to suggest taxing actual people to pay for benefits, politicians come up with taxing insurance companies. Insurance companies are not people and can, in any case, be painted as the cause of the problem and therefor deserving of the tax as a form of punishment.

And these are Democrats.

Democrats and their proponents love to bloviate about how stupid and self destructive Republicans are, but look at what Democrats come up with. Impose taxes and additional costs on insurance companies to get them to lower their rates, while leaving doctors, hospitals, and pharma free to continue charging whatever fees and prices they want to charge. Then claim that you have created “fundamental health care reform” and are “bending the cost curve” of whatever it is that you are reforming, which is health care one moment and health insurance the next.

As the Daily Howler says, we live in an idiocracy.

Insanity Increases

The America's Health Insurance Plans released a report saying that the cost of health insurance will increase under legislation presently being proposed as “health care reform.” Democrats are outraged and cannot understand why the industry is attacking them at this stage of the game after being quiet so long.

Marc Ambinder refutes the report by saying that it overlooks subsidies.

Without those subsidies, mostly in the forms of tax credits, insurance premiums would rise for most everyone. With them, they're going to rise for some folks -- this is where Republicans get their "tax increase on the Middle Class" trope -- but no one assumes that the final bill won't provide any subsidies whatsoever. In fact, that assumption is fairly ridiculous on its face.

Which doesn’t say the premiums won’t increase, of course, and actually acknowledges the factuality of the report. It also doesn’t point out that people above a certain income range won’t be eligible for those subsidies.

The second assumption is ideologically defensible, to a point. The report assumes that, faced with higher fees on certain services and products and new tax on expensive individual plans, the insurance industry will raise prices to compensate themselves for lost revenue.

Of course insurance companies will pass additional costs on in the form of increased premiums. Why in the world would they not do that? That is not only business 101, it is high school level. When the cost of a product increases the selling price of that product increases. There is no business school anywhere in the world that suggests that when the cost of a product increases you begin selling it at a loss.

Democrats, the White House and most health economists believe that the insurance industry has larger incentives to reduce the costs of these plans (by reducing benefits) -- rather than increasing their price.

So reduced benefits are not a problem, so long as premiums don’t increase? Notwithstanding that reform legislation is aimed at increasing, not reducing benefits? We are going to legislate for elimination of caps along with lower deductibles and copays, and the insurance companies are going to offset the increased cost of that with reduced benefits rather than by increasing premiums.

Pay the extra cost of increased benefits by reducing benefits.

Each time I think this debate has gotten about as insane as it can get, someone comes along and proves that insanity has not yet reached its peak.

Opposing Reform

A study has been released saying that the “health care reform” currently being proposed would raise the cost of health insurance. The study was done by Price Waterhouse and paid for by the health insurance industry, so take it for what it may be worth, but I don’t know why health care reform proponents are surprised. Whether or not Price Waterhouse would cook a report to satisfy the needs of the paying client is not a bad question; before Enron we would have said it was a stupid question, but now…

Still, suppose you are making a product that costs $10 and selling it for $11 and the government comes along and adds a $2 tax on that item. Are you going to begin selling that item at a $1 loss, or are you going to raise the price by the amount of the tax and begin selling it for $13?

But the government proposes to “pay for health care reform” by imposing a tax on health insurance companies on the policies it sells for a price above a certain threshold, and it expects that insurance companies will pay that tax without passing that cost on to its customers. Why would a company do that?

The entire thrust of the “health care reform” debate has been demonizing health insurance companies and increasing the amounts that health insurance companies must pay out, with politicians, including the President, using phrases like “keeping insurance companies honest” and accusing insurance companies of “holding America hostage.” And now proponents are amazed, utterly astonished, that insurance companies at this late hour would begin publicly opposing this reform.

I’m surprised they waited this long.

Football Wrap, 10/12

The San Diego Chargers had the week off, but LSU provided me with the barf-inducing performance of the week. Their defensive front four performed like a front two or so, and their offence had all of the punch of a bowl of Jell-O. For some reason Florida chose not to score on about five occasions that it had a chance to do so. Neither team really wanted to win this game, but LSU wanted it less than Florida did. “House of Death,” indeed; something certainly killed the game. I kept looking to see if I had inadvertently left my dvr on slow motion but, no, I was watching it live.

My niece lives in Oakland; she and her husband just bought a home there. Fortunately, they are not into football, since Oakland does not have a football team. Oakland has the Raiders.

Hate to see Denver reach 5-0, but it was maybe worth it to see Belichek and the Patriots go down.

The Chargers, currently at 2-2, face Denver here in San Diego next week on Monday night. The Charger players say they know how to correct their sorry caliber of play and will do so easily, which I doubt. If that’s the case, why didn’t they do so before going to Pittsburgh last week and humiliating themselves on national tv?

Shawne Merriman was going to restore the defense to glory with his return from injury this year and has five tackles in four games, no sacks. I make it that the Chargers are paying him something like $3.4 million per tackle, which strikes me as a little pricey.

Health Care Reform Clarification

I should point out that I am not opposed to health care reform, nor am I opposed to what Congress is working on now. I think it should be passed in whatever form Congress can get it done.

I am just pointing out that what we are doing is not health care reform. It is, at best, health insurance reform, but it is not even that in any fundamental sense. It will extend insurance coverage to some of those who do not have it, but there is little liklihood that it will be even approximately universal.

When legislators talk about the current plans reducing costs, they are talking about the federal budget, not about the prices that Americans pay for health care. Nothing in any of the plans proposes to regulate or address the rates that are charged by doctors, hospitals, clinics or drug companies.

While it purportedly will not increase the federal budget, and some of the ways it proposes that are dubious to say the least, I have strong reason to believe it will increase individual costs for health insurance. Insurance companies are being required to pay out more money and premiums are not being regulated, so anyone that believes premiums will do anything but increase as a result of this reform are delusional.

The panacea of "public option," if it is included at all, will be structured to allow private insurance premiums to increase. Most of the plans so far, for instance, provide that if a person is covered by an employer's plan they will not be allowed to drop that plan and enroll in the public option.

Proponents of this reform are correct in saying that the status quo is unacceptable, but I do not agree that just any degree of incremental reform is acceptable. We are a better nation than this and we can do a better job than this. We must take whatever we can get, of course, but to celebrate this piece of weak tea as a victory is pathetic.

Follow The Leader

It is amazing to me how the polarization of party politics has become so integral with the discussion of “health care reform.” According to proponents of reform, Democratic legislators should simply vote the party line; no thinking or individual conscience is required here, the party leadership tells you how to vote and you vote that way.

I don’t know what form of government that is, but it is not democracy.

I suggested as much in a comment on a quite liberal blog, and I was roundly attacked. I was rebutted in no uncertain terms that if individual legislators were allowed to think for themselves, and did not follow party leadership and vote as a block, that nothing would ever get done.

Olbermann and Maddow, supposed bastions of liberal thinking, are highly critical of Democratic legislators who are “standing in the way of reform.” They are both insisting that these Democrats get in line and vote with the party. These two “liberals” are opposed to legislators having an open mind, thinking for themselves, which is the very definition of the word “liberal.”

If a Congressman gets letters from his district which oppose legislation by a margin of 100:1, but party leadership tells him to vote in favor of that legislation, he is supposed to ignore the advice of his constituents and follow the dictates of his party leaders. If he finds something in a bill morally objectionable, he is supposed to disregard his conscience and vote per the dictates of his party leadership.

We are, by all of this thinking, redefining oligarchy downward. The legislation that gets passed is determined not by thinking of 535 men and women who are elected to national office, but by a much smaller number of people who constitute the leadership of the party in power.

That certainly means fewer people that lobbyists need to buy off.

And let’s do remember that we had just such a Congress when George Bush was President. That Congress voted to authorize the war in Iraq. It gave us the Patriot Act and the authorization to imprison people without trial. It gave us the Bankruptcy Reform Act of 2005. It got things done.

More Incoherence on Health Care

Kevin Drum at Mother Jones yesterday, responding to the question, “Why do we spend so much more on health care than any other nation?”

We pay our doctors about 50% more than most comparable countries.
We pay more than twice as much for prescription drugs […]
Administration costs are about 7x what most countries pay.
We perform about 50% more diagnostic procedures than other countries
and we pay as much as 5x more per procedure.

He's basically saying, "We pay more for health care because our health care costs more." Brilliant. He goes on, (emphasis mine)

Underlying all this is the largely private, profit-driven nature of American medicine, but regardless of how you feel about that, the main lesson here is how hard it would be to seriously bring these costs down. We can jabber all we want about incentives and greed and systemic waste, but the bottom line is that if we want to do anything more than nip around the edges, we'd have to pay doctors and nurses less, pay pharmaceutical companies less, pay insurance companies less (or get rid of them entirely), pay hospitals less, and pay device makers less.

And how are we proposing to institute “health care reform” and restrain costs? By making insurance companies enroll more people, pay out more money, and somehow collect lower premiums.

Regulate greater payouts by insurance companies.
Hope for, but don't legislate lower insurance premiums.
Do nothing to change the way that doctors are paid.
Do nothing to bring down the cost of prescription drugs.
Do nothing to significantly reduce administration costs.
Suggest fewer diagnostic tests, but do not regulate it.
Do nothing to bring down the cost of diagnostic procedures.

Notice that was "restrain costs," not "reduce costs." We apparently do not consider an actual reduction of costs to be an achievable goal

Keith Olbermann rants about how evil health insurance companies are and then says that the solution is to, wait for it, make sure everyone has health insurance.

Lawrence O’Donnell says that it is “awful policy” to pass legislation that states can opt out of, despite his participation in passing Medicaid which, wait for it, states can opt out of.

Chris Matthews declaims the uselessness of health insurance, claims that the industry “contributes nothing to the distribution of health care,” and then rants about the millions who die yearly because, wait for it, they have no health insurance.

The longer we argue this issue, the more incoherent we become.

Presidential Nobel

So the man who was campaigned against in both primary and general elections as being too inexperienced in foreign policy has a Nobel Peace Prize. He was a mere “community organizer” and the least qualified of any candidate in the realm of foreign policy. He could not see Russia from his house, and had never been held prisoner by any foreign power.

Do please make note that in international polling we have gone from the 7th most admired nation to the 1st most admired, which is where we were before… Well you know when that was.

The Nobel made note of his efforts on eliminating nuclear weaponry, an effort that he has succeeded in getting Russia to join. They noted his effort at peacemaking in the middle East in his first year in office, not his last year, and recognized that the lack of progress to date was not his failure. They noted his administration's talks on the nuclear issue with Iran that have yielded small but actual results.

Republicans are going to go ballistic. They are going to bash him for accepting a foreign award. They are going to criticize the Nobel Committee for awarding the Peace Prize to the President who escalated the war in Afghanistan, and will see no irony in that.

Screw them. This nation has a President with a Nobel Peace Prize.

Stellar Politicos

Duncan Hunter, R CA, was on Hardball Tuesday to dazzle us with his expertise on the subject of the necessity of maintaining a strong presence in Afghanistan and winning the battle against, and this is where things start to drift into lalaland, “the Islamofascists” there. Apparently no one told him that term went out of favor about the time George W. Bush moved to Dallas.

He finished by saying, “Yes, Chris, these are the people who have camels and will throw stones at us.” I swear, I am not making that up.

There is something to be concerned about besides the obvious issue of having people like Duncan Hunter and Michele Bachmann casting votes in Congress and determining the future of this nation, the thought of which sort of makes me shudder.

This guy served in the USMC, and it has to make one concerned about the caliber of our modern Marine Corps that a former officer of that service is lying awake at night worrying about our principal enemy being in the form of stone-throwing camel jockeys.

Chris Matthews Is An Idiot

Matthews has a new mantra, which he repeated several times on Hardball yesterday, about Al Qaeda returning to Afghanistan. He wishes they would, so that "we could bomb the hell out of them." No more getting permission from Pakistan, he asserts, no more limitations, "we could just bomb the hell out of them."

Apparently he is unaware of our current use of unmanned drones to "bomb the hell out of them" in Pakistan, something that we have been doing for a bit over a year.

Eye On The Ball

It’s hard for me to be certain of any opinion on our presence in Afghanistan when I get so much conflicting statements on why we are there. There is much vague talk about “national security” and defeating the “enemies of freedom,” all of which is war drum demagoguery, and all of which I ignore. The actual reason is as variable as the reasons we went into Iraq, and that fills me with dread and suspicion.

There is the “magic bullet” about the government knowing things that I don’t know. If it doesn’t tell me those things, then it cannot blame me for being unsupportive of the wars it chooses to fight. It is not incumbent upon me to support the government just because it says so; this is a free country, and it is the government’s place to convince me that it is doing what I want it to do. So why are we entering a ninth year of war in Afghanistan?

Who is the enemy? To me that answer has to be any group who has attacked us or who has made pronouncements of intent to attack us. The only organization the fits that description is Al Qaeda. Although often called “the enemy,” the Taliban does not fit the description. They have never expressed the slightest desire to attack the United States, and the only reason they are fighting us now is to drive an invader out of their country. If that is incorrect, then the government needs to make that case and provide evidence.

President Obama said that Bush “took his eye off the ball” by invading Iraq, but at this point we don’t seem to know where the ball is. Who is the enemy?

Why are we fighting to defeat the Taliban? The Taliban is not our problem. They engage in a harsh form of justice and treat women badly. That is Afghanistan’s problem, not our problem. Saudi Arabia engages in a harsh form of justice and treats women badly and their king eats dinner in our White House. It is not our place to determine the form of law and social justice used by other nations.

We must make sure that Al Qaeda “never returns to Afghanistan.” Someone needs to convince me that they even want to; I’ve never read anything that says they regard Afghanistan as the place they want to be. Is there some sort of magic that allows them to plan attacks in Afghanistan that they cannot plan anywhere else?

I will support any effort to destroy Al Qaeda. Occupying Afghanistan for an undefined length of time and defeating the Taliban after admitting that Al Qaeda is not located there does not fit that bill. Spending American blood and treasure to “deny victory to terrorists,” on some vague ill-defined “national security” basis, or to deny territory to Al Qaeda in a non-territorial war against them is unacceptable.

Obama promised an “eye on the ball.” When is he going to do that?

Jobs and Recovery

Quoting Paul Krugman again, this time in agreement with him as he did a column yesterday answering questions for readers. He was asked for a definition of “the economy” and replied,

I’d say that the economy is everything that involves making or using goods and services.

He also has said recently that the economy is improving but that “jobs are a lagging indicator” and at that point he and I part company. How can “making and using goods and services” improve while jobs are being lost at a very rapid pace?

When a recession ends unemployment is a lagging indicator because “employers are reluctant to rehire until they have evidence that the recovery is real.” That means that unemployment does not reduce from the level that obtains at the time that the recession ended. It takes time after the end of the recession for unemployment to begin to improve.

That’s not what we have here. The unemployment picture is not merely failing to improve, it is still getting worse. Employers are not “reluctant to hire,” they are still rapidly shedding jobs. They are not “waiting to see if the recovery is real,” they see no recovery and are forecasting that they cannot maintain their status quo.

I would suggest that until unemployment at least levels off we should not even be talking about recovery. I am not suggesting that we should require that employment be improving, but when it is still declining, and declining rather rapidly, I think it is insanity to be swooning over the stock market numbers and claiming that the economy is “recovering.”

Deja Vu on Terror

In the movie A Few Good Men (a really trite, corny movie that I have watched several times) Tom Cruise asks Demi Moore why she is so intent on defending the Marines. “Because they stand on the wall,” she replies, “and they say no harm will come. Not on my watch.” I love that line.

Glenn Greenwald “stands on the wall” in defense of the constitution. To him that thing is not just a piece of paper, it is a set of principles; it is the foundation of this nation. He takes every word of it as seriously as a Fundamentalist Christian regards the Bible.

He can be a little bit of an alarmist at times, and some of his conclusions may be debatable. So be it, alarmism is by no means inappropriate in these times and no two people think precisely alike. No one has ever successfully challenged him on fact, though; this guy knows his stuff and he researches more thoroughly than anyone else I read. His factual accuracy and the depth of his training lends his writing an almost unique credibility.

He supported Obama, as I recall, during the election campaign but he also decries the kind of slavish loyalty to anyone that maintains that the person is right in all things no matter what he does. He casts such blind loyalty in an almost unpatriotic light, and by implication seems to regard it as stupid.

I could not agree with him more. I like Obama; I like his personality, I like his style, and I agree with much of what he is doing as he leads this nation. But I am at serious odds with Mr. Obama in his methodology as to “national security” issues and Glenn Greenwald sheds light on the issue in yesterday’s Unclaimed Territory, describing the current administration releasing the interception of no fewer than three hyped-up terrorists plots just coincidentally as the Patriot Act and its infringements on civil liberties are up for renewal.

Keith Olbermann had many segments on what he called the “Nexus of Terror,” illustrating how the Bush Administration would dramatically intercept some heinous plot to commit terrorism in the US and it would turn out that the drama would be distracting the public from some administration debacle, or would be furthering some legislative goal. Olbermann, increasingly becoming the Rush Limbaugh of the left, has not noticed the “nexus” between the Zazi plot, hailed by the administration as "the most significant since 9/11," and the plots to blow up buildings in Dallas and Springfield, with Obama’s thrust to get the infringements of civil liberties contained in the Patriot Act renewed by Congress

Déjà vu all over again. Go read Glenn Greenwald.

Health Care and Public Interests

My neighbor just returned from spending six months in England, and his comments regarding their attitude toward their National Health Service were interesting. He said that both political parties are supportive of the NHS, and that no politician would dare attack or even criticize it because to do so would mean catastrophic defeat at election time. The British love their NHS and think the United States people are complete idiots for the way we do health care.

What the British spend, in the form of taxes: $2,992.00
What the United States spend per person: $7,290.00

That is spending per person, per year on healthcare, and we do not get any better results. No wonder the British think we are idiots. We are idiots.

Yesterday I cited Paul Krugman’s column and agreed with his comment about Republicans campaigning using adolescent spite, but disagreed by implication with his assertion that Democrats are the party of logic and reason. Well, perhaps it was more than implication.

Tactics aside, both parties govern with the primary goal of the preservation of their own hold on political power. Democrats add a sop to populism, but their primary purpose is just as nakedly about power maintenance as is Republicanism.

The “health care reform” debate is a case in point. If public interest were really the purpose of debate, then reform would be to “assure that everyone receives health care,” not to “assure that everyone can buy insurance.”

The cost goal would be to reduce the cost that Americans pay for health care, so that Americans would be paying proportionally closer to the same amount as the rest of the world to receive the same benefit as the rest of the world receives. One Democratic politician after another says that health care costs have risen unacceptably and are presently crippling American industry and American people, but the cost goal is “to slow the growth of health care costs.” Not one single Democrat, from the President down, has so much as suggested actually reducing present costs.

If the best interests of the American people was the goal, the debate would be focused on regulating health care costs more at the provider level where they are created, and not merely at the insurance level where they are paid. Certainly regulation of the insurance industry is necessary, but doing so in the absence of regulation of providers is demagoguery, not reform.

The Democratic goal is not the best interests of the American people. The Democratic goal is to pass a bill that they can applaud as “fundamental health care reform” to assure their own reelection, and the actual content of that bill is not really important. They will cheerfully accept whatever that can get through the lobbyists who actually write our legislation, using whatever “deal making” is necessary.

And we keep reelecting Congress at a 95% rate. We are idiots.

Sinking in the Mainstream

Chuck Todd was on Hardball yesterday opining that Obama has had nine whole months and has a lot of “balls in the air” but has not “closed the deal” on much of anything. He admitted that Obama did get the stimulus bill passed, but went on to say that not all the money has been spent, implying that even that accomplishment is of dubious value.

Presumably if Obama were more capable the money would all have been spent by now and unemployment would be down to 4% or so.

There was no mention, of course, that what is keeping all these “balls in the air” from actually landing is not Obama’s fecklessness, but rather the fact that Congress is, as my father would have phrased it, “about as useful as teats on a boar hog.” Chuck Todd even spoke of the delays on health care reform saying, “we’ve missed several deadlines that were supposed to be met in Congress” as if that were somehow Obama’s fault.

He even went so far as to say that the failure to secure the Olympics for Chicago typified Obama’s problem in getting things done and was a “punch in the gut” for his administration.

Good God, but the “mainstream media” has become a tired and sick joke.

Incoherent Health Care Debate

Paul Krugman writes in an NY Times op-ed today that Republicans campaign using adolescent spite, while Democrats are paragons of thoughtful and logical argument. While that may be a bit hyperbolic in describing his column, Krugman has become such an inveterate cheerleader for the Obama Administration that it’s hard to take him seriously any more.

If the “health care reform” debate is an example of Democrats being thoughtful and rational, then we need new definitions of those two words. They can’t even decide what to call the debate, because sometimes it is “health care reform” and other times it is “health insurance reform.” They cannot decide on the goal, which is sometimes universal insurance coverage and other sometimes cost reduction. The one goal that seems never to be sought is universal provision of health care.

Even if the cost reduction, which gets most of the discussion, is the goal, they go about that in a truly bizarre manner. Our health care delivery system is a complex and massive profit machine, and Democrats are focused on one small aspect of it; the red arrow in the diagram below. All of the blue arrows represent cash flow that is being omitted from the discussion completely.

Sort of like having a car that is failing; motor running badly, leaking oil, transmission blowing smoke, body rusting out and u-joints clanking. Democrats are going to “fix that car” by putting new tires on it and hoping that the rest of the problems will magically repair themselves.

Notice, too, the cash flow at that red arrow. Democrats are going to pass measures that will require insurance companies to pay out huge amounts of additional payments for care, but insist that premiums collected to make those payments will decrease.

Insurers will be required to insure people with preexisting conditions. Excellent; a moral thing to do, but how much will that require in additional payments by insurance companies to medical providers? No one knows, and no estimate has even been made.

Insurance will not be allowed to cap benefits or drop insurance, and must lower copays and deductibles. Also excellent and moral things to do, but how much will they require in additional payments by insurance companies to medical providers? No one knows, and no estimate has even been made.

These additional costs will be offset, Democrats say, by the new insured who do not have insurance but are healthy and so will not result in payments by insurance companies. That is somewhat belied by the Democratic arguments of the numbers of people who are dying because they don’t have insurance; how healthy are they if they are dying? It’s also belied by the claims of hospital costs being high due to treating uninsured patients; that does not make the uninsured sound particularly healthy.

Add to those the decision that younger people will pay one-fifth the amount that older people do for premiums, due to their lower expectations of using the insurance, and that supposed offset of higher payouts against new insureds becomes even more suspect.

Democrats point out that insurance premiums have increased by x% in past years. The amount varies, but is always horrendous. Do they ever state the increase in the amounts that have been paid out by insurance companies; the amounts charged by hospitals, doctors and pharmacutical companies? True health care costs are not insurance premiums, they are the charges made by medical providers, and those are not being discussed at all.

The basic Democratic argument is that compelling higher payouts by insurance companies in unknown amounts will be offset by mandating an uncertain number of new insured people who will pay mostly lower premiums and will result in unknown amounts of mandated additional payouts by insurance companies, but it will all work out for lower costs because of a “public option” that will “keep insurance companies honest.” Meanwhile we will “suggest” that everybody else in the health care system do a better job of not being greedy.

That does not sound like a thoughtful and logical argument to me.

Football Wrap

LSU won, but they did not look like a #4 team doing it. In the second half they did not look like a nationally ranked team. I have about as much chance of building a snowman in my front yard as they do of winning against Florida next week.

The Denver Broncos are 4-0, having beaten Dallas to get there? Really?

Meanwhile the Chargers are taking comfort in the fact that they "did not quit" after going down 28-0 to Pittsburgh tonight. Um, football is not like boxing; there is no provision for tossing a towel onto the field in surrender. The Chargers gave up 165 yards to one running back and 500+ yards overall. They didn't quit; to quit you have to start, which they never did.

And we have now answered the immortal question about how many Chargers are needed to tackle a Steeler. Answer, "More than three."

Presidential Failure

Well, I’m certainly not going to vote for this worthless head of state again, if he can’t even get the Olympics for us. I mean, what is he good for if he can’t do that?

Of course the fact that we have this “do not fly list” and about half of the known world is listed on it may have had something to do with it. Holding the Olympics is problematic when the host country will not allow about half of the world to enter the country, and the ones it does allow are subjected to a cavity search. Plus, the issue that half our nation is paranoid and the other half are bigots might have something to do with it.

The fact that the Obama Administration has made more progress on the Iran issue with one buffet lunch than the prior administration did with eight years of bs and saber rattling might sway my vote back in Obama’s direction, though. I’ll have to think about that.

Olympics failure vs. avoiding nuclear war. Hmmm; tough call.