Asshole of the Week

And if we do a proper job, if we break the windows of hundreds, thousands, of Democrat party headquarters across this country, we might just wake up enough of them to make defending ourselves at the muzzle of a rifle unnecessary.
Sons of Liberty, this is your time.
-Mike Vanderboegh

Mike Vanderboegh is a 'Christian Libertarian' and former militiaman who lives outside Birmingham, Alabama. Recently, he's gotten a lot of attention for his online call to break the windows of Democratic party offices nationwide, in response to passage of the Affordable Care Act, which he deems an unacceptable intrusion of government into the lives of its citizens. And despite the fact that people have taken him up on it, and have indeed taken things even further (death threats, noose-faxes, the gas line at a Democratic Congressman's brother's home intentionally and maliciously cut), he stands by his call to vandalism.

So, you ask, what does this principled libertarian, who so abhors government handouts and the redistribution of wealth to the poor and the sick, do for a living? You know, when he's not committing acts of sedition and encouraging petty criminality in the service of right-wing terrorism?

Why, it turns out Mr. Vanderboegh doesn't work at all. Doesn't earn his money by trading his skills and his productivity for money in the free market. Nope. Mike Vanderboegh is on federal disability.

That's right. This principled libertarian is just another welfare queen, buying t-bones with his food stamps. Probably has a cell phone, too. I bet if he were old enough, he'd probably be on Medicare.

What an asshole.

Posted Without Comment

What's being tested here is not just our ability to solve this one problem, but our ability to solve any problem. Right now, Americans are understandably despairing about whether partisanship and the undue influence of special interests in Washington will make it impossible for us to deal with the big challenges that face our country. They want to see us focus not on scoring points, but on solving problems; not on the next election but on the next generation. That is what we can do, and that is what we must do when we come together for this bipartisan health care meeting next week.
-Barack Obama

Posted Without Comment

Failing to pass healthcare reform will succeed in killing 44,000 Americans every year.
-Bob Cesca

Why Everyone in the Circular Firing Squad Should Turn Around

There was a lot of delusion among progressives who convinced themselves, in the face of clear evidence to the contrary, that Obama was a strong champion of their values. He wasn’t and isn’t.
That doesn’t mean that there’s no difference between the parties, that everything would have been the same if McCain had won. But progressives are in the process of losing a big chance to change the narrative, and that’s largely because they have a leader who never had any inclination to do so.
-Paul Krugman

For what it's worth, I never thought Barack Obama was anything more than a center of the road politician. I appreciated that he at least told the lies I wanted to hear during the campaign, and it was nice to hear lip service being paid to my beliefs and agenda. But I never expected him to be anything other than what he is, which is a politician. Perhaps smarter and certainly more eloquent than the average politician, but a politician nonetheless.

But whatever he is, it remains the case that a good portion of the electorate that voted for him, his 'base' if you will, was the Progressive Left, many of whom did a little projecting, unfortunately, and came to believe, in the face of plenty of evidence to the contrary, that he shared their values and their policy agenda. And to some extent he might have. Probably not as much as they (or I) might wish, but at very least he recognized many of the obvious problems that thirty years of being a 'center-right nation' have caused, and at least paid lip service to solving them.

Now, after months of bickering and mishandling, one of those solutions, Health Care Reform, which is something that's needed doing for several decades if not a centrury now, is on the brink of getting the foundation laid or failing for another generation. And while it's important in and of itself, it's also important in that it provides a rallying point for Progressives to organize around.

You can bitch and blog all you want, and God knows I do plenty of both myself, but at the end of the day, you gotta get in there and do your duty as a citizen. You gotta write the letters and make the calls and put the pressure on your elected representatives, because if you don't, they'll just listen to and aim to please the people that do, starting with the people that pay for their campaigns. Votes are great, and we all know that nobody gets elected without them, but money comes in a close second, and it certainly concentrates influence more than votes do.

Progressives may not have the leverage we think we deserve, and perhaps we never will, but we have more now than we've had in decades, and it's more important than ever that we use it. For most of the last decade, we could howl and scream all we wanted, but the people in power (i.e. Republicans) weren't going to listen because it wasn't our votes that elected them.

But that's all changed now. Obama and the 111th Congress need us in order to stay in power, which means that, if we act in sufficient numbers and with a modicum of discipline, we can influence the direction of policy more than we could in the recent past. If we can actually get some legislation enacted, like Health Care Reform (imperfect though it is), then it will make life better for people, which will go a long way to convincing them that our ideas are better than the ideas of the people on the other side of the aisle. We're already halfway there, because the folks on the right had the whole damned government for six or eight years and everybody saw how well that went.

But now we own it, at least in the eyes of the public. So that means we have to make it work.

Eyes on the prize, people. It's a long, hard slog, and it'll be filled with disappointment, but if we aren't willing to get in there and make it happen, nobody else is going to.

In Defense of the Democratic Party

There is no realistic scenario in which the electorate is impressed by policymakers who spend a year doing the hard work of tackling a seemingly-impossible challenge, pass the landmark legislation, and then somehow manage to come up short anyway.

-Steve Benen

Look, I hate the Democrats as much as anybody. They're feckless, and gutless, and they lack the courage of their convictions. They're in bed with many if not all of the same kleptocrats as the Republicans. But they do at least try to govern effectively when they're in power, and they do try to identify and solve the many looming crises that hang over our world and our nation like the proverbial Sword of Damocles. Yes, they must often compromise the best solutions to those problems, because the people with whom they negotiate have pretty much abandoned the notion that government is for anything other than handing out fat defense and energy contracts to their friends and the people and corporations who subsidize their campaign efforts. And they're a little too like Jesus, turning cheek after cheek until they're red and raw both top and bottom.

I wish they'd fight harder. I wish they'd get more accomplished.

I wish they'd at least realize that the other side isn't interested in finding common ground or even common sense solutions to the serious problems we as a nation, a people, hell, even a species, face.

But there really aren't any other options. No other game in town, except for the Republicans, and they've already amply demonstrated that they think campaigning is more important than governing, and when they do manage to get ahold of some power we end up with an endless series of debacles like the George W. Bush presidency.

For those, like me, who would pursue a largely Progressive agenda, who would like to see real problems addressed and life made better for everyone, both at home and abroad, there really isn't another credible vehicle for making the change I desire, the change I believe, in my inmost heart, is needful if we all are to survive for much longer. It may break my heart, and does on a regular basis, but the Democratic party, with its big, dysfunctional tent and its penchant for the circular firing squad, is pretty much it if what I want is Progressive legislation.

And that is what I want.

More Health Care Bill Explanation! This time from Paul Krugman!

Take it away, Dr. Krugman.

Start with the proposition that we don’t want our fellow citizens denied coverage because of preexisting conditions — which is a very popular position, so much so that even conservatives generally share it, or at least pretend to.

So why not just impose community rating — no discrimination based on medical history?

Well, the answer, backed up by lots of real-world experience, is that this leads to an adverse-selection death spiral: healthy people choose to go uninsured until they get sick, leading to a poor risk pool, leading to high premiums, leading even more healthy people dropping out.

So you have to back community rating up with an individual mandate: people must be required to purchase insurance even if they don’t currently think they need it.

But what if they can’t afford insurance? Well, you have to have subsidies that cover part of premiums for lower-income Americans.

In short, you end up with the health care bill that’s about to get enacted. There’s hardly anything arbitrary about the structure: once the decision was made to rely on private insurers rather than a single-payer system — and look, single-payer wasn’t going to happen — it had to be more or less what we’re getting. It wasn’t about ideology, or greediness, it was about making the thing work.

What's the takeaway? Because we lack the political will for the better system (cuz, you know, socialism), what we got is about what we had to get.

Hopefully, what we're getting will be a step in the right direction. After all, the single most successful subsystem of American health care is Medicare, which has its faults but that everybody seems to agree works pretty good, which is a single payer system.

But thanks to politics, echo chambers, and the seeming disconnect between the stakes of the game and the game itself in some circles, we can't just move to the smarter, more efficient, more humane system right away.

Okay. Guess we'll just have to take a deep breath, steel ourselves for the long slog up the hill, keep up the pressure on our duly elected representatives, and keep winning the war of evidence and ideas.

I think these words of Churchill's, though used in a different context, might prove instructive:

The United States invariably does the right thing, after having exhausted every other alternative.

A Good Point from an Old Friend

As a physician....I appreciate the post on your blog. One huge issue that is missing; is the amount of waste that occurs with defensive medicine and end of life care. I know you have heard this before from physicians. I assure you that from the trenches......10 to 20 times is wasted with defensive medicine compared to ...medical errors etc. In fact many preventable events in health care could be avoided if defensive testing and unwarranted procedures were not performed. The system is broken! Unfortunately many feel that medicare is like a blank check and families request unneccesarry procedures and treatments that do not provide better health and only serve to prolong an inevitable death! When this type of coverage is expanded, without rationing, we are all screwed I assure you!
-George E.

George makes a good point, and one I haven't yet touched on in my ongoing bloviations here at the anticontrarian blog.

It's something of a truism that most of the money spent on any given individual's health care is spent at the end. Grief-stricken families with loved ones on their death beds will often, quite naturally, do just about anything to prolong their lives, even if what they're prolonging is the persistence of a vegetative state or simply unalloyed pain and suffering. The case of Terri Schiavo is a perfect example, where the body was kept alive long after the person inside had gone.

Now, this is some dangerous territory we're entering, as I'm quite well aware. After all, people are rarely rational in the face of death, whether theirs or that of a loved one, and George's point that having a blank check to extend that life, no matter what the quality of it is or will be, will inevitably lead to waste and abuse is a good one. The term 'rationing' is a loaded one, freighted with all manner of unhappy connotations, but it's also something that we, as grown-ups, quite frankly need to face up to.

There is, after all, only so much care to go around. Period. And only so much good that can be done for someone who is going to die. Period. That there will be rationing is inevitable, and even just. It sucks, but there really isn't any way around it, at least until there is more supply than demand when it comes to health care. I don't see that happening. Do you?

This is why end-of-life counseling and directives are so important. 'Death panels' nonsense aside (and it is nonsense, another example of willful misinterpretation in the service of scoring cheap political points, which I will not deign to rebut here), it really is important for everybody, and most especially those who're either sick or getting on in years, to sit down and figure out how they want things to go down when the end is nigh. Nobody wants to think about things like that, of course, but it's one of those things grown-ups have to and ought to do, if for no other reason than to see that their wishes are carried out. After all, when the time comes, you might not be conscious or capable enough to make your own decisions, and I can tell you from personal experience that it's a hell of a thing to put on someone else to decide it for you. The Schiavo family can tell you that, too.

Lucky for me, when my mother began her terminal decline, all of the decisions had been made, and the appropriate legal documents drawn up and notarized. She made her wishes crystal clear, which spared me from having to make that decision. She had long ago made her wishes clear to me verbally, and so I knew what she would've wanted, but it was a great comfort to have it in writing, to know that she'd thought it out and made her decision. Things were difficult enough at the time, and even having had the burden of decision taken off my shoulders it was hard enough to make the decision to move her to hospice and to sign the do-not-resuscitate order.

But it was what she would've wanted. What she always said she wanted. She would've been horrified to spend her last days in an ICU, shot through with tubes and surrounded by beeping machinery that could only stave off the inevitable for so long and at great cost, without changing the inescapable outcome.

Personal stories aside, what pisses me off most about the 'Death Panels' meme is the childishness of it. The unwillingness to face the fact that life ends, and that each of us should be able to decide how we want ours to end, if that choice is given us, and to have those choices respected. Why it should be problematic for any- and everyone to sit down with a medical professional and decide just how far they want things to go to draw just a few more breaths when the end is in sight and inescapable is beyond mysterious to me. That the government would be willing to compensate doctors for their time in doing so seems perfectly reasonable.

That there comes a time when it isn't worth it to do anything else but try and ameliorate the pain and ease a dying person's passage into whatever's on the other side is something we all have to face up to. Better to do it proactively, for ourselves and for the sake of our loved ones.

That it makes sense from a policy perspective, too, well, I suppose that just goes to show that life gets better for everybody when the grown-ups live up to their responsibilities. I, for one, would rather not waste finite medical resources to keep me alive in pain or a vegetative state for a few more hours or days when it's my time, not when they could be better used on someone whose life is still ahead of them. I suspect that most of the grown-ups out there would agree.

The Good Things the Senate Health Care Bill Does

It's easy to get confused about the health care debate, what with both extremes going to extremes to take it down, and the folks in the middle who are actually trying to solve problems not really articulating the depth and breadth of what they're doing. Even your faithful correspondent here at the anticontrarian blog gets a bit confused here and there.

So mad props to Jonathan Chait at The New Republic for laying it out, debunking some myths, and putting the whole thing in the context of the present fiasco we call Health Care in America.

A few choice quotes:

The salient fact, though, is that the United States currently has, among advanced countries, a uniquely horrible system—twice as costly as the OECD average while producing mediocre results and denying care to millions.

...

Health reform solves the affordability problem by subsidizing insurance coverage, or expanding Medicaid, for low- and moderate-income families. And it solves the pre-existing condition problem by setting up a marketplace, called an exchange, where insurers must sell policies to anybody, at one price, and cover all basic services. In order to prevent people from going uninsured until they get sick, it also requires everybody to purchase insurance, except in limited hardship cases.

...

Employer-sponsored health insurance is tax-deductible, while wages are, of course, taxed. This means an additional dollar of health care benefits costs less than an additional dollar in wages—an anomaly that has contributed to runaway health care costs. Taxing high cost plans, which do not produce better health outcomes, will give employers a strong incentive to shop for cheaper plans. Either way, the government would collect revenue—either directly through the excise tax, or (better still) indirectly when employees start getting less compensation in the form of tax-free health care, and more in the form of taxable wages.

...

Small pockets of high-quality, low-cost care, like the Mayo Clinic, exist throughout the country, but most doctors and hospitals have not embraced the methods that produce this efficiency. Health reform contains a number of pilot programs to encourage more efficient care—such as penalizing hospitals with high infection rates, an easily-preventable failure that causes 20,000 deaths a year, or various provisions to reimburse Medicare providers based on results rather than the number of procedures used. Numerous other experiments abound in the bill.

...

The sum total effect of this legislation is fairly simple. It would redirect a large chunk of the money sloshing around the health care system away from ineffective treatments and toward providing care for the uninsured. On top of that, it would prod the system, in dozens of ways large and small, to adopt cutting edge methods.

I'll spare you all the laundry list of things I'd've liked to see in the bill that aren't there. But anyone who tells you that this bill doesn't do any good is lying, misinformed, or both. To those on the right, this ain't socialism, and even if it was, our most successful health care system here in America, Medicare, is a single-payer system. Just about everybody who's got it thinks it's just great, and you maybe ought to take that into consideration before you keep spouting off about government encroachment on health care. To those on the left, you maybe didn't get everything you wanted this Christmas, but love it or hate it, politics is the art of the possible, and the one thing that was not acceptable was a continuation of the status quo. I'm not fully satisfied either, but the solution is not to take your bat and your ball and go home, thinking that somehow it'll work out better next go 'round. The solution is to keep up the pressure on lawmakers and to keep making the argument that the more Progressive our health care system is, the better the outcomes will be for everybody. That you're probably right should make it easier on you.

I know it was rough in the Bush years, but just cuz Obama got elected doesn't mean the whole game magically changed.

Posted Without Comment

[H]ow anyone can call a plan to spend $200 billion a year on Americans in need a defeat for progressives is a mystery.
-Paul Krugman

On Being the Good Guys (1)

[T]here's nothing wrong with taking a tough stand for or against what we believe in. But until we're willing to be as immoral and unreasonable as Joe Lieberman, our leverage will be limited.
-Bob Cesca

If there's one thing we've learned over the last few weeks and months, it's that Joe Lieberman is more interested in smacking back the Left than he is in serving his constituents or in helping the American people. Ben Nelson might have grabbed more headlines, but a case can be made that he was, at least, serving his constituents. Nebraska, after all, seems to have mixed feelings about HCR, and, if nothing else, Nelson secured them some $100 million in savings on the cost of the programs in the bill once it goes into effect. Sure, it ain't fair, or right, but part of what every lawmaker is sent to Congress to do is to bring home the bacon for their fair state, and on that, at least, Nelson delivered. Whether or not he had any actual conscientious objections to reforming Health Care in America is between himself and his God, but there seems, at least, to be some excuse for his holding thirty million uninsured Americans hostage. Excuse may be too generous a term. Reason, maybe, would be more appropriate. At any rate, you get the idea.

Joe Lieberman, not so much. For one thing, some 70% of Connecticutians favored HCR. Parse the numbers how you will, but if seven out of ten people agree on something, then it's probably a good idea to pay attention. I should note that seven out of ten Americans do not agree that the Earth is older than 4000 years, and it's probably a close one as to whether seven out ten believe the Earth revolves around the sun.

Now, some have said, and I think there's something to this, that Lieberman opposed HCR because the DFHs were for it. He sure seems to have taken it pretty personally when the Connecticut Democrats declined to nominate him for Senate back in 2006. I mean, he did campaign with the Republican nominee for President last year. Sure, he and John McCain are total BFFs, but it seems not unreasonable to expect that someone who caucuses with the Democrats ought to campaign for the Democrats. They let him keep his Committee Chairmanship, after all. Seems like it'd be nice if he could've at least just STFU.

I guess the personal really is political. Thank you, '90s. And here I thought we were all just circle-jerking with our postmodernism and identity politics while the bad guys tightened their collective grips on the levers of power.

But as much satisfaction as I'm sure Lieberman derived from bucking his caucus and being showered with attention from the media, the White House, and the office of the Senate Majority Leader, and from sticking it to those no good dirty liberal hippies who never gave him more than single-digit support in the '04 Primaries and then almost succeeded in unseating him in '06, at the end of the day, what it comes down to is that Joe Lieberman's self-interest is best served by doing exactly what he did.

It's a bit of a twofer. First off, you've got to ask yourself, 'If this guy's going to get elected again in '12, who's going to vote for him?' Is it the same people who repudiated him in '06? It is not. The only way this guy holds onto his seat, which is probably more important to him than his grandchildrens' souls, is to hold on to the centrist and conservative voters that put him over the top last time around, and to add whatever he can from voters to the right of them. Will it work? It might. By that point, he might just have drifted far enough to the right to get a Teabagger endorsement (though I, for one, would dearly love to see Lieberman teabagged), capturing the far right while holding on to whatever vestiges of Democratic support remain to him. He probably blew it when he agreed to vote for cloture, but I suppose that time will tell. He can probably make up for some of that loss by voting against the bill itself.

The second, and arguably more important, reason Joe Lieberman's self-interest runs counter to that of the American people he is ostensibly elected to serve (or even just the people of Connecticut) is that Joe Lieberman is the Senator from Hartford, where a large number of nationwide insurance companies are headquartered. Put briefly, they pays the bills when it comes campaign time, and only a fool bites the hand that feeds him.

We've now met the first necessary precondition for evil: the privileging of oneself and one's own personal interests over that of the greater good.

Now, obviously we all look after our own, and that's a good thing, both morally and from an evolutionary/survival standpoint. But the game of life and survival is not a zero-sum game. The skeleton is civilization's closet has always been that there's always been plenty to go around, except that certain segments of the population have essentially hijacked the production surplus that allows for civilization itself, largely through the capacity for organized violence.

But that's a thing to be explored later. Here I'm not so much interested in what evil is (though I am interested in that), but in what evil does. And here's where Joe Lieberman comes in as a useful illustration.

As Steve Benen noted, way back in late October, in the Washington Monthly's Political Animal Blog, Joe Lieberman's opposition to the Public Option had evolved through roughly one rationale per month starting in June. Most recently, he stated his opposition to the Medicare buy-in for people over 55, calling it a deal-breaker even though he had come out in favor of it on a radio call-in show not three weeks before.

Take a step back and what you see is an outcome in search of a reason. That the reasons keep changing, as each is refuted by reality's well-known liberal bias, is a clear indication that the man's mind was made up, and that the only way Joe was going to vote for HCR was if he could be convinced that the reform part was going to be more or less toothless.

And that gets us to the crux of what I'm trying to get at here, however circuitously. The short version is simply this: when you're the good guys, a lot of times you have to fight with one arm tied behind your back. People like Joe Lieberman can successfully hold tens of millions of Americans hostage because, at the end of the day, seeing to the continuation of his own political power and the continued economic well-being of his major campaign contributors is more important to him than seeing to the physical and economic well-being of the American people. Progressives feel betrayed, by their President and their Congressional caucus. They feel like they gave away the store, and the base got sold out again, because, at the end of the day, they were not willing to throw the un- and underinsured under the bus to spite their political opponents. This whole kill the bill movement, foolish as it is, is an expression of that anger. After all, the Left thought it was finally going to get to enact its agenda, because when Arlen Specter crossed over suddenly the Democrats had their 60-seat Supermajority and should have been able to DWTFTW.

But that only works if you're willing to enact your agenda by any means necessary. And here's the problem: only the bad guys are willing to do that. At the end of the day, doing evil in the service of good (or even just perceived good) demeans the good you are trying to do, makes it something other than what it is supposed to be. The good guys are, and will always be, at a competitive disadvantage in the throwdown against evil, because the moment they stop fighting fair they stop being the good guys.

That the proponents of Health Care Reform were unwilling to play fast and loose with so many peoples' lives and well-being speaks to the goodness of the cause as well as its partisans. As I've said before, I think that however imperfect the Senate version of the HCR bill is, it's a start, a step in the right direction, and though I would've liked to see a little more back-room arm-twisting on the part of the President and the Majority Leader, at the very least nobody on that side of the issue lost sight of what it was that was at stake. Sure, they could've played their hand a little better, but when your options are limited by your conscience and your determination to do the right thing in the right way for the right reasons, well, you have to win with the tools at your disposal. When all you care about is winning and getting yours, well, it hardly matters how you get there, or who you fuck over on the way.

It sucks being the good guys sometimes. But being a bad guy, well, fuck that.

Cloture, not Closure

So I see that Health Care Reform finally got its cloture vote, which from what I've read means that it can now be debated and voted on on the Senate floor, and passed with a simple majority. Sure, it's not over then, as it has to be reconciled with the House version, which is probably more in line with what Progressives were hoping for when this whole mess started, and there'll be some tricky procedural bullshit thanks to the Republicans, who would rather that tens of millions of Americans go without health care (not just insurance, but actual care), tens of millions more go broke trying to pay for health care, and tens of thousands die early every year because they have no health care than for President Obama and those damned pesky Democrats to score a legislative victory, because, let's face it, they're just vicious and spiteful like that, and don't much cotton to losing, even when they richly deserve to, which they did after the last decade or so.

And while I've been paying only marginal attention to the blogosphere lately, because, well, I have a life, I'd've had to've been hiding under a rock to miss the howls of outrage from the Left over the various big sellouts and compromises necessary to get us to this point. After all, Progressives really want Single Payer, which wasn't even on the table. But the Pubic Option looked good, until it was a deal-breaker and had to be scrapped. Then there was the Trigger, which was fine with Snowe and Lieberman et al until it looked like the Dems might actually go for it, then it became a deal-breaker. Then the Medicare Buy-in for those 55 and over, which was Joe Lieberman's idea, until he heard that Russ Feingold liked it, and then suddenly he was totally against it and it had to be dropped to get to cloture.

Big shout-out to the voters of Connecticut, by the way, for sending Joe Lieberman back to the Senate. Thanks, guys. That was awesome.

So what we end up with is, charitably put, a mixed bag. Devotees of conventional wisdom will say that something must be right with it, because the radical wings on both sides of the spectrum are livid with outrage. On the one side, the Teabagger Wing on the Right side of the aisle thinks that government is staging a takeover of their lives and their health care, and that soon government bureaucrats will be getting together over lattes and arugula to decide which old folks are worth saving and which ones are gonna get put on an ice floe and set adrift. They cry 'Socialism!' and 'Keep your government hands off my Medicare!' Unaware, apparently, that Medicare, which everybody who has it loves and is one of the single most successful government programs of all time, is, in fact, a single payer system that works pretty good.

On the Left, the Progressive Wing, who in a truly amazing feat of collective hallucination and projection apparently thought Barack Obama was secretly one of them and would reveal his true colors once safely in office, feel shafted because the Health Care Bill they're getting is not the Health Care Bill that they dreamed about. As if the whole edifice could be torn down and rebuilt according to rational first principles. And hey, don't get me wrong, I would love that, because what we got now is the worst of all possible worlds, which is reflected in the fact that we spend twice what any other developed nation does on Health Care (it's something like 16% of the whole economy), but still get consistently worse outcomes than any other (higher infant mortality rates, lower life expectancy: you name it, we're worse at it). They feel particularly sold out when they hear that Rahm Emmanuel told Harry Reid "Everything is on the table. Get the bill."

The worst thing is, like everyone on the far end of either side of the spectrum, they're increasingly likely to stay home in 2010 in a fit of pique, like spoiled children holding their breath, and they'll lose what ground they've gained electorally, while the Teabaggers will pick up a seat or ten in the House, and it'll be that much harder to pass Progressive legislation.

I understand the frustration. Believe me, I'm not all that thrilled with the Health Care Reform bill as it now stands. It's beyond imperfect, and it might in the short run turn out to be a giveaway to the insurance companies, who really don't need any more money, whatever their CEOs and shareholders might think. After all, an individual mandate, with or without subsidies, without a Public Option to drive costs down thanks to the Federal Government's access to economies of scale and lack of a profit motive, could shake out to be an absolute windfall for insurance companies.

But let's step back from the trees for a second, and take a look at the forest.

First off, we were never going to get it right the first time. That's not how America works. America's great innovation, there at the start, was the realization that people only very rarely agree with each other over how they ought to live or how government ought to work, and so the best we could do is to set up a framework for hashing it out without resorting to killing each other. And while each side might see the other as traitorous, or dumb as a box of rocks, everybody gets a chance to have their say, and leverage their numbers, and then what gets hashed out gets tested in the crucible of the real world. I absolutely believe that what we'll get will shortly be revealed to be inadequate, and the necessary improvements will become obvious with time. No, it's not the best possible outcome, but I have a certain faith in America that it seems others lack, because Americans are, at their core, pragmatists. We want shit to work, and so when it doesn't, we fix it.

For those disappointed that the legislation is not Progressive enough, well, I feel your pain. I myself tend to have pretty Progressive policy goals, though I come at them from a more pragmatic point of view. I think certain aspects of public life ought to be outside the realm of profit, because they're too important to leave to capitalists to manage.

But for those who deride the Democrats for having the White House, a majority in the House of Representatives, and a 60-vote majority in the Senate, and still not being able to ram through the totality of the Progressive Agenda in Obama's first year in office, well, all I can say is that thsoe folks don't have a very clear understanding of who's a Democrat and how this works. Democrats have a bigger tent than Republicans, which means a broader range of views, some of which, quite frankly, are way more conservative than the base. Remember, that 60-vote majority in the Senate essentially gives veto power to people like Ben Nelson and Joe Lieberman (who seems to be taking his revenge on the Progressives who denied him the Democratic nomination), because the Republicans have been whittled down to the hard-core and pretty much threaten to filibuster just about everything the Senate tries to do, so for anything beyond passing say, the Defense budget, all 60 Senators who caucus with the Democrats have to be united. As you might expect, this is no mean feat.

But the main thing I think Progressives have lost sight of, now that they've gotten all huffy and started in on the whole circular firing squad thing (which is never attractive), is that now, for the first time ever in our nation's history, we have acknowledged that quality health care is a right, something everybody should have as a result of their citizenship. That was the thing the insurance companies didn't want to happen. That was the thing the Republicans were marching in lockstep against. Yeah, the current version sucks, but you know what? The first draft of Social Security wasn't all that awesome either, nor the first draft of Medicare either. There were all sorts of exceptions, and all sorts of true believers who said their elected representatives sold them out. But nobody has ever seriously tried to walk those programs back, and over the years the gaps have been plugged, and improvements made, and these days no American can really even conceive of a world without them.

So take heart, Progressives. No, you didn't get everything you wanted this Christmas (who did, really?). But what you got is something that will never be taken away, that will improve with age and become a natural part of the American political landscape, a foundation upon which can be built a healthier and more just society. Something had to be done. The tide had to be turned. The present arrangement was unsustainable and, more importantly, morally wrong from an outcomes point of view. And, imperfect though it may be, the first step has been taken, and it's in the right direction.

And for those opposed (at least those not in the pockets of the insurance companies, who I could give fuck-all about), take a deep breath and have a little faith in America. Like Winston Churchill said, she can always be counted on to do the right thing, after every other possibility has been exhausted.

The things you fear will not come to pass. Life will get better as a result of this legislation.

Why Capitalism in its Current Form Needs to Die

In 2007 alone, the chief executive officers at these companies collected combined total compensation of $118.6 million—an average of $11.9 million each. That is 468 times more than the $25,434 an average American worker made that year.
-from a report by HealthCareforAmericaNow.Org

When your economic system produces outcomes like this, where the executives of a protected (read: functionally monopolistic) industry make exorbitant amounts of money for figuring out ways to not provide the service which is their companies' reason for being, something is broken and needs to be fixed.

Now don't get me wrong. I am pro-capitalism. I agree with the market fundamentalists that it's the best way to drive innovation, which makes everyone's life better, or at least should. But when the rules are gamed such as to produce outcomes like this (or, worse, outcomes like Goldman, Sachs' current balance sheet less than a year after they helped nearly drive the economy over a cliff, taking themselves with it), then the rules need to be changed.

Myself, I favor the installation of both a ceiling and floor to compensation. I think that, until the entirety of humanity is brought into the twenty-first century in terms of access to education, health care, and economic opportunity (which would solve at least half of the world's problems right off the bat), that anybody being allowed to make more than, say, half a million dollars a year is, quite frankly, obscene.

Yeah, yeah. I can hear the grumbles already, that I don't really believe in capitalism, that I'm nothing more than a dirty fucking Marxist bent on redistributing wealth away from the productive class towards the great unwashed, and hey, to you maybe I am (I consider myself post-Marxist, personally, but opinions being like assholes, everybody gets one). But I'm really a radical democrat (note the small d). I believe that every American citizen, upon paying their taxes, ought to get to say what those taxes go towards paying for. So by all means let corporate boards compensate their executives as richly as they like. They'll take home a half mil and they can decide what the rest should be used for, and that can be their reward for being so high-powered and smart, or whatever justification it is they offer for their ridiculous and obscene compensation packages.

But that's beside the point. The point is that the system we have is broken, and will doom us, both as a nation and as a people (perhaps even as a species) to the inevitable slide into Imperial Senescence and Banana Republic-hood, and if we don't fix it we'll deserve every bad thing that happens as a result.

And no, I won't be happy about it. Schadenfreude's not my thing. I love this country, and all the good things it stands for. It's too bad the fuckers making all that money denying coverage and preventing competition don't feel the same.

Alan Grayson Really is My New Hero

Alan Grayson is My New Hero

Nice to see one of the good guys not pulling his punches for once.

Here's the Email I Wrote to My Senator

Senator Cantwell,
It is my understanding that as a member of the Senate Finance Committee you are participating in debate today over the inclusion of a robust public option in the health care reform legislation being written by that committee. I want to urge you, in the strongest possible terms, to vote yes on the Schumer/Rockefeller amendment, and include a robust public option in the bill. Without a public option to provide a benchmark of fairness against which insurance companies would be forced to compete, I fear (and expect) that the current trend of insurance industry rapacity will continue. We as a nation and a people can no longer afford to spend so much money to prop up an industry that's protected from competition and yet still fails to deliver on satisfactory outcomes, both in the countless individual cases we hear about on the news every day, and in the larger national sense.

Please, vote yes on the public option. And please understand that this constituent's continued support is contingent on that vote.

Thank you,
Dallas Taylor
Seattle WA

I also called. Her number in DC is 202-224-3441.

Today is a Very Important Day

Today the Senate Finance Committee debates the Public Option, an amendment offered by Schumer (NY) and Rockefeller (WV). If you believe, as I do, that without a public option to spur competition and keep insurance companies honest, any health care reform will be, if not meaningless, then certainly toothless, call or email the following Senators right now:

Max Baucus (Montana), Tom Carper (Delaware), Robert Menendez (New Jersey), Kent Conrad (North Dakota), Jeff Bingaman (New Mexico), John Kerry (MA), Blanche Lincoln (Arkansas), Ron Wyden (Oregon), Debbie Stabenow (Michigan), Maria Cantwell (Washington), and Bill Nelson (Florida)

Something that Can't be Made Clear Enough

The United States is the only industrialized democracy that does not offer universal health care to its citizenry, which leads to things like this.

Even the Cubans get free health care. And they ain't got shit, thanks to us.

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Protect Insurance Companies PSA from Will Ferrell

(hat tip Cogitamus)

Newsflash: New Guy Surprisingly Similar to Old Guy

So Obama gets elected and swoops into Washington with a big mandate and now the question for him becomes, how do I make all of my various sponsors happy? If you look at the proposals carefully you can see that the whole policy debate is shaped by this dynamic. What is consistently present throughout the policies favored by the White House is an effort to use tax money to subsidize the existing employer-based private system instead of doing the logical thing and taking the bite — for a bite had to be taken out of someone — out of the pharma and insurance industries.

As an added bonus for all of us, the “reform” will include individual mandates designed to significantly increase the insurance and pharma industry’s customer base. So in the end, what we’re looking at is a pair of handouts to corporate donors: tax subsidies to ease the cost of insurance for employers, and mandates to push more business to the health care industry.

-Matt Taibbi

Here's a fun fact: during the dueling Golden Ages of the '50s and '60s (depending on where you stood on the political/cultural spectrum), and for a few years before and after, the United States of America experienced one of the longest and most sustained periods of prosperity in its (or possibly anyone's) history. Wages rose, year after year. Homeownership became the default setting, even for the lower middle-class. The segment of the population able to attend college and get higher education exploded, and even those without a degree managed to live the middle-class American Dream, thanks to the efforts and sacrifices of labor and community organizers and the (perhaps enforced) largess of the massive companies that employed most people, who typically hired on somewhere and stayed there for life, taken care of by and invested in their workplace, where they were provided not only a living (and generally rising) wage, but benefits like pensions and health insurance. It was a good deal for everyone, lots of mutual back-scratching going on, where if you made the good faith effort to see that your employer thrived, your employer in turn saw to it that you had what you needed, both now and in the future, after you retired.

Then, somewhere around 1973, things changed. Since then, wages have been stagnant, which means that even if you make a little more money every year than you did the last, for the most part wage growth has, at best, just barely kept up with inflation. This means that even if you get paid more money (your cost of living raise), your purchasing power remains the same, because, thanks to the magic of inflation, that money is worth less than it used to be. This is why bankers and people at the Fed and at Treasury are always so on about curbing inflation, because even the rich and powerful with whom they lunch and play golf feel the effects of inflation, and they sure as hell don't want their money to be worth less than it was last year, just the same as you and your socioeconomic peers.

So what happened? Well, for one thing, corporate profits are up some 200% in that time, and executive pay has gone from an average of 42 times average worker pay in 1980 to 344 times average worker pay in 2007 (down from a high of 525 times average worker pay in 2000). But that's not the whole story.

The truth of the matter is, you have been getting those raises. It's just that, instead of getting them in the form of spendable cash, the money goes to your employer-sponsored health care. See, it's not just you who pays more for health care, though the magic of higher premiums and higher deductibles. The cost to employers goes up, too, to the tune of double-digit percentage increases every year. Right now, one out of every six dollars spent in the US is spent on health care. GM went broke thanks to its health-care (and, to a lesser extent, pension) liabilities, to the point where some $1100 of the price of every car they made was already promised, to pay for the ever-more-expensive health care of its active and retired workforce. That's just one example, and it's one of the reasons that health care reform is even possible now, because American industry, stuck offering health insurance by its own historical choices, is finding its ability to compete in a global marketplace hampered by its obligations.

Now, them on the right would tell you that the right thing to do is to back out of the deal and leave those folks high and dry. After all, to them on the right, if a person makes a bad decision, then that person must pay the price, and they will, as a general rule, be glad to stand around and hoot and holler while the punishment is being meted out. They love them some punishment on the right, so long as it's individual people (and poor ones, at that) being punished. Serves 'em right, they say, between cackles and hand-rubbing. But let it be a large corporate entity that makes said mistake, and consequences simply cannot be allowed to happen, for them on the right, whether they know it or not, are the tools of said corporate entities, and most of them don't even get compensated. They're like suicide bombers: they'll pay the price so their masters can make a buck (or a point).

But it's not GM's fault that health care keeps getting more expensive. It is, for the most part, the insurance companies' fault. The fee-for-service model, and the lack of competition, cause perverse incentives to be built into the system, making it more profitable for doctors to order unnecessary tests and medications, because that's how they make money. Not to mention the whole dropping you when you get sick because you had acne/toenail fungus/a headache once thing. There's a whole article in the September 2009 issue of the Atlantic that deals with some of this stuff, as well as make some recommendations as to what to do about it. I don't agree with all of the man's conclusions, but it's provocative stuff.

Health care reform is necessary. Of that there's no doubt. That we will not get the radical reworking we so desperately need is also not in doubt. What scares me is that we are likely to end up with a mushy middle-ground 'compromise' like the one in the Taibbi quote above that is the worst of both worlds. Yes, we'll probably get specific rule changes that, say, make it harder for insurance companies to deny people with 'pre-existing' conditions treatment or coverage, and they might even force health care into the information age, so that records are kept electronically, which with a few other common-sense, tinkering-around-the-edges-reforms could save up to $2 trillion (that's $2,000,000,000,000) over the next ten years. But if things go as they seem like they might, what we'll end up with is the individual mandate, in which you will be fined for not having health insurance, but without, say, a public option, which would be a (gasp! pearl-clutch! faint) government-run health care provider (like-gasp!-Medicare, or the VA) that would, ideally, be able to engage in economies of scale and common-sense cost-saving measures in order to deliver a better product at a lower price, which would provide a benchmark against which private insurance could (and should be made, imho) to compete. So the insurance companies are rewarded for their years of fuckery by a vastly expanded, captive pool of fuckees who are now required by law to buy their product, without an effective counterbalance to the new fuckery that will inevitably result.

See, I'm a big believer in capitalism, despite any appearances to the contrary. I think that insurance companies that say they couldn't compete with a government-run health plan aren't trying hard enough. I think they lack faith in American ingenuity, which managed to go from Great Depression to Kicking Fascism's Ass in less than a decade, and, as such, have shown themselves to be the parasitic, anti-American scum that they are.

I guess I'm like the folks on the right, except opposite. I'm for giving people, living, breathing, fallible-but-trying people another chance, especially when they find themselves in a bad situation through no fault of their own. But cold-blooded corporate entities whose food, air, and water is the sweat of the working man's brow and the product of his labor? Fuck 'em. Evolutionary conditions change, and those that can't adapt will perish. And when they do, something will arise from their ashes that can do the job for a fair price, and I will be the first one to sign up.

Capitalism works. It really does. But the rules have to be set up to where the right people win. We got out of the jungle, and we built this nice city to live in. We should start acting like it. As for Barack Obama, well, I'm willing to reserve judgement for just a bit longer, but he sure is starting to look like more of the same, just another politician, even if he does give good speech. We didn't elect him to hand the insurance companies another few quarters of unsustainable growth at the expense of middle- and working-class prosperity, much as we didn't elect him to continue Bush's policies of domestic surveillance or Wall Street's continued rapacity. We sent him to Washington with the expectation that he'd do what he said he would. It's high time he started.

Posted Without Comment

With solid majorities now, and God knows what will happen in 2010, the clock is ticking on Barack Obama to take charge of what once promised to be the defining issue of his administration. Back In January Obama told Republican leaders "I won."

It's time to fucking start acting like it.

-tbogg, at firedoglake