Tuesday, June 30, 2009

Rudy Giuliani Still Considering Run for Governor of New York

The Political Carnival
June 30, 2009

Nothing but fun times ahead if he decides to run. I mean, really, who gets tired of cross dressing serial adulterer jokes?
Via Taegan-

Former New York City Mayor Rudy Giuliani (R) said that he is considering running for governor of New York in 2010, Politico reports. But he was very coy about it.

Said Giuliani: "I don't know if I am or if I'm not."

A more definitive sign he's considering it: The former mayor speaks to
John Avlon "on how he might how he'd tame the nation's most dysfunctional legislature." Avlon is a former Giuliani speechwriter.
Copyright 2009

Monday, June 29, 2009

Overlooked Savings from Single-Payer Healthcare

Mugsy's Rap Sheet
Monday, June 29, 2009

Ask any Republican, “If you could pass a tax cut that saved the average American $10-$30,000 a year and the average corporation millions of dollars a year, would you do it?” What do you think their answer would be?

It’s harder to argue against a “Single-Payer” healthcare system when you phrase it in those terms, and let’s be honest, “framing is everything“. Sadly, Democrats often allow the Republican minority and a handful of Conservative DINOs beholden to the insurance lobby to frame the debate against healthcare reform with fictitious horror stories of “Socialized Medicine”. They’ve been doing it for years:

I couldn’t help but notice that one of Reagan’s chief arguments was how the government could tell some doctors that they couldn’t practice in a town because they didn’t need any more doctors there. Funny, but I don’t remember a time when a medical degree was a guarantee of employment in the town of your choice. Then again, I wasn’t alive in the 1950’s. Maybe it was different back then .

The debate over Health Care is shaping up to be the most contentious battle in Washington since “Bush v. Gore” in 2000, except this time billions (trillions?) of dollars and thousands of American lives are at stake (arguably, in retrospect, it was in 2000 as well, we just didn’t know it). But sadly, just as in 2000, we see a dozen or so milquetoast Democrats conceding that “maybe the Republicans have a point”; unwilling to fight for their position as hard as the ideologues on the Right, watering down their position to try and please a bunch of WATB’s thateven a majority of Republicans don’t support on this particular issue. Following the absolute disaster of the Bush Administration, failing to prevent 9/11, attacking Iraq before completing Afghanistan, unable to end either war, the failure of Katrina, economic collapse, collapse of the U.S. auto industry, Wall Street run amok requiring a Trillion dollar bailout, record unemployment not seen since The Great Depression, all while adding another $5T to the National Debt… the American people SO rejected the Republican way of doing things, they voted in a Democratic president with a Super-Majority of Democrats in both houses of Congress. If the American people have ever spoken louder in one voice to reject the Republican way of doing things, I haven’t seen it in my lifetime (since LBJ). Yet STILL we have President Obama and Democrats in Congress concerned with “bipartisanship”, kowtowing to the Concerns of Republicans. We desperately need a National Healthcare System in this country if for no other reason than to pay for a spine transplant for all the gutless Democrats.

BY FAR, the most comprehensive, all-inclusive, most cost-efficient healthcare solution is a system known as“Single Payer”, where the Federal government pays the healthcare bills for each and every American (typically paid for with taxes). Denmark, Sweden, and Canada are example of countries with single payer financing of health care. England and France, where every doctor is a Federal employee and every hospital is owned by the government, are not (theirs is a true “Socialized” system). But the latter is what Republicans WANT you to believe “Single Payer” is. President Obama is advocating NEITHER. His is a third choice called “the public option”, where a government “health insurance company” competes for your business just like any other insurance company, but with lower overhead (such as advertising costs), no shareholders to pay dividends to or huge CEO bonuses to pay.

Republican arguments against “Single Payer” are truly absurd. They tell us a “government option” would simultaneously be a huge failure, cost a trillion dollars, provide worse care and still leave millions uninsured(warning: that last link is to Sen. Boehner’s homepage), WHILE SIMULTANEOUSLY threaten to put private insurance companies out of business because it would be SO GOOD and SO CHEAP that private insurance companies would be “unable to compete“, resulting in millions of Americans giving up their private insurance for the cheaper/better government option (which shows were their true loyalties lie).

I can’t help but think of “
FedEx” every time I hear this bizarre argument. Isn’t “the US Mail vs. FedEx” the perfect metaphor for the “Public Option”? I remember when people argued that a company like “Federal Express”, whose entire business revolved around simply “overnight mail delivery” would NEVER be able to compete with the USPS with its “unfair advantage” of being able to ship packages on any airline (not just their own planes) and delivered by their own postal carriers. And yet, FedEx is an enormously successful corporation competing against the government in the “Express mail” business.

UPS and their fleet of Big Brown Trucks was founded in 1907 and has successfully competed with government-run package delivery for over 100 years.

Now argue “private” insurance companies won’t be able to compete with the government. Funny how little faith “free market Republicans” truly have in “the free market”.

Currently, the popular “compromise” on Capitol Hill is something called a “co-op“, being put forth by DINO’s likeKent Conrad and DiFi (Sen. ”Diane Feinstein” of California). A “co-op” is basically a group of individuals that pool their money to cover each others healthcare costs. Of course, to have any leverage, you’re not going to control costs and/or be solvent enough to cover the extended hospital stays of very many members at once with just a few dozen… or even a few hundred members. No, to have that kind of leverage & security, were talking about a co-op with hundreds of thousands of members, like “Group Health” in Washington and Idaho, a co-op with some600,000 members. That’s not a “co-op”, that’s an insurance company! When you get that big, who’s going to Administrate it? We’re talking a full time job. Now you’ve got administrative costs, hiring bonuses to attract top talent, and (most importantly) a profit motive and plenty reason to deny coverage. This is their idea of acompromise???

Government-run “Single Payer” health insurance has numerous obvious advantages:

  • Dramatically lower costs: With no profit motive, advertising costs, shareholders or bonuses to pay, single-payer would cost less. And if private insurance wants to compete, they’re going to have to cut those expenses or else lose customers.
  • No “pre-existing condition” exemptions: No one can be denied coverage because of a “pre-existing condition”.
  • See any doctor you like: Unlike an HMO or other closed system where you can only see “in-network” doctors, you can continue to see your current doctor or any other doctor of your choosing. (Excuse me, but doesn’t an HMO do EXACTLY what Republicans claim a government system would do… tell you “what doctor you may see” and “whether or not they’ll cover a particular procedure“? Apparently, “socialized medicine” is just fine when the private sector does it.)

But there is a plethora of “hidden” benefits from insuring every single American that are not immediately obvious and go unmentioned on the Network News (I know, big surprise):

  • No more need for Workman’s Comp - with every single American receiving guaranteed injury protection coverage that can not be denied for any reason, companies will no longer have to carry costly “injury-protection” on their policies (though they may still need coverage for “negligence”), thus saving businesses billions each year.
  • Ditto on your car insurance. No more need for injury liability coverage on your car insurance. - I have a minimal policy that covers only around “$25,000 per person, one driver and up to two passengers” if someone I hit is injured in a car accident. At today’s healthcare prices, a ride in an ambulance for a trip to the ER could burn through that $25,000 maximum in minutes. I would then have to make up the differenceout-of-pocket. But with every person having full medical coverage, you won’t need “injury protection” on your car insurance any more, and rates should drop considerably (but before you shed tears for the insurance companies losing all that money in premiums, I’ve had to sacrifice better “collision” coverage, and have a high deductible, to cover those injury costs. I’d likely increase the coverage of my car so that my insurance pays for more of the damage, rather than take the savings and run if my rates were to go down significantly.
  • More people would be able to afford health insurance while unemployed or under-employed. - While hard numbers are difficult to come by, it is not uncommon for health insurance to cost between $800 and $2000 (or more) a month per person, an amount extremely difficult to afford even in the best of times with a well-paying job. With lower rates under a national program, many people who suddenly find themselves without a job (or a low-paying job) won’t necessarily have to give up their health insurance because it is too costly. This means fewer people relying on the costly Emergency Room for their medical needs… an expense that explodes insurance costs for all Americans.
  • According to a Harvard Medical School study earlier this month, over 60% of all bankruptcies in the U.S. are due to medical bills either because their illness/disability exceeded their coverage or disallowed by their insurer. With “Single Payer” public health coverage, as long as a treatment is ruled “medically necessary”, it must be covered. And if private insurance companies expect to survive, they’re going to have to do the same or else risk losing that customer to the Public Option.
  • Malpractice insurance would no longer need to cover the expense of a lifetime of medical care resulting from negligence, thus driving down malpractice insurance rates that then get passed on to the patient. (Some Republicans think the healthcare crisis can be solved through tort reform. Not only do malpractice lawsuits account for only two percent of healthcare costs (according to an April, 2006 AARP report), tort reform would result in a savings of just 0.4 to 0.5 percent, while limiting the jury award to the victim, possibly disabled for life, by some arbitrary cap pulled out of the air by some Conservative bureaucrat. A reduction in malpractice insurance rates would do far more to reduce costs across-the-board than tort reform.)
  • I am presently unable to find figures on the costs associated with “lost productivity” for the time employees are out sick or function at less than full capacity if they come to work sick because they can’t afford to take time off, but I’ve sure it is significant.

In January, The National Coalition on Healthcare issued a report that (among other things) listed some of the costs created by the uninsured population:

  • The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.
  • Hospitals provide about $34 billion worth of uncompensated care a year.
  • Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.
  • The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stay estimated to be about $3,300.
  • The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.
  • A study found that 29 percent of people who had health insurance were “underinsured” with coverage so meager they often postponed medical care because of costs.
  • Nearly 50 percent overall, and 43 percent of people with health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.

We don’t have a “HEALTH CARE” System in America, we have a “DISEASE TREATMENT” System. We don’t treat people when they are healthy to keep them that way for low cost, we have a “Wellness” system where people put off going to the doctor until they’re already symptomatic, needing treatment at a far greater expense.

The need for “extreme profits” (along with uncontrolled hospital and prescription costs) has caused insurance premiums to rise at twice the rate of inflation (according to the same NCHC report referenced above). Removing the “extreme profit motive” to payoff shareholders and award exorbitant bonuses will encourage researchers to focus on REAL cures for serious illnesses and not just the next high-profit diet pill or (no joke) a drug to grow longer eyelashes (and, perhaps the perfect metaphor for the big money to be made from such inane cosmeceuticals: the preceding link pulls up a slick, professionally done, big-budget website).

I know I’ve barely scratched the surface of benefits we can expect from Universal heath insurance that guarantees coverage for each & every American, but I think I’ve hit many of the most significant points, as well as highlight some of the stupidity, cluelessness and rank hypocrisy on the Right… people claiming to be concerned over making healthcare affordable for everyone, while proposing “solutions” that do little or nothing to actually fix the problem.

Some light reading for those looking for more “meat”:

Read “Hidden Costs, Value Lost: Uninsurance in America“, entire book is online.

The Obama Healthcare Plan was posted online (pre-election) and worth a read. It hasn’t changed as much as you might think, at at only 9 pages (8 plus appendix), it’s worth a look.

Postscript: Tuesday is the big handover of Iraqi security to the people of Iraq, and the removal of thousands of American troops from the streets of some of Iraq’s biggest cities. While tens of thousands of American soldiers will remain in the country for months to come, it will be mostly in an “advisory roll” with the Iraqi government in charge and U.S. forces no longer calling the shots (no more American-led missions inside Iraq unless specifically requested by the Iraqi government). This will be a historic shift in the Iraq War and (I hope), will reveal that a quicker exit than “the end of 2010″ is possible. A recent uptick in violence in just the past few weeks appears to be… not a sense of what’s to come after we leave… but a pitiful attempt by groups like alQaeda that hope to “trick” America into reneging on its pledge to leave so they can say, “Look! We told you they’d never leave!” They also know Iraq is a distraction from Afghanistan/Pakistan and is costing the hurting U.S. economy billions of dollars a month.

Copyright © 2009 “Mugsy’s Rap Sheet”

Sunday, June 28, 2009

Genius in the Bottle

Maureen Dowd
Op-Ed Columnist
The New York Times
June 28, 2009

As in all great affairs, Mark Sanford fell in love simultaneously with a woman and himself — with the dashing new version of himself he saw in her molten eyes.

In a weepy, gothic unraveling, the South Carolina governor gave a press conference illustrating how smitten he was, not only with his Argentine amante, but with his own tenderness, his own pathos and his own feminine side.

He got into trouble as a man and tried to get out as a woman.

He wanted to get his girlfriend a DVD of the movie “The Holiday,” presumably the Cameron Diaz-Kate Winslet chick flick about two women, one from L.A. and one from England, who trade homes and lives. He was fantasizing about catapulting himself into an exotic life where stimulus had nothing to do with budgets.

With Maria, he was no longer the penny-pinching millionaire Mark, who used to sleep on a futon in his Congressional office and once treated two congressmen to movie refreshments by bringing back a Coke and three straws.

No, he was someone altogether more fascinating: Marco, international man of mystery and suave god of sex and tango.

Mark was the self-righteous, Bible-thumping prig who pressed for Bill Clinton’s impeachment; Marco was the un-self-conscious Lothario, canoodling with Maria in Buenos Aires, throwing caution to the e-wind about their “soul-mate feel,” her tan lines, her curves, “the erotic beauty of you holding yourself (or two magnificent parts of yourself) in the faded glow of night’s light.”

Mark is a conservative railing against sinners; Marco sins liberally. Mark opposes gay marriage as a threat to traditional marriage. Marco thinks nothing of risking his own traditional marriage, and celebrates transgressive relationships. He frets to Maria in e-mail that he sounds “like the Thornbirds — wherein I was always upset with Richard Chamberlain for not dropping his ambitions and running into Maggie’s arms.”

Marco, the libertine, wonders how they will ever “put the Genie back in the bottle.” And in the sort of Freudian slip that any solipsistic pol like Mark would adore, Maria protests in Spanglish: “I don’t want to put the genius back in the bottle.”

Mark is so frugal for the taxpayers that he made his staffers use both sides of Post-it notes and index cards, and once brought two (defecating) pigs named “Pork” and “Barrel” into the statehouse to express his disgust with lawmakers’ pet spending projects.

Marco is a sly scamp who found a sneaky way to make South Carolina taxpayers pay for a south-of-the-border romp with his mistress.

Mark is so selfish he tried to enhance his presidential chances by resisting South Carolina’s share of President Obama’s $787 billion stimulus package, callously giving the back of his hand to the suffering state’s most vulnerable — the jobless and poor and black students.

Marco is generous, promising to send a memento of affection that Maria wants to keep by her bed.

Mark hates lying. As he said of Bill’s dalliance with Monica, “If you undermine trust in our system, you undermine everything.”

Marco lies with brio, misleading his family, his lieutenant governor, his staff and his state about his whereabouts, even packing camping equipment to throw off the scent from South America. He told whoppers to his wife, a former investment banker who managed his campaigns and raises his four sons (solo on Father’s Day). She put out a statement quoting Psalm 127 to snidely remind her besotted husband “that sons are a gift from the Lord.”

Jenny Sanford told The Associated Press on Friday that Mark had told her he needed time to be alone and write, so she was stunned to learn he was in Argentina on a “Roman Holiday.” Before he left to “write,” she warned him not to skip off to the other woman.

Mark, who disdains rascals, agreed that he wouldn’t. Marco, who is a rascal, skipped off.

Mark went back to work on Friday, giving his cabinet a lecture on personal responsibility and comparing himself to King David, who “fell mightily ... in very, very significant ways but then picked up the pieces and built from there.”

Actually, the one thing David didn’t do after his adulterous fall was build, because he was forbidden by God to construct his dream temple in Jerusalem.

Sanford should give his piety a rest. He told his cabinet that the Psalms taught him humility. (There’s a chance that a younger Argentine boyfriend of Maria’s also taught him humility, by jealously hacking into her e-mail account and leaking the governor’s missives.)

Sanford can be truly humble only if he stops dictating to others, who also have desires and weaknesses, how to behave in their private lives.

The Republican Party will never revive itself until its sanctimonious pantheon — Sanford, Gingrich, Limbaugh, Palin, Ensign, Vitter and hypocrites yet to be exposed — stop being two-faced.

Copyright 2009 The New York Times Company

Wednesday, June 24, 2009

Why critics of a public option for healthcare are wrong

Those opposing a public option -- Big Pharma, the AMA, the insurers -- are doing so out of economic self-interest

Robert Reich
June 24, 2009

Without a public option, the other parties that comprise America's non-system of healthcare -- private insurers, doctors, hospitals, drug companies, and medical suppliers -- have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightning rod. The American Medical Association is dead set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won't consider it. No other issue in the current healthcare debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course they don't want it. A public option would squeeze their profits and force them to undertake major reforms. That's the whole point.

Critics say the public option is really a Trojan Horse for a government takeover of all of health insurance. But nothing could be further from the truth. It's an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal -- more and better healthcare for less.

Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn't the whole point of cost containment to provide the public with healthcare on more favorable terms? If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans could seek similar deals.

But, say the critics, the public plan starts off with an unfair advantage because it's likely to have lower administrative costs. That may be true -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but here again, why exactly is this unfair? Isn't one of the goals of healthcare cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that's fine.

Critics complain that a public plan has an inherent advantage over private plans because the public plan won't have to show profits. But plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality healthcare more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, that's a plus.

Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that's being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford healthcare, not to a public plan. Individuals and families use the subsidies to shop for the best care they can find. They're free to choose the public plan, but that's only one option. They could take their subsidy and buy a private plan just as easily. Legislation should also make crystal clear that the public plan, for its part, may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans must not favor the public plan.

Finally, critics say that because of its breadth and national reach, the public plan will be able to collect and analyze patient information on a large scale to discover the best ways to improve care. The public plan might even allow clinicians who form accountable-care organizations to keep a portion of the savings they generate. Those opposed to a public option ask how private plans can ever compete with all this. The answer is they can and should. It's the only way we have a prayer of taming healthcare costs. But here's some good news for the private plans. The information gleaned by the public plan about best practices will be made available to the private plans as they try to achieve the same or better outputs.

As a practical matter, the choice people make between private plans and a public one is likely to function as a check on both. Such competition will encourage private plans to do better -- offering more value at less cost. At the same time, it will encourage the public plan to be as flexible as possible. In this way, private and public plans will offer one another benchmarks of what's possible and desirable.

Mr. Obama says he wants a public plan. But the strength of the opposition to it, along with his own commitment to making the emerging bill "bipartisan," is leading toward some oddball compromises. One would substitute nonprofit health insurance cooperatives for a public plan. But such cooperatives would lack the scale and authority to negotiate lower rates with drug companies and other providers, collect wide data on outcomes, or effect major change in the system.

Another emerging compromise is to hold off on a public option altogether unless or until private insurers fail to meet some targets for expanding coverage and lowering healthcare costs years from now. But without a public option from the start, private insurers won't have the incentives or system-wide model they need to reach these targets. And in politics, years from now usually means never.

To get healthcare moving again in Congress, the president will have to be clear about how to deal with its costs and whether and how a public plan is to be included as an option. The two are intimately related. Enough talk. He should come out swinging for the public option.

Copyright ©2009 Salon Media Group, Inc.

Tuesday, June 23, 2009

When It Comes to Health Care, Why Do Republicans (and Some Centrist Democrats) Hate Americans?

Mitchell Bard
Huffington Post
June 22, 2009

A couple of weeks ago, in discussing torture, I asked why so many Republicans hate America. Now that the debate over how to fix the heath care system has moved forward, listening to the Republican position (which is, unfortunately, shared by some centrist Democrats), I can't help but wonder why these individuals hate Americans?

Okay, again, I am being cheeky, invoking the Republican claims during the Iraq war that Democrats hated America because they didn't support the administration's draconian approach to fighting terror. And I'm doing it again here, because, at heart, the Republicans (and, again, some centrist Democrats) who are opposing a public option in the new plan are doing so to protect profitable health insurance companies at the expense of the average American citizen. The arguments used by the Republicans (and centrist Democrats) against a public option are absolutely disingenuous.

When asked about a public option, Republicans tend to lapse into the same red-herring argument Sen. Lindsay Graham made on This Week yesterday:

"The last thing in the world I think Democrats and Republicans are going to do at the end of the day is create a government run health care system where you've got a bureaucrat standing in between the patient and the doctor. We've tried this model -- people have tried this model in other countries. The first thing that happens -- you have to wait for your care. And in socialized health care models, people have to wait longer to get care and the government begins to cut back on what's available because of the cost explosion."

I was half expecting Graham to move close to the camera and yell "Boo!" in an effort to further scare Americans.

Except, nobody is proposing the U.K.-style plan he is railing against. So why is he doing it? Simple. Because the Republicans (and centrist Democrats) are supporting the big insurance companies at the expense of the people, but they can't very well say that out loud, so they have resorted to changing the subject and trying to scare Americans into not noticing where they have tossed their allegiances.

You see, the Republicans are speaking out of both sides of their mouths. They are quick to tell you, as Graham did, how terrible government-run health care would be, with long waits for inferior service. But when you argue for a public option, with people being given the chance to keep what they have (with private insurers) or opt for a new public option (especially for those who don't currently have any insurance) that would compete with the private companies, then the Republicans say that the private insurers would be driven out of business because they can't compete with the public plan. But if the government-run plan would be so bad, why would the private insurers lose to it? Shouldn't Americans, terrified at the big bad government trying to run their health care decisions, run screaming away from the new public plan and into the arms of the wonderful private insurers they adore? What is the risk? And if the government-run plan is so good it would be an improvement over the private insurers, why are the Republicans against it (if they can't admit that they are protecting the business interests over the health of Americans)? Isn't the goal better care at lower costs?

It is a truly odious game the Republicans (and centrist Democrats) are playing now, which is even more despicable because of the stakes involved. The bottom line is that the American health care system is not working, and it's only getting worse. Medical costs are skyrocketing, tens of millions have no insurance at all, and those that do are facing higher fees and dwindling service. According to a recent report, 17 percent of American households put off health care in the last year due to cost. And 40 percent of respondents said they would need to to postpone care in the next three months, including 15 percent who said they had to put off routine doctor visits. The way health care works in the U.S. now, for-profit companies make decisions on Americans' health care based not on what is good for the patient, but on what will add to the company's profits. That's no way to care for our citizens.

And it's not like Americans are afraid of the government providing a public option for health care. A recent CBS News/New York Times poll found that 72 percent of respondents (including 50 percent of Republicans) favored a government-sponsored health-care plan to compete with private insurers, and 57 percent said they were willing to pay higher taxes so that all Americans could be covered. In fact, 64 percent of those polled said that the government should guarantee health insurance for all Americans.

So if the people want a public option, and the Republican arguments are, on their face, hypocritical (if the government-run plan is as terrible as they say, it would not be a threat to private insurers), why are so many Republican and centrist Democratic senators opposing a public plan?

After all, anyone happy with his/her current coverage would be free to keep it as it is. Only those with lousy coverage (or no coverage at all) would be exploring the public option.

Health care is one of the thorniest and most important issues the government has to face, and there needs to be a full and thorough debate in Congress. Concerns about cost, taxes, and systems are absolutely valid, and there are no easy solutions to the hole we've dug for ourselves. But the scare tactics and diversions being offered by the Republicans on the public option are more than just dishonest, they are dangerous, because they could derail necessary change to the current failed system. If Republicans oppose a public option because they want to support the insurance companies, they should say that, rather than making up stories about socialized medicine plans that nobody is proposing. The debate needs to be on honest terms.

The bottom line is that in the U.S. right now, millions of people have no health insurance, others are getting bumped from their coverage, and many people are fighting increased costs (in premiums, co-payments, and uncovered care), and the result is less care for more money. That simply is not acceptable, and the increased costs to the country of medical care are unsustainable. Something has to be done. If Republicans (and centrist Democrats) have a better suggestion than a public option, something that will effectively provide quality coverage to more Americans and bring down costs, then let's hear it. But if the best they can do is come up with scary language like Graham offered on This Week, while proposing only alternatives that will, in effect, perpetuate the broken status quo, that's unacceptable.

It's time for the Republicans and, especially, the centrist Democrats to listen to the will of the people. The discussion has to be on the level, and the solution has to be a system in which for-profit insurance monoliths no longer control the country's health care. If a public option will lead to increased coverage and lower health-care costs, then that's where we need to head. The Republicans and Centrist Democrats are currently protecting the insurance companies. I say it's time they start protecting the American people instead.

Copyright © 2009, Inc.

Sunday, June 21, 2009

Obama’s Make-or-Break Summer

Frank Rich
Op-Ed Columnist
The New York Times
June 21, 2009

THAT First 100 Days hoopla seems like a century ago. The countless report cards it engendered are already obsolete. The real story begins now. With Iran, universal health care, energy reform and the economic recovery all on the line, the still-new, still-popular president’s true tests are about to come.

Here’s one thing Barack Obama does not have to worry about: the opposition. Approval ratings for Republicans hit an all-time low last week in both the New York Times/CBS News and Wall Street Journal/NBC News polls. That’s what happens when a party’s most creative innovations are novel twists on old-fashioned sex scandals. Just when you thought the G.O.P. could never match the high bar set by Larry Craig’s men’s room toe-tapping, along came Senator John Ensign of Nevada, an ostentatiously pious born-again Christian whose ecumenical outreach drove him to engineer political jobs for his mistress, her cuckolded husband and the couple’s son. At least it can no longer be said that the Republicans have no plan for putting Americans back to work.

But as ever, the lack of an adversary with gravitas is a double-edged sword for Obama. It tempts him to be cocky and to coast. That’s a rare flaw in a president whose temperament, smarts and judgment remain impressive. Yet it is not insignificant. Though we don’t know how Obama will fare on all the challenges he faces this summer, last week’s big rollout of his financial reform package was a big punt, an accommodation to the status quo. Given that the economy remains the country’s paramount concern — and that all new polling finds that most Americans still think it’s dire — this timid response was a lost opportunity. It violated the Rahm Emanuel dictum that “you never want a serious crisis to go to waste” and could yet prompt a serious political backlash.

A tip-off to what was coming appeared in a Washington Post op-ed article that the administration’s two financial gurus, Lawrence Summers and Timothy Geithner, wrote to preview their plan. “Some people will say that this is not the time to debate the future of financial regulation, that this debate should wait until the crisis is fully behind us,” they wrote by way of congratulating themselves on taking charge.

Who exactly are these “some people” who want to delay debate on the future of regulation? Not anyone you or I know. Most Americans were desperate for action and wondered why it was taking so long. The only people who Summers and Geithner could possibly be talking about are the bankers in their cohort who helped usher us into this disaster in the first place. Both men are protégés of one of them, Robert Rubin, the former wise man of Citigroup.

There are some worthwhile protections in the Summers-Geithner legislation, especially for consumers, but there’s little that will disturb these unnamed “people” too much. I’ll leave it to financial analysts to detail why the small-bore tinkering in the administration blueprint won’t prevent another perfect storm of arcane derivatives, unchecked (and risk-rewarding) executive compensation and too-big-to-fail banks like Citi. Suffice it to say that the Obama team has not resuscitated the Glass-Steagall Act, the New Deal reform that Summers helped dismantle in the Clinton years and that would have prevented the creation of banking behemoths that held the economy hostage.

A particularly dramatic example of how the old Wall Street order remains intact can be seen by looking at the fate of credit-rating agencies like Moody’s, which gave triple-A grades to some of the cancerous derivatives at the heart of the economic meltdown. As Gretchen Morgenson of The Times reported last year, Moody’s sins during the subprime frenzy included upgrading its rating of securities underwritten by Countrywide Financial, the largest mortgage lender, after Countrywide complained that the ratings were too tough.

Since then, more details have emerged in this unsavory narrative. When the Securities and Exchange Commission charged Countrywide’s former chief executive, Angelo Mozilo, with securities fraud and insider trading this month, it produced e-mails from 2006 in which Mozilo referred to his company’s subprime loan products as “toxic” and “poison.” Mozilo wrote that “we have no way, with any reasonable certainty, to assess the real risk of holding these loans on our balance sheet.” Yet Moody’s didn’t warn the public by downgrading Countrywide’s securities until the summer of 2007. Meanwhile, this supposed watchdog for investors, which, like other credit-rating agencies, is paid by the very companies it monitors, took its own tranche of the bubble. Moody’s profit margins even surpassed Exxon’s.

And how have it and its peers in the credit-ratings game fared in the Obama regulation crackdown? Incredibly enough, they can still collect fees from the companies they grade. “It is as if Hollywood studios paid movie critics to review their would-be blockbusters,” wrote Eric Dash in The Times.

Non-Wall Street Americans who signed on to Countrywide’s toxic loans are doing far less well. The White House stood by passively this spring as banking lobbyists mobilized to castrate the administration’s Helping Families Save Their Homes Act. The final version eliminated the key provision that would have allowed judges to lower the principal for mortgage holders whose homes are worth less than their loans. Dick Durbin, the Democratic senator from Illinois, correctly observed in April that the banks are “still the most powerful lobby” in Congress and that “they frankly own the place.”

The banks’ influence at the other end of Pennsylvania Avenue is also conspicuous. The revolving door between the government and Wall Street is as greasy as ever in this White House. It’s all too depressing that the administration enforced its no-lobbyists policy to shun a human-rights advocate, Tom Malinowski, a lobbyist for genocide victims in places like Darfur, but granted Geithner a waiver to appoint a former Goldman Sachs lobbyist, Mark Patterson, as his chief of staff.

Obama is very eloquent in speaking of the “culture of irresponsibility” that led us to the meltdown, but that culture isn’t changing so much as frantically rebranding. A.I.G. is now named A.I.U., and has employed no fewer than four public relations firms, including one whose bipartisan roster of shills ranges from the former Hillary Clinton campaign strategist Mark Penn to the former Bush White House press secretary Dana Perino.

Taxpayers are paying for that P.R., having poured $170 billion-plus into A.I.G. But we still don’t have a transparent, detailed accounting of what was going down last fall when A.I.G. and its trading partners, including Goldman, snared that gargantuan cash transfusion. Perhaps if there had been a thorough post-crash investigative commission emulating the Senate investigation led by Ferdinand Pecora after the crash of 1929, we would now have reforms as thorough as F.D.R.’s. It was because of the Pecora revelations that Glass-Steagall was put in place.

If you watch CNBC, of course, the recovery is already here, and the new regulations will somehow stifle it. The market is up, sort of. Even some bank stocks are back. Unemployment, as Obama reminds us, is a lagging indicator. And so, presumably, are all the other indicators that affect most Americans. One in eight mortgages is now either in foreclosure or delinquent, with the share of new mortgages going into foreclosure reaching a record high in the first quarter of 2009. Credit card debt delinquencies are up 11 percent from last year in that same quarter.

The test for Obama is simple enough. If the fortunes in American households rise along with Wall Street’s, he is home free — even if his porous regulatory fixes permit a new economic meltdown decades hence. But if, in the shorter term, the economic quality of life for most Americans remains unchanged as the financial sector resumes living large, he’ll face anger from voters of all political persuasions. When the Fox News fulminator Glenn Beck says “let the banks lose their tails, they need to,” he illustrates precisely where right-wing populism meets that on the left.

It’s still not too late for course correction. Before rolling out his financial package, Obama illustrated exactly what’s lacking when he told John Harwood on CNBC: “We want to do it right. We want to do it carefully. But we don’t want to tilt at windmills.”

Maybe not at windmills, but sometimes you do want to do battle with fierce and unrelenting adversaries, starting with the banking lobby. While the restraint that the president has applied to the Iran crisis may prove productive, domestic politics are not necessarily so delicate. F.D.R. had to betray his own class to foment the reforms of the New Deal. Lyndon Johnson had to crack heads on Capitol Hill to advance the health-care revolution that was Medicare. So will Obama for his own health-care crusade, which is already faltering in the Senate courtesy of truants in his own party, not just the irrelevant Republicans.

Though television talking heads can’t let go of the cliché that the president is trying to do too much, the latest Wall Street Journal/NBC News poll says that only 37 percent of Americans agree. The majority knows the country is in a crisis and wants help. The issue has never been whether Obama is doing too much but whether he will do the big things well enough to move us forward. Now that the hope phase of his presidency is giving way to the promised main event — change — we will soon find out.

Copyright 2009 The New York Times Company