Friday, July 31, 2009

Are our political leaders trapped in the past?

Sen. Ben Nelson is threatening that the "centrists" may kill the health care reform initiative rather than let it go forward.

Nelson is aware that the Democratic "centrists" killed Clinton's effort at health care reform in 1993. He thinks that history is predictive. He'd better be wrong.

If Nelson and the centrists can kill health care reform, then the Democratic Party is as doomed as the conservative Republicans have already proven themselves to be. That means that both major parties will go into the November 2010 election after being completely out of touch with the voters and quite discredited. With both current major parties self-discredited by the 2010 election then what comes out of November 2010 is simply unknowable. But the public is going to latch onto something. This is the kind of event that revolutions are made of. In the extreme such a political event led to the 1917 takeover of what became the Soviet Union, and the 1933 Nazi takeover of Germany. But it is also what Franklin Delano Roosevelt headed off quite effectively during the 1930's.

It might be time right now to start building a true Progressive party outside the two major parties. The media won't figure this out for at least two election cycles. The conservatives, with their backwards view of politics as being a move to what was good in the past, cannot take advantage of such a situation. Progressives, however, are more capable of dealing with such s changing political and social situation.

This is, of course, pure "Blue Sky" thinking, but the problem seems to be that both parties are mired in the experience of the Congressional Leadership with the past, but facing a society and economy that is moving rapidly into the (currently undescribed) future.

A window into the conservative political culture - the cutout

The D.C. lobbying firm Bonner and Associates is now known to have sent at least six forged letters to Democratic Congressman considering The Climate Change bill urging the local congressman to oppose the bill. All six known fakes are supposedly from the local branch of the NAACP. But now Bonner and Associates has been caught. So what's Bonner and Associates' excuse?

They claim that the letters were sent by a rogue Temp employee. The Temp has since been fired.

Yeah. Right. A rogue temp employee sent six letters carefully designed to look like they came from the local NAACP or from a local Hispanic group.

Look. This is a standard conservative method of polluting the discussion of real issues that effect real people. What does "rogue temp employee" mean?

"Rogue temp" is shorthand for "The designated scapegoat who is a cut-out to be fired in order to insulate those higher in the organization when something like this is actually tracked back to the organization." As we all know "Scooter" Libby was Dick Cheney's designated scapegoat. Cheney himself was Bush's designate scapegoat. I wonder how deep the stack of scapegoats goes?

Needless to say, if no one spots such fakes and there is no risk to the company of exposure, then the employee who was designated as the scapegoat gets a bonus. Very probably such designated scapegoats quickly get hired at other firms with the concealed assistance of the company that fired them. They have proven their willingness to not only conduct such operations, but also to fall on their swords to protect the higher-ups.

I find it strange that being cynical about conservatives is not only normally extremely accurate, but also that it rarely leads to the very worst and most unbelievable of the ethical and legal atrocities conservatives actually conduct. We non-conservative cynics never seem to be able to match the conservative imagination.

Conservatives do not have an ideology that is easily sold to the majority of people, since the conservative ideology is essentially the idea that the wealthy should rule society and make them richer than before without the impertinence of average people questioning them. They win elections either by buying propaganda or by buying politicians, then fooling the majority of people through the two methods of mass propaganda based largely on fear and on declaring scapegoats. These fake letters sent to a politician and other like them are just one example of the kinds of lies that conservatives base their political actions on.

Addendum 4:57 pm
Zachary Roth (TPM Reporter) is all over the Bonner and Associates covert propaganda operation.
...a former Bonner and Associates employee who spoke to TPMmuckraker significantly complicated that picture, portraying Bonner and Associates as a place where ethical missteps were far from rare. "They just got caught this time," he said.

Texas; The inevitable long-term result of conservative philosophy in government

Texas under the control of conservative evangelical Republicans for more than a decade now is seeing the result of the conservative Republican low-tax low services small government business-friendly philosophy. The following information is from Texas Senator Eliot Shapleigh:
After a decade under Perry, Texas is last in the number of people who have a high school degree and near last in average SAT scores. Texas is second in population only to California; yet Texas doesn't have a single public university in the top forty while California has five. Perry’s own Select Commission on Higher Education and Global Competitiveness declared that:

Texas is not globally competitive. The state faces a downward spiral in both quality of life and economic competitiveness if it fails to educate more of its growing population (both young and adults) to higher levels of attainment, knowledge and skills.

Texans breathe air with more carcinogens than citizens of any other state. Perry’s highway department is broke; within two years, by admission of Perry’s former chief of staff, now chair of the highway department, the department will have no money to build new roads.

On the streets of Texas, predatory lenders now charge Texas families interest rates of 1100% per year.

Over the last few days, in the sharp glare of national headlines on health reform, Perry’s health record has become a national scandal. By percentage and number, Texas has more uninsured than any state in America, with one out of four Texans lacking health insurance. In some Texas counties, up to 40% have no health insurance. Contrary to the claims of some, even if non-citizens (who include legal residents as well as undocumented immigrants) were removed from the statewide estimate, Texas would still have the highest uninsured rate in the country with 4.1 million uninsured citizens.

One in six uninsured American children resides in Rick Perry’s Texas. In 2003, Perry cut over 200,000 kids from the state's Children's Health Insurance Program (CHIP). Over the course of his tenure, rather than insure more kids with the $958 million that the federal government specifically set aside for Texas to expand CHIP, Perry sent those taxpayer dollars back to Washington, D.C. so that other states like Illinois could use those dollars to provide coverage to all of their children. In 2009, when 29 of 31 Texas Senators voted to expand CHIP, Perry said he’d veto the bill.

Our state ranks in the bottom ten in the U.S. when it comes to the number of physicians, dentists and nurses per capita. Here in El Paso, with thousands of new troops on the way to Ft. Bliss, we struggle to provide care with fewer doctors and nurses per capita than any large city in the country.

Due to the lowest reimbursement rates in the U.S., nursing homes are leaving Texas just as baby boomers seek care. After years of opposition to basic public health education, Texas is second in the U.S. in teen pregnancies.

When it comes to care for our most vulnerable Texans, all 13 of Texas’ state schools for the mentally retarded have been under a Department of Justice investigation for systemic abuse and neglect. "Fight clubs" at the Corpus Christi State School, where staff pitted residents against one another, recently made headlines on CNN.

That is the reality of Rick Perry’s Texas today. When change is on the way, Perry talks of suing the U.S. government to stop it. Here’s what he said in recent radio interview:

I think you’ll hear states and governors standing up and saying 'no’ to this type of encroachment on the states with their healthcare. So my hope is that we never have to have that stand-up. But I’m certainly willing and ready for the fight if this administration continues to try to force their very expansive government philosophy down our collective throats.

What philosophy was Perry talking about? President Obama’s plan to provide health care coverage to every American, even Texans.

Who benefits from Rick Perry’s reality? In Texas today, three of the most expensive hospitals in the U.S. rake in profits, with charges that are almost three times the national average. Brownsville Medical Center was #8. From El Paso, Sierra Medical Center was #37 and Providence Memorial Hospital was #46. All three are owned by Tenet Healthcare Corporation.

Is Tenet's priority patient care or maximizing profits? Let's look at some numbers. The average cost of cardiac care at Providence Memorial Hospital is more than $15,000 per day, and at Sierra Medical Center, it's more than $18,000 per day. At University Medical Center of El Paso—the "public option"—it's less than $4,000 per day. In other words, these Tenet-owned hospitals charge about four times what the public hospital charges. And that's why Tenet spent hundreds of thousands of dollars trying to kill our new Children's Hospital, another "public option."

Rick Perry’s Texas is also home to health insurance companies for whom record profit, not better patient care, is the prime value. Health insurance premiums have risen substantially over the last decade. From 1996 to 2006, the cost of family coverage in Texas increased 85.7%. Over the same time period, our incomes increased just 8.6%. With premiums growing 10 times faster than incomes, coverage becomes less affordable for more and more Texans every year.
Conservative philosophy is essentially the refusal to permit anyone to plan and work for long-term social goals combined with permitting wealthy individuals to prey at will and unrestrained on most customers in the economy. Conservatism is an abdication of social goals if those goals interfere with the effort of self-centered powerful wealthy individuals who want only to increase their own personal wealth. Senator Shapleigh provides the numbers behind the last decade and a half of conservative control of the Texas government, and it is almost all bad - unless you take the view that only wealthy families who want to get richer matters and everyone else should sacrifice to support them.

Removing Rick Perry as Governor in the November 2010 election is a start to correcting the conservative stupidity that dominates Texas today.

Wednesday, July 29, 2009

And yet, Glenn Beck still has a job.

Glenn Beck's latest atrocity on the air should have been enough to get him fired by any reputable media or news organization. But he's with FOX, so they love him. Here is Meteor Blades with an evaluation and samples of Beck's simple-minded racism.

Next we have Eric Kleefeld who points out that "Obama-Haters Becoming Increasingly...Racial In Their Rhetoric."

Bill Clinton received the same kind of treatment after he was elected President, apparently because he had the effrontery to be a Democrat who defeated the Republican candidate to take the job. Only Barack Obama has the super-effrontery to be an African-American who defeated a Republican. So not only were the liberals so consumed with Lese Mageste that they took the job of President that the right-wing assumes belongs to conservative Republicans, they even did it with a Black man.

It is driving the conservatives around the bend. Reading the right-wing blogs is a study in insanity and anger. And those are Beck's audience.

The entire right-wing crew is out there playing with matches and explosives. Look for more lone-wolf assassins coming out of the woodwork because the right wing talk show hosts and FOX commentators are inviting them.

Monday, July 27, 2009

Nate Silver and Steve Benen argue that Democrats should use primary challenges to enforce Democratic Party discipline

The Republicans have long been able to enforce party discipline in the House and Senate by threatening and sometimes even carrying out primary challenges against incumbent politicians in their own party. That tactic has been a key element in causing the Republicans to consistently move towards a more extremist right-wing agenda over the last three decades. For reasons I do not clearly understand, the Democrats loath to conduct such exercises on their members, instead defending incumbents who could better by dispensed with. Sen. Joe Lieberman is one example of that.

Now Steve Benen together with Nate Silver makes the case that selected primary challenges are needed to make the Democratic Party in Congress more effective and more useful to the nation.

I'm inclined to agree. Diane Feinstein gets off the reservation too often, and California is a quite Democratic state now. She needs a primary challenge badly to either replace her or at least force her to represent her constituents.

The clear insanity of the "birther" movement explained

I have been puzzled by the vehemence, energy and clear insanity that is represented by the "Birther" movement. Surely no sane person actually believes that in spite of all the evidence, including a certified birth certificate provided by the state of Hawaii and vouched for by them, along with original newspaper records from the time of Barack Obama's birth in Hawaii stating that he was born there, no one sane can really believe that Barack Obama was somehow born outside the United States. But there is a clear audience for those lies and strange made-up stories, and there are a number of politicians and political advocates happy to encourage the true-believers with propaganda, words and irrational emotions.

But why are the core true believers so dead set in believing that Barack Obama was not born an American citizen?

Josh Marshall has presented an explanation for this puzzle that I find satisfying.
Others have said this. But the best way to understand the 'birther' craze is as a proxy for people who don't want to accept a black man with a Arabic-derived first name as President of the United States. Really as simple as that.
The birthers are true conservatives who cannot get their minds to wrap around the idea that America has elected a Black man whose father was a native African. Instead of accepting the incontrovertible evidence that he was born in Hawaii (a state in the United States by 1961) they'd rather be lied to.

The propaganda experts who are milking those frightened people are playing their fancy word games in the media and stoking their belief that the truth - Barack Hussein Obama is the legitimately elected, inaugurated, and functioning President of the United States - is instead a lie.

I can see what Rush Limbaugh gets out of it. He is a Fascist and exists to pump fear and anger in those elements of the public who he caters to. Sen. Inhofe has built a political career in Oklahoma and in the U.S. Senate with similar tactics, but a more subtle approach than Limbaugh's flat screaming lies.

But what the devil is the matter with CNN's Lou Dobbs? Senility? Desperation for ratings? Or is he somehow living in a bubble and suffering from some strange group-think? Or does he have an adviser who is steering him very badly wrong? Whatever it is, he has destroyed his own credibility and pretty much guaranteed that his career has peaked at its present job. However long that remains.

So essentially Josh Marshall has provided a satisfactory explanation for what was bothering me about the strange "birther" movement. All that remains now is to try to understand the individual motivations of the public players involved.

It is rather frightening to realize how many utter crazies there are out there, and worse, how many predators there are preying on them and who are making it clear that they want to prey on all of us. Extremist politics is alive and well and very dangerous.

National Public Radio website is becoming more text journalism oriented

NPR is bringing its unique form of journalism to the web, according to the New York Times.

At a time when those of us who love newspapers are finding them shrinking almost before our eyes, it appears that journalism is not dead. Instead it is finding other methods of taking good reporting from the news sources to the interested public. As a part of this, National Public Radio is expanding its online presence and focusing on presenting stories more in text versions.

Sunday, July 26, 2009

Private unregulated free market insurance cannot handle health care unaided. Krugman explains.

In our current lack of a health care system, the private insurers are strongly encouraged to skim off the healthy rate-paying clients from the overall insurable pool of possible clients and then to shift costs for expensive care to the government, other insurers, the health care providers or the ill patients themselves. Private insurers do whatever they can to increase their revenue and lower their payments for medical expenses. The difference between the revenues and the costs of insurance is the gross profit the insurance companies suck out of the health care system without providing payment for health care services. Those gross profits are then paid out in executive payments, dividends and sales expenses instead of paying for needed health care.

There is also a perverse incentive for private insurers to spend large sums of money to select only health rate payers and to avoid making large health care payments. None of the money going to those places is used to cover health care costs themselves. That's why America has the highest per capita expenditure for health care with outcomes that are significantly worse than other industrial nations have.

Here is Paul Krugman's excellent explanation why we can't leave health care to the vagaries of the unregulated economic free market.
There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.

This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (”I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.
This is based on Kenneth Arrow's discussion of the issue. The name Kenneth Arrow is one that is immediately recognized by anyone who has studied Macroeconomics at the graduate level because he has made so many critically important contributions to the field.

Look at those key points. 1. When health care is needed it comes as a surprise both regarding to cost and regarding timing. It cannot normally be anticipated. So it must be insured for. But that means that 2. the choice of what is paid for and how much is paid must be surrendered to the insurer.

The inherent problem with this is that in the free market the insurer is motivated only to make a profit, while the purchaser is buying protection, not using the product to similarly create revenue and a profit. That leads to point 3. If the insurer is to make a profit and still sell insurance at a competitive price he has at least two major methods of doing so. He will have to refuse to insure high risk individuals (however they are determined) and he will have to work to limit payments for claims and they have a strong incentive to cancel policies sold to individuals who submit large claims. An independent rule setting agency with strong enforcement powers can limit by not totally prevent those profit-making tactics.

So most of the major problems of current health insurance are based on the very nature of the free market for health insurance. They cannot be prevented.

What are the symptoms we see in the failing health insurance market? Two of the biggest problems are a growing number of uninsured and limitations created by insurers on how much they will pay and what treatments they exclude. The insurers actively search for indicators of increased medical risk and work hard to refuse to sell or to cancel policies to individuals who they decide are increased risk. That is the reason for the Preexisting conditions limitation on sales. It also is the reason for refusing to cover or raising the copay expensive medications. It is also the reason for raising the price for so-called out-of-network treatments or treatments which they deem to expensive so they label them "Experimental."

Those and other cost limiting and cost-shifting tactics by health insurers create a large pool of uninsurable individuals. That pool must exist if health insurers are to sell policies at competitive prices and still make a profit on those policies they sell. Those problems will always exist as long as there are insurance companies that are allowed to skim the healthiest individuals out of the overall pool of potential insurable individuals and thus throw the costs of paying for health care for the ill and those likely to need health care onto those individuals or on the remaining groups of more high risk insurable individuals.

In fact it becomes very profitable to spend large sums of money on careful selection of who is insured and on lawyers who are paid to defend cases where the "insurance" company reneges on paying for high cost treatments. Those high costs of selection, cancellation and limitations of the amount the insurer pays so that the so-called insured has to pay more of the cost go directly to profit for the insurers but are removed from the money available for health care treatment. Profit making private health insurers make their biggest profits by shifting the cost of health care away from themselves.

The only way to stop the waste of health care dollars that are siphoned off away from actually paying for health care services is to create a single pool of insurable individuals and to stop all renegade organizations from collecting the insurance payments but skimming off only the healthy or avoiding actual payment for needed health care. As long as there are private for-profit insurers in the system, they will be motivated to cheat by shifting the cost away from themselves and onto the individuals themselves or onto any other health insurance payer.

The last problem of the current health care payment system is the runaway costs of health care. These are also resolvable is there is an overall health care system that redirects the efforts of health care providers to more efficient and effective ways of using the various procedures and tools for improving health care. This can be done by changing what insurers measure and pay for. The result becomes an example of the power of the free market to encourage innovation. How?

Dr. Michael Porter presents the case for stopping the runway costs of American health care. His argument is that they are primarily caused because we have an insurance system that encourages payment for individual medical services but no system in place for measuring the health care outcomes for the patients receiving those services.

If health care providing organizations and individuals are paid based on outcomes in health and patient satisfaction instead of the number and cost of services provided then the profit motive will be redirected to innovative and lower cost treatments and also better patient outcomes.

This is not a system of changed regulations. It is instead a system of changing how information on patient outcomes is collected and how health care providers are reimbursed.

Dr. Porter's discussion can be found in a video at this link.

The Cambridge cop who arrested the Black Harvard professor in his own home.

The incident in Cambridge, Mass between "Skip" Gates and Cambridge police Sargent Crowley really is an excellent example of how far America has come in Race Relations between African-Americans and White Police officer. Jim Sleeper at TPM Cafe linked to this excellent post by a New York Police officer. It really is the best single comment I have seen on the entire incident. It pretty much confirms what I had gotten from first reading Gate's account of what happened, then the next day hearing Crowley's account on the radio. The background in police procedure clarified that part to me. My conclusion has to be that neither individual is himself racist, but that there is still an institutionalized racism in America that effects the expectation of each of them. Had there been any room for judgement by either Gates or Crowley, then one or both could have backed off the aggressive position each of them was taking, but both reasonably expected the media to cover the incident (as in fact happened) and neither felt free to give way to the other in front of an audience.

The one thing that is clear to me is that the incident ended up with two men going all testosterone on each other, although I don't think it is reasonable to think either is personally racist. Here's why I don't think that individual racism was involved.

Henry Gates is African American and is sensitive to racial slights, as most African-American men in America are. Anyone who is familiar with the incident a few weeks ago in Dallas where a Black Houston football player was hurrying with his wife to go to Dallas' Parkland hospital where the wife's mother was dying.

The football player ran a stop sign trying to get there before his wife's mother died. The (White) Dallas police officer stopped them and simply would not let them get to the hospital in time to be there with the wife's mother died. He seemed incensed that the guy was trying to leave before the officer have him permission, although the request was clearly perfectly reasonable. The whole incident was caught on the officer's video, and the police officer was completely unreasonable, with no real reason except the probability that he felt "dissed" when an African American was disagreeing with him. Anyone familiar with such incidents knows that they are a lot more common for African-American men than for White men. Last year's well-publicized flap over a 15 year-old black teenager's case in a Paris, Texas school in which she was sent to juvenile facility for an indeterminate sentence of up to three years (and spent a year there) for merely pushing a school teacher in the hall at school demonstrated how African-Americans get a lot less leeway than White's do. So did the recent criminal case of the African American student in Jena, Louisiana. President Obama's first public reaction reflects the quite justified African-American view of the danger of police acting arbitrarily.

On the other side, Sgt. Crowley is an experienced officer who teaches about racial profiling and no doubt has justifiable pride in his race-neutral personal behavior. More important, he knows the protocol for dealing with belligerent individuals cold. He may have even written it himself. I seriously doubt that there is any significant room for judgment in the official protocol because it is designed to limit the discretion of the perhaps 10% of officers who are in fact racist.

Then, as I understand it, there was an audience, and very likely the situation was clearly one that was going to the media. That being the case, Sgt. Crowley's best course of action was to follow the protocol to protect himself and the Cambridge Police Department.

So between them, Gates was tired, a bit ill, and primed to expect the worst from the police while Crowley no doubt expected to be attacked in the media no matter what he did. Both were angry, and neither was ready to cut the other any slack.

I don't see much chance that the incident could have worked out any way other than what it did.

The next day both Sgt. Crowley and the Cambridge Police Department announced that Sgt. Crowley had acted completely correctly and that they were not going to apologize. They were defensively digging their feet in. But they had committed themselves to the actions that Sgt. Crowley had taken. he really had done everything by the book, and they did not want to demonstrate any flexibility since the book protocol did not permit it, and they did not want to have to deal with a public that expected greater flexibility when it was not warranted.

I don't see much chance that the incident could have worked out any way other than what it did. That's true even though there is no indication that either man was acting based on Racist motives. The problem was the residual effects of three centuries of slavery and Racism and an aggressive media both expected to criticize them both, especially Sgt Crowley, for whatever action they took.

The fact that neither party was acting in bad faith is a big advance in American race relations. It's good that America has come as far as it has since Truman integrated the military, but the movement to eliminate racism in America still has a way to go. Obama's effort to make it a teachable moment is an excellent move towards reducing the institutional racism that infused the situation, even though it appears that neither man involved was himself racist. I think the entire incident has created a lot of discussion that was badly needed.

Addendum 4:48 pm CDT
Mark Kleiman offers three additional very interesting notes on the Gates/Crowley confrontation. I admit that my focus has been on the possible racial nature of the confrontation which at most I have concluded was sort of a left over institutional residue of racism past. What I had overlooked was the class nature of the confrontation. In the case of class inequality, it was Henry Gates that has the advantage and Sgt. Crowley who is the clear inferior.Mark also points out that the conflict in Cambridge has a strong resemblance to the confrontation between Shari Barman and a San Diego Sheriff's deputy at a Democratic fundraiser which as recently in the news.

I'm also going to agree with Mark when he writes
Yes, cops have a hard and important job, and I've expressed impatience with some liberals who seem to be more concerned with controlling police misconduct than with controlling crime. That said, arrest for "contempt of cop" is way too frequent, way too tolerated by the police culture, way too likely to be backed up with false testimony. And that sort of misconduct is way too likely to be supported by prosecutors and way too unlikely to be punished by superiors.
I live in a neighborhood that 15 years ago was declared the most crime and gang-ridden urban neighborhood in the U.S. It took intensive police effort to bring it down to the point that it is now better than most urban neighborhoods. But at the same time, I also am quite disturbed by the frequency of arrest for "contempt of cop" with the frequently false testimony to back it up and the acceptance of such conduct by police superiors.

Saturday, July 25, 2009

Harvard's Dr. Michael Porter explains how to cut medical costs and simultaneously get better health outcomes.

The problem with Medical costs is that we pay for and measure medical processes rather that outcomes. When we ask if someone got good medical care we take a protocol and a checklist and see if everything on the list for given symptoms was tested for and the care provided.

The current system does not consider and pay for the results, only for the number of separate procedures applied to any case. So if someone got every possible procedure,their insurance is considered good, even if the patient had a relapse or died. That fragments the treatment by various specialties and encourages more procedures, without measuring or maximizing the effectiveness of the treatment for the patient.

The result of this fragmented care is to increase the cost of specialist treatments without ever measuring or determining how well the full set of treatments works for the patient. The current system also locks the specialists into older checklists and hinders the adoption of newer procedures, protocols and technologies. At the current time patient outcomes are not even subject to effective measurement schemes. There is no incentive for medical care suppliers or insurance companies to measure patient outcomes, just the quantity of procedures applied to each patient.

The solution is to measure and pay for outcomes. Then let the providers determine what sets of tests and procedures achieve the best outcomes. The providers are then measured by the effectiveness of medical care for the patients instead of how many different procedures they apply to each patients. Once patient outcomes are effectively measured and payments are made on that basis, then the medical care suppliers will quickly apply the most effective and lowest cost set of protocols and procedures to achieve those results. It's been known since the late 19th and the early 20th centuries that organizations will improve processes that are measured but will not improve those which are not measured. America's current health system simply does not take advantage of that age-old management knowledge.

Here is Dr. Michael Porter explaining how this works.

This process is built into Barack Obama's and the Democrat's proposed revised health care system. Money is to be spent in revising the medical records system to measure patient health and satisfaction outcomes.

Then a second critical element of the revised system is the public option. The public option is designed to place a competing system based on those outcomes next to the results offered by private insurers. Without the public option the the private insurers will tacitly collude to keep health delivery costs unnecessarily high. That keeps their revenues high without forcing them to spend money adopting new imaginative cost saving techniques. The public option is absolutely necessary to force the shift to measuring and paying for outcomes instead of continuing the current system of paying for individual procedures applied. With out the pubic option competition private insurers have no incentive to lower the revenue they can charge for individual procedures as the currently do. No profit-oriented businessmen will want to have to lower their revenue to meet effective competition.

If you believe in the free market then this system is assured of reducing the overall cost of health care and at the same time providing improved health care outcomes. it's just like the way Detroit found that the costs of including safety devices in automobiles was both much lower than they had predicted and at the same time increased the profitability of the autos sold. We can count on it happening again. But only with an overall health care system installed. Currently there is no system, and America is the only industrial nation in the world that permits the extremely negative results of the lack of any overall well-designed health care system.

While the insurers don't want to have to compete for their revenue, their flexibility and imagination will be a real advantage in that competition. The result will be a major advantage for patients as they get better and more innovative health care delivered to them, while also lowering the overall cost of the system to the nation. The thing is, like when Detroit was forced to install seat belts and safety improvement, they could not plan in advance for how effective their efforts would be. They achieved the installation of those improvements at roughly a tenth of the costs they had anticipated in advance. That's how the free market works.

Interestingly the improved results and lower costs will be a direct result of the proper use of the free market system of fair and well-measured competition.

The following video describes measuring medical outcomes.

What planet are the "Birthers" and Lou Dobbs from?

The national Republicans are demonstrating their insanity, power-hungry natures and political desperation by embracing the "Birther" movement. But it's clear why they are doing that. They have been removed from power in the federal government for incompetence in governing together with widespread corruption. Not only have the despised Democrats taken over both Houses of Congress, to add insult to injury Bush was replaced by of all people a man whose father was an African. A man the conservatives call "Black" has become President of the United States. Such events are so unbelievable to the conservative Republicans that the conservatives are in shock and acting like their entire world has turned upside down. When a few crazies started publicizing the idea that Obama is not a native-born American citizen and thus not eligible to become President, many have grabbed onto the idea in desperation. But it is desperation, as Jon Stewart demonstrates.

Jon Stewart accurately and with his usual humor presents the case that the "Birthers" are attempting to make that Barack Obama is not a native born American citizen eligible to be elected President. Stewart's case is as even handed a description as any reasonable person could present, since the "case" is itself insane and irrational and it is being offered by self-centered crooks and whacked-out crazies.

So who are the crazies and crooks? The crazies consist largely of the shocked and frightened conservative voters who simply can't believe that the conservative world they thought they were creating here in America has collapsed. The crooks are the more sane among the career conservative politicians who have built political careers out of the conservative movement since Reagan was elected.If the conservative movement has collapsed, then their careers are in real jeopardy.

The conservative crazies include a large number of angry right-wingers who will vote for anyone who promises anything that might possibly be used to replace Barack Obama as President and to replace the Democratic leadership of the House and Senate with people more to their liking. Those politicians who would be more to their liking are racist right-wing fundamentalist evangelists like ex-Representative Tom Tancredo, as well as Sen. Sessions, Sen. Coburn, Sen. Ensign or Sen. Vitter. Individually the conservatives may not appear crazy, but they all belong to a culture that is irrational in nature. They all know what they hate about the current more liberal culture, and they simply want it changed. They are disinterested in the process necessary to bring about that change. Since they are interested in getting the results they want and find that no rational process gets there, they reject rationality and in many cases, even science. The result is that the conservative culture is tends to be anti-rational. Those politicians who are riding this electorate for personal advantage and are not themselves crazies are the conservative Crooks. Those are the crooks, a groups strongly represented among the elected politicians.

In the House the crazies include Minnesota's Michele Bachmann who is famous recently for trying to get people to illegally refuse to fill out the 2010 census among other insanities. Similarly, there is Katherine Harris who famously ramrodded the theft of the Florida election for George Bush in 2000 when she was Florida Secretary of State. She later represented the Florida 13th Congressional District from January 3, 2003 – January 3, 2007, displaying all the sanity that we currently see from Michelle Bachman. Most of her problems became public when she ran for Senate in 2006. These are just samples of the Republican conservative caucus which is clearly filled with such kooks.

Many of the conservative politicians themselves are often not crazy like the voters who elect them are, but they cater to those voters so they can be elected to office. They have embedded themselves in that anti-rational conservative culture, generally because their family and/or friends belong to it. Then they have created political careers within that culture. Texas Senator Cornyn may be one of the more sane group who is capable of moving whatever direction the wind blows in order to protect his career and current seat in the Senate.

Generally, however, as the national Republicans have gained their reputation for being unable to government effectively - largely because of their demand that government not operate on rational scientific processes - the conservative politicians have found it harder to attract Independent voters. This has become true even as the voters identifying as Democrats have grown in numbers. Those identifying as Democrats have clearly rejected what the conservatives claim to offer, so they are not open to conservative arguments. So the only thing the Republican office holders can do to remain in office is to appeal to the more extreme crazies among the voters. The "Tea Parties are one example of this, as is the "Birther" movement. So is the greater use of right-wing extremism issues by leading Republican politicians as they are led by Rush Limbaugh, Newt Gingrich, and the gaggle of right-wing shock-jocks on radio.

The "Birther" movement itself is run by a gaggle of incompetent "lawyers." Here are descriptions of those lawyers reported by The Washington Independent.
  • "Phil Berg, the original “birther” lawyer, has been forced to pay out sanctions for legal malpractice." His arc of career failure continues as he pushes this idiotic "birther" case.

  • Orly Taitz, a California lawyer featured in the Jon Stewart routine above," her law degree from an online correspondence school." Jon Stewart provided additional information on her career. She has also claimed to be a Dentist and a real estate agent. One has to wonder how many careers she can fail in.

  • "Charles Lincoln, who has been assisting Taitz — [he] provided judges with amended complaints in Keyes et al v. Obama et al last week and he showed up at the last hearing on the case— has been disbarred in California, as well as Florida and Texas." Since he has been disbarred in so many states, it would appear that he is practicing as a law clerk supervised by Orly Taitz who apparently still maintains a law license in California.
Apparently Lou Dobbs has bought the arguments made by Orly Taitz. Why he sticks with the story is unknown. He frames his "reporting" as presenting the conflict, but no one else with any sanity recognizes any valid conflict now, including the President of the CNN Network, Jon Klein. Is Dobbs so hard up for ratings that, like the conservative Republican incumbent politicians, he has to troll for viewers among the crazy right-wing extremists? Or perhaps he got suckered by Taitz and can't find a reasonable way to drop the subject. It is an unanswered puzzle why he is now trashing his own reputation as an on-air pundit to keep bringing the so-called story back up time and again.

In any case, that appears to be the current status of the major elements surrounding the "Birther" movement. That strange movement looks like a clear symptom of the total collapse of the conservative movement and the self-destruction of the national Republican Party. That the "Birther" issue is still making news as all demonstrates the collapse of the news industry and it's wide spread replacement by political advocacy media organs. But that's another story in itself.

Friday, July 24, 2009

The Dow is up, but not as much as it went down

Wall Street has become euphoric and the stock market is going up again. Has recovery arrived?

No. It hasn't.

Here's Robert Reich explaining what has really happened.
What's pushing the stock market upward? Mainly, unexpectedly positive second-quarter corporate profits. But those profits aren't being powered by consumers who have suddenly found themselves with a lot more money in their pockets. The profits are coming from dramatic cost-cutting -- including, most notably, payroll cuts. If a firm cuts its costs enough, it can show a profit even if its sales are still in the basement.

The problem here is twofold. First, such profits can't be maintained. There's a limit to how much can be cut without a business eventually disappearing -- becoming, in effect, a balance sheet in space. Secondly, when businesses slash payrolls to show profits, consumers end up with even less money in their pockets to buy the things businesses produce. Even if they hold on to their jobs, they're likely to fear that they won't have the jobs for long, which causes them to retreat even further from the malls.

Most companies that have reported earnings so far have surpassed analyst's estimates, but that only means that earnings have been less bad than analysts had feared. According to the chief investment officer at BNY Mellon Wealth Management, if the companies that haven't yet reported earnings show the same pattern a the companies that have reported so far, overall corporate earnings will have dropped 25 percent over the past year. That may not be as much of a drop as analysts had expected, but it's still awful. Operating income for companies in the S&P 500 that have reported so far has been almost 29 percent lower than last year, more than 80 percent lower than 2007, according to Standard and Poors. Ouch.
That's what I wrote yesterday. The only thing that is keeping the economy from it's steep dive into Depression is the federal government stimulus. The economy itself is not yet moving into recovery. The recent profits reported by the banks and some businesses are a chimera, reflection only the government efforts to keep interest rates low, add money to the economy and try to kick start employment by funding the building of infrastructure projects.

Wednesday, July 22, 2009

The Cambridge cop screwed up arresting Proffesor Gates in his own home for being Black

It's pretty clear from the news that Professor Gates (Harvard University) was arrested for being a Black man standing in a house in what the cop considered a White neighborhood, and for not treating the cop with sufficient deference when he asked to cop to provide his name and badge number. This was after Professor Gates provided the officer with his ID with the address on it and with his Harvard ID. The cop was on a power trip and did not like being shown to be out of line. MSNBC has an interview with Professor Gates.

The Boston Globe Metro Desk has a less one sided article on the incident.

President Obama was asked about the incident in a Press Interview today. Here it is.

America? Post Racial? None of us living today will ever see the day, but there has been a lot of progress since Truman integrated the military. It's just not yet time to quit striving for real race neutrality.

What do America's executives do that is worth the money?

This is from the Wall Street Journal:
Executives and other highly compensated employees now receive more than one-third of all pay in the U.S., according to a Wall Street Journal analysis of Social Security Administration data -- without counting billions of dollars more in pay that remains off federal radar screens that measure wages and salaries.

Highly paid employees received nearly $2.1 trillion of the $6.4 trillion in total U.S. pay in 2007, the latest figures available. The compensation numbers don't include incentive stock options, unexercised stock options,...
Look at that again. Executives and other highly compensated employees now receive more than one-third of all pay in the U.S.

This is just executive wages, mind you, and does not include the stock and bonuses they get paid - and for what? If you are an employee, do you think you are getting paid fairly for actually doing the work when the non-working suits get paid what each two of you employees gets paid?

Is the company getting its money's worth from the suits?

Do you wonder why they don't want you to unionize and get your representatives to sit down and ask for a fair wage increase when you, the workers, get more productive and do more work with fewer people?

Add this to the fact that under Bush, nearly half of the tax cuts went to these same suits. Yet somehow, they can't afford to help pay for your health care now. You, the worker are finding that the deductibles on your health insurance are going up so that the out-of-pocket medical expenses have risen over 50% since 2000.

Go back and look at the source of this report. This is from the Wall Street Journal, the daily newspaper for the suits themselves. It's not propaganda.

This is what the Reagan Revolution was all about. Creating a new American high-paid aristocracy that is above the law, untaxable, and not responsible for American society as they live in their gated communities. This is the people on Wall Street with their high wages followed with multimillion dollar (and currently taxpayer subsidized) bonuses.

The F-22; an unaffordable useless jobs project for politicians

At last new production of the F-22 fighter has been ended by Congress. There are currently 187 F-22's in service at a total cost of $67 billion. This is for an aircraft that requires 34 hours of maintenance on the ground for every single hour in the air. More important, this is an aircraft that has never seen a single hour of combat time, even though America has been in constant war since 2003. The F-22 is a useless and overpriced political boondoggle.

The F-22 is an aircraft that is designed to fight no known enemy of America either now or in the foreseeable future. There is no justification for spending more money on such as expensive waste. In addition to its extremely high cost per plane, there is no possibility that any other nation will buy F-22's and lower America's average cost because the law specifically forbids selling the aircraft to foreign nations. It is too hard to predict who America's enemies will be in a decade, and we don't want to sell them our latest technology today. Besides, they don't need the F-22 either - unless America decides to attack them.

Think about what the cost to every American family and American non-defense-related business of the constant war that America's mostly Republican and entirely conservative leaders costing this country are forcing America to fight. Here's what President Eisenhower said in 1953:
Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.

This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals.

It is some 50 miles of concrete highway. We pay for a single fighter with a half million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people.
That's not to say that America should not be fighting against the al Qaeda, Taliban, or the narco-traffickers in Mexico, Colombia, Peru and Afghanistan. We should. But the expensive gold-plated flying machine called the F-22 has no value in those conflicts, and the cost of the things means that there are fewer resources available to fight those real enemies.

Killing the budget item for purchasing more F-22's is one of the rare good moves to come out of the Senate Recently.That $1.75 billion that congress tried to spend for seven more unwanted F-22 jet fighters can now be applied to bring down the total cost of a decent health care system for this nation. That is just under one one-hundredth of the estimated annual cost of Obama's health care plan, for those "fiscal" (meaning bought by the health insurance industry) Blue Dog Democrats. I'm sure that if the corporate lobbyists could be kept away from the corporate whores who populate Congress (and especially the rich man's 100 member protection club called the Senate) another 50 or so such budget cuts would be easy to find.

America has adopted the idea of Americans being perpetually at war somewhere

When did America decide that it would always be at war somewhere? Because that's what today's generation is being told. David Bromwich, Professor of Literature at Yale, addresses this problem.
We have begun to talk casually about our wars; and this should be surprising for several reasons. To begin with, in the history of the United States war has never been considered the normal state of things. For two centuries, Americans were taught to think war itself an aberration, and "wars" in the plural could only have seemed doubly aberrant. Younger generations of Americans, however, are now being taught to expect no end of war -- and no end of wars.


Couple the casualty-free air war that NATO conducted over Yugoslavia with the Powell doctrine of multiple wars and safe exits, and you arrive somewhere close to the terrain of the Af-Pak war of the present moment. A war in one country may now cross the border into a second with hardly a pause for public discussion or a missed step in appropriations. When wars were regarded as, at best, a necessary evil, one asked about a given war whether it was strictly necessary. Now that wars are a way of life, one asks rather how strong a foothold a war plants in its region as we prepare for the war to follow.

A new-modeled usage has been brought into English to ease the change of view. In the language of think-tank papers and journalistic profiles over the past two years, one finds a strange conceit beginning to be presented as matter-of-fact: namely the plausibility of the U.S. mapping with forethought a string of wars. Robert Gates put the latest thinking into conventional form, once again, on 60 Minutes in May. Speaking of the Pentagon's need to focus on the war in Afghanistan, Gates said: "I wanted a department that frankly could walk and chew gum at the same time, that could wage war as we are doing now, at the same time we plan and prepare for tomorrow's wars."

The weird prospect that this usage -- "tomorrow's wars" -- renders routine is that we anticipate a good many wars in the near future. We are the ascendant democracy, the exceptional nation in the world of nations. To fight wars is our destiny and our duty. Thus the word "wars" -- increasingly in the plural -- is becoming the common way we identify not just the wars we are fighting now but all the wars we expect to fight.

A striking instance of journalistic adaptation to the new language appeared in Elisabeth Bumiller's recent New York Times profile of a key policymaker in the Obama administration, Undersecretary of Defense for Policy Michele Flournoy. Unlike her best-known predecessor in that position, Douglas Feith -- a neoconservative evangelist for war who defined out of existence the rights of prisoners-of-war -- Flournoy is not an ideologue. The article celebrates that fact. But how much comfort should we take from the knowledge that a calm careerist today naturally inclines to a plural acceptance of "our wars"? Flournoy's job, writes Bumiller,
"boils down to this: assess the threats against the United States, propose the strategy to counter them, then put it into effect by allocating resources within the four branches of the armed services. A major question for the Q.D.R. [Quadrennial Defense Review], as it is called within the Pentagon, is how to balance preparations for future counterinsurgency wars, like those in Iraq and Afghanistan, with plans for conventional conflicts against well-equipped potential adversaries, like North Korea, China or Iran.

"Another quandary, given that the wars in both Iraq and Afghanistan have lasted far longer than the American involvement in World War II, is how to prepare for conflicts that could tie up American forces for decades."
Notice the progression of the nouns in this passage: threats, wars, conflicts, decades. Our choice of wars for a century may be varied with as much cunning as our choice of cars once was. The article goes on to admire the coolness of Flournoy's manner in an idiom of aesthetic appreciation:
"Already Ms. Flournoy is a driving force behind a new military strategy that will be a central premise of the Q.D.R., the concept of 'hybrid' war, which envisions the conflicts of tomorrow as a complex mix of conventional battles, insurgencies and cyber threats. 'We're trying to recognize that warfare may come in a lot of different flavors in the future,' Ms. Flournoy said."
Bromowich provides a great deal of recent history explaining why we have become desensitized to the idea and practice of perpetual war. It's worth reading.

It looks like funding for more F-22's has died.

So there will apparently be no more F-22's bought by the Air Force. Good. It's the most expensive fighter ever and has never performed as expected. Here is Steve Benen's comment.'s worth remembering that the F-22 is a bit of a mess. For every hour it spends in the air, it requires more than 30 hours of maintenance. One of its key problems is -- I'm not kidding -- "vulnerability to rain." After years of effort, the plane, in operational flight tests, has met only seven of its 22 "key requirements." It features a radar-absorbing canopy that tends to imprison pilots for hours. It was designed to address Cold War-era national security needs, and has flown a grand total of zero missions in Afghanistan and Iraq.
The only politicians who will vote for the F-22 now are those paid by the manufacturer to vote for it. America simply can't afford any more of the donation magnets which have no current or anticipated combat value.

I say this as a Fort Worth resident who will regret the job loss here. Our economy will take a hit because of this budget item disappearing. But our troops in combat will either get better support or they will get better care if they come home wounded. This is a support-the-troops move.

Tuesday, July 21, 2009

I seriously doubt that America has a competent government

It is my opinion that the first function of every government in existence is to provide social and economic stability and general security to its population. It's job is not to provide protection to the wealthy oligarch or to large corporations nor is it the job of a competent government to fight wars of choice because some stupid leader thinks that they can change another society to something that leader prefers. That's the Iraq war, and earlier the one in Vietnam if you don't already get the reference.

Because of the increasing cost and complexity of health care, and because of the many health dangers that exist in our increasingly complex and globalized economy and society, any government that fails to assure health care to every citizen and legal resident is failing in a major test of what it takes to justify its existence and it should be replaced immediately with a government that will provide universal health care. It is inexcusable that any citizen should for any reason have their health insurance canceled with they file any claim or be forced into bankruptcy because of the costs of care for an illness or accident.

Harry Truman ran for President on a platform that included a demand for and the promise of national health care. That was over 60 years ago, and the wealthy American oligarchs together with a greedy and insensitive medical establishment has delayed and blocked every effort to provide that program in all those decades. The American government has failed its people for more than two generations now. Will it fail again this summer?

Apparently I am not the only person who feels this way. David Kurtz of Talking Points Memo published this email earlier this evening:
TPM Reader AB:
Just to mention something that is obvious, but hopefully not overlooked, i.e., if this country cannot pass a bill which insures that every citizen has access to medical care, which every developed country has managed to do (and got done many many years ago), there is something very fundamentally and structurally wrong with this country.

Such an event, in my mind, would confirm that we live with a completely corrupt and dysfunctional form of government. Forty nine states, each with bicameral legislative bodies, some of which have distinguished themselves recently with unabashed levels of incompetency and cluelessness. Then, graft a federal government over that, which is also bicameral, the non-representative portion of it being filled with officials who are certifiable morons and/or who are bought and sold like whores by wealthy contributors.

Talk about a Waterloo.

This is a defining moment in our history. Do we fulfill our supposed status as a "shining city on a hill" or continue our long slow decline into a second rate oligarchy?

I am not one prone to hyperbole.

I believe this to the depths of my soul.
I have no idea who TPM Reader AB is, but he has it right.

If the government fails to pass the health care bill this Summer, then it is time to change to government to a party that will pass it. That's clearly not the Republicans or Libertarians, and if the Democrats fail this summer, it is no longer the Democrats.

Rep Mark Kirk has to transform to become a Senator; Texas Michael Burgess is already just a total "No!" man

This web ad regarding Rep. Mark Kirk (R - IL) in his run for Senator there is quite good. But then, Kirk lives in a state which is not yet dominated by radical right-wingers, and he's trying to run state wide. He's got to appear different to state wide voters than he does in his own (gerrymandered) Congressional District.

Unfortunately, here in Texas the radical right-wing took over state-wide over a decade ago. "My" Congressman, Michael Burgess, has no need to appear anything more than the small-minded conservative pro-status-quo nay-sayer that they all are. Hey, they get well paid to be nay-sayers, and don't give a damn who gets hurt.

When does the economy start to recover on its own?

I got a good comment to my previous economic post and replied to it. The reply grew into what I think is worth another post of its own, so here it is. First, the comment.
Slice said...

The economy has to recover at some stage. Most likely towards the end of the year.
I agree with the first half of Slice's statement. But the second - recover by itself when?

The Depression lasted a decade until war spending was big enough at last to shake the economy loose. Japan's doldrums lasted at least a decade and they never fully recovered because so many competitors had popped up and Japan never made the necessary fundamental changed in their economy.

Right now I still see no reliable indication that the economy itself is trying to recover. It remains on life support based on government spending.

The economy itself will not recover until the consumers (70% of GDP)start spending again, and to do that they have to have more jobs, better pay, and less employment uncertainty. Right now all of these things are going the wrong direction.If consumers don't start spending, then investors will not invest in putting unused plant and equipment back into use because their is no market for the product.

Since investment is locked to consumption and lags behind it, there remain international trade and government spending. But international trade is still trending down, particularly since the Buy American actions are causing other nations to retaliate. That leaves only government spending to support the economy. It's all we have right now, and it's not enough to fund a recovery. All it has done is slow the collapse into what very probably was Depression II (if you don't count the Great Depression of the 1870's.)

Jobs and payrolls are the key. They are still trending in the wrong direction for the economy to help itself any time soon. It won't be this year. The lag time on creating new jobs, hiring and making masses of consumers feel secure enough to start spending again is at least a year from now, probably more.

Addendum 3:14 PM
For an additional view of how long it will take to recover, the excellent blog Calculated Risk offers two strong views that the worst is not yet over.
  1. Feldstein: Risk of Double Dip and
  2. Philly Fed State Coincident Indicators: Widespread Recession in June
I trust both Martin Feldstein and the Philly Fed a lot more than I do the politically motivated anti-Obama Associated Press and their hand-picked hatchet woman, Nedra Pickler.

The difference between the Philly Fed and Marty Feldstein is that both of those are primarily analysts trying to understand what is actually happening. The AP and Nedra Pickler are both political advocates in the business of swaying public opinion, and they merely hide behind the Associated Press's long history as a relatively objective news source.

Republicans defend health care status quo, offer no improvements

Steve Benen reports on a partisan Republican memo that explains their strategy for defeating the health care initiative. Here's what they plan to do as a party. It has three major parts:
  1. They will defend the status quo. They will push the assertion that the current health care system isn't as bad as it is being painted.

  2. They will heavily use frightening words and phrases. Obama's plan for health care is
    • an "experiment"
    • a "risk"
    • could "bankrupt the country"
    • "dangerously" "change the doctor-patient relationship."
    Note the total absence of explanation of how these things could happen. Note also that they will be presented without connecting any of them to the current disaster that is America's exploitable lack of a health care system. Items # 1 and #2 will not be presented in the same paragraph because they don't want the two sets of ideas connected.

  3. They will take every possible action to delay the forward movement of the legislation to provide greater opportunities to kill it. This is from the memo itself.
    "The Republican National Committee will engage in every activity we can to slow down this mad rush while promoting sensible alternatives that address health care costs and preserve quality," the memo affirmatively declares.
This process is no surprise. It is what the Republicans and conservatives have been doing for over 60 years to stave off a system of national health care financing that would limit their chanced to exploit vulnerable sick people and get rich.

As long as the conservatives can raise enough money from the superwealthy to keep funding the conservative think tanks, keep pumping out the propaganda, to elect their own politicians and to buy off the top leaders of out-of-the-mainstream evangelical churches and keep them politicized, they will continue these anti-social tactics.

Steve Benen points to Reagan's diatribe against Medicare 48 years ago

This is rather interesting. Steve Benen reports on Jonah Goldberg's NRO description of Ronald Reagan's diatribe against Medicare in 1961 as somehow "still fresh today."

Maybe Goldberg got the words "still fresh today" right, but he hasn't a clue what they mean. In fact, Reagan's rant was dead wrong about Medicare then, and the same arguments are all the conservatives have to oppose Obama's health care reform today. They words are fresh today because we are hearing them from the panicky idiots on the right-wing again, but they are as wrong today as they were with Reagan mouthed them as a conservative spokesman for GE 48 years ago about Medicare.

Economic uptick on the way?

I've been posting consistently gloomy economic prognoses for well over a year based on not seeing any hints that the economy might turn around. While I might not yet be ready to jump on the "It's almost over!" bandwagon yet, This Associated Press report is in fact the first indication I have seen of what might be a harbinger of economic recovery. So here it is:

More plans to build homes, higher stock prices and fewer people filing first-time claims for jobless aid sent a private-sector forecast of U.S. economic activity higher than expected in June.

It was the third straight monthly increase for the New York-based Conference Board's index of leading economic indicators, and another sign pointing toward the recession ending later this year.
Now I am suspicious of what this is an indicator of, and I am always suspicious with I see an AP news report with a byline by Nedra Pickler who has done some character assassination and misleading reports in the past and has earned a reputation of a reporter with a right-wing bias rather than of a reporter who tries to report as accurately and neutrally as possible.

Besides the suspicious nature of reporter herself, there is a question regarding the nature of the report itself. While these indicators may predict that the recession is nearing the end, they may also be very early and unreliable indicators. They may not indicate that the economy itself is beginning to recover on its own. They may be merely indicators that the stimulus funds are building up steam and becoming more effective.

How's that? Well, they may not yet be indicators that the economy is trying to regenerate itself. They may be indicators that the economy is sort of in the mode of a gasoline engine that coughs and sputters, then dies again when it has problems and is trying to start. But while I am suspicious of reading much positive into these indicators, at the same time they are still the best news out of the economy in well over a year. Again back to the metaphor of the gasoline engine that is trying to start but can't yet do so, that is a real indicator that the gasoline engine does not have something that totally prevents it from starting.

To again shift metaphors, these may not be indicators of a true dawn. They may instead be little more than indicators that resemble the false dawn that sometimes is noticed early on a cloudy day as the sun's rays are reflected to the ground before the sun itself actually has risen. So I find it guardedly good news.The time is too early to believe that the economy is actually coming back.

Monday, July 20, 2009

Here is why the health care crisis so critical to America

Any government that fails to meet the needs of large segments of the population for economic and social stability for a long time becomes less legitimate. As the government loses legitimacy, threats to replace it by one means or another rise. The health care crisis has reached the point where government can no longer protect its legitimacy by buying off large groups of people. The number of uninsured is growing, and a much broader group of those supposedly with health insurance are beginning to realize that it may not mean anything. Even if you can get care, the uninsured cost can bankrupt you. Too often the insurance company itself will cancel the policy before paying large claims. Add the health care crisis to the near brush with Depression and the rising unemployment and the government is in trouble. Any politician in office right now should be looking over their shoulder and feeling that their job is threatened. Only those politicians in the most radically gerrymandered states or districts can feel safe. Watch the contortions that Arnold Schwarzenegger has been going through to try to act sane for the moderate voters and still keep his conservative creds with the right-wingers.

When the government attempts to enforce an ideology or religious doctrine on large groups of unbelievers they face push back. When the numbers of active unbelievers get large enough, the threat becomes dangerous to the incumbent government's continued hold on power. The government then has two choices on how to deal with that loss of legitimacy and the resulting threats to its continued hold on power. It can either step in and do what is required so that fewer people face the problems or it can resort to more extreme authoritarian methods of repressing those who threaten to replace the government in power.

China's communist government considers the Uighur population to be a threat because they reject the Communist doctrine based on materialism. That was also the Chinese government's problem with the Falun Gong and the Tibetan Buddhists. But it has also been the problem for the American conservatives who are trying to enforce their strange ideology on America. It explains the pressure to steal elections and conduct dirty tricks, as well as the expanded actions by right-wing extremist groups like the anti-abortionists, the racists and the anti-immigration groups. The push-back the conservatives get from those of us who recognize the snake oil they are peddling is why they still feel like they are an oppressed minority.

But that mechanism is also the basis for why Obama is dropping in the polls. Fewer and fewer people see him acting to protect them from the economy or from the American medical disaster-zone that is good primarily to make a few more people rich and occasionally provide pretty good medicine but unreliably for anyone but the very rich.

While the economy was expanding a lot of people who were not rich thought they might become rich, so the threat of a health care crisis seemed less likely. Now that the conservatives have also destroyed America's economic growth, that group has clearly gotten smaller as more and more people are sweating out just keeping their job.

The real problem for health care reform is clearly in the rich man's club in Congress - the Senate. The Republicans have been a shrinking minority, but they are no longer in power. The Democrats are, and the economy and health care crisis reflect on the Democrats now. It's clear to the Republicans who are left that if they can just hang on they begin to regain the power of the opposition during times of social and economic crisis. Which leaves the gang of six. All of them appear threatened and desperately grasping for funds to gain reelection. How to deal with them is the question.

Obama's advertising in their states is a really good idea. Let's hope it works, because the health care crisis is ground zero for the continued existence of the Demorats in power in Congress and in the federal government. This is one the Democrats must win. That is equally true for the conservatives.

So that's the battleground in a nutshell. And politically, nothing else matters now. Nothing.

A few items of interest from over the weekend

  • Juan Cole says that the al-Maliki government and the new Iraqi military were able to successfully shepherd large numbers of Shiite pilgrims through a pilgrimage over the weekend without a major terrorist bombing to disrupt it. That may suggest that Obama's plan to withdraw American troops from Iraq soon can work - if the relations of the Kurds to the north with the rest of Iraq don't blow up in the meantime.

  • Juan Cole also reports that the political battle between the Iranian hardliners and the more moderate groups who have opposed the recent (stolen?) reelection of Ahmadinejad continues as the hardliners slam Rafsanjani. This followed Rafsanjani's Friday sermon which encouraged continued resistance against the hardliners.
  • From Ben Katcher at the Washington Note we learn of the potential competition between Iran and Russia to provide natural gas to Turkey, Bulgaria, Romania, Austria and Hungary. This highlights the rather complicated relationship between Russia and Iran. The proposed 2,050 mile natural gas pipeline that aims to diversify Europe's gas supplies away from Russia has interesting political as well as economic ramifications for the entire middle east and eastern Europe. Here is Katcher's view of how it looks from Russia's point of view:
    Russia perceives Iran as both a tactical ally against the United States and as a strategic competitor as an energy supplier to Europe. Russia fears that a rapprochement between the United States and Iran would open Iran's energy markets and threaten Russia's dominant position as Europe's primary natural gas supplier.

  • Faith Smith writes an interesting article in the Washington Note on the conflict between the Chinese Communist Government and the Uighur population in Xinjiang province. Here is a key insight in her article
    "Fundamentally, the Chinese Communist Party, which was founded on materialist principles and encourages atheism among its members, doesn't understand religion. Its leaders see every non-state-supervised religious gathering, or attempt to impart values to children, as a potential threat to their political authority."

    This immense lack of understanding has led the Chinese government to create a threat where one previously did not exist and an enemy out of a traditionally peaceful people.
    That same insight would seem to also apply to Tibet. Could it be generalized to apply to any ideology or religious doctrine attempting to run a government over a culturally non-homogeneous population? Enforcing a doctrine or ideology seems to cause a government to abandon the most important basic function of any government. That function is to provide peace and stability to the population it governs.

    Any government which does not provide peace and stability will inevitably face threats to its existence. The normal government reaction to those threats will be authoritarian actions unless it abandons its efforts to enforce the doctrine or ideology. If it does not abandon those efforts the threats will continue and grow until that government is replaced by another. The biggest advantage of democracy is that it provides non-violent methods for replacing such a failed government.

  • Sunday the Washington Post published an interesting article on the early stages of the development of torture techniques used by the CIA during the Bush administration. The article highlights the role of contractors, particularly James E. Mitchell, a retired clinical psychologist for the Air Force and John "Bruce" Jessen,another former CIA contractor. The two of them were important in developing the interrogation policies the CIA used. But at least equally important if not more so was the constant pressure from Langley saying in essence "You aren't getting enough Intelligence. If there is another terrorist attack you will be responsible. Get tougher and get more Intelligence."

    This isn't stated in the article, but it is certainly implied. The reported pressure from Langley almost certainly originated in Cheney's Vice Presidential office and was transmitted through the political appointees that Cheney had placed in the CIA when he was running the staffing function at the time of the transition from the Clinton White House to the Bush White House.

Sunday, July 19, 2009

Mark Sanford needs to resign as SC governor over his incompetence

South Carolina Governor Mark Sanford is desperately trying to keep his job after his dalliance with his Argentine temptress. Here is his fourth mea culpa since he disappeared for six days and got caught on the way back.

Sanford is desperately trying every trick in his (christianist) work book to keep his job. He thinks that he should be forgiven for his flaws and given a second chance to be Governor. Apparently, judging by his repeated efforts at getting forgiven by the voters, it's not working. It shouldn't. Sanford is too incompetent to be left in the job of governor.

I won't disagree that true Christianity suggests that we should forgive the sinner his sins. Of course, I don't think he is aware of all the sins he committed in that little escapade. All he sees is the adultery, and he excuses that because of his "love" for the woman involved. What about his sins of abandoning the job he took on and committed to perform for nearly a week?

Nothing in Christian forgiveness says his constituents should keep an incompetent governor filling that job. He disappeared for for roughly a week, did NOT turn his job over to his Lt. Governor and left no method of contacting him. What would have happened if he had died en route or had a accident or was robbed and killed in Argentina? How long would it take to straighten out the mess he left behind? He can ask for personal forgiveness from those who are close to him. He has no right to ask for professional forgiveness in a job for which he is profoundly unsuited.

I don't think it is any of the public's business if Sanford cheated on his wife and family -- If he can keep that subterfuge from effecting his job. He clearly cannot keep the two separate, so he should resign immediately. He is simply not a competent governor.

Regarding Sanford's profound incompetence to be Governor, consider the Diagnostic and Statistical Manual's criteria for the Narcissistic Personality Disorder.
DSM IV-TR criteria

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:[1]

1. Has a grandiose sense of self-importance
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love (megalomania)
3. Believes they are "special" and can only be understood by, or should associate with, people (or institutions) who are also "special" or of high status
4. Requires excessive admiration
5. Has a sense of entitlement
6. Is interpersonally exploitative
7. Lacks empathy
8. Is often envious of others or believes others are envious of him or her
9. Shows arrogant, haughty behaviors or attitudes
He appears to be likely to meet at least item's 1, 5, 6 and 9. His repeated public statements about how much he loves his paramour suggests that he has no empathy at all for his wife and children, so item 7 is probably there also. The only reason he is saying anything at all is that he was caught out cold with no chance of "spinning" his sin and trying to keep it out of the public discussion. As for the other items on the list, we simply have no information at all in the national public record. Yet.

Saturday, July 18, 2009

The six "centrist" Senate Democrats are fools

There are six so-called "centrist" Democrats in the Senate gearing up to kill the health care reform. Mark Kleiman points to the exact same situation in 1993 when the "centrist" Democrats did kill the Clinton effort at health care reform.
In 1993, Democratic "centrists" on Capitol Hill helped defeat Hillarycare, believing that their power was unshakable and would be increased by teaching the new President a lesson about who was boss. The Gingrich Revolution was condign punishment for them, though what the rest of us did to deserve it I don't know.

For Gingrich and his allies, the health care debate wasn't really about health care: it was about destroying the power of a Democratic President.

It's not surprising that the Republicans have remembered that lesson, but it's disappointing that the "centrist" Democrats have forgotten it. This bill is make or break for the Democratic Party, and Harry Reid ought to enforce party discipline on the cloture vote. No on cloture should mean no subcommittee chair, no pork, and no money from the DSCC.
I don't think those Democratic Senators will wake up to the facts they are facing until it is too late. I sure hope that somehow Harry Reid and Barack Obama can get the seriousness of their situation over to them.

Did Ayatollah Khomeini intend a government based on popular sovereignty in 1979?

According to Iran's Akbar Hashemi Rafsanjani in his Friday prayers sermon Khomeini the government to be that of a Supreme Leader who makes important decisions himself. Rafsanjani, according to Juan Cole, intended that Iran be governed as a Republic whose base of power was the sovereignty of the people. That implies that the Khomeini Revolution was taken over by authoritarian Shiite hardliners who are misruling Iran today. The evidence of that misrule is the extreme public suspicion of the declared outcome of the recent Iranian elections. So Rafsanjini stated yesterday what had to be done to restore the true nature of the 1979 Khomeini Revolution:
Rafsanjani then speaks of a plague of doubt about the election results that has afflicted a not inconsiderable number of Iranians, including many intellectuals and thinking persons.

His solution to this crisis of confidence consists in the following steps:

1. All parties to the dispute should act only in accordance with the law.

2. The authorities must exert themselves to regain the confidence of the people.

3. The door must be left open to free and unrestrained public debate among the contending parties, including on the state-run radio and other media.

4. Demonstrators and other prisoners of conscience must be released by the regime.

5. The press must be left free to publish a wide range of opinion on these issues.

Rafsanjani seems to have been acknowledging that the results of this election are unlikely to be overturned. But he is urging fresh legislation and wide open debate as means of resolving the crisis.
I don't know or understand Iran or the Iranian culture and politics, so I won't pass public judgment on the accuracy of what Rafsanjini said in his sermon except to suggest that while I hope his view is correct it remains up to the people of Iran to decided. Juan Cole has been kind enough to pass it on for our information. Obviously there are strong political factions for both a more democratic Iran responsive to the will of the people and for the hard line authoritarian theocracy of Iran. The U.S. and the other nations surrounding Iran would certainly be better off if Rafsanjini's view were that of those in power there.

Friday, July 17, 2009

Texas is rapidly moving from Conservative to Liberal politically

This is an article from the Economist that presents the most positive political changes in Texas in nearly two decades. The problem is, after the Evangelicals and the Conservatives took Texas to the far right (and gave two right-wing Presidents to America) there is one Hell of a long way to go. But as I sit here in North Texas and recall that in November of 2008 every major city in the state except Fort Worth voted Democratic, the signs are good.

Jul 9th 2009
From The Economist print edition

Whisper it softly, but Texas looks set to become a Democratic state

THE elected sheriff of Dallas County is a lesbian Latina. The leading candidates to become mayor of Houston in November include a black man and a gay white woman. The speaker of the House of Representatives is the first Jew to hold the job in 164 years of statehood and only the second speaker to be elected from an urban district in modern times. In this year’s legislative session, bills to compel women to undergo an ultrasound examination before having an abortion (to bring home to them what they are about to do) and to allow the carrying of guns on campus both fell by the wayside; a bill to increase compensation for people wrongly convicted sailed through. Lakewood, in Houston, the biggest church not just in Texas but in America, claims to welcome gays. As Dorothy in “The Wizard of Oz” might have said, we’re not in Texas any more.

Or at least, not in Texas as we have recently come to know it. A Democratic-voting Texas would be nothing new, but political memories are short, and the blunders of the Bush presidency have coloured global perceptions of what Texas is like. It mostly voted Democratic in presidential elections until 1968, when, alone among the former Confederate states, it went for Hubert Humphrey, and 1976, when it voted for Jimmy Carter. Many of those voters were highly conservative “Dixiecrats” and later flipped to the Republicans. But there has always been a strong radical streak too. William Jennings Bryan was hugely popular in Texas. Jim Hightower, a former Texas agriculture commissioner and the perennial voice of Texas populism, says that “Texas has always been a purple state”—up for grabs by either the red Republicans or the blue Democrats.

It had a Democratic governor, in the feisty and liberal shape of Ann Richards, until as recently as 1995; but since that year, which saw George Bush’s ascent to the governor’s mansion, the Republicans have been firmly in control, and no Democrat has won statewide office. Since 2003 the Republicans have controlled the House as well as the Senate, monopolising every lever of power in the state. Now the pendulum is swinging back.

With no prospect of a local son to vote for in future elections (a Bush has been on the ballot paper for six of the past eight presidential votes), the Republicans have lost one big advantage. In the 2008 election the Democrats did much better all over the state. They won the presidential vote in all the big cities except Fort Worth (see map). They made big inroads into the Republicans’ dominance of the suburbs, where American elections are lost and won these days. Overall they took 44% of the vote, up from 38% in 2004, even though Barack Obama barely campaigned in Texas.

They secured a blocking minority, 12 seats out of 31, in the heavily gerrymandered state Senate, and almost took control of the Texas House of Representatives: the Republicans now hold it by just 76 seats to 74. The conservative speaker was promptly ousted and replaced by Joe Straus, who depended for his election on a sizeable block of Democratic votes.

The mild-mannered and charming Mr Straus has turned out to be a bipartisan and moderate figure, though he insists that he made no promises to the Democrats who backed him. But this year’s legislative session showed the Democrats flexing their muscles in the House, blocking a bill on voter identification that they said discriminated against their supporters.

The rise of the Democrats poses a dilemma for Republicans in Texas, just as it does nationally. And just as the national party seems to be lapsing into fratricide, so a vicious internal war has broken out over the governorship. Rick Perry is running for a third full term in the job, but the main challenge he faces is not from the Democrats who, oddly, have come up with a remarkably unconvincing candidate: Tom Schieffer, who used to be Mr Bush’s business partner and who is famous mainly because his brother is a TV presenter. The real rival is within, in the shape of Kay Bailey Hutchison, probably the most popular politician in the state. Mrs Hutchison has served as one of Texas’s two senators in Washington, DC, since 1993, and was last re-elected in 2006 with 62% of the vote.

Mr Perry has a strong economic record to run on, but because his toughest fight is against a fellow Republican, this has already turned into a battle for the souls of the 600,000 conservative sorts who vote in the Republican primary, due to be held next March. Mr Perry has lurched to the right to woo this atypical electorate.

Thus, he has backed allowing “Choose Life” to be an official Texas car licence-plate motto. This hurts Mrs Hutchison, who is in trouble with social conservatives for having once voted against overturning Roe v Wade, the Supreme Court decision that protects the right to abortion. He has also refused to take up a big chunk of the stimulus funds offered to Texas to help pay unemployment benefit, on the ground that this would create a long-lasting obligation.

No one doubts that Mrs Hutchison would beat Mr Perry or anyone else in Texas in a general election, but recent polls have her lagging behind Mr Perry in the primary. If she does formally enter the race, as expected, she will have to face being branded as a baby-killer and a creature of spendthrift Washington, DC.

Mrs Hutchison insists that “it’s very important that we don’t build a party around an issue [abortion] that is so personal, on which even families disagree.” She is surely right, but primary voters may not see it that way. This race matters hugely to Texas: it is a moment when the state’s Republicans will have to decide which wing of the party they are on.

The Democrats, meanwhile, are pinning their hopes for the 2010 election on securing a majority in the state House of Representatives and on winning a US Senate seat (which may come up sooner if Mrs Hutchison resigns to concentrate on her race for governor). Their chances in the House are good: as the recession starts to bite in Texas, later than elsewhere in the country, support for the Democrats is likely to rise. On the other hand Barack Obama will not be at the head of the ticket in 2010, as he was in 2008—though in Texas he was never quite the draw he was on the coasts.


And now for someone completely different

The steady rise in the Hispanic population, coupled with a slow but continuous increase in Latinos’ tendency to vote, bodes well for the Democrats. George Bush did an impressive job courting the Hispanic vote, but the Republican Party threw that advantage away by rejecting his plans for immigration reform in 2006-07. In the 2008 presidential election Texas Latinos voted Democrat by 63% to 37%. Mr Obama’s nomination of the first Hispanic Supreme Court justice is unlikely to hurt, and nor will his commitment to immigration reform. As Hispanics increasingly spread out across the state they will start to tip the balance in many suburban counties, which is where the big political battles in America are being fought.

In the Senate race the Democrats’ probable candidate will be Bill White, the current mayor of Houston. He has done an excellent job balancing the needs of business with those of his core voters, and he will have a lot of money behind him.

Texas had become used to being at the centre of events, having supplied the president, the vice-president or at least the treasury secretary for all but a handful of the past 50 years. Now it does not even have a senator in the majority party, meaning that Texas has no voice in any of the big deliberations in Washington, DC. That will help the Democrats too.

But it does seem fair to ask what Texas Democrats actually stand for. They say they want more money spent on health and education, but pretty much every politician in Texas says the same, and the party’s leadership shows no appetite for delivering this by taxing Texans more heavily. Hardly anyone seeks to abolish the death penalty, even though, in most years, Texas executes as many people as the rest of America put together. Gun control and recognition of gay marriage are off the table. Everyone has jumped on the renewable-energy bandwagon.

It would, in short, be possible to imagine Texas slipping back to the Democrats without much happening in consequence, except for two considerations. The first is that, should Texas go Democratic at the presidential level, the Republicans nationally would be in deep trouble: with its 34 electoral-college votes, Texas is the only big state they have regularly won in recent presidential elections. The second consideration is the Hispanics. As they become ever more powerful in an ever stronger Democratic Party, there is every chance that they will turn against a model that has left far too many of them behind.

[I am presenting this article in its entirety under the fair use provision of the copyright law. It is intended both to spark discussion and to show that even in London the recent
political changes in Texas are known.Editor WTF-o]