swimming freestyle

U.S. health care rates poorly

The Commonwealth Fund's newly released study of health care effectiveness clearly demonstrates only half the job is done following the passage of the American Recovery and Reinvestment Act.

Ranking seven industrialized nations (Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States) health care systems, the study found the United States ranked last overall on "dimensions of access, patient safety, coordination, efficiency, and equity."

From the study:

 

The six other nations have universal health care as a mandate, something the U.S. won't implement until 2014.  That mandate will address the access and equity issues, but the U.S. also fares poorly when it comes to the quality of the care received. 

Interestingly, this is the first time the number one ranked Netherlands has been included in the survey.  The Dutch revamped their health care system in 2006.  All residents are required to purchase health insurance through highly regulated for profit or non-profit private insurers.  In other words, no Medicare or Medicaid.  No one can be refused coverage and the government provides subsidies to insurers to compensate for sicker, or chronically ill participants.   There are some differences however:

The required standard insurance is financed by a mixture of income-related contributions and flat premiums. The individual contribution is set at 6.5 percent of income, which is contributed by employers if the patient is enrolled through their job or by the patient if they are self-employed or unemployed. The insured also pay a flat-rate premium to their insurer for a policy. (Link)

It would likely be every Republican's wet dream to fantasize about a health system completely managed by private insurers.  What would likely kill the mood would be an obvious, clear requirement for a system that includes both highly regulated insurers and providers.

Deepwater drilling moratorium lifted

A federal judge in Louisiana overturned the six month moratorium on deepwater oil drilling in the Gulf today.  The ban, ordered by the Obama Administration following the explosion of BP's Deepwater Horizon well, put on hold all drilling in more than 500 feet of water and all new applications.

A group of boat operators and equipment suppliers had challenged the moratorium, claiming there's no evidence existing operations pose a threat and the ban imposed serious financial hardship.

In issuing the ruling, (U.S. District Judge Martin) Feldman said, "the court is unable to divine or fathom a relationship between the findings (of the government) and the immense scope of the moratorium. The plaintiffs assert that they have suffered and will continue to suffer irreparable harm as a result of the moratorium. The court agrees." (Link)

No evidence existing operations pose a threat?  Sixty four days ago that might have been a plausible defense.  It's hard to imagine how a broken well leaking some 60,000 barrels of oil a day into the Gulf doesn't constitute evidence of a threat.

The purpose of a moratorium is to establish time to establish a commission that will study current industry standards for safe deepwater oil drilling (if there is such a thing).  That committee is just being formed now, and should concentrate on both safety standards going forward and some assessment of the adequacy of current deepwater drilling operations.

The government has already announced they'll appeal Judge Feldman's ruling.  It seems a safe bet the farther from New Orleans the more likelihood an appeal ruling that places long term safety above near term economic issues.

In order to have an opportunity cost, there needs to be an opportunity

Opportunity costs are those things that don't get done because one's too busy doing something else.  A friend recently sent me an editorial from an Arizona newspaper that expresses concern China will be, sometime soon, eating our lunch.

In the nine years since we invaded Afghanistan, China has gone from a second-rate manufacturer of cheap goods to the most significant economic power in the world. While the rest of the industrial world spent the past two years in recession, China’s economy expanded by 5 percent. 

While we have spent hundreds of billions of dollars on bullets, armored vehicles and prosthetic limbs, China has invested hundreds of billions in its energy grid, its cellular and Internet networks, its roads and its ports. The most modern industrial economy in the world is now in China (it used to be Japan, but they’re in worse shape than we are, these days).

The author includes a list of examples of China's bare knuckled moves to guarantee the supply of needed minerals and building materials necessary for the continued building of Chinese infrastructure.

We need to ask ourselves why we spend hundreds of billions of dollars on our military every year so Chinese communist industrialists can safely travel the globe securing the resources it needs to become the greatest economic power on the planet?

I agree with the premise.  Our government is being managed in a 1950's mentality that equates military strength as the only determinant of world power.  Sixty years later, we can pretty clearly see a world in which very significant world powers can assert themselves without invading countries and having the most nuclear warheads.

However, I don't agree with the notion that if the U.S. wasn't dumping money hand over fist in Afghanistan and on "bullets, armored vehicles and prosthetic limbs" we would be spending it, instead, on our energy grid, our cellular and internet networks and our ports.  My guess is that, if we weren't spending all that dough on the military, there would be an irresistible push from Congress to just provide greater and greater tax breaks.  

If China ever does kick our ass, it will be because we let them.

The Obama speech and missed opportunities

First, to those that questioned why Barack Obama would speak from the Oval Office, a stage historically used for the most grave situations; what the hell do you think is going on down in the Gulf?  Crude oil is spewing into the Gulf at a rate of 60,000 barrels a day and, best case, it won't end for another two and a half months.  An area where the three largest industries are fisheries, oil and tourism and where millions of people once relied on what's now a big, putrid black soup for their livelihoods.

The transcript of the president's speech is here.  The video is here.   There's plenty of good analysis available from Kevin Drum, Jonathan Chait, and Ezra Klein, and James Fallows. 

There's only two things I would add to their comments.  Towards the end of the president's speech, he said:

The one answer I will not settle for is the idea that this challenge is somehow too big and too difficult to meet... time and again, we have refused to settle for the paltry limits of conventional wisdom. Instead, what has defined us as a nation since our founding is the capacity to shape our destiny -– our determination to fight for the America we want for our children. Even if we’re unsure exactly what that looks like. Even if we don’t yet know precisely how we’re going to get there. We know we’ll get there.

It’s a faith in the future that sustains us as a people.

Damn, I really want to believe that, but find it increasingly difficult.  I believe it was once true, but now I'm not so sure - the notion that, as a country, we can tackle the most difficult objectives.  And, if Barack Obama really believes that, why didn't he make the specific commitments required to finally address oil dependence and climate change?  I'd love to be wrong about this, but more and more I feel like the ability to accomplish the big tasks may now be beyond our reach.

Finally, I'm good with prayer.  But prayer as a substitute for policy will not get the Gulf clean, allow the millions effected to find support for themselves and their families, and set in motion the kind of things required to assure this never happens again.

'How big' will Obama go tonight?

President Obama has now done it often enough that it seems to be his strategic approach.  When tackling big issues, racism and health care are good examples, he allows the problem to fester for a while, throws a Hail Mary pass that's full of pragmatism and common sense late in the fourth quarter, and ultimately settles for a compromised solution that's often less than satisfying for all involved.

The president is scheduled to speak from the Oval Office tonight to address the Gulf oil spill and will presumably turn it into one of his fourth quarter speeches, this time about energy and climate change.

The question is "how big" will the president go tonight?

If the Center for American Progress really is pulling the strings on the President's energy policy, then POTUS will Go Medium Big: check out this memo from Dan Weiss, CAP's director of climate strategy: 

President Obama must use this moment to rally Americans to support a sweeping oil reform agenda that permanently changes the way big oil does business. This means building public demand for standards and investments that deeply cut the $1 billion per day spent on foreign oil, ending tax loopholes for big oil companies, and beginning to crack down on global warming pollution. 

If "Go Big" means a strong push for carbon pricing, then this would be the middle ground -- a speech that focuses on the oil industry, pollution reduction (including renewable standards and CAFE standard enhancement), lots of money for relief and reconstruction, and an assumption of responsibility for the clean-up. (Link)

It struck me that one of the tactical failures during the health care debate was going in with a compromise position right from the get go.  Rather than begin with a single payer system and negotiating down to a public option, President Obama and Congressional Democrats had no room to negotiate and ended up handing over the entire country's insurance needs back to the same private insurers who'd mismanaged it before.

I hope they don't repeat those same mistakes here.

How socialist is the U.S.?

Not very, if one actually bothers to look at real data.  Thomas F. Schaller, a political scientist at the University of Maryland, evaluated economic data, compared it to various nations and concluded that despite programs like Social Security and Medicare, the U.S. doesn't even come close to what would be considered socialist.

...in America, state and federal taxes as a share of the gross domestic product amount to 28 percent. He points out that's among the smallest in the 31 first-world nations in the Organization for Economic Cooperation and Development. Mexico, Turkey, Japan and South Korea pay smaller shares.

According to Gini (coefficient), the more evenly income is distributed, the closer the coefficient is to zero.

America's number, before government taxes and transfers, is 0.46. This is just at the Organization for Economic Cooperation average of 0.45. After taxes and transfers, it drops to 0.38, indicating the redistribution of wealth.

But that 0.38 is the highest of any first-world country, indicating the U.S. is the least redistributive. (Link)

The folks screaming "socialism" fall into one of several groups; there are those that have absolutely no idea what they're talking about and wouldn't recognize "socialism" if it came up and bit them on the nose.  Another group just incorrectly uses the term to describe any liberal program.  And, finally, there's the cynics who use this kind of hyperbole to make political points. 

Gulf oil spill FAR worse than estimated

Five thousand gallons of oil a day.  That's what's become the conventional wisdom of the amount of oil leaking into the Gulf of Mexico.  But experts, after reviewing underwater video of the gushing well, have suggested the leak could be "four or five times" that estimate.  And more troubling is what appears to be an unwillingness on BP's part to allow a more accurate measurement of the leak.

BP has repeatedly said that its highest priority is stopping the leak, not measuring it. “There’s just no way to measure it,” Kent Wells, a BP senior vice president, said in a recent briefing.

Yet for decades, specialists have used a technique that is almost tailor-made for the problem. ... Richard Camilli and Andy Bowen, of the Woods Hole Oceanographic Institution in Massachusetts, who have routinely made such measurements, spoke extensively to BP last week, Mr. Bowen said. They were poised to fly to the gulf to conduct volume measurements.

But they were contacted late in the week and told not to come, at around the time BP decided to lower a large metal container to try to capture the leak. That maneuver failed. They have not been invited again. (Link)

Steven Wereley, a professor of mechanical engineering at Purdue University, studied videotape of the leaking well using advanced analytical techniques and estimated the oil is flowing at fourteen times the official estimate.  70,000 barrels a day.  2.94 million gallons per day.  That's the equivalent of an Exxon Valdez spill every four days.  

Meanwhile, there are some fears that it will simply be impossible to shut down the gusher of oil, and that the spill will get worse until it's tapped dry. BP's chief executive has estimated "that the reservoir tapped by the out-of-control well holds at least 50 million barrels of oil." That's about 2 billion gallons -- making this disaster easily the worst ever. (Link)

It's really impossible for me to put this into some kind of perspective.  It's unfathomable.

GOP blocks increasing oil spill cleanup liability

There's currently a $75M cap on an oil company's liabilities in the event of an off shore drilling accident.  There's a bill now being debated in the Senate that raises that cap to $10 billion and when it came up for a unanimous consent vote today, Alaska Republican Senator Lisa Murkowski blocked it from proceeding. 

Ms. Murkowski claimed those damages would prove unbearable for "smaller" companies that wouldn't be able to get insurance and financing, driving them out of the market.  Sen. Robert Menendez, one of the bills sponsors, noted the "smaller" companies that Sen. Murkowski is so concerned about are $20B/year corporations themselves.  (Video here).

Menendez also raised the obvious question:  Who is going to be responsible for the balance of the cost for a clean-up if the cap is set too low? 

The details of the costs associated with the Exxon Valdez accident (curiously, in Sen. Murkowski's home state) might be helpful here:

The consequences for Exxon of its two-pronged disaster - the spill and its environmental consequences, alongside its disastrous communications - were enormous. The spill cost around $7B, including the clean up costs. $5B of this was made up of the largest punitive fines ever handed out to a company for corporate irresponsibility. (Link)

(It should also be noted that, in 1989, Exxon had limited liability and only those that had been physically touched by the leaked oil could sue for damages.  In 1990, Congress passed the Oil Pollution Act, which lifted that restriction and allowed anyone who was effected to seek damages.)

Just today, British Petroleum announced they've spent $450M so far to fight and contain the spill and some experts have predicted total cost will exceed $8B.

It seems pretty clear that a $75M cap on liability is ridiculously low.  Free market advocates like Sen. Murkowski surely agree that if a company, any company, wants to engage in a competitive marketplace, it has to adequately assess risk and benefit, be accountable for its actions, and not rely on the government to come in and bail it out when it screws up.

House Republicans give up responsibility for governing

This is stupid for sooooo many reasons:

House Republicans will launch a project Wednesday in which they will offer bills to eliminate spending programs that Americans vote online to cut. House GOP Whip Eric Cantor (Va.) will unveil the project, called "YouCut," which will combine Republicans' push for spending cuts with attempts toward online engagement.

People can vote online or through text message on a list of five proposals to reduce types of spending, on which House Republicans will then force a vote in the House the following week. 

"People will have the power and the ability to make Congress consider votes that will save people money with the click of a button or a simple text message," said Brad Dayspring, a spokesman for Cantor. (Link)

Oh gosh, just off the top of my head:

  -  I think the way it's supposed to work in a representative democracy is that voters elect lawmakers who are responsible to carefully study the issues and vote on behalf of their constituents.

  -  Look at California for evidence of how well it works when the citizenry votes directly, replacing their elected representatives, on budget and policy matters. 

  -  What happens when people select a cut that's untenable for the Republicans?  Do they vote to cut funding (unlikely) or ignore, in that case, the people's vote (way more likely)?

Lowest tax bills in 60 years

This is beginning to feel like a race to the bottom:

Amid complaints about high taxes and calls for a smaller government, Americans paid their lowest level of taxes last year since Harry Truman's presidency, a USA TODAY analysis of federal data found.

Federal, state and local taxes — including income, property, sales and other taxes — consumed 9.2% of all personal income in 2009, the lowest rate since 1950, the Bureau of Economic Analysis reports. That rate is far below the historic average of 12% for the last half-century. The overall tax burden hit bottom in December at 8.8.% of income before rising slightly in the first three months of 2010.

"The idea that taxes are high right now is pretty much nuts," says Michael Ettlinger, head of economic policy at the liberal Center for American Progress. The real problem is spending,counters Adam Brandon of FreedomWorks, which organizes Tea Party groups. "The money we borrow is going to be paid back through taxation in the future," he says.  (Link)

I don't like paying taxes.  I reckon no one does.  But this notion that either we're paying too much in taxes or, when pressed, conclude the solution to deficit spending is either to raise taxes on someone else (e.g., sin taxes) or cut whatever programs that don't effect us is crazily short sighted.

It's ironic that the ones that scream the most about the tax burden that we'll leave to our kids and grandchildren are the same ones that demand their taxes go ever lower.  So much for their own sense of sacrifice.