Archive for September 2009

Politics of Delay and Confuse versus Trust Me

September 30, 2009

As the Senate moves slowly towards a Health Care Reform bill, I am struck by the display of politics based upon “delay and confuse” versus “trust me”. In fact there is no basis for either position. Republicans are simply irresponsible and/or cruel to keep up their campaign to confuse Americans about what might happen and not to propose anything that could fix the current system. Democrats, on the other hand, cry out about the morality of fixing health care and are totally silent about the underlying problems inherent with the current system and especially Medicare.

What neither party is addressing is that the current health care system is too costly (by any standard) and going broke, and compared too all other modern industrialized countries does not deliver as good health care. This is the real problem.

It is also true that in other systems, like those of Canada, Germany, France, and Japan (to name a few), no one can be denied basic health care for any reason. So why are our politicians not focusing on “best in class”?

Polls have consistently shown a majority of Americans favor a single payer approach. Yet neither party is talking about it. Why? Medicare works well with respect to the ease Americans 65 and older find it to use. But Medicare is paying cents on the dollar for the health care services it covers and is still projected to go bust in the near future. Why?

At this point Americans are not being served well by either political party. The “reform” that is likely to be enacted will be to include more people which is noble but an illusion until the main problems are fixed. Like most things in America it will take a crisis, like when doctors and hospitals stop dispensing their services. We could do so much better if we simple used data.

Public Option Option?

September 29, 2009

The reports in today’s newspapers are that Maine Senator Olympia Snow’s proposal that the Health Care Reform bill contain “an option” that under certain conditions would call for the creation of a Medicare like public option. The “certain conditions” would refer to private insurers controlling yearly premium increases. Is this the basis for compromise?

On one hand, it seems elegant. More Senators could support the bill and still claim they did not vote for the public option (which is like saying I didn’t know the gun was loaded). On the other hand, it is almost certain to result in another Congressional fight when the option is triggered. But that’s politics.

Last week the New York Times released a poll they conducted with CBS which said that most people were confused about what was health care reform, were luke warm about President Obama and Democrats in their leadership, were dissatisfied with the Republican effort, and in a surprisingly straight forward question “do you favor a public options”, 65% said yes. Despite all the rhetoric, a majority plus of Americans think they are quite comfortable with Medicare-like coverage.

I am less comfortable with the public options (in competition with private insurance) because neither one addresses actual health care consumption and associated costs. A total switch to a “single payer” system, like Canada or Europe, could address health care and return it to a service like public water, not free, subject to reasonable annual rate increases, but available to everyone.  I guess I’ll have to wait for that.

Graham Says Stay

September 28, 2009

Senator Lindsay Graham, in an interview over the weekend, sternly advised President Obama that the US must not only stay in Afghanistan but must insure that the Taliban does not win. He told anyone who had been sleeping for the last 8 years that if US forces left Afghanistan, the Taliban would surely return to power. Graham said this with his most sincere and serious face.

The irony of this situation is that Senator Graham is correct and you are struck by the notion of where he has been for the last 8 years. Like almost all Republican “advice” for President Obama, there is plenty of help on what not to do but little insight on what to do. There is no amount of troops that can change the ultimate outcome until there is a stable and capable Afghan central government.  This is true now, and it has been true for the past 8 years.

President Obama hopefully will take his time in making any decision on troop strength and couple it with an exit strategy. The military can delay (even for a very long time) the outcome but they can not change what is inevitable.

The path forward in Afghanistan is not very clear and it would be much more helpful for Senator Graham to cease partisan politics and offer to be supportive of the President’s decision. For 8 years, Graham’s party ran the White House and the Department of Defense and presided over a slow rot of the Afghan central government. It is time for a comprehensive plan with bi-partisan support.

Where’s The Shame?

September 27, 2009

Obama Administration officials are saying that the deadline to close Guantanamo Detention Facility will not be met. The reason given was that there was not enough time to complete a careful review of each case. What do they think we are smoking?

Almost all the detainees have been in Guantanamo (or detention someplace) for over 5 years and many for 7 years. Do we not have a legal tradition of a “timely presentation of charges and subsequent trail”? Do we not have a tradition of enacting laws that apply to US citizens around the world? How then could any Justice Department allow individuals to be detained for 7 years and authorities not have an open and shut case to justify this detention?

The devastation of 9/11, for sure, caught the Bush Administration off guard. This Administration loved to wear its religious values on its sleeves and was understandably at a loss when a radical and religious group, citing authority from the great one in the sky (the same location of the Bush higher authority), could and would do so much damage. In an effort to eliminate this threat, and possibly to settle the score with the “higher authority” impostors, the Bush Administration encouraged the round up of as many radicals as they could find. Like so many other things the Bush people did, step one was accomplished without any idea what would be step two.

That is water over the damn so to speak. President Obama inherited Guantanamo and it is on his watch that it should be closed. There are undoubtably some very dysfunctional people there, and we are probably better off with them in detention. The only criteria should be a reason supported by evidence. No evidence, no detention. Other wise the shame will continue and the values of America’s past will be done a continuing disservice.

A Year Later

September 26, 2009

The current discussions swirling around whether the US should increase its Afghanistan military presence, stand pat, or reduce troop strength is in itself a refreshing example of good governance. It is an important strategic and foreign policy decision.

On one side of Afghanistan is Iran. They are experiencing internal difficulties within their ruling faction.   At the same time they are apparently moving forward to join the nuclear club. Iran could become an unstable, missile possessing, nuclear threat in the Middle East.  How would the US deal with that threat if it had 200,000 troops tied down in Afghanistan?

On the other side of Afghanistan is Pakistan. This large, relatively poor country is struggling with two external threats. India with its larger Army and nuclear weapons, and the presence of the ugly religious intolerance of Hinduism and Islam, put India and Pakistan on the knife edge poised for instant battle. Pakistan, however, must also contend with Taliban and other frontier tribes on its northwestern boarders who operate across the Afghan-Pakistan boarder. Pakistan has nuclear weapons and means to deliver them.  What would the US do if the Taliban somehow destabilized the Pakistan Government?

So you have to ask, “what is the reason, again, why the US is in Afghanistan and poised to commit so many troops”?

With the Bush Administration, there was little debate about our presence in Afghanistan. Vice President, Dick Cheney, decided we should be there and Presidential Advisor, Karl Rove added his support because the war provided excellent nation security spin for political purposes. With the Obama Administration, the nature of the Administration debate is different. Vice President Joe Biden is counseling against adding more troops. He is cautioning President Obama that more troops is about nation building and to do that you must have a partner in the Afghan Government. Biden’s concern is whether the Karzai Government is credible and strong enough to be that partner.

President Obama seems confident enough to not be hurried into a premature decision. He is wisely delaying any decision and instead domestically focusing on health care and the economy, and overseas through Secretary of State Hillary Clinton, building alliances and understanding among key foreign countries.

What a difference a year can make!


September 25, 2009

Yesterday I heard someone says with much disdain for unnamed others, that America was now going socialist.  Our Government had gone way over the line when it bailed out Wall Street and when it did the same for General Motors and Chrysler. With the public options staring at us (read socialized medicine), should there be any doubt that the Obama Administration and the Democratic Party are leading the Country to the dark side?

There is no doubt that the stimulus package, the outright cash infusions into banks, and the rescue steps for GM and Chrysler were actions where our Government used tax payer money to “fix” private industry and in doing so ended up with government ownership or at least an unusually large voice in corporate decisions. And that does sound a lot like socialism.

The implications (which overlook the emergency nature of these actions and that they are all intended to be temporary) are, of course, “this is what you get when you elected progressives, or even plain old Democrats”. The great fabric of American society is being torn and shredded. Oh, for the old days, when conservative ways ruled.

What was probably the most breath catching part of this conversation was the apparent flea’s size memory this person displayed. Collateralized debt obligations and credit default swaps, and unbounded salary and bonus demands were not the creation of any socialist system. The misuse of these “innovative” financial tools was also not the work of socialism. The amount of wealth destroyed when the markets crashed was not the result of socialism. These were all examples of capitalism in full bloom.

The timing of the 2008 Presidential election and coincident the collapse of Wall Street make it a mute point whether Republicans would have done pretty much what President Obama has done. It would seem to me clear that any responsible public official would do what they could to prevent a depression and restart the economy. But, that is commonsense. The rhetoric of the right today does not concern itself with facts or logic. It has an ideology to peddle and nothing is going to get in the way, especially facts or commonsense.

Public Option

September 24, 2009

A survey of the modern, industrialized world does not yield the “single payer” health care system as the only effective one. In Germany and France, for example, private insurance competes right along side of Government plans quite well. So what is the big deal being made here in the US?

To begin with in the rest of the modern world, health care is a right and not a “for profit” business. It follows from that basic assumption that “private” insurers are highly regulated and run as non-profits. Of course these companies make a profit but the amount is quite small. So let’s fast forward to the US.

The “public options” is so threatening here for one reason and one reason alone. Insurance companies and the shareholders who own them see the probability that their fat salaries and stock dividends and capital gains will disappear overnight. To these people this is wealth destruction.

In a way there is a touch of fairness to this concern. Why should this group of people suffer losses? Even when the President says that with free enterprise there should be competition, and there is no reason why private insurers could not compete.  There is a little tongue in cheek in that claim. While for sure private insurers could compete, but if they chose to compete by matching prices, their fat profits would disappear and so would the demand for their stock. Hence wealth destruction.

The so-called “public option” instead of a direct switch to “single payer” would allow a transition for private insurers. They could offer coverage above or different from some basic level (available to everyone) and possibly earn their desired profit levels. Not likely, however. Another approach might be for the Government (all of us) to buy out these private insurers, say at their capitalized value. (Each shareholder would receive the stock price at some designated day). The Government could then undertake an IPO and return the company to private investors as a “non-profit” insurer.

While this would undoubtably be costly, it would cut the Gordian Knot and get the country quickly to a reduced cost health care system.