Archive for June 2012

What Is Driving The Health Care Argument?

June 29, 2012

With the Supreme Court deciding that the Affordable Care Act was Constitution (mostly), one would think the raging political argument would be over.  The law won, let’s get on with life.  Wrong.

In speeches by both President Obama and GOP candidate Mitt Romney, exaggeration, if not outright miss truths filled their comments.  The President gave the ACA more credit than it has actually earned, and Romney criticized the law for reasons that don’t stand the test of “so what if it is true”?  Fact Check has an analysis.

Both Romney and Obama are using their party’s sound bites.  The President is trying to convince the 80% of insured Americans everything is ok (while asking the other 20% to vote for him), while Romney is trying to tell the same 80% that life as you know it is about to end (so vote for him).  No one is telling the 80% why helping the 20% uninsured is actually in their best interest.

The American health care delivery system rests upon employers, using tax incentives, to provide health care insurance to their employees.  Most of the 80%, think this is great and many see no need for change.  But what if?

What if employers decided it was better for them to not offer insurance?  Where would the newly uninsured workers go to find coverage?  What prices would they need to pay?

If ACA is repealed, the uninsured would be at the mercy of insurers.  Pre-existing condition?  Oh, you pay this large amount or in some cases, there is no insurance at all.

So let’s consider the rest of the GOP statement, “replace”.  Replace with what?

The GOP is all over ACA for the inclusion of about $500 billion in new taxes and fees.  Why?  The fees help to pay for the new services.  Does the GOP know how to increase health care coverage and sharply reduce its costs?  If so, this would be break through information.

Of course countries like Germany and France already offer health care with better outcomes than the US and at costs per capita about one half of the US.  Is that what Romney is thinking?

I remember his (and anyone else following the conservative talking points) say that Europe uses “socialized” medicine.  They say that is not good for us.  Hmmm.  Everyone insured, better outcomes, half the cost.  Hmmm.

Well if the GOP does not mean a European style health care system, what do they mean?

The “repeal” part I understand.  The “replace” part seems still vague.  Does it include all Americans?  Does it lower health care per capita costs?  Will Medicare remain the same without the $500 billion the ACA says will be saved over the next 10 years?

I will have to be patient, I guess.

What I suspect, in any case, is that the GOP and all the conservatives backing them, will aim to keep the 80% happy and simply forget about the 20%.  There is no way their math works if they attack the 20%.  In the future, maybe the 20% will grow to 40% or more.  If so, then it will be time to change the spin and adopt an ACA-like plan, maybe one more like Romney instituted in Massachusetts when he was Governor.

Hmmm.

Son Of ACA

June 28, 2012

I had a dream last night.  The dream was about the Affordable Care Act and healthcare in the US.  It actually was more like a nightmare.

The Affordable Care Act has brought America closer to the practices of all other humane, civilized, and modern Countries.  ACA has provided a route to near total coverage and outlawed discriminatory insurance company practices that denied coverage in favor of higher profits.  In later years it offers some hope for both better costs and better outcomes.

But ACA is flawed and needs to be replaced.

The Son of ACA of was not what made me toss and turn.  It is relatively easy to envision a better and fairer system.  My nightmare was what would the pending Supreme Court decision do?

For example, here’s the vision I dreamed.

Son of ACA ought free itself from any involvement by employers.  In this manner, healthcare coverage must be totally portable.

All Americans should be covered and none discriminated against due to age, sex, or previous medical condition.

Healthcare must be a national program.  It is inconceivable that someone living in Maine should be offered different care than someone in California just as residents of Berlin do not have different care than those living in Frankfurt.

The Son of ACA’s administration should fall to a professional, non-political agency.

The “basic healthcare” standard would be that which public sector workers receive.  That level of care would be assured to all Americans.  A second tier of coverage (privately offered) could be allowed in order to cover services not include in “basic coverage”.

America’s healthcare would be paid for by a combination of earned income (wages, salaries, rents, interest, dividends, capital gains, etc) taxes and a national sales tax.

In my dream, the Son of ACA would be about covering all residents with affordable healthcare.  Prevention would be emphasized and catastrophic illness could no longer bankrupt anyone.

Oh, wake up.  The Supreme Court has just ruled ACA constitutional.

That was the nightmare.   I wonder where the political will lies to make these changes?  Will Mitt Romney come forward and propose something even better that his Massachusetts “Romneycare”?

EJ Speaks

June 27, 2012

EJ Dionne spoke last evening at the Philadelphia Free Library… for free.  He is on a book tour and if your bought his new book, he would sign it for you.  His talk (mostly from notes) was marvelous.  If you have a chance to hear him, it will be well worth your while.

Let’s be clear, Dionne is an unabashed progressive.  He is also a learned man and someone who can articulate his points vividly.  He tosses in the right amount of humor and his medicine goes down a lot easier.

It is always more pleasant to listen to someone who tells you what you thought you were already thinking but tells you so clearly that it makes you say, “I thought so.”

For example, Dionne pointed out that Democrats have done a poor job explaining to voters what they have done since 2009 and why that was good.  Democrats have done a poor job of defending “government” as an institution, and have been totally silent on how they would make that government function even better.  In this vacuum it should not be hard to understand how the likes of the Koch brothers and Karl Rove can steal center stage.

Dionne suggest that anyone, who assumes that were government spending to be reduced, that private funded charity would step forward to fill the gap is simply dreaming.  Why would the wealthy who are quick to lay off workers or outsource jobs to foreign countries suddenly want to plow back money for America’s poor?

Left unanswered unfortunately are question like how does the country reduce the poor, how do we get control of healthcare costs, how do we repair the infrastructure, and how do we get more purchasing power into the middle class NOW THAT WE ARE PART OF A GLOBAL MARKET?

What Dionne does lead a rational lister to realize is there is no light at the end of the Tea Party/Conservative tunnel.  He is also sure that winning answers lie to the right of progressives’ liberal side, more towards the center.

Like all pundits, he offers no ideas on how to get the two sides (strong right and strong left) talking.  It is just good to know I am correct… I think.

 

Antonin Being Antonin, Or Has Time Passed Him By?

June 26, 2012

In the Supreme Court’s Arizona’s SB-1070 ruling, Antonin Scalia took the time to issue a 22 page dissent.  The Court’s majority opinion was a 5-3 majority with Elena Kagen sitting this one out.  The decision could have been 6-3.  So why dissent, and why 22 pages?

Some might say it is the sign of a well working court where a lot of legal research has gone into the rulings.  Others might say that Scalia enjoys center stage and even more so when he can pontificate his views.  Take your pick.

What it does say, however, is that at least one Justice views the world as if he were living in the 18th century.

Scalia’s dissent was sprinkled with clearly political references.  He derided the Obama Administration for its decision to selectively enforce the deportation of undocumented aliens.  Scalia called the Administrations efforts on enforcing immigration laws “lax”.  On this basis, Scalia says States should have the right to enforce these laws themselves.

The Constitution does establish protecting the boarders and setting immigration rules with the Federal Government.  Can you imagine New York allowing only 50 Canadians a year to enter the US while Vermont set no limits?

It has not registered that President Obama’s Administration has deported more undocumented aliens than previous Administrations.  The overall undocumented situation is estimated at about 11 million.  This cries out for a comprehensive solution.  Scalia thoughts on a comprehensive solution are unknown but his views (dare I say) are that Democrat Barack Obama has been lax.

Scalia could have said all this in 2 pages but 22 seems heftier.  One of his best examples of why he is no longer fit to sit on the highest court in the land is as follows:

So the issue is a stark one: Are the sovereign States at the mercy of the federal Executive’s refusal to enforce the Nation’s immigration laws?

A good way of answering that question is to ask: Would the States conceivably have entered into the Union if the Constitution itself contained the Court’s holding? 

Imagine a provision—perhaps inserted right after Art. I, §8, ci. 4, the Naturalization Clause— which included among the enumerated powers of Congress “To establish Limitations upon Immigration that will be exclusive and that will be enforced only to the extent the President deems appropriate.” The delegates to the Grand Convention would have rushed to the exits from Independence Hall. 

The ship the founding fathers sailed left the dock a long time ago.  The question is not whether the original 13 Colonies would or would not have formed a Union.  Had the 13 not formed a Union, what we call the US today, most probably, would have taken a different path.  The US geography would likely look more like Europe or South America with many States and separate currencies.  The great wealth created as America “manifest destiny” was achieved would be someplace else.

Like so many other Scalia favored decisions, most recently striking down gun laws and affirming that corporations are people, they flow from a different era and do not reflect the American history in between.

Immigrants have been the backbone of America.  Most of us are descendants of immigrants who came here within the last century.  Never the less, having 11 million undocumented aliens living within the boarders is patently a failure.  Clearly immigrants with skills are desirable and those who cannot or will not work are a burden.

We also have a history of assimilation so immigrant groups who do not want to learn English or wish to practice customs which are not compatible with existing US customs or laws present real difficulties.   This is not the subject for States individually to solve.  Rather it will require a comprehensive approach.

Ironically the one provision of the Arizona law that survived was the “show me your papers” provision.  There is little chance for this to survive in real time since any good lawyer will point out that only brown skinned people are being asked for proof of citizenship.  That is profiling.

The ironic part is that in order to control undocumented residents, every one of us must be subject to “show me your papers” and that means all of us carrying a national identify card.

I wonder whether the founding fathers and Scalia were thinking that way?

Running For Another Term

June 25, 2012

Summer has arrived and the national political stage is in intermission.  The audience is wondering what the next four years will bring should their favorite candidate win in November.  Here are my thoughts.

One thing we can count upon is that a President Romney will lead cautiously during 2013-2016.  His over riding goal will be to become a two term President.  Cautiously means no big decisions on anything.  And, “anything” means domestic issues such as health care, deficit reduction, defense spending, or any “Scott Walker-like” surprise actions.

Romney’s foreign policies are another question.  Foreign policy, especially as it relates to oil, is ready made for flexing America’s military muscle.  Romney may not intentionally go to war like “W”, but he will not lose a chance to increase military spending.  Defense spending is the surest form of corporate welfare America has.

I would like to think that Obama’s second term will be different from his first and be full of bold, superbly stated, progressive initiatives.  Health care reform as well as a serious attempt to trim government spending while increasing taxes should headline his 2013-2016 years.

Since he is unlikely to have control of Congress, he will not likely see much enacted.  As they say, the can will be just kicked further down the road.

So why not Romney?

What is most mind boggling about the Romney prospect, is that the Country is seriously thinking about returning a Republican to the Oval Office, so shortly after “W’s” disastrous 8 years.  Maybe Americans remember the employment climate (jobs) was reasonably strong during “W’s” years.  And Americans want more jobs.

Don’t Americans also remember “W” did use tax reductions to stimulate the economy with one hand, started two wars with the other, and then sat back.  When not mountain biking, “W” watched the deficit and debt climb, the housing bubble burst, and the American financial sector almost take down the global banking system. And in addition to two wasted wars, a broken US economy, and a torture tarnished US global reputation, “W” left a legacy through his Supreme Court appointees.

Those were the good old days.

Romney may not do anything disastrous like “W”.  You can, however, expect him to appoint more white, male, “Alito and Roberts-like” Justices to the Supreme Court.

Hmmm.

By the same token, I cannot see nor do I expect that President Obama will suddenly become a ball of fire if he gets term two.  In this regard, who gets elected seems irrelevant.

Almost irrelevant.  It’s not jobs, it’s the Supreme Court, stupid.

This Is The Week, Maybe

June 24, 2012

The Supreme Court’s term ends this week.  It happens often that in the last week in session, a lot of rulings are unveiled.  This year there is a biggie, Affordable Health Care.  The question, which way will the Court rule?

Based upon past experience and political leanings of at least 4 Justices, some part of the ACA will be struck down if not the whole Act.  The Court’s four plus swing voter Anthony Kennedy, seem to have viewed the US landscape as over crowded with debris from Federal power extending laws.  It is time, in their opinion, to cut back this “over reach” regardless of the issue or situation in play.  Citizens United shows the short sightedness of the Courts crusade as well as any recent decision.  Will the Health Care surrogate receive the same treatment?

US Health Care costs are the highest in the world.  US residents consume more health care related services than any other country on a per capita basis.  Yet not all Americans receive the same level of coverage (some are not insured), and the US health out comes are not the best (or even in the top ten).  So what will the Court’s wisdom focus upon?

It should be manifestly obvious that health care should be viewed as a national service.  Why should someone in Idaho receive better health care than someone in Texas?  Why should some in New York City receive no coverage while most all in Naples, Florida be covered?  How can the average US resident spend twice as much for health care than someone in Germany or France?

It is also true the Affordable Care Act is a flawed law. ACA does not attack costs enough.  Amazingly, however, ACA represents a huge step forward from what existed before.  A Country that touts itself as the land of freedom and opportunity, and is the richest in the world, cannot be proud of a second class health care delivery system.  The ACA misses the mark on offering health care at a globally competitive cost but it says clearly, everyone should have an affordable and dignified way to receive health care which as good as the next person receives.

The Court must respond to the lower court rulings and none of these rulings strike at the true failing of ACA (cost).  So, we may get a ruling that says the individual mandate is unconstitutional, or that the Federal Government cannot expand the Medicaid rolls at State expense, or that the entire 2000 page Act is invalid because one part was deemed unconstitutional.

What we are less likely to get is a scathing opinion (for or against) that says the ACA is putting lipstick on a pig.  The greatest country in the world should have a universal plan that at least ranks in the top five for cost and outcomes.  This Court is more interested in pontificating on measures that may have been the case 100 or 200 years ago.

From a flawed 21st century interpretation of “the right to bare arms” to “corporations are people”, this Court simply fails to recognize how much the world has evolved and how little this Court has.

 

Justice?

June 23, 2012

Yesterday two sensational court cases were concluded.  Jerry Sandusky and Monsignor William Lynn were found guilty.  One was guilty of doing the crime, and the other for covering one up.  In a somewhat unrelated event, Cardinal Timothy Dolan kicked off two weeks of protests by the US Catholic Church.  Is there a connection is these events?

The quick answer is no.

The longer answer is maybe.  Here’s why.

Sandusky was found guilty of 45 counts of child molestation.  Nine victims testified and while some may have been motivated by potential civil suits’ rewards, their testimony was riveting and sickening.  It remains to be seen whether there was a cover up, but it is clear that no one at Penn State or the local community seemed keen on following up on the first allegations years ago.

Lynn was found guilt of one count of child endangerment.  Lynn administratively passed on accused child abusers to other unsuspecting parishes. While Lynn was following orders, he could have in fact done more to prevent priest child abusers from finding new victims.  Lynn, himself, was not accused of any abuse but it was clear from the trial that no one around him in the church hierarchy cared about following up on the allegations.

Cardinal Dolan is leading his lemmings towards a cliff they do not see.  Dolan kicked off a two week protest against the Obama Administration’s inclusion of contraceptive coverage in health care plans.  Dolan says this is about “religious freedom”.  Said differently, Dolan’s religious freedom can trump the freedom of others to receive birth control methods as part of their health care coverage.  Consider, for instance, the staff members of Notre Dame’s $70 million per year football program would be denied birth control coverage that, for example, Penn States $70+ million per year coaching staff would receive.

Sandusky’s conviction exposes the convenient and loyal life around big time football.  Penn State and local residents saw no evil, heard no evil, and said no evil.  Monsignor Lynn’s conviction sends a lightning bolt message to senior leaders in the Catholic Church as well as all sorts of other institutions, “the laws apply to you too”.

Dolan, other senior leaders of the US Catholic Church, and their superiors in Rome are leading their institution down an ethically indefensible path and one that is not compatible with secular laws (or common practices).  It is one thing to say our churches and monasteries should be exempt, it is quite another to say what ever is owned (affiliated with) by the Catholic Church is above secular law.  Football is important but not that important.

If the Cardinal had his way, then both Sandusky and Lynn could have been excused for their crimes if it was more convenient for the Cardinal and safer for his Church.