What Do I Know?

A Modest Proposal Regarding Those Who Voted No

While I was sleeping, a health care reform bill passed the House. That's nice. Now if it passes the Senate and becomes law, about a million people a year who would otherwise declare bankruptcy when faced with mounting bills for medicine and other medical expenses probably won't have to. And around 40,000 people a year will get to keep on living instead of dying from a preventable illness or medical complication.

It's hard to believe, but 215 Representatives, mostly Republicans, voted against the measure.

I have a modest proposal: Each of those no-voting Representatives should have to attend the funerals of those who die for lack of health care. Since the new proposals won't take effect for a while, there are still certain to be a few thousand who will die this year alone before the legislation is enacted.

And before the Senate even has time to vote, thousands of families who won't get a chance to purchase affordable insurance on the new exchanges will have to declare bankruptcy when faced with the cost of medical treatment. I propose that the dissenting Representatives have to explain to their creditors why they didn't vote for legislation that would have prevented this from happening in the future.

And then all 215 should be striped of their own health insurance, so that one day they will have to face the choice of paying their mortgage or paying for a daughter's operation.

And finally, I propose that those Representatives who voted against providing health care for all Americans be excommunicated from their church congregations.

Because Jesus dies just a little inside every time someone votes to deny one of His loved ones health care.

Bobby Jindal Endorses Dem Health Care Plan

Very few Republicans have signed on to the Democratic health care reform bills that have passed through the committees in Congress, and those who have are either not currently in office (Bill Frist, Bob Dole) or are not in a position to run for president: Arnold Schwarzenegger. In other words, they have no partisan ax to grind and are willing to simply speak out for what's right, not what's politically expedient.

But now Bobby Jindal, the young governor of my home state of Louisiana and a possible contender for president in the future, has penned an editorial in the Washington Post that endorses the Democrats' health care reform plan. That's right, Jindal is on board with Obamacare.

Before Jindal's people call my people to protest, let me say he didn't exactly use the words "I endorse the Democrats' bills." But that's essentially what his editorial does, in calling for ten basic health care reforms. Nine—count 'em, nine—are already in the bills in one form or another, in fact, in at least one case, Jindal's prescription goes even further than what's in the bills. The tenth, tort reform, doesn't exactly belong in such a bill, nor does anyone who's looked at the matter seriously believe malpractice reform would lower costs, but regardless, President Obama has already said—on the very floor of the House and Senate—that he would be willing to add tort reform to the mix if that's what Republicans want.

One of Jindal's prescriptions deserves special mention. It's the one nearest and dearest to my own heart, since I have two daughters: The part about covering young adults on their parent's insurance plans when they graduate from college. (Currently they're kicked off their parent's plan, even if they can't find work or decide to go to grad school. This happened to my oldest, who was without insurance for over a year while she subbed in high school, and will soon happen to my youngest.) And yes, it's in the Democrats' plan, always has been.

Here's Ezra with more, and also the background on Jindal, who used to serve as President Bush's assistant secretary of Health and Human Services.

So why aren't Republicans in Congress lining up to endorse what one of the bright young leaders of their party thinks is a pretty nifty idea? Could it be that they don't really want any health care reform at all? Could it be that, like in 1994, when Clinton's failure to pass a health care plan doomed the Democrats to lose their majorities in Congress, Republican congress critters would prefer nothing at all to pass?

The answer is yes.

I suggest you ring your Republican congressperson and ask him or her why she or he isn't planning to vote for a plan that even Bobby Jindal is willing to endorse. And maybe, if Louisiana Senator David Vitter is in between sex scandals, Governor Jindal could give him a ring and tell him all about how swell Obamacare is.

Shocking News on Health Care Reform!

That's right, this deserves the scary headline. No one else has reported this, and believe me, I've looked.

Did you know that the INSURANCE COMPANIES are IN FAVOR of health care reform? And what's more, they endorsed or even WROTE much of what's in the current bills in Congress!

Okay, my pinkie's getting tired; no more scary all-caps. But isn't it shocking to find out that those death panel and evil rationing stories you're hearing from the far right are about a bill that the insurance industry wants to see happen?

Don't believe me? Watch this C-SPAN interview with Karen Ignagni, head of the health insurance trade association, AHIP. It will air tomorrow (Sunday) at 10 a.m. and 6 p.m. ET.

Here's the deal: Insurance companies are tired of being the meanies, and denying coverage to people with pre-existing conditions and denying expensive treatments to folks who need them. They know deep inside things have got to change. But they can't do it on their own. They need government to step in and force some regulations on them. In exchange, they get something they want: Universality. That's right, insurance companies want to see 100% of the population covered. Because that's the only way they can afford to make some of the concessions they realize they will have to make.

How? Because a significant proportion of those uninsured are young and healthy. Insurance companies need their premiums, as much as those uninsured people need to be covered, in case something bad happens. It's sort of a win-win proposition. (For a more complicated explanation of how universality is tied to insurance regulation and cost control, read Uwe Reinhardt on the "three-legged stool" of health care reform.)

And what about the soaring costs in health care? The insurance companies also want to see something done about that. Their current business model is unsustainable. As costs rise, employers drop coverage for their employees. This forces insurance companies to become even more mean, and figure out how to deny payment for treatment while at the same time raising premiums.

Now, I don't for a minute think insurance companies lie awake at night, worried about their mortal souls in the afterlife or even their reputations. They're purely motivated by profit, which is what their shareholders expect. So the fact that they're in favor of most of what's being proposed isn't shocking—there's a lot of good stuff in there for insurance companies, including the regulations that are being proposed. After all, these regulations will apply to all, equally. If AETNA isn't allowed to cancel your insurance when you get sick, neither is Blue Cross. And they get their greedy little paws on a whole new chunk of uninsured, who'll be mandated to participate so they don't free load on the system once they get sick.

This isn't speculation on the insurance companies' part, either. A lot of this has actually been done already—in Massachusetts, where they've achieved near universal health care coverage, and in the process, learned a lot of valuable lessons about how it can be achieved. (In the interview, Ignagni goes on at some length about the lessons learned in Massachusetts. You have watched it, right?)

So why are the right wing mobs so angry? One reason may be that part of the plan the insurance companies don't like—the so-called public option. The public option is included in the House bills, but will not likely be in the Senate version. By the time the bill goes to committee, something's got to give. Likely the public option will be severely watered down, or won't exist at all. That's a shame, because it's going to be very difficult to control costs if the public option isn't there. And liberals like me are very much in favor of controlling costs, so that resources can be spent on more important things, like early childhood education. 

But I don't think it's the idea of a public option that's got right wing mobs so riled up. I think it's the disinformation coming from people like Sarah Palin and other Republicans, who should know better. But they've decided to put partisan interests in front of the truth. They're even putting partisan interests in front of the business community, including small business owners who stand to benefit from this bill. (They'll be able to offer their employees the same low-cost insurance plans that currently are only available to large employers, through the insurance exchange.)

If this bill passes, the only losers will be Republican politicians. So they have to scare people about what the bill actually contains. They won't vote for it, or defend any parts of it, even though they've contributed much of the language in the bills. (You won't hear them admit that, either, but watch C-Span.)

I know this sounds odd coming from a liberal who's longed railed against all-powerful insurance companies, but if you really want to do your insurance company a favor, you'll phone your Congressperson and ask them to vote for the health care reform bill. It'll make Karen Ignagni happy, and it just might help a lot of Americans who currently don't have health insurance—and that could very well be you if insurance reform doesn't pass.

Karl Marx, Soylent Green, and Middle Class Suicide

"Karl Marx once said that history always repeats itself, first as tragedy, then as farce; and it's true, the US Congressional Democratic Party, as if they were understudies at a community college summerstock production of "How not to run a country", has slipped into the role of its predecessors in the 1993-94 Congress, the institution which morphed into a giant tub of writhing Jello rather than vote on then first lady Hillary Clinton's healthcare initiative."

That's Julian Delasantellis writing in Asia Times, explaining the American health care system to, I guess, Asians who watch a lot of films.

He begins at the beginning, explaining how Roosevelt's attempt to include government funded health care in the New Deal failed, but with wage and price controls, employers learned to offer relatively cheap health insurance to workers instead of higher wages. It worked, for a while, until health insurance was no longer cheap and American factories were no longer operating as monopolies in a playing field destroyed by WWII. It no longer made sense for employers to offer generous health insurance packages to any but their most valuable employees, and consequently, we now have 47 million without insurance—many of them middle class workers.

To borrow an analogy, it's as if someone were shooting a movie, called How Not To Devise a Health Care System, but the really scary part is its sequel: It's called Soylent Green.

"Another future-as-hell epic, Richard Fleischer's 1973 Soylent Green, has New York City police detective Robert Thorn (Charlton Heston) investigating the source of a mysterious new food product, Soylent Green, designed to feed an overpopulated and starving world . He is none to happy to find out the truth.

"It's people. Soylent Green is made out of people. They're making our food out of people! Next thing they'll be breeding us like cattle for food. Soylent Green is people!"

Well, the American middle class is at present being voluntarily consumed so the rich can have their healthcare. Still, a great many of them oppose any Obama health plan; it's not easy to warn somebody that they're about to be eaten alive when you find them waiting patiently under the ketchup nozzle."

Read the whole thing. It's long, but worth it. It describes how the middle class, which for so long has been the prop upon which the American health care system rests, can no longer continue to do so when health care costs are rising faster than the rate of their productivity. Something's got to give, and what gives is the middle class worker, who loses their health care so that others may keep theirs.

Yet, like certain characters from certain fictional movies, they go along with it.

That's where the farce comes in—note that this article was written before the whole notion of "death panels" was invented by a certain former Alaskan governor. Can you spell "prescient?"

Who needs death panels when you have Soylent Green? And ketchup.

Crackers, Train Wrecks, and Sarah Palin

I admit, I haven't been paying too much attention to the Palin train wreck up in Alaska...even when I'm not busy I have better things to do than focus on John McCain's trophy running mate. But like any train wreck, the wreckage invites speculation and analysis.

But not from me. I, like I said, have better things to do. Fortunately there are Republicans like Mike Murphy, who thoughtfully tweeted "It's clear the gubernatorial CHEESE has slid off the CRACKER" in response to Palin's disjointed and exclamation-heavy speech, posted online by her office. You'd think someone would have cleaned it up first, but I suppose the idea of editing is the first to fly out the window during train wrecks. *((Gotta put First Things First))* (For moments when exclamations fail you, there are always double parentheses, with a dab of asterisks for emphasis.)

Democrats, like frequent travelers who knew that stretch of track was weak, can only gape, stunned by the sight despite their foreknowledge. But Republicans provide the most interesting commentary. Mike Murphy calls her "the political train wreck that keeps on giving" in an article he originally titled "Sarah Palin and the Madness of Crowds." Ross Douthat seems to think if she'd only said no when McCain came calling, we'd never have noticed her resemblance to Tina Fey, and she'd still have a promising career. Andrew Sullivan, never a Palin fan, thinks she'd be voted off a reality show in the first round. More importantly, though, he wants to see the Republican party reformed. He wants to fix the track that caused the train wreck.

This is where I come in. I do think there's something fundamentally wrong with the party, and not just with a lone Alaskan governor. The Senate is full of wacky Republicans who can't keep their pants on and vote at the same time. Senators like James Inhofe, who thinks sci-fi author Michael Crichton is (was) a credible climate scientist, and John Ensign, who thought if his parents made eight separate $12,000 payoffs to his mistress and her family no one would find out.

Nobel prize winner in economics Paul Krugman once called the Republican party the "party of stupid." And that was before they nominated Sarah Palin, who fancies herself a foreign policy expert because she can see Russia from her front porch, as their vice presidential candidate. (No doubt he's appalled by the Republican governors who reject Economics 101 along with stimulus funds.) The Economist echoes Krugman, claiming the GOP has lost "the battle for brains" at the same time America is becoming smarter.

It's no wonder only 6% of scientists consider themselves Republicans. Unfortunately, 23% of the general public still does. Unless the party takes the advice of its wise men, like Mike Murphy, I suspect that number too will drop.

It was a Grand Old Party while it lasted, wasn't it?

Misplaced Loyalties

Recent polls have shown that the American public supports the so-called "public plan" whereby the government provides health insurance along with private insurers. But when polled on whether they support a public plan if it means it would drive many private health insurers out of business, support drops to 37%.

What I can't figure out is why Americans are so loyal to the very same insurance companies who'd drop them like a hot potato if they ended up very sick.

Silly Americans. Blue Cross just isn't that into you.

Some Pie With That Tea?

I'm trying really hard to put myself in their place. If Bush were president, and he ran up a huge deficit and raised cut my taxes, would I be mad enough to go to a demonstration called a "tea party" and toss away perfectly good tea in a protest derivative of the Boston Tea Party...okay, there's no if. Bush really did run up a huge deficit, squandering the budget surplus Clinton left him with. And he didn't cut my taxes, but he did cut taxes for the very wealthy and those who earn capital gains.

But I still didn't protest, at least not until he started that stupid war.

So, in my view, starting a stupid war where thousands die needlessly is a reason to protest. Raising taxes on the very wealthy, while cutting taxes on the middle class, is not. Spending billions to boost the economy and put people back to work is not a reason to protest, but spending trillions in Iraq building bridges and ill-will is.

This is making my head spin. Try as hard as I might, I can't understand the reasoning behind those protests yesterday. Except to blame it on partisan, Fox-induced rabble raising, with a touch of sore-loser thrown in. Is this what the next eight years are going to be like? It's sort of like watching a two-year old have a  tantrum; at first it's funny but then it gets really annoying.

For some sanity, you can read Robert Reich, who I turn to those times when I desperately need irony laced with good old-fashioned expertise.

And if you prefer a pie chart, here's a nice looking one that separates the cherries from the chaff:

Yes We Can: Perform Stem Cell Research

Today, with the Executive Order I am about to sign, we will bring the change that so many scientists and researchers; doctors and innovators; patients and loved ones have hoped for, and fought for, these past eight years: we will lift the ban on federal funding for promising embryonic stem cell research.  We will vigorously support scientists who pursue this research.  And we will aim for America to lead the world in the discoveries it one day may yield.

That's my president, Barack Obama, in remarks he made while signing the executive order reversing George Bush's wrongheaded decision, made shortly before 9/11/01, to prohibit federally funded stem cell research.

I'm one of those loved ones he talks about: my mom, and now my aunt, suffered from Huntington's Disease, one in a long list of diseases that may one day be cured by stem cell therapy. When there was an opportunity to replace George Bush with a better, more stem cell research-friendly, president, I dropped everything and fought for that to happen. But of course it didn't, and stem cell research was delayed another four years.

Advances have been made since then, not just in embryonic stem cells but in all stem cell research across the globe, where scientists weren't inhibited from performing research using discarded and soon-to-be-destroyed embryos. But there's no doubt that the ban restricted advancement in the research, as American universities and research facilities struggled to separate their facilities that received federal funding in a way that complied with the ban.

One day there will be a cure for Huntington's Disease and all the other diseases for which currently there is no cure. It may or may not come about through stem cell research, but at least it won't have been prevented by political ideology.

One other thing my president said today:

It is about letting scientists like those here today do their jobs, free from manipulation or coercion, and listening to what they tell us, even when it's inconvenient – especially when it's inconvenient. It is about ensuring that scientific data is never distorted or concealed to serve a political agenda – and that we make scientific decisions based on facts, not ideology.

This too is excellent news. It makes all that hard work worth it...a fact that my president recognized when he read a quote that hung in the exercise room of Christopher Reeve, a tireless advocate for stem cell research (and my mom's neurologist's brother):

“For everyone who thought I couldn't do it. For everyone who thought I shouldn't do it. For everyone who said, ‘It's impossible.' See you at the finish line.”

Oh, yes we can.

An Idiot Tax

So not only does Louisiana have an idiot for a governor, but somewhere in Lafayette there's an idiot lawyer running around saying things like this:

A 63-year-old attorney based in Lafayette, La., who asked not to be named, told ABCNews.com that she plans to cut back on her business to get her annual income under the quarter million mark should the Obama tax plan be passed by Congress and become law.  ...

"We are going to try to figure out how to make our income $249,999.00," she said.

"We have to find a way out where we can make just what we need to just under the line so we can benefit from Obama's tax plan," she added. "Why kill yourself working if you're going to give it all away to people who aren't working as hard?"

The attorney says that in order to decrease her income she'll have to let go of clients, some of whom she's been counseling for more than a decade.

"This means I'll have to tell some of my clients we can't help them and being more selective in general about who we help," she said. "I hate to do it."

Apparently LSU law school doesn't teach how tax rates work. Jonathan Chait does a pretty good job mocking the ignorance of wealthy taxpayers and then does it again for good measure, so I won't pile on.

Although, since they don't know the difference anyway, why don't we just tax them at the old rate of 70% and eliminate their deductions. Obviously they've never received a copy of the tax code in Louisiana, so they haven't heard of the Idiot Tax. Oh wait...I wasn't going to pile on. Nevermind.

A Tale of Two Speeches

This morning I checked last night's news online, and clicked on this clip posted at TPM, of Senator Lindsey Graham getting "theatrical" on the Senate floor.

Then I immediately went over to Politico, and watched this clip, of President Obama speaking to the Democratic caucus, reminding them of why he—and they—were elected.

Now, that's theatrical...and it's also great. We need more fired-up-ness, more heat, and less whining about this program or that.

We also need some economics lessons for lawmakers, starting with the above-mentioned Lindsey Graham. If you want to stimulate the economy and create jobs, the government has to spend money, on projects like roads and schools and health care and research. As the business columnist for the Washington Post writes, employing economists to explain economics to Republican lawmakers would be a great way to spend some of the stimulus.

A few speechwriters wouldn't hurt either.