Rants of Rob

Progressive Politics and Culture

Archive for August, 2009

How We Lost The Public Option

Aug 18

Posted by Rob Field in Culture, Florida, Politics | 2 Comments

Secretary Sebelius on Sunday claimed that the public health insurance option is “not an essential element” of health care reform. President Obama said at a town hall on Saturday that the public option was just “one sliver” of reform. This could hardly be more wrong. A universally accessible public option would give low-income people too rich for Medicaid access to meaningful health insurance and is the only way to approach universal access to insurance without a mandate or single-payer.

The wave of chronic conditions America faces over the rest of the century demand early detection and intervention to control the costs and misery that they produce. Gaps and lapses in coverage will make those diseases more expensive for those patients and the rest of us. Preventing those gaps in coverage will require serving the low-income patients currently ill-served by the current mix of overstretched public programs and private high-deductible plans and still bend the cost curve down. That will require a plan that can deliver overhead in the 3-6% range. Only a public plan can do that.

The best solution would have been to put the entire population on a very low overhead plan. This was HR 676, Medicare for Everybody, Single-Payer. It never had a chance. Both Houses “placed it off the table” before negotiations began. The reasons for that decision are irrelevant, its consequences are all too clear. Moderate Democrats now pronounce the barely adequate public option DOA in the Senate. Without single-payer to draw fire, the opposition can focus on defeating the public plan option, If they had focused their energy on the socialism (i.e., public policy with which conservatives disagree) of single-payer health care, we could respond with the massive market reform of retaining the entire private health insurance with a single public program with subsidies for those who earn up to 4 times the localized poverty rate. Conservatives would hail this as a leg-up to the middle class, rather than welfare. We would have gotten the public plan we wanted, with ribbons affixed. They would hail their great market-driven defeat of the evil socialism of the hated liberals and declare it a great victory,

Instead we took the bogeyman away before the game started, leaving the public option as the target of the antis. We did so hoping to make them pros. This was possibly the most naive moment in contemporary American politics. The antis are anti not because of the actuarial tables or because Ludwig Von Mises hated regulation, but because we’re not them. We can’t be trusted to worship at the alter of God, CEO, therefore we are the enemy of all that is fine and good.

President Obama and Congressional leadership egregiously underestimated the irrational sectarian motivations of their opponents and chose to try to accomodate them, which merely served to slide the agenda rightward while buying nothing we couldn’t already take were we willing to ignore those we beat in November, as they have done to us and will again.

Thus are 22,000 Americans a year sacrificed to the demon of “Dear God, don’t let us be seen being Democrats.” God Bless America.

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The Bottom Line On Health Care Reform

Aug 8

Posted by Rob Field in Politics | No Comments

Before we can start talking meaningfully about health care reform, we have to understand the nature of the problem.

The biggest national problem is the entitlement gap. Over the next seventy-five years, we have a shortfall in our entitlement programs of about 50 trillion dollars, give or take ten trillion. Most of that gap is in Medicare and Medicaid. The gap is based on extrapolating current trends in health care expenditures, but current trends are not sustainable. Diabetes, obesity, and heart disease are increasing at a frightening rate, and we are not detecting these diseases early, when they can be prevented or treated more cheaply. The problem is particularly bad at lower income levels, where people away away from doctors until conditions become obviously life-threatening. Treatment is then sought at emergency rooms, where it is most expensive.  There should be no deductibles or co-pays, therefore, for routine, diagnostic, and preventive care. That’s the only way we can control the spiraling cost of treating chronic disease.

The same logic demands that coverage be universal and life-long. Portability must be automatic. Gaps in coverage will result in billions of dollars for unnecessary treatment for chronic disease. A child born today has a ONE IN THREE chance of developing Diabetes during their life. If that doesn’t wake you up, I don’t know what will. Cutting into those numbers will reverse the rising cost trend more effectively than any other measure.

The fastest-growing component of costs is in pharmaceuticals. We need to close the “no negotiations” loophole in Medicare Part D. If we are the industry’s largest customer, they will negotiate with us or face cuts in pharmaceutical spending. It’s not the taxpayer’s job to put money in the pockets of Big Pharma shareholders. We’re paying the highest drug prices in the world and it is time we stopped.

We also need to stop pretending there is some artificial dividing line between agricultural policy and health care. We are subsidizing the production of astronomical quantities of refined carbohydrates that are converted directly to glucose in the blood-stream, overwhelming the body’s capacity to absorb them. This is why obesity and diabetes are out of control. We evolved in an environment where fats and sugars were rare. Our bodies are optimized to process them as efficiently as possible. When placed in an environment where fats and sugars are the most plentiful foods, that efficiency kills us. The dietary habits of humans are very sensitive to considerations like convenience and cost. Artificially subsidized fats and sugars are helping to make us sick.

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Seventh District Candidates’ Forum

Aug 5

Posted by Rob Field in Florida, Politics | 4 Comments

Tonight, in Daytona Beach, the three Democratic candidates for Congress in Florida’s Seventh District spoke to a handful of Progressive Democrats. Well, two of them did.

Stephen Bacon entered the venue seemingly confused by the existence of other candidates for the nomination and it went downhill from there. Before the candidates were scheduled to speak, he was trying to speak over the PDA organizer who was running the meeting. He was asked to yield the floor and advised that he would have a chance to address the meeting along with the other candidates. Instead of ceding the point, he chose to argue. When the organizer’s father confronted him for his rudeness, he chose to leave. “Bacon fried himself tonight,” said Lisa Walker, Beaven’s campaign manager.

First to speak was Heather Beaven, the Palm Coast education activist. She spoke for five minutes, covering her biography and making the case that her bio gave her a better grasp of the issues than the out-of-touch Washington crowd. She fielded questions about single-payer health care (she’s for it) and tax policy (she has no litmus test for tax reform, but she’s pro-unfunded-mandate reform and concerned that PAYGO could be abused by conservatives) She was coherent and concise.

Next to speak was Faye Armitage, the 2008 nominee for the Seventh District seat. Her message was more fragmented, blending a laundry list of policies with a half-formed argument that her background as an economist presented an alternative to the out-of-touch Washington crowd. (See a pattern?) Still, this was a clear improvement over her performances in the 2008 cycle, and her more Progressive issue positions were a better fit for the room than the somewhat more centrist Mrs. Beaven.

The room was well to the left of the majority of Primary voters, however, and the evening did nothing to reverse my impression that Beaven is the more likely choice to beat John Mica in 2010.

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