Friday, March 12, 2010

Health Reform Myths by Paul Krugman

humble says:

I don’t very often say anything of a political nature, but I’m going to do so now. I’m going to give you my definition of a democrat. A democrat is a nice guy who works hard to put a nice guy in office. And when the democrat’s candidate wins, he complains that the man he elected doesn’t have the chutzpah of a republican.

The humble Farmer

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Health Reform Myths

By PAUL KRUGMAN

Published: March 11, 2010

Health reform is back from the dead. Many Democrats have realized that their electoral prospects will be better if they can point to a real accomplishment. Polling on reform — which was never as negative as portrayed — shows signs of improving. And I’ve been really impressed by the passion and energy of this guy Barack Obama. Where was he last year?

But reform still has to run a gantlet of misinformation and outright lies. So let me address three big myths about the proposed reform, myths that are believed by many people who consider themselves well-informed, but who have actually fallen for deceptive spin.

The first of these myths, which has been all over the airwaves lately, is the claim that President Obama is proposing a government takeover of one-sixth of the economy, the share of G.D.P. currently spent on health.

Well, if having the government regulate and subsidize health insurance is a “takeover,” that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.

The only part of health care in which there isn’t already a lot of federal intervention is the market in which individuals who can’t get employment-based coverage buy their own insurance. And that market, in case you hadn’t noticed, is a disaster — no coverage for people with pre-existing medical conditions, coverage dropped when you get sick, and huge premium increases in the middle of an economic crisis. It’s this sector, plus the plight of Americans with no insurance at all, that reform aims to fix. What’s wrong with that?

The second myth is that the proposed reform does nothing to control costs. To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.

Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.

And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first.

Furthermore, there’s good reason to believe that all such estimates are too pessimistic. There are many cost-saving efforts in the proposed reform, but nobody knows how well any one of these efforts will work. And as a result, official estimates don’t give the plan much credit for any of them. What the actuary and the budget office do is a bit like looking at an oil company’s prospecting efforts, concluding that any individual test hole it drills will probably come up dry, and predicting as a consequence that the company won’t find any oil at all — when the odds are, in fact, that some of the test holes will pan out, and produce big payoffs. Realistically, health reform is likely to do much better at controlling costs than any of the official projections suggest.

Which brings me to the third myth: that health reform is fiscally irresponsible. How can people say this given Congressional Budget Office predictions — which, as I’ve already argued, are probably too pessimistic — that reform would actually reduce the deficit? Critics argue that we should ignore what’s actually in the legislation; when cost control actually starts to bite on Medicare, they insist, Congress will back down.

But this isn’t an argument against Obamacare, it’s a declaration that we can’t control Medicare costs no matter what. And it also flies in the face of history: contrary to legend, past efforts to limit Medicare spending have in fact “stuck,” rather than being withdrawn in the face of political pressure.

So what’s the reality of the proposed reform? Compared with the Platonic ideal of reform, Obamacare comes up short. If the votes were there, I would much prefer to see Medicare for all.

For a real piece of passable legislation, however, it looks very good. It wouldn’t transform our health care system; in fact, Americans whose jobs come with health coverage would see little effect. But it would make a huge difference to the less fortunate among us, even as it would do more to control costs than anything we’ve done before.

This is a reasonable, responsible plan. Don’t let anyone tell you otherwise.

Tuesday, March 9, 2010

The United States Is At War

The Anti-Empire Report

March 8th, 2010

by William Blum

www.killinghope.org

Informed consent

About half the states in the US require that a woman seeking an abortion be told certain things before she can obtain the medical procedure. In South Dakota, for example, until a few months ago, staff was required to tell women: "The abortion will terminate the life of a whole, separate, unique, living human being"; the pregnant woman has "an existing relationship with that unborn human being," a relationship protected by the U.S. Constitution and the laws of South Dakota; and a "known medical risk" of abortion is an "increased risk of suicide ideation and suicide." A federal judge has now eliminated the second and third required assertions, calling them "untruthful and misleading."

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I personally would question even the first assertion about a fetus or an embryo being a human being, but that's not the point I wish to make here. I'd like to suggest that before a young American man or woman can enlist in the armed forces s/he must be told the following by the staff of the military recruitment office:

"The United States is at war [this statement is always factually correct]. You will likely be sent to a battlefield where you will be expected to do your best to terminate the lives of whole, separate, unique, living human beings you know nothing about and who have never done you or your country any harm. You may in the process lose an arm or a leg. Or your life. If you come home alive and with all your body parts intact there's a good chance you will be suffering from post-traumatic stress disorder. Do not expect the government to provide you particularly good care for that, or any care at all. In any case, you may wind up physically abusing your spouse and children and/or others, killing various individuals, abusing drugs and/or alcohol, and having an increased risk of suicide ideation and suicide. No matter how bad a condition you may be in, the Pentagon may send you back to the battlefield for another tour of duty. They call this 'stop-loss'. Your only alternative may be to go AWOL. Do you have any friends in Canada? And don't ever ask any of your officers what we're fighting for. Even the generals don't know. In fact, the generals especially don't know. They would never have reached their high position if they had been able to go beyond the propaganda we're all fed, the same propaganda that has influenced you to come to this office."

Since for so many young people in recent years one of the determining factors in their enlistment has been the economy, this additional thought should be pointed out to them — "You are enlisting to fight, and perhaps die, for a country that can't even provide you with a decent job, or any job at all."

"I fear for us all, but I especially fear for those already poor. How much lower can they go without being cannon fodder or electric chair fodder or street litter or prison stuffing or just plain lonely suicide?"

– Carolyn Chute, novelist, Maine USA

Monday, March 8, 2010

Capitalism: A Love Story

In his film Capitalism: A Love Story, Michael Moore squares off with the free-market system for its role in leveraging the United States's wealth into the hands of a few.

But in one clip cut from the documentary -- which Moore provided exclusively to RAW STORY -- he interviews Pulitzer Prize-winning New York Times reporter Chris Hedges, who explains how capitalism is actually contributing to the very downfall of the human race and the "degradation of the planet."

"All sorts of people who have spent their lives studying climate change, from Bill McKibben on down, have warned us that we don't have a lot of time left," Hedges said. "So it's not just that capitalism has destroyed our economic system and hijacked our political system, but it literally is extinguishing the system that sustains life. If that's not thwarted soon...then we will begin to see massive dislocations, environmental refugees, further depleting of natural resources. Overpopulation is also an issue. The UN estimates that by 2050 the size of the planet will double."

The very concept of capitalism, Moore declares in the film, is the problem because it inevitably leads to a system where the richest few control the means of production as well as the levers of power -- leading to a "plutonomy," a term used in a leaked Citigroup memo from 2005, in which the finance juggernaut concluded that the United States is no longer a democracy.

In the interview, Hedges decries America's turn toward supply-side economics over the last three decades as the cause of stagnating middle class incomes, contrasting it with the increasingly lavish fortunes of the wealthy and the aid they often receive from the government at the expense of working people

A Green Governor For Maine

David Bright writes:

This weekend Jean and I spent a lot of time in Hancock County looking for members of the Maine Green Party to sign nomination papers for Lynne Williams.


At one point we ended up driving down this long dirt driveway to a small rural home where we were greeted by a couple of enthusiastic canines and their person, who wanted to know (the person, not the dogs) all about Lynne -- who she was, where she was from, what she did.


When I told him she was a lawyer he said "I don't like most most lawyers, and I don't like most politicians, especially those two woman we have in the U.S. Senate."


"Then, you'll like Lynne," I told him, "because she represents every person who gets arrested in Collins' or Snowe's office."


"Well if that's the case," the guy says, "how is she ever going to find enough time to be governor?"

Friday, March 5, 2010

An essay on Hoax Emails

Because not a day goes by but what I receive a raft of hoax emails, and because I myself have written quite a bit about the great number of hoax emails and the unfortunate uneducated people who delight in sending them, I found the following article to be of interest.

It says:

That Chain E-mail Your Friend Sent to You Is (Likely) Bogus. Seriously.


by Lori Robertson

March 18, 2008

I’ve noticed that chain e-mails, particularly those about politics, have a lot of things in common: urgent and frightening messages; spelling errors; a tendency to blame mainstream media for not telling the real story; and false, misleading, utterly bogus, and completely off-base claims.

If there was ever a case where readers should apply a guilty-until-proven-innocent standard, this is it. We at FactCheck.org ask the public to be skeptical about politicians’ claims. With these e-mails, outright cynicism is justified. Assume all such messages are wrong, and you’ll be right most of the time.

Yes, there are a few chain e-mails floating around the Web that are actually true – but not many. And when it comes to messages about the top presidential contenders, truth in e-mail is an elusive quality. In our Ask FactCheck feature, launched late last year, we’ve looked into several e-mails our readers have sent to us. We’re just getting started, but overwhelmingly they have turned out to be false. Snopes.com has been investigating e-mail and other urban legends since 1995, and the site’s founders, Barbara and David Mikkelson, have written articles about 31 e-mails about Barack Obama and Hillary (and Bill) Clinton. Only two e-mails were completely accurate. While a handful had elements of truth in them or couldn’t be verified, the vast majority were flat-out false.

Another writer who debunks rumor and lore is David Emery, author of About.com’s Urban Legends page. He lists seven e-mails about Hillary Clinton and five about Barack Obama. His verdict: 12 false and misleading, 0 true.

We have yet to see e-mails about John McCain, and Emery notes a decidedly anti-Democrat tilt to the bulk of the e-mail chatter. But there’s still plenty of time before the election. In 2004, a left-leaning e-mail claimed the Bush administration was quietly pushing legislation to reinstate the military draft. The claim was bogus, but the e-mail prompted such paranoia that a GOP-controlled House overwhelmingly voted down a bill to reinstate the draft just to show that it rejected the measure. Snopes has chronicled two claims about McCain – both were true, and one was a positive story.

In an e-mail to FactCheck.org, Emery says in 10 years of this line of work, he has looked into a thousand or so e-mails. Pressed to give a ballpark figure for how many are true, he responds: "I’d venture to say that less than a tenth of what’s circulating out there at any given time turns out to be 100% true. A substantially larger portion – maybe around half of all the emails or a little more – contain a mixture of facts and falsehoods." Then, there’s a little thing called "spin." "You can take a string of incontrovertible facts and present them in such a way that they point to a false conclusion."

As for e-mails with political themes, Emery, who has been at this longer than we have, says the phenomenon has increased greatly in recent years, with a marked surge in 2004 with attacks on John Kerry. "I’m tempted to say that Internet rumor-mongering has become, for lack of a better word, ‘integral’ to the political process over the past few election cycles." Internet-fueled innuendo has prompted stronger and quicker responses from the candidates, says Emery, who adds that it’s unclear whether or not any of these e-mails were written by political staffers themselves. "It’s possible, and I think even likely, that at least a few of these rumors were started by political operatives, but I’m not aware of any hard evidence of that."

More Popular = More Likely to Be Bogus

We’ve noticed that the more times something is forwarded, the more likely it is to be false. We suggested this perverse theory when we threw cold water on the claim that the United Kingdom, or the University of Kentucky, had stopped teaching about the Holocaust. E-mails about Obama, for instance, have been particularly popular – they now rank as No. 3 on Snopes.com’s list of the 25 Hottest Urban Legends and one rumor holds the No. 1 spot in Emery’s top 25. But only one of the e-mails these sites have examined is true – and actually only a certain version of it passes the truth test.

This is the one claiming that Obama didn’t put his hand over his heart while the Star Spangled Banner played. That specific allegation is correct, as documented in a photo of presidential candidates at an Iowa steak fry. But it’s false, as some versions of the e-mail said, that he "will NOT recite the Pledge of Allegiance nor will he show any reverence for our flag." We debunked this and other legends about Obama early this year after receiving a rush of questions about them. Again, for the record, he is not a Muslim, his middle name is not Mohammed, and he placed his hand on a Bible when he was sworn into the Senate. And he puts his hand over his heart when he says the Pledge of Allegiance. We even have pictures to prove it.

Still, two months after we wrote that story, we continue to get messages from readers asking about his patriotism, his religion, his church and whether he’ll take the presidential oath with the Quran.

Often, the message itself includes major red flags that should alert readers that the author is not to be trusted. Here are just a few of what we’ll call Key Characteristics of Bogusness:

The author is anonymous. Practically all e-mails we see fall into this category, and anytime an author is unnamed, the public should be skeptical. If the story were true, why would the author not put his or her name on it?

• The author is supposedly a famous person. Of course, e-mails that are attributed to legitimate people turn out to be false as well. Those popular messages about a Jay Leno essay and Andy Rooney’s political views are both baloney. And we found that some oft-quoted words attributed to Abraham Lincoln were not his words at all.

• There’s a reference to a legitimate source that completely contradicts the information in the e-mail. Some e-mails will implore readers to check out the claims, even providing a link to a respected source. We’re not sure why some people don’t click on the link, but we implore you to do so. Go ahead, take the challenge. See if the information you find actually backs up the e-mail. We’ve examined three such e-mails in which the back-up material clearly debunks the e-mail itself. One message provided a link to the Tax Foundation, but anyone who followed it would have found an article saying the e-mail’s figures were all wrong. Another boasted that Snopes.com had verified the e-mail, but Snopes actually said it was false.

• The message is riddled with spelling errors. Ask yourself, why should you trust an author who is not only anonymous but partially illiterate?

• The author just loves using exclamation points. If the author had a truthful point to make, he or she wouldn’t need to put two, three, even five exclamation points after every other sentence. In fact, we’re developing another theory here: The more exclamation points used in an e-mail, the less true it actually is. (Ditto for excessive use of capital letters.)

• The message argues that it is NOT false. This tip comes from Emery, who advises skepticism for any message that says, "This is NOT a hoax!"

• There’s math involved. Check it. One message that falsely claimed more soldiers died during Bill Clinton’s term than during George W. Bush’s urged, "You do the Math!" We did. It’s wrong.

We hope that by writing about some of these messages we can enlighten a few readers and arm some of them with ammunition against their e-mail-forwarding friends. But clearly our battle against the viral e-mail monster has just begun. Months after debunking a popular piece of rubbish about Nancy Pelosi’s plan to tax your retirement savings and give the revenue to illegal immigrants, we’re still getting questions about whether it could possibly be true. Let me repeat: It’s not.

In another item on a common falsehood (but not yet, as far as we know, an e-mail legend), we suggested that a reader try ridiculing his friends to dispel their apocryphal beliefs. And we were serious. If the cold hard truth – or even an ounce of common sense – isn’t an effective weapon in combating a bogus notion, what is?
It seems that no matter the facts, the desire to believe some of this stuff is just too strong. Emery, too, has come to believe that there’s not enough proof in the world to stop certain political propaganda. "I have come to the conclusion that especially where political rumors are concerned, most people are so locked into a particular world view that they tend to reject any information, no matter how well supported, that contradicts their cherished assumptions," he says. "It’s scary, actually how polarized we have become."

In a 2004 report on this topic, our director, Brooks Jackson, called for an end to the e-mail madness, saying, "This cyber-sickness should stop. All it takes is a little bit of common sense and skepticism, some curiosity and a few keystrokes. Nailing these lies can even be fun."

Apparently, lots of Americans didn’t heed the call. If you don’t find checking out these e-mails to be fun, or just don’t have time, I suggest an easier alternative: a healthy use of the delete key.

Monday, March 1, 2010

The Case for Single Payer Health Insurance

The insurance companies pay a lot to control the debate in this country. That means you are paying it in your premiums. Anthem wants to go up 23% in Maine. They gotta cover their advertising and political contributions (now unlimited). When they compare us to Canada they like to focus on certain things and ignore others. They live four years longer than we do.

Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger."

A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada[7] while a Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S.[8][9]. In the same poll, when asked “overall the Canadian health care system was performing very well, fairly well, not very well or not at all?” 70% of Canadians rated their system as working either "well" or "very well".[citation needed] A 2003 Gallup poll found only 25% of Americans are either "very" or "somewhat" satisfied with "the availability of affordable healthcare in the nation," versus 50% of those in the UK and 57% of Canadians. Those "very dissatisfied" made up 44% of Americans, 25% of respondents of Britons, and 17% of Canadians

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Robert Kuttner

Co-Founder and Co-Editor of The American Prospect

Posted: February 28, 2010 10:21 PM

The Cure That Dares Not Speak Its Name

In all of the debates about health care reform, one of the stubborn realities is that neither the Obama plan, nor any of the Republican alternatives, will seriously alter the trajectory of relentless cost-escalation in health care. If you look at the Administration's own projections of federal deficits in the next decade and after 2020, virtually all of the alarming growth in deficit spending is Medicare and Medicaid.

And that's only the public part of the health care bill. In 2009, total health care costs increased to 17.3 percent of GDP, with escalating premiums eating into both corporate profits and worker take home pay. The consensus among the usual policy experts is that there is no good solution. The march of technology and demography will just continue to raise health costs.

But you can reach that conclusion only by ignoring how the rest of the club of affluent countries manages to insure everyone for 9 or 10 percent of GDP, and have a healthier and longer-lived population, to boot. They do it, of course, through universal, socialized insurance.

There is no single formula. The Canadians do it with a single payer system for the insurance part, but physicians are private. The Brits have an integrated National Health Service. The Germans achieve near-universal coverage through a system of nonprofit health insurance plans.

What every other nation has in common is that they have taken the commercialism out of their health systems. As a consequence, they can direct health spending to areas of medical need rather than letting the market direct health dollars to areas of greatest profit. And with everyone covered, they can use highly cost-effective strategies for prevention, wellness, and public health. That's how you cover everyone for ten percent of GDP.

Our one island of single-payer medicine, Medicare, is phenomenally popular -- so popular that the Republicans' most effective attack on the Obama plan is that it would divert some money from Medicare. The Republicans, on the one hand, fiercely attack "government-run health insurance," while on the other they defend Medicare (which they would just as soon privatize).

But most Democratic politicians and policy wonks behave as if the option of a national health plan simply did not exist. These blinders are the result of the immense power of the medical-pharmaceutical-insurance complex combined with a failure of political leadership. Sooner or later, mainstream politicians will stumble their way to some form of single payer because there are no good alternatives unless we want to spend half of our GDP on health care.

In that regard, the best things about the still inconclusive end-game of Obama's efforts to enact his plan are that (1) the administration finally broke with the insurance industry, and (2) Obama is starting to get over the delusion of bipartisanship. So if we don't need either Harry and Louise, or John Boehner and Mitch McConnell, as part of the health-reform coalition, we might as well do it right.

With Obama's health summit behind us, there will now be a mad scramble for Democratic votes in the House and Senate to pursue the strategy that Obama should have used all along -- a Democrats-only bill relying on 51 votes in the Senate via the reconciliation procedure.

The problem is that Obama may have missed the moment. The prolonged, enervating battle for health reform, using a badly flawed bill, has scared off both conservative and liberal Democrats in both houses. The bill is politically toxic to legislators facing re-election, for good reason. The original formula, designed to enlist insurance industry allies, required a mandate to purchase insurance, diversion of Medicare funds, and unpopular taxes. Now that Obama has broken with the industry, an entirely different formula should be possible.

Alas, we are too far down the present road to advance single-payer in this legislative session. The president has done nothing to move public opinion in that direction, and has backed away even from the truncated version of it, the so-called public option.

I would put the odds at about one in three of Obama succeeding. Several Democrats who voted for the House-passed bill in November by the narrow margin of 220-215 have now defected, and several more are increasingly gun-shy. I don't much like this bill, but I still hope it passes so that the Republicans don't get rewarded for their relentless obstructionism.

Win or lose, the next great push should be for single-payer, assuming Democrats have a working majority again in foreseeable future. Given the collateral damage of Obama's strategy, that could be a long time coming.

Thursday, February 25, 2010

Single Payer Universal Health Care

R. B. MD, Writes on February 25, 2010:
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I've worked as a doctor for over thirty years now. As well as seeing patients with every insurance to no insurance and paying for health insurance for my family and employees I have come to the conclusion that a Medicare like health coverage for all is the way to go. Ask anyone over 65 if Medicare works for them and the answer is always yes. Yes, one buys supplemental, and that could, and perhaps should continue and/or medical savings account that could also be allowed.

Medicare insures the worse population.......the older folks and most certainly the ones who will pass away while under that coverage and spend a lot of money in the process. Best way to "spread the risk"...insure the young as well as the old.

Use of money for health and illness care really should not be thought of as insurance. Insurance is something you hope you don't use and insures against risk, like getting into a car wreck, or hitting a deer or moose, or having your dog bite the meter man. Everyone uses, or should use some health dollars, for preventive care, immunizations, having babies. We should think of having health coverage (and paying for it), as well as insurance to the catastrophic unanticipated events, like hitting a moose or being the meter man who gets bitten.

So what does health insurance cost now? Well, here in Michigan I have a Blue Cross Policy for my wife and me, a reduced policy from what I had two years ago, because I couldn't afford that one anymore. Now I have $8,000 deductible, which I fund through a medical savings account (allowed in this state), and then pay $1000 a month for "catastrophic" coverage, up from about $700/month just last year.

Now, instead of paying Blue Cross $12,000/year, how would I feel about payroll deduction of about $5,000-$8,000/year for my wife and me that went for Medicare like coverage. Pretty good. I believe Medicare is better run than many private insurance companies, has less administrative costs, does not have to pay expensive executives, does not have to create reserves. I believe all should contribute through payroll deduction, amount of which can be "means" tested and dependent on factors such as age, income, and perhaps life-style (smokers should pay more). The insurance should cover certain valuable preventive care fully, and have some copays or deductibles on other care. Medical savings accounts should be allowed to build up as savings over many years and be used for supplemental care, the deductibles and copays.

Here's another problem many of the public don't understand. Doctors and hospitals bill maximum for everything in order to capture every insurance dollar. But most accept insurance as full payment. Thus there may be a $300 doctor bill but the doctor accepts $150 from insurance. Or the Hospital bill $20,000 but accepts $10,000. It is illegal to bill lower to the self pay or uninsured or underinsured. So if you don't have insurance you have to pay much more. It would be much better for all if the "billing" side was appropriate and fair, and that the full amount was paid by all. Right now if doctors or hospitals or pharmacies lower their fees, insurance is likely to pay them even less.

So who would lose out on this? The insurance companies? No..claims processing would still be needed so I think those jobs would be preserved. The highly paid execs? Probably. Okay by me.

Doctors and hospitals? No matter what, they are needed and must be paid appropriately to stay in business and keep health care the best and available. Reductions in payment on the high end would likely be compensated by receiving payment for all, whereas now there is still lots of free and underinsured care given in ER's, doctor's offices and hospitals.

I don't think a government administered plan would fail. All Americans would have a stake in it.

Lastly, there is medicare, medicaid and other insurance fraud and abuse. Some real teeth have to be put into saving those lost dollars, and such savings would benefit all.

Skog....keep up the good work. What is really needed for most of our problems is education about the problem. Too often emotion, false beliefs, politics obscure and distort reality and the correct path to solutions. If you got this far, accept my thanks for listening. R B , MD