Progressive Calendar 07.21.09
From: David Shove (shove001tc.umn.edu)
Date: Tue, 21 Jul 2009 03:53:31 -0700 (PDT)
             P R O G R E S S I V E   C A L E N D A R   07.21.09

1. NWN4P vigil        7.21 4:45pm
2. Galloway/Palestine 7.21 5pm
3. RNC court watch    7.21 6pm
4. Salon/poetry       7.21 6:30pm
5. Cheap fuel end     7.21 7pm

6. Rural feedlots     7.22 11am

7. Billy Wharton - Lipstick on a pig: Obama's failed health-care reform
8. Carl Finamore - Would you rather be eaten by a wolf or a fox?
9. Kip Sullivan  - Bait and switch: how the "public option" was sold
10. ed           - One-way love  (haiku)
11. ed           - Longer yachts  (haiku)
12. ed           - Rich people  (haiku)
13. ed           - bumpersticker

--------1 of 13-------

From: Carole Rydberg <carydberg [at] comcast.net>
Subject: NWN4P vigil 7.21 4:45pm

NWN4P vigil every Tuesday.
Corner of Winnetka and 42nd Avenues in New Hope. 4:45 to 5:45 PM.
All welcome; bring your own or use our signs.


--------2 of 13--------

From: Eric Angell <eric-angell [at] riseup.net>
Subject: Galloway/Palestine 7.21 5pm

Smiley St. Paul Neighborhood Network (SPNN) viewers:

"Our World In Depth" cablecasts on SPNN Channel 15 on Tuesdays at 5pm,
midnight and Wednesday mornings at 10am, after DemocracyNow!  All
households with basic cable may watch.

Tues, 7/21, 5pm & midnight and Wed, 7/22, 10am
George Galloway: Viva Palestina

Ahead of a second historic humanitarian aid convoy bound for Gaza, British
Member of Parliament George Galloway recently spoke in the Twin Cities. In
the talk, Galloway shared his experiences from his first trip to Gaza.

In early 2009, as the bombs were still falling on Gaza, Galloway organized
a humanitarian convoy. In just five weeks, Galloway pulled together 107
vehicles, 255 people and $2 million of aid.  Starting in Britain and
driving through France, Spain and North Africa, the aid convoy arrived in
Gaza to tumultuous acclaim.

Aiming to be the biggest single aid effort for Palestine from the US,
Galloway is now heading a second convoy (at the writing of this
description, the convoy is being held up in Egypt). If the convoy arrives,
it will be a source of great strength and hope for the Palestinian people
and will also have a major impact for the United States.

Opening the talk are the event co-sponsors: American Muslims for Palestine
and the Al Aqsa Institute.


--------3 of 13--------

From: Do'ii <syncopatingrhythmsabyss [at] gmail.com>
Subject: RNC court watch 7.21 6pm

RNC Court Watchers are in need of participants to help with organizing
court information, documentation and etc.  RNC Court Watchers Meetings are
every Tuesday, 6 P.M. at Caffeto's. Below is announcement for our
meetings.

Preemptive raids, over 800 people arrested, police brutality on the
streets and torture in Ramsey County Jail. Police have indiscriminately
used rubber bullets, concussion grenades, tasers and chemical irritants to
disperse crowds and incapacitate peaceful, nonviolent protesters. The
RNC-8 and others are facing felonies and years in jail. We must fight this
intimidation, harassment and abuse!

Join the RNC Court Solidarity Meeting this coming Tuesday at Caffetto's to
find out how you can make a difference in the lives of many innocent
people.

Caffetto's Coffeehouse and Gallery (612)872-0911 708 W 22nd Street,
Minneapolis, MN 55405
Every Tuesday @ 6:00 P.M to 7:00 P.M
participate and help organize RNC court solidarity.
For more information, please contact: rnccourtwatch [at] gmail.com
THE PEOPLE UNITED WILL NEVER BE DEFEATED!


--------4 of 13--------

From: patty <pattypax [at] earthlink.net>
Subject: Salon/poetry 7.21 6:30pm

Tuesday, July 21, is Open Poetry night.  Please come to listen or to read
poetry of your own or of other poets.

The following Tuesday, July 28, will be the first discussion of The LIttle
Book of the Odd Month Club.  The book we will read and discuss is Desert
Solitaire by Edward Abbey.  Wonderful book.

Pax Salons ( http://justcomm.org/pax-salon )
are held (unless otherwise noted in advance):
Tuesdays, 6:30 to 8:30 pm.
Mad Hatter's Tea House,
943 W 7th, St Paul, MN

Salons are free but donations encouraged for program and treats.
Call 651-227-3228 or 651-227-2511 for information.


--------5 of 13--------

From: Lynne mayo <llen [at] usfamily.net>
Subject: Cheap fuel end 7.21 7pm

Collapsing economies, end of cheap fuel & cheap energy
PEAK OIL
Rising costs of food, housing, heat, gasoline
Evaluating our needs and searching for solutions.

South Side Energy Commons is hosting a talk by  Jon Freise with Q&A to
follow
Center School, 2421 17th Ave. South,
Tuesday, July 21, 7pm

A peak in energy supply will cause a peak in the economy and a general
decline in standard of living over the next few decades. A future energy
shortage gives rise to many questions: How much energy do we use today?
Are there alternatives that can replace fossil fuels? Can we generate
enough energy from Ethanol to replace oil? How much wind power is out
there and can it help us replace oil?

Our discussion will examine alternative energy and lifestyle solutions to
our energy crisis. Along the way we will end up with a framework for
evaluating solutions to see which ones really work and which ones are
snake oil and smoke.

This talk will be based in part on "Sustainable Energy - without the hot
air" by David J. C. MacKay (available free from www.withouthotair.com).


--------6 of 13--------

From: Andy Driscoll <andy [at] driscollgroup.com>
Subject: Rural feedlots 7.22 11am

TruthToTell
KFAI - 90.3FM-Minneapolis/106.7FM Saint Paul
WEDNESDAY, JULY 22
RURAL FEEDLOTS: AIR- AND WATER-BORNE DISEASES PLAGUING GREATER MINNESOTA

The long crusade to halt air and water contamination from a dairy
feedlot's open lagoons of fetid manure releasing upwards of 300 dangerous
chemicals into communities surrounding Thief River Falls has thrown a
glaring light on the unwillingness and inability of citizens, state
agencies and the Attorney General to regulate the serious health impacts
of Minnesota's corporate farms on rural life. Massive hog and dairy
feedlots enjoy far greater legislative and judicial support than do the
official rulings of the State Health Department and the federal Centers
for Disease Control that such operations pose a provable health hazard to
humans after in-home air quality monitoring. These are not the friendly
family farms we all grew up believing were integral to our Upper Midwest
culture and sensibility, not to mention our economy. These corporate farms
are the outgrowth of decades of erosion in the agricultural foundations we
viewed as America's breadbasket, gobbling up land and cramming animals
into immobility, never nurtured and literally milked of whatever market
value their bodies can produce with little investment in their well-being
and ignoring the effects of their toxic wastes on their surrounding
communities.

A prime example of this agribusiness phenomenon sweeping the state is the
case of Thief River Falls-based Excel Dairy and its three open lagoons of
animals wastes feeding toxic chemicals into air and water, sickening,
sometimes to death, the humans living in the communities surrounding its
operations, but which has - in court - escaped the consequences of its
flagrant violations of law and regulations governing such enterprises.
Even the often-compliant MPCA joined with Attorney General Lori Swanson
asked a local district court judge to declare the lagoons a health hazard
and nuisance and to cease Excel's waste emissions. He dismissed the suit
out of hand. Despite thumbing its nose at regulation, Excel was given a
new permit.

Minnesota's watchdog Clean Water Action has taken this issue head-on,
joined by activist neighbors who have felt the toxic sting within their
families.

This week, TTT's ANDY DRISCOLL and a guest co-host examine the Excel Dairy
case in light of the larger issues plaguing many rural communities - and,
by extension, all of Minnesota and the core cities downriver from many
similar operations, seriously threatening our air and water quality,
therefore the health of humans everywhere.

GUESTS:
 JULIE JANSEN - Rural Communities Program Organizer, Clean Water Action
 JEFF BROUSE, Thief River Falls resident , small businessman, and
anti-feedlot activist
 OTHERS TBD
AND YOU! CALL 612-341-0980  CAN'T GET US OVER THE AIR? STREAM TTT
LIVE and LATER


--------7 of 13--------

Lipstick on a pig: The failure of Obama's health-care reform
By Billy Wharton
Mon, 20 Jul 2009
Journal of International Socialist Renewal
http://links.org.au/node/1159
moderator [at] portside.org

Consider it a symptom of a larger disease. A fervent commitment to defend
the profit margins of private industry seems to be a national religion for
politicians in the United States. No matter how deeply the private sector
mucks up society, some senator or representative or, if things get really
out of control, president will appear to rescue the day for the
corporations all in the name of justice for the citizens of the US. Like
any religion, this process has highly crafted rituals. First a confession,
then march the sinners around at one hearing or another, then mete out
acceptable penance and then all is forgiven.

It is difficult to tell whether the US House of Representatives-sponsored
"America's Affordable Health Choices Act" is the penance or just straight
forgiveness. The bill purports to be the solution for United States'
health-care crisis. Representative Christopher Dodd went further, calling
it, "The bill we all have been waiting for and fighting for, for 60
years." Curbs on industry excesses, a public option and high-sounding
rhetoric about universal care all dress up the fundamental motivation of
the bill - find a way to prolong the life of an already failed private
health insurance industry.

Of course, failure is a relative term. Private health insurance companies
are quite efficient at completing the task they were designed to carry
out: accumulating profits. In 2006, for instance, health-care companies
accumulated more than US$10 billion in profits. Not surprisingly, they are
far less able to deliver health care. About 50 million people or 16% of
the US population, have no health insurance, another 30 million more can
be considered under-insured and about 20,000 die each year from treatable
illnesses.

Americans have developed two responses to this unjust system - avoiding
care and filing for bankruptcy. A recent Kaiser Family Foundation poll
indicated six in ten Americans had either delayed or deferred necessary
medical care in the last year. The four who do attempt to use the
health-care system, will likely face the prospects of high fees and,
ultimately, indebtedness. The majority, some 52% by last count, of
personal bankruptcy claims are, therefore, the result of debts related to
health care.

The bill does little to address the structural failures of private
corporations. Instead of a single-payer plan which would address the
problem of cost and coverage by eliminating private health insurers,
thereby opening access, the House bill proposes coercive mandates to herd
the great mass of the uninsured toward private plans. Key to this is a
focus on keeping costs low in the private plans. The problem is that there
are only two ways to do this - offer high-fee, high-deductible plans or
offer plans with bare-bones coverage. Both maintain high profitability for
the corporations, while fuelling the logic of health-care avoidance and
debt accumulation. [Longer yachts! -ed]

Some of the uninsured may resist this drive into private health insurance
plans designed for corporate profitability. The House of Representatives,
under the advice of President Barack Obama, has therefore designed an
intricate system of coercive penalties. Americans will either have to
prove enough hardship to qualify for the public option or pay a 2.5%
penalty on their annual income. Considering the high costs of monthly
health-care premiums, we can imagine that many may opt to pay the fine in
order to avoid the higher costs of a private plan.

To make up the difference, the House bill proposes the issue of
"affordability credits" in order to, "reduce cost-sharing to levels that
ensure access to care". Where will these credits, read taxpayers' money,
be headed? Directly to the private health insurance industry. Here again
the new logic of the Obama regime is put to work. Instead of using the
state to solve social problems by nationalising, or socialising industry,
the administration chooses to toss taxpayers' funds at the private sector.
All the while, they employ free-market language - increased competition,
market areas and individual responsibility - to cover what is essentially
a transfer of public funds to large corporations. No wonder nary a word of
protest has been uttered by the normally vociferous private health-care
industry. [If this happens, time to bring down the corpo-fascist
government with general strikes. If we don't we're corporate slaves. -ed]

As the House of Representatives trots out its 1000-page bill complete with
360 amendments from the Republicans, objections are sure to emerge. Obama
and Congress will face harsh, and not entirely unjustified, criticism from
fiscally conservative Democrats and Republicans. Most will base their
arguments on the Congressional Budget Office estimate that the plan will
cost more than $1 trillion over the next ten years. Others will play the
small business card, arguing that a disproportionate burden may fall on
this sector. A few right-wing libertarians will object to the coercive
penalties, but this criticism might be done far more skillfully from the
left. Yet, the fact remains that the institutions and the logic that
fuelled the health-care crisis will survive. In fact, those who can claim
the largest market share in the health-care industry will enhance their
position.

What is evident in this debate is the decomposition of the neoliberal
capitalist project born in the 1990s. No longer able to peddle the gospel
of unfettered markets, corporate United States has returned to its origins
by making a parasitical living off of state funds. If now the public
sector can no longer be automatically discredited ideologically, it will
be bankrupted financially. Obama was more correct then he knew when he
commented, in relation to comments made by Republican vice-presidential
candidate Sarah Palin, "You can put lipstick on a pig, but it is still a
pig." Americans would do far better, in regards to the private health
insurance industry, with a plate of bacon than a bill for lipstick.

Meanwhile, somewhere in the US House of Representatives there lies a
13-page bill called HR 676. This Act would create a publicly funded
National Health Insurance Program - a single-payer system. Single-payer
health care would guarantee full medical coverage to every person in the
US and would be funded through combining the budgets of existing programs
with a payroll tax shared by employers and employees and a tax on wealth.

Its existence marks the urgency of the crisis; its elimination from
health-care reform discussions marks the narrow parameters of "the
possible" in Obama's Washington. This confirms the ideas of left-wing
advocates of single-payer health care, that only a mass social movement
can make such fundamental changes as the elimination of the private health
insurance industry possible. The rallying cry for such a movement might be
a slogan from the Black freedom struggle of the 1950s and 60s - 99 and a
half per cent free just won't do.

[Billy Wharton is the editor of The Socialist and the Socialist WebZine.
His articles have recently appeared in the Washington Post, Monthly Review
Webzine, The Indypendent, Common Dreams and Links International Journal of
Socialist Renewal.]


--------8 of 13--------

Would You Rather be Eaten by a Wolf or a Fox?
By Carl Finamore
portside 7/20/09

Several of my favorite, most memorable quotations come to mind these days
as I sadly observe what seems to me like abject, deferential genuflection
before Washington's Democratic Party majority by major labor and
progressive organizations in this country.

Oddly enough, it is a poet and not a politician that provides the first
insight into the problem. It is Oscar Wilde who famously quipped with his
brilliant Irish wit that "true friends stab you in the front." You have to
think about that for a moment.

Maybe the much ballyhooed hope in President Obama has in fact stunned into
silence the American reform majority that elected him. Maybe getting
snubbed by Obama in the front is more disorienting and confusing than
getting stabbed directly in the back by Republicans?

Let us consider a few developments since Obama's election.

Recall that it was only in May that the heroic pro-choice Dr. George
Tillman was murdered in cold blood. Not too long ago, such a violent
challenge to the rights of women would have unleashed a massive series of
public protests exposing the lies and provocations of right-wing
anti-abortionists.

Instead, the National Organization for Women (NOW), Planned Parenthood and
other prominent women's rights organizations followed Obama's lead and
limited themselves to issuing paper condemnations, urging letters to
Congress and proposing specific legislation.

Of course these are important initiatives, but only in conjunction with
action campaigns. Without broad national mobilizations organized by large
independent organizations like NOW, we are left with the deafening silence
of the pro-choice majority. This vacuum leaves the two major parties
defining terms of the debate.

                        What are Friends For?

Close acquaintances can get close enough to stab us in the front because
we do not expect deception as they approach.

The Mafia has long understood this. Recall the "Godfather's" Don Corleone
explaining to his son Michael that he should anticipate the dirty traitor
would be a close member of their own crime family.

But it doesn't really feel any different being stabbed front or back.

Ask the poor beleaguered people of Afghanistan.  The Democratic
administration is dramatically escalating US military intervention in that
country above what we had during the Bush administration. Where is
MoveOn.org? This extremely popular liberal organization gained millions of
supporters for its anti-war stance during the 2008 national elections.

Today, their once loud voice for peace is but a whisper.

Then, of course, there is the bankrupt economy supposedly heading towards
a "jobless recovery." A ridiculous oxymoron conjured up by Wall St.
sycophants in the administration who steadfastly refuse to support wage
increases and a massive federal jobs program as the most effective relief
for suffering working class families.

Facing this crisis, or rather backing away from it, the national AFL-CIO
kept the midnight oil burning lobbying legislators but it wasn't enough
to keep the lights on at worksites across the country.  Millions are laid
off and just go home, if they still have one.

There has been not one significant protest.

Not even the United Auto Workers (UAW) with its long proud history
asserted itself when they were falsely blamed for driving the industry
collapse that was actually steered by the auto barons. Not in one plant,
not in one shop was there any resistance organized by national labor
leaders even though the dramatic local example in Chicago of the Republic
Glass factory workers occupying their plant still lingers in our memory.

The malaise doesn't stop there. We are witnessing labor's number one
legislative priority, the Employee Free Choice Act, being ripped apart on
Capitol Hill like a gazelle carcass on the African savanna and yet labor
sits quietly in their tents waiting to be rescued.

                     Do You Want to Be Lunch?

I'm Mad as Hell!" Peter Finch once shouted from his office window in
the 1976 Sidney Lumet film, Network.

Where now is that same spirit of resistance? How much economic and social
injustice has to happen before the labor and progressive movement leaders
begin shouting "we're not going to take it anymore?"

Just as it doesn't feel very good being stabbed anywhere, it also doesn't
really make any difference whether you are eaten, as Malcolm X pithily
observed, by the "'liberal' fox or the 'conservative' wolf."

Malcolm X himself didn't want to be anyone's lunch so he warned
against both the stealth Democratic foxes and the unrepentant carnivorous
Republican wolves of his day.

Consider the largely unchallenged lies of racist politicians like Senator
Sessions and commentators like Pat Buchanan who flagrantly mischaracterize
affirmative action during Congressional hearings for Judge Sotomayor. The
Democratic majority sidestepped the whole discussion instead of defending
affirmative action gains in the last quarter century.

And then there is the painful truth that discussion of a Single-Payer
government medical plan has been completely marginalized by both parties
in Congress. Grass-roots organizations are doing their best to expose the
lies spread by insurance companies but there is no echo in Washington and
no prospect for mass street actions proposed by any organization with real
clout.

It's also completely wrong to expect the administration to lead a staunch
defense of Medicare, Social Security and the GI Bill as three examples of
essential government programs benefitting millions?  It won't happen. The
job has to be done by a re-energized social protest movement. Right-wing
mouthpieces would stutter and stumble if challenged to explain their
opposition to these hugely popular programs as "socialistic."

Finally, we had to endure the ridiculous spectacle of reactionaries
mischaracterizing President Obama's plan to lapse Bush's tax largesse for
the super rich as "Marxist redistribution of wealth." Where are the voices
from powerful national organizations explaining loud and clear that
dramatic and steady redistribution of wealth upward actually began in the
early 1980s and, oops, continued under both Democratic and Republican
administrations?

Perhaps the truth is too embarrassing for some of President Obama's
liberal allies to admit, but whatever the reason, none of these
conservative political blows will be answered effectively unless unions
and progressive organizations stop waiting for cues from "friends" in
Washington.

That's why it was so refreshing to see significant opposition briefly
emerge to successfully shed a bright light on Obama's inaction and extreme
hypocrisy regarding equal rights for Gays. The White House felt the
pressure.

We must honestly admit, however, that overall, recent attacks against
working people, women and minorities have gone largely unchallenged. No
national demonstrations, rallies or protests. No civil-disobedience
sit-ins, nothing.

                I Dreamed I saw Joe Hill Last Night

Joe Hill possessed the absolute defiance and determination we need today
in our reform movement leaders.  Hill was an Industrial Workers of the
World (IWW) itinerant labor organizer who was murdered by the mine-owners
controlled Utah state government in 1915.  Joe's admonition to his
supporters that they "don't waste any time mourning, organize," is of
course known the world over.

But the lesser-known next sentence in his final testament is also very
powerful.  Joe asked IWW leader Big Bill Haywood if he "could have my
body hauled to the state line to be buried? I don't want to be found dead
in Utah." 1

That's taking the lies leveled against him and throwing it right back in
the faces of his accusers. Standing up to those in power with his last
breath, Joe yelled "Fire" just before execution by firing squad.

I don't see any of these bold, daring impulses today from leaders of our
larger political organizations. As a result, when looking at politics in
America, emotions range from anger to disappointment. But there is room
for optimism.

The historical record provides ample evidence that people will ultimately
act in their class interests. Sooner or later, today's profoundly
depoliticized mass will experience a liberating social awakening just as
yesteryears' slaves, serfs and colonial oppressed have all eventually
done.

That's when modern Joe Hill rebels will emerge and perhaps be capable of
assuming the leadership of the unions and other mass organizations of
working people.

But why is it taking so damn long?

I'll throw in one last quote that addresses that issue. This time the
concise and insightful nugget comes from an expatriate African-America
woman living in Paris. She appears in Michael Moore's exceptional film
"Sicko."

Moore asked why millions of French people demonstrate on social issues
rather often whereas nothing like that happens in America. Paraphrasing
this woman, she poignantly responded that "in France, the government is
afraid of the people. In the United States, it is the people who are
afraid of the government."

Enough said. This woman's words of wisdom concisely describe, for me,
the basic dilemma in this country.

Until and unless we chickens grow some sharp teeth and learn to bite back
when chased by either a wolf or a fox, we will likely be running around
with our heads cut off. Now I realize that it goes against the laws of
nature for chickens to grow teeth, but we humans already have incisors and
two legs to hold us upright enough to get up off our knees.

All that is necessary is the insight to discern when we are being suckered
and the will to stand up and bite back against both our foes and those
posing as friends.

1 In fact, Joe's ashes were placed in small envelopes and spread by his
comrades to every state in the union, except Utah, with several requests
from other countries as well.

Carl Finamore is a veteran labor and political activist living in San
Francisco. His growl is bigger than his bite but he is working on that. He
can be reached at local1781 [at] yahoo.com


--------9 of 13--------

Bait and switch: How the "public option" was sold
by Kip Sullivan
Monday, Jul 20, 2009
www.pnhp.org/blog/2009/07/20/

The people who brought us the "public option" began their campaign
promising one thing but now promote something entirely different. To make
matters worse, they have not told the public they have backpedalled. The
campaign for the "public option" resembles the classic bait-and-switch
scam: tell your customers you've got one thing for sale when in fact
you're selling something very different.

When the "public option" campaign began, its leaders promoted a huge
"Medicare-like" program that would enroll about 130 million people. Such a
program would dwarf even Medicare, which, with its 45 million enrollees,
is the nation's largest health insurer, public or private. But today
"public option" advocates sing the praises of tiny "public options"
contained in congressional legislation sponsored by leading Democrats that
bear no resemblance to the original model.

According to the Congressional Budget Office, the "public options"
described in the Democrats. legislation might enroll 10 million people and
will have virtually no effect on health care costs, which means the
"public options" cannot, by themselves, have any effect on the number of
uninsured. But the leaders of the "public option" movement haven't told
the public they have abandoned their original vision. It's high time they
did.

                           The bait

"Public option" refers to a proposal, as Timothy Noah put it, "dreamed up"
by Jacob Hacker when Hacker was still a graduate student working on a
degree in political science. In two papers, one published in 2001 and the
second in 2007, Hacker, now a professor of political science at Berkeley,
proposed that Congress create an enormous "Medicare-like" program that
would sell health insurance to the non-elderly in competition with the
1,000 to 1,500 health insurance companies that sell insurance today.

Hacker claimed the program, which he called "Medicare Plus" in 2001 and
"Health Care for America Plan" in 2007, would enjoy the advantages that
make Medicare so efficient - large size, low provider payment rates and
low overhead. (Medicare is the nation's largest health insurance program,
public or private. It pays doctors and hospitals about 20 percent less
than the insurance industry does, and its administrative costs account for
only 2 percent of its expenditures compared with 20 percent for the
insurance industry.)

Hacker predicted that his proposed public program would so closely
resemble Medicare that it would be able to set its premiums far below
those of other insurance companies and enroll at least half the
non-elderly population. These predictions were confirmed by the Lewin
Group, a very mainstream consulting firm. In its report on Hacker's 2001
paper, Lewin concluded Hacker's "Medicare Plus" program would enroll 113
million people (46 percent of the non-elderly) and cut the number of
uninsured to 5 million. In its report on Hacker's 2007 paper, Lewin
concluded Hacker's "Health Care for America Plan" would enroll 129 million
people (50 percent of the nonelderly population) and cut the uninsured to
2 million.

Until last year, Hacker and his allies were not the least bit shy about
highlighting the enormous size of Hacker's proposed public program. For
example, in his 2001 paper Hacker stated:

[A]pproximately 50 to 70 percent of the non-elderly population would be
enrolled in Medicare Plus.. Put more simply, the plan would be very
large.. [C]ritics will resurface whatever the size of the public plan. But
this is an area where an intuitive and widely held notion  - that
displacement of employment-based coverage should be avoided at all costs -
is fundamentally at odds with good public policy. A large public plan
should be embraced, not avoided. It is, in fact, key to fulfilling the
goals of this proposal. (page 17)

In his 2007 paper, Hacker stated:

For millions of Americans who are now uninsured or lack ... affordable
work place coverage, the Health Care for America Plan would be an
extremely attractive option. Through it, roughly half of non-elderly
Americans would have access to a good public insurance plan.. A single
national insurance pool covering nearly half the population would create
huge administrative efficiencies. (page 5)

Hacker's papers and the Lewin Group's analyses of them have been cited by
numerous "public option" advocates. For example, when Hacker released his
2007 paper, Campaign for America's Future (CAF) published a press release
praising it and drawing attention to the large size of Hacker.s proposed
public program. The release, entitled "Activists and experts hail Health
Care for America plan," stated:

Detailed micro-simulation estimates suggest that roughly half of
non-elderly Americans would remain in workplace health insurance, with the
other half enrolled in Health Care for America.. A single national
insurance pool covering nearly half the population would create huge
administrative efficiencies.. Because Medicare and Health Care for America
would bargain jointly for lower prices ., they would have enormous
combined leverage to hold down costs.

When the Lewin Group released its 2008 analysis of Hacker's 2007 paper,
CAF's Roger Hickey wrote in the Huffington Post, "efficiencies achievable
"through Hacker's public health insurance program" would save so much
money that the US could "cover everyone" for no more than we spend now.

                                The switch

Now let's compare the "single national health insurance pool covering
nearly half the population" that Hacker and other "public option"
advocates enthusiastically championed with the "public option" proposed by
Democrats in Congress, and then let's inquire what Hacker and company said
about it.

As readers of this blog no doubt know, the Senate Health, Education,
Labor, and Pensions (HELP) Committee, and three House committee chairman
working jointly, published draft health care "reform" bills in June. (The
third committee with bill-writing authority, the Senate Finance Committee,
has yet to produce a bill.) According to the Congressional Budget Office,
the "public option" proposed in the House "tri-committee" bill might
insure 10 million people and would leave 16 to 17 million people
uninsured. The "public option" proposed by the Senate HELP committee,
again according to the Congressional Budget Office, is unlikely to insure
anyone and would hence leave 33 to 34 million uninsured. The CBO said its
estimate of 10 million for the House bill was highly uncertain, which is
not surprising given how vaguely the House legislation describes the
"public option".

Here is what the CBO had to say about the HELP committee bill:

The new draft also includes provisions regarding a "public plan," but
those provisions did not have a substantial effect on the cost or
enrollment projections, largely because the public plan would pay
providers of health care at rates comparable to privately negotiated rates
- and thus was not projected to have premiums lower than those charged by
private insurance plans. (page 3)

Obviously the "public option" in the Senate HELP committee bill (zero
enrollees; 17 million people left uninsured) and the "public option" in
the House bill (10 million enrollees (maybe!); 34 million people left
uninsured) are a far cry from the "public option" originally proposed by
Professor Hacker (129 million enrollees; 2 million people left uninsured).
Have we heard the Democrats in Congress who drafted these provisions utter
a word about how different their "public options" are from the large
Medicare-like program that Hacker proposed and his allies publicized? What
have Professor Hacker and his allies had to say?

In public comments about the Democrats' "public option" provisions, the
leading lights of the "public option" movement imply that Hacker's model
is what Congress is debating. Sometimes they come right out and praise the
Democrats' version as "robust" and "strong". But I cannot find a single
example of a a statement by a "public option" advocate warning the public
of the vast difference between Hacker's original elephantine,
"Medicare-like" program and the Democrats' mouse version.

For example, on June 23, Hacker testified before the House Education and
Labor Committee that "the draft legislation prepared by [the] special
tri-committee promises enormous progress". He went on to enumerate all the
benefits of a "public option". Yet the House tri-committee proposal bore
no resemblance to the public plan he described in his papers and that the
Lewin Group analyzed. Later, when Kaiser Health News asked Hacker in a
July 6 interview why "your signature idea - a public plan - has become
central to the health care reform debate," Hacker again praised his
"public plan" proposal and offered no hint that the "public option" so
"central to the debate" was very different from the one he originally
proposed.

Ditto for Hacker's allies. Representatives of Health Care for America Now
(HCAN), the organization most responsible for popularizing the "public
option," repeatedly describe the House and Senate HELP committee bills as
"strong" or "robust," always without any justification for this claim, and
have repeatedly failed to warn the public that the "public options" they
promote today are mere shadows of the "public options" they endorsed in
the past. On July 15, the day the HELP committee passed its bill, Jason
Rosenbaum blogged for HCAN:

The Senate HELP Committee has just referred a bill to the floor of the
Senate with a strong public option.

Searching the websites of the organizations that serve on HCAN's steering
committee - AFSCME, Democracy for America, Moveon.org and SEIU, for
example - one will find not a shred of information that would help the
reader comprehend how small and ineffective the "public options" proposed
in the Democrats' bills are, nor how different these are from the one
Hacker originally proposed. Yet these groups continue to urge their
members and the public to "tell Congress to support a public option".

  Hacker's original model compared with the Democrats' mouse model

It has become fashionable among advocates of a "public option" to trash
the expertise and the motives of the Congressional Budget Office. But the
CBO's characterization of the "public option" proposed in the Democrats'
legislation is entirely reasonable. This becomes apparent the moment we
compare Hacker's blueprint for his original "Medicare Plus" and "Health
Care for America" programs with the "blueprints" (if tabula rasas [blank
slates] can be called "blueprints") contained in the Senate HELP Committee
and House bills.

Hacker's papers laid out these five criteria that he and the Lewin Group
said were critical to the success of the "public option":

 * The PO had to be pre-populated with tens of millions of people, that
is, it had to begin like Medicare did representing a large pool of people
the day it commenced operations (Hacker proposed shifting all or most
uninsured people as well as Medicaid and SCHIP enrollees into his public
program);
 * Subsidies to individuals to buy insurance would be substantial, and
only PO enrollees could get subsidies (people who chose to buy insurance
from insurance companies could not get subsidies);
 * The PO and its subsidies had to be available to all nonelderly
Americans (not just the uninsured and employees of small employers);
 * The PO had to be given authority to use Medicare's provider
reimbursement rates; and
 * The insurance industry had to be required to offer the same minimum
level of benefits the PO had to offer.

Hacker predicted, and both of the Lewin Group reports concluded, that if
these specifications were met Hacker's plan would enjoy all three of
Medicare's advantages - it would be huge, it would have low overhead
costs, and it would pay providers less than the insurance industry did. As
a result, the "public option" would be able to set its premiums below
those of the insurance industry and seize nearly half the non-elderly
market from the insurance industry. According to the Lewin Group's 2008
report, Hacker's version of the "public option" would, as of 2007:

 * Enroll 129 million enrollees (or 50 percent of the non-elderly);
 * Have overhead costs equal to 3 percent of expenditures;
 * Pay hospitals 26 percent less and doctors 17 percent less than the
insurance industry (but these discounts would be offset to some degree by
increases in payments to providers treating former Medicaid enrollees);
and,
 * Set its premiums 23 percent below those of the average insurance
company.

I question some of Hacker's and the Lewin Group's assumptions, including
their assumption that any public program that has to sell health insurance
in competition with insurance companies could keep its overhead costs
anywhere near those of Medicare (Medicare is a single-payer program that
has no competition), especially during the early years when the public
program will be scrambling to sign up enrollees. A public program will
have to hire a sales force and advertise. It will have to open offices. It
will have to negotiate rates, and perhaps contracts, with thousands of
hospitals and hundreds of thousands of clinics, chemical treatment
facilities, rehab units, home health agencies, etc. Or it will have to
contract with someone to do all that. But I have little doubt that if a
public program were to open with a large enough customer base, and it had
the advantage of a law requiring that only its customers receive
substantial subsidies, it could do what the Lewin Group said it could do.

Now let us compare Hacker's original model with the mousey "public
options" proposed by the Senate HELP Committee and the House. Of Hacker's
five criteria, only one is met by these bills! Both proposals require the
insurance industry to cover the same benefits the "public option" must
cover. None of the other four criteria are met. The "public option" is not
pre-populated, the subsidies to employers and to individuals go to the
"public option" and the insurance industry, employees of large employers
cannot buy insurance from the "public option" in the first few years after
the plan opens for business and maybe never (that decision will be made by
whoever is President around 2015), and the "public option" is not
authorized to use Medicare's provider payment rates. (The House bill comes
the closest to authorizing use of Medicare's rates; it authorizes
Medicare's rates plus 5 percent).

Is it any wonder the CBO concluded the Democrats' "public option" will be
a tiny little creature incapable of doing much of anything? More curious
is that CBO gave the House "public option" any credit at all (you will
recall CBO said it would enroll maybe 10 million people). The CBO should
have asked, Can the "public option" - as presented in either bill -
survive?

       Put yourself in the "public option" director's shoes

To see why the "public option" proposed by congressional Democrats remains
at great risk of stillbirth, let's engage in a frustrating thought
experiment. Let's imagine Congress has enacted the House version (it is
not quite as weak as the HELP Committee model and thus gives us the
greatest opportunity in our thought experiment to imagine a scenario in
which the "public option" actually survives its start-up phase). Let us
imagine furthermore that you have been foolish enough to apply for the job
of executive director of the new "public option," and the Secretary of the
Department of Health and Human Services (the federal agency within which
the program will be housed) decided to hire you. It's your first day on
the job.

You know the House bill did not create a ready-made pool of enrollees for
you to work with the way the 1965 Medicare law created a ready-made pool
of seniors prior to the day Medicare commenced operations. You realize, in
other words, that you represent not a single soul, much less tens of
millions of enrollees. You will have to build a pool of enrollees from
scratch. You also know the House bill authorized some start-up money for
you, so you'll be able to hire some staff, including sales people if you
choose. You can also open offices around the country, and advertise if you
think it necessary. But you know you can't pay out too much money getting
the "public option" started because the House bill requires that you pay
back whatever start-up costs you incur within ten years. In other words,
you may hire enough people and open enough offices and buy enough
advertising to create a critical mass of enrollees nationwide, but you
must do it quickly so that your start-up costs don't sink the "public
option" during its first decade.

The only other feature in the House bill that appears to give you any
advantage over the insurance industry is the provision requiring you to
use Medicare's rates plus 5 percent, which essentially means you are
authorized to pay providers 15 percent less than the insurance industry
pays on average. But the House bill also says providers are free to refuse
to participate in the plan you run.

So what do you do? Let's say you open offices in dozens or hundreds of
cities, you hire a sales force to fan out across the country to sign up
customers, you advertise on radio and TV to get potential customers
(employers and individuals) to call your new sales force to inquire about
the new "public option" insurance policy. What happens when potential
customers ask your salespeople two obvious questions: what will the
premium be and which doctors they can see? What do your employees say?
They can't say anything. They haven't talked to any clinics or hospitals
about participating at the 15-percent-below-industry-average payment rate,
so they have no idea which providers if any will agree to participate.
They also have no idea what the "public option" premium will be because
they don't know whether providers will accept the low rates the plan is
authorized to pay. And they have no idea about several other factors that
will affect the premiums, including how much overhead the "public option"
will rack up before it reaches a state of viability, or who the "public
option" will be insuring - healthy people, sick people, or people of
average health status.

So, let's say you redeploy your sales force. Now instead of talking to
potential customers, you direct them to focus on providers first. But when
your salespeople call on doctors and hospital administrators and ask them
if they'll agree to take enrollees at below-average payment rates,
providers ask how many people the "public option" will enroll in their
area. Providers explain to your salespeople that they are already giving
huge discounts, some as high as 30 to 40 percent off their customary
charge, to the largest insurers in their area and they are not eager to do
that for the "public option" unless the plan will have such a large share
of the market in their area that it will deliver many patients to them. If
the "public option" cannot do that, providers tell your salespeople, they
will not agree to accept below-average payment rates.

In other words, you find that the "public option" is at the mercy of the
private insurance market, not the other way around.

This thought experiment illustrates for you the mind-numbing
chicken-and-egg problem created by any "public option" project that does
not meet Hacker's criteria, most notably, the criterion requiring
pre-population of the "public option". If the pre-population criterion
isn't met, the poor chump who has to create the "public option" is
essentially being asked to solve a problem that is as difficult as
describing the sound of one hand clapping. You need both hands to clap.

            How did the mouse replace the elephant?

How did the "Medicare Plus" proposal of 2001 (when Hacker first proposed
it) get transformed into the tiny "public options" contained in the
Democrats' 2009 legislation? The answer is that somewhere along the line
it became obvious that the Hacker model was too difficult to enact and had
to be stripped down to something more mouse-like in order to pass. Did the
leading "public option" advocates realize this early in the campaign? Or
midway through the campaign when the insurance industry began to attack
the "public option"? Or late in the campaign when they found it difficult
to persuade members of Congress to support Hacker's original model?
Whatever the answer, will they find it in their hearts to tell their
followers their original strategy was wrong?

I suspect the answer is different for different actors within the "public
option" movement. Hacker surely knew what was in his original proposal and
surely knows now that the Democrats' bills don't reflect his original
proposal. Hacker and others familiar with his original proposal were
probably betrayed by the process. As the "public option" concept became
famous and edged its way toward the centers of power, they couldn't find
the courage to resist the transformation of the original proposal into the
mouse model.

For other actors within the "public option" movement, ignorance of
Hacker's original proposal and of health policy in general may have led
them to rely on more knowledgeable leaders in the movement. Their error,
in other words, was to trust the wrong people and, as the "public option"
came under attack, to cave in to group think. This error was facilitated
by the "public option" movement's decision to avoid mentioning any details
of the "public option" whenever possible.

                            What next?

Those of us in the American single-payer movement must continue to educate
Congress and the public on the need for a single-payer system. We must
also convince advocates of the "public option" that they have made two
serious mistakes and, if they learn quickly from these mistakes, that real
reform is still possible.

The first mistake was to think that a "public option" that merely took
over a large chunk of the non-elderly market (as opposed to one that took
over the entire market) could substantially reduce health care costs and
thereby make universal coverage politically feasible. Any proposal that
leaves in place a multiple-payer system - even a multiple-payer system
with a large government-run program in the middle of it - is going to save
very little money. Even if Hacker's original Health Care for America Plan
had taken over half the non-elderly market and then reached homeostasis
(something Hacker swore up and down it would do), the savings would have
been relatively small. The reason for that is twofold. First, any
insurance program, public or private, that has to compete with other
insurers is going to have overhead costs substantially higher than
Medicare's. (It is precisely because Medicare is a single-payer program
that its overhead costs are low.) Second, the multiple-payer system Hacker
would leave in place would continue to impose unnecessarily large overhead
costs on providers.

The second mistake the "public option" movement made was to think the
insurance industry and the right wing would treat a "public option" more
gently than a single-payer. Conservatives have a long history of treating
small incremental proposals such as "comparative effectiveness research"
as the equivalent of "a government takeover of the health care system". It
should have been no surprise to anyone that conservatives would shriek
"socialism!" at the sight of the "public option," even the mouse model
proposed by the Democrats.

The bait-and-switch strategy adopted by the "public option" movement has
put the Democrats in a terrible quandary. Seduced by the false advertising
about the potency of the "public option" to lower costs, Democrats have
raised public expectations for reform to unprecedented levels. Failing to
meet those expectations during the 2009 session of Congress, which is
inevitable if the Democrats continue to promote legislation like the bills
released in June, is going to have unpleasant consequences. Is there no
way out of this quandary?

Conventional wisdom holds that if the Democrats don't pass a health care
reform bill by December, they will have to wait till 2013 to try again.
But if the "public option" movement were to join forces with the
single-payer movement, the two movements could prove the conventional
wisdom wrong. This won't happen, obviously, if the "public option"
movement fails to perceive the reasons it failed.

It is conceivable the "public option" movement could decide the
bait-and-switch strategy was wrong and that their only error was not to
stick with Hacker's original model. It should be obvious now that that
would also be a tactical blunder. We have plenty of evidence now that
conservatives will react to the mousey version of the "public option" as
if it were "a stalking horse for single-payer". We can predict with
complete certainty they will treat Hacker's original version as something
even closer to single-payer. If a proposal is going to be abused as if it
were single-payer, why not actually propose a single-payer? At least then,
when a particular session of Congress comes and goes and we haven't
enacted a single-payer system, we will have educated the public about the
benefits of a single-payer and have further strengthened the single-payer
movement.

To sum up, "public option" advocates must choose between continuing to
promote the "public option" and seeing their hopes for cost containment
and universal coverage go up in smoke for another four years, and throwing
their considerable influence behind single-payer legislation. At this late
date in the 2009 session, it is unlikely that a single-payer bill could be
passed even if unity within the universal coverage movement could be
achieved. But if the "public option" wing and the single-payer wing join
together to demand that Congress enact a single-payer system, December
2009 need not constitute a deadline.

Kip Sullivan belongs to the steering committee of the Minnesota chapter of
Physicians for a National Health Program.

PNHP welcomes comments on its blog by its physicians and medical student
members, and other health professionals active in the movement for single
payer national health insurance. Comments by other readers are welcomed
but may not be posted.


--------10 of 13--------

 Obama lovers
 love Obama bad. But he
 doesn't love them back.


--------11 of 13--------

 We can't have single
 payer because rich people
 must have longer yachts.


--------12 of 13--------

 Rich people are
 the meanest sons of bitches on
 the face of the earth.


--------13 of 13--------


           --------------------------------------------
            American Capitalism: survival of the worst
           --------------------------------------------


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   rhymes with clove         Progressive Calendar
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