|Progressive Calendar 07.21.09||<– Date –> <– Thread –>|
|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 -------------------------------------------- --------------------------------------------------------------------------- - David Shove shove001 [at] tc.umn.edu rhymes with clove Progressive Calendar over 2225 subscribers as of 12.19.02 please send all messages in plain text no attachments vote third party for president for congress now and forever Socialism YES Capitalism NO To GO DIRECTLY to an item, eg --------8 of x-------- do a find on --8
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