2009 - %3, August

Another Sign of the Death of EFCA

| Mon Aug. 3, 2009 10:52 AM PDT

Sen. Tom Harkin (D-Iowa), one of the most labor-friendly senators, is headed to the White House for a closed-door meeting with the President this afternoon. It's one of a series of meetings on health care, Harkin's office says. Noticeably not on the agenda is the Employee Free Choice Act, which would make it easier for unions to organize.

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Health Insurance Hell

| Mon Aug. 3, 2009 10:34 AM PDT

The big fault line in the healthcare debate right now is over the "public option" — a proposal that people should have the option of getting healthcare coverage from either a private insurance carrier or from a government program.  Conservatives are worried that this would put too much pressure on private insurers, but Michael Hiltzik asks the obvious question: who cares?

The firms take billions of dollars out of the U.S. healthcare wallet as profits, while imposing enormous administrative costs on doctors, hospitals, employers and patients. They've introduced complexity into the system at every level. Your doctor has to fight them to get approval for the treatment he or she thinks is best for you. Your hospital has to fight them for approval for every day you're laid up. Then they have to fight them to get their bills paid, and you do too.

....Why do we tolerate this? The industry loves to promote surveys indicating that most Americans are "satisfied" with their current health insurance — 37% are "very satisfied" and 17% "extremely satisfied," according to one such study.

Yet these figures are misleading. Most people are satisfied with their current insurance because most people never have a complex encounter with the health insurance bureaucracy. Medical care generally follows the so-called 80-20 statistical pattern — 20% of patients consume 80% of care. If your typical encounter is an annual checkup or treatment of the kids' sniffles, or even a serious but routine condition such as a heart attack, your experience is probably satisfactory.

But it's on the margins where the challenges exist. Anyone whose condition is even slightly out of the ordinary knows the sinking feeling of entering health insurance hell — pre-authorizations, denials, appeals, and days, weeks, even months wasted waiting for resolution.

Sounds great to me!  Why would anyone want to change this system?

Health insurance is a weird industry.  Healthcare itself is provided by doctors, nurses, hospitals, pharmaceutical companies, hospices, and device makers.  Insurance companies do none of this.  They don't do research, they don't perform surgeries, they don't change bedpans, and they don't make diagnoses.  They're just middlemen.  All they do is pay the bills after marking them up 30%.  They don't do anything at all to make healthcare better or more efficient.

But for some reason we're supposed to care about whether they continue to exist or not.  Why?  I care about the quality of my doctors, my nurses, the hospital I go to, and the drugs I take.  I don't really care who takes on the administrative task of paying the bills — except that I wish they were handled a lot more efficiently and with a lot less hassle than private insurers typically do.  Frankly, a world without private healthcare insurers sounds pretty good to me.

And as long as we're reading the LA Times, they've got a nice piece by Michael Rachlis, a doctor in Toronto, about the Canadian healthcare system.  Guess what?  It's pretty good!  It's not the system I'd choose — in particular, I think public funding should provide a basic level of healthcare but patients should always have the right to pay more for better care if they want to — but it works as well or better than ours for a fraction of the cost.  Read the whole thing for more.

Obama Nude with Unicorns, Stalin

| Mon Aug. 3, 2009 10:30 AM PDT

Some web weirdness/wonderfulness to perk up your Monday. Check out these paintings of an unabashedly nude Obama riding a unicorn, getting a massage from said unicorn (left), and confronting a fetal-looking Rush Limbaugh. Along Obama's naked travels, he meets a glum-looking Dr. House, Stalin, and Sarah Palin.

Dusting off my art history major, I would say that some of artist Dan Lacey's artistic inspirations are Frida Kahlo, Diego Rivera, and early 20th century Russian Art with a dash of Chagal. Though given the high unicorn density, I'm sure Lacey has many other, ahem, non-traditional influences. Enjoy!

h/t to former MoJo fellow Daniel Luzer

Dramatic Change is "Radical"

| Mon Aug. 3, 2009 10:07 AM PDT

Ezra Klein says "I'm not sure I'd term calls for procedural reform 'radical,' much less 'revolutionary.'" Here's what I said when Matt Yglesias said something similar:

Just because a reform is possible or even theoretically easy (i.e., doing away with the filibuster or carving out a federal district and making the rest of DC a state) doesn't mean it has any realistic chance of being enacted. So that puts pragmatists like Yglesias and Ezra Klein back in the same spot. If what the country needs is unlikely to happen without political reform, and political reform is very unlikely to happen, what is a pragmatist to do?

This conversation has drifted somewhat far afield from its original topic, which was Democracy in America's claim that Yglesias and Klein are not the "fundamentally moderate, process-oriented wonks" the conventional wisdom says they are. I took that claim to mean that such people would be incrementalist third way types who think that change can be accomplished by working within the system and the existing process. But that's not what the young progressive blogosphere is calling for. Instead, Klein and Yglesias are advocating for fairly dramatic changes to the way American politics works in practice. Right now, their message is largely that the system doesn't work, and Barack Obama can't get anything done because the system is flawed. Wouldn't making that system work be a pretty big change? Maybe we're just getting caught up in semantics here. But changing the way the President is elected, or changing the way powerful Senate committee chairs are picked, or making DC a state—as opposed to working within the system we have—all seem like pretty radical changes to me.

Public Diplomacy Takes Center Stage

| Mon Aug. 3, 2009 9:47 AM PDT

The New York Times reports that the communicator-in-chief plans to take his show on the road:

In coming weeks, senior administration officials said, the White House will begin a public-relations campaign in Israel and Arab countries to better explain Mr. Obama’s plans for a comprehensive peace agreement involving Israel, the Palestinians and the Arab world.

The campaign, which will include interviews with Mr. Obama on Israeli and Arab television, amounts to a reframing of a policy that people inside and outside the administration say has become overly defined by the American pressure on Israel to halt settlement construction on the West Bank.

If Obama's pressure on Israel to halt new construction in West Bank settlements was Phase 1 of his Mideast game plan, Marc Lynch says we're now moving on to Phase 2:

This, I suspect, is something very different: a strategic communications campaign designed to build support for a push towards a two-state solution among key Israeli, Palestinian, and Arab constituencies.  Reassurance, yes, but within the context of explaining the  American view of the urgency of the moment for a push towards peace — and of building support for, and even a demand for, such a push towards peace among those publics.  There are many tools which could be deployed in such a campaign — not just the television interviews mentioned in the article, but the whole portfolio of campaign outreach tools, including new media, which could be deployed in support of such a strategic objective.

Along with practically everyone else on the planet, I've been extremely non-optimistic for the past decade about the chances for some kind of Israeli-Palestinian accord.  And Obama or no Obama, I can't say that anything recently has changed my mind.  It still seems politically impossible for Israel to take any serious action on the settlements, just as it seems unrealistic to expect that Fatah and Hamas can come to any kind of agreement that allows them to effectively represent Palestinian interests.  There are distinct limits to what Obama's oratory can do, and this seems like one of them.  But I'm glad he's at least trying.

Follow the Money

| Mon Aug. 3, 2009 9:04 AM PDT

Clean-energy companies have increased their K Street spending by 5x over the past couple of years.  But Bloomberg reports it's still a drop in the ocean:

Exxon Mobil Corp., the biggest U.S. oil producer, spent more on Washington lobbying during the first half of the year than all clean-energy companies combined, researcher New Energy Finance Ltd. said.

Exxon Mobil, based in Irving, Texas, spent $14.9 million lobbying in the six months, 23 percent more than the $12.1 million laid out by companies that make solar panels or wind turbines to generate electricity, London-based New Energy Finance said today in a note to clients.

The entire oil and gas industry spent $82.2 million in the first half of the year.  If you're ever wondering why the Waxman-Markey climate bill kept getting watered down so much, now you know.

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A Lobbyist By Any Other Name Smells Just As Bad

| Mon Aug. 3, 2009 8:55 AM PDT

Business Week has an interesting piece this week about the stigma of lobbying in the age of Obama, and how it's driving lobbyists to rethink how they do business. True to form, some of the industry's heavy-hitters have found a loophole: they've stopped calling themselves lobbyists. Obama pal Tom Daschle is now a "strategist" and "special policy adviser" on health care and finance at Alston & Bird; GOP lobbyist kingpin Ed Gillespie styles his services as "strategic planning," "message development," and "crisis management." The new jargon, of course, means that they don't have to register or disclose information about their lobbying activities. Sorry, I mean their strategizing activities.

The new terminology is convenient in another way, too: It allows Daschle to play the role of an independent expert on health care rather than someone with a direct financial stake in the legislative battle. For instance, Newsweek recently interviewed him about the issue, describing him only as Obama's failed nominee for health care czar who is now "watching from the sidelines." For his part, Daschle coyly noted that he felt "very fortunate to be able to play the role of what I would call a resource to members of Congress and to the White House and to others who are interested in public policy relating to health care."   

Picking the Fed's Pocket

| Mon Aug. 3, 2009 8:32 AM PDT

The Federal Reserve is not known for its transparency, but in one area the banking regulator may be a bit too upfront—so much so that Wall Street players are able to parlay this openness into huge profits. The Financial Times explains:

The Fed has emerged as one of Wall Street’s biggest customers during the financial crisis, buying massive amounts of securities to help stabilise the markets. In some cases, such as the market for mortgage-backed securities, the Fed buys more bonds than any other party.

However, the Fed is not a typical market player. In the interests of transparency, it often announces its intention to buy particular securities in advance. A former Fed official said this strategy enables banks to sell these securities to the Fed at an inflated price.

The resulting profits represent a relatively hidden form of support for banks, and Wall Street has geared up to take advantage. Barclays, for example, e-mails clients with news on the Fed’s balance sheet, detailing the share of the market in particular securities held by the Fed...

A former official of the US Treasury and the Fed said the situation had reached the point that “everyone games them. Their transparency hurts them. Everyone picks their pocket.”

Next Sunday on "This Week": Jeremiah Wright!

| Mon Aug. 3, 2009 8:11 AM PDT

Michelle Malkin, a person who wrote a book defending the internment of Japanese-Americans during World War II, was a panel member on This Week With George Stephanopoulos on Sunday. Paul Krugman asks the obvious question, then goes a bit further:

When I saw that Michelle Malkin will be on the Stephanopoulos panel this week, my first thought was that nobody as far to the left as she is to the right would ever appear on such a panel. But then I started to wonder (a) what I mean by that (b) if it’s true.

I don’t want to be like Bill O’Reilly, who considers anyone he disagrees with a "far-left" activist. So we need some objective metric. The most natural would seem to be voter opinion: what fraction of the American public is to Malkin’s right? Would somebody with an equally small number of people to his or her left get on a Sunday morning panel?

Clearly there's a kind of Doppler effect when it comes to politics. Paul Krugman probably sees little difference between someone who's an "8" on the conservative scale and someone who is a "10." The same thing, in reverse, goes for Bill O'Reilly. What to do? Media Matters has some data about the Sunday shows' ideological balance, but right-wingers will obviously dispute some of MM's categorizations of various people as "liberal," "neutral," or "conservative."

Still, Krugman's idea of basing "scaling" on voter opinion is a bit odd. Shouldn't the Sunday shows try to expose viewers to a variety of viewpoints, even if some of those viewpoints are more marginal than others? Minority viewpoints will never become majority ones if people aren't exposed to them.

In other words, even if dramatically more people agree with Michelle Malkin than do with, say, Rolling Stone's Matt Taibbi (and I don't mean to suggest an equivalence between the two), that doesn't mean people shouldn't hear what Taibbi has to say.

Obama's Anger Problem?

| Mon Aug. 3, 2009 7:34 AM PDT

MoJo DC bureau boss-man David Corn has an interesting post over at AOL Politics Daily arguing that President Obama needs to get mad. Money quote:

In the debate over health care reform, Obama has tried to bring all the parties together: the medical profession, the pharmaceutical companies, the insurance companies. The plan is obvious: buy off the various special interests and prevent them from trying to kill an effort to remake a system by which they now profit greatly. House Speaker Nancy Pelosi, on the other hand, has called insurance companies "villains"—a view that many Americans, according to the polls, are sympathetic toward. (I've always believed that an easy way to win an election in this country is to run against health insurance companies and cable companies. Don't most people despise both groups?)

That's right. I read somewhere (anyone remember where this is from?) that Sarah Palin learned during the campaign that mass politics is all about creating a drama with yourself at the center. Barack Obama did an excellent job of that during the campaign. But every drama needs a villain, and right now, the health care fight doesn't have one. People hate their insurance companies, so insurance companies would be a great target. David's right: if Obama's mad, he needs to tell us who he's mad at.