Kevin Drum

Newt the Visionary

| Wed Aug. 12, 2009 11:46 AM PDT

Matt Taibbi points out today that up until very recently, Newt Gingrich was a big booster of advance care directives and hospice care:

Well, what happens when suddenly the Republican party decides it wants to scare the shit out of a bunch of old people by telling them the new health care bill is going to include a provision in which “death panels” ask them “when they want to die”? Now all of the sudden Gingrich is violently against the same programs he was so windily praising earlier this year.

And make no mistake, this is exactly the same thing. The only thing that’s actually in the health care proposals is a provision that would allow Medicare to pay for exactly the kind of programs Gingrich praised, on a voluntary basis. The programs are not government-administered in any way, there’s just government money now to pay for the private programs. And now Gingrich is suddenly aghast at them.

Nobody ever accused Newt of not being opportunistic enough, so this is no surprise.  It's also pretty much identical to his flip-flop on cap-and-trade.  Two years ago he was a huge fan because it used market mechanisms to control greenhouse gas emissions.  Hooray for the market!  But when an actual cap-and-trade plan was introduced — by Democrats — it suddenly became a "command-and-control, anti-energy, big-bureaucracy agenda, including dramatic increases in government power and draconian policies that will devastate our economy."

But Newt's a visionary.  Never forget that.

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Cooling the Planet for Free

| Wed Aug. 12, 2009 10:17 AM PDT

"Why do we tune up our cars but not our far more complex buildings?" asks Evan Mills, a scientist at the Lawrence Berkeley National Laboratory.  He's talking about "commissioning," a basket of techniques for increasing the energy efficiency of buildings:

Energy-wasting deficiencies are almost always invisible to the casual observer, and unfortunately also to building designers, operators, and owners. Commissioning is not a widgit or “retrofit”; it is an integrated quality-assurance practice.

....Back in 2004, the U.S. Department of Energy asked my team at Lawrence Berkeley National Lab to build a national database of commissioning experience....The results are compelling. The median normalized cost to deliver commissioning was $0.30/ft2 for existing buildings and $1.16/ft2 for new construction....Correcting these problems resulted in 16% median whole-building energy savings in existing buildings and 13% in new construction, with payback times of 1.1 years and 4.2 years, respectively.

....Applying our median whole-building energy-savings value (certainly far short of best practices) to the U.S. non-residential building stock corresponds to an annual energy-savings potential of $30 billion by the year 2030, which in turn yields greenhouse gas emissions reductions of about 340 megatons of CO2 each year.

In other words, this is a way of reducing greenhouse emissions significantly — and it's not just free, it saves money.  It's a no-brainer, and it's the kind of thing that will become more widespread if the Waxman-Markey climate bill passes.

It's also why the cost of Waxman-Markey, despite the pronouncements of the doomsayers, is likely to be close to zero.  The CO2 goals in W-M are actually fairly modest (a 17% decrease from 2005 levels by 2020), and commissioning could provide upwards of a thirds of that at no cost.  Other technologies have similar paybacks, and the net result is that we can almost certainly achieve a 17% reduction at a net cost that's very, very small.  Things gets tougher after 2020, but that's also the point at which W-M has provided several years of incentives to develop green technologies that will make further cutbacks considerably less painful than they would be today.  Warts and all, that's why Waxman-Markey needs to pass.

In Which I Remain Confused

| Wed Aug. 12, 2009 9:17 AM PDT

Via Tyler Cowen, Randall Kroszner writes in the Financial Times about the delicate role the Fed has to play as we (hopefully) exit the current recession.  If they keep monetary policy loose too long, they risk long-term inflation.  But if they tighten too fast, they risk cutting off the recovery too soon, as they did in 1937.  What to do?

Just last autumn, Congress gave the Fed a new tool that will play a crucial role as it exits from its unusually accommodative monetary policy: the ability to pay interest on reserves. Previously, a recovery would mean more opportunities for banks to lend and so they would draw down non-interest-bearing reserves and expand credit and hence the money supply. Interest on reserves, however, can cut that logic short by providing incentives for banks to hold reserve balances rather than lend them out, as the Federal funds rate target rises. The Fed now has a greater control over the reserve choices of banks because it can raise the return on reserves relative to banks’ lending opportunities, and thereby better manage credit and money growth in a recovery.

The basic idea here is simple: if the Fed raises the rate it pays on bank reserves, banks will park money at the Fed.  That reduces the amount of money they lend out.  Cut the rate and banks will pull their money out and find a better use for it.  Lending will increase.

Fine.  That makes sense and always has, as long as you trust the Fed to handle this particular monetary knob properly.  But what I still don't get is why you'd turn this knob up during a crisis, as the Fed did last year.  That reduced bank lending at a time when credit had already dropped off a cliff and was threatening to choke off the economy completely.  Is there some triple bank shot (no pun intended) here that I'm not getting?  Did the Fed figure that banks just flatly weren't going to loan out funds no matter what, so they might as well pay them interest as a backdoor way of recapitalizing them?  Or what?  I'm still confused.

Betsy Yet Again

| Wed Aug. 12, 2009 8:29 AM PDT

The intellectual superstructure for the "death panel" nonsense — such as it is — derives partly from sections of the House bill related to living wills and partly from the academic writings of Ezekiel Emanual.  Zeke is Rahm Emanuel's brother, a sometime advisor to the White House on healthcare, and a longtime medical ethicist who has written extensively on some of the most difficult kinds of healthcare decisions.

That was enough to make him a poster boy for the death panel crowd.  The heavy lifting, unsurprisngly, was done by our old friend Betsy McCaughey.  Michael Scherer explains:

In her Post article, McCaughey paints the worst possible image of Emanuel, quoting him, for instance, endorsing age discrimination for health-care distribution, without mentioning that he was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources. She quotes him discussing the denial of care for people with dementia without revealing that Emanuel only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy. She notes that he has criticized medical culture for trying to do everything for a patient, "regardless of the cost or effects on others," without making clear that he was not speaking of lifesaving care but of treatments with little demonstrated value. "No one who has read what I have done for 25 years would come to the conclusions that have been put out there," says Emanuel. "My quotes were just being taken out of context."

The whole piece is worth a read.  McCaughey and her ilk obviously don't care about any of this, but it's worth understanding how it all happened.

U.S. Attorney Finale

| Tue Aug. 11, 2009 10:47 PM PDT

The Washington Post reports on the release of internal White House documents from the Bush era related to the mass firings of U.S. Attorneys:

The dismissal of U.S. Attorney David C. Iglesias of New Mexico in December 2006 followed extensive communication among lawyers and political aides in the White House who hashed over complaints about his work on public corruption cases against Democrats, according to newly released e-mails and transcripts of closed-door House testimony by former Bush counsel Harriet Miers and political chief Karl Rove.

A campaign to oust Iglesias intensified after state GOP officials and Republican members of the congressional delegation apparently concluded that he was not pursuing the cases against Democrats in a way that could help then-Rep. Heather A. Wilson (R) in a tight reelection race in New Mexico, according to interviews and Bush White House e-mails released Tuesday by congressional investigators.

....Miers told investigators that Rove called her in September 2006, "agitated" about the slow pace of public corruption cases against Democrats and weak efforts to pursue voter-fraud cases in the state. In the call, Miers said, Rove described Iglesias as a "serious problem" and said he wanted "something done" about it.

Just to give you a taste, here's one of the emails in question.  The chairman of the New Mexico GOP, after attending an RNC meeting, emails the White House to say that Iglesias has been unhelpful in ginning up voter fraud cases against Democrats.  "To be perfectly candid, he was 'missing in action' during the last election," he says.  Rove's response? "Talk to the counsel's office."  After all, if a U.S. Attorney can't be counted on to help out during the election cycle, what good is he?

MoJo Mix: Birthers and Vegas, Baby, Vegas

| Tue Aug. 11, 2009 5:09 PM PDT

It's Laura, zooming by with a few odds and ends you might enjoy. (Don't worry, Kevin will be back in the next post):

1) Birther bio cheatsheet: 4 wingnuts you need to know.

2) Sheik down: How the Pentagon bought stability in Iraq by funneling taxpayer cash to strongmen.

3) Tweeting Las Vegas: A solar energy expert's notes from Monday's National Clean Energy Summit.

Laura McClure hosts podcasts, writes the MoJo Mix, and is the new media editor at Mother Jones. Read her investigative feature on lifehacking gurus in the latest issue of Mother Jones.

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Fundraising Time Again!

| Tue Aug. 11, 2009 1:29 PM PDT

I wrote a fundraising letter the other day.  Here's how it started:

Have you noticed the virtual flood tide of crap floating around these days?  Me too.  Turn on the TV and Lou Dobbs is noodling on the air about whether or not Barack Obama was really born in the United States.  Open the newspaper and George Will is telling his readers that global warming is just a sham.  Listen to Fred Thompson’s radio show and Betsy McCaughey is warning listeners that the House healthcare bill would “absolutely require” end-of-life counseling sessions every five years for senior citizens.

Everyone who reads this blog knows the rest of this story, so I won't repeat it here.  But the past couple of weeks have really brought some things into focus, and one of them is how difficult it is for any of us to make a difference all by ourselves.  I mean, what can you do when you're competing against Lou Dobbs and FreedomWorks and the entire cast of Fox News?

Answer: contribute a few bucks to Mother Jones!  It helps sustain this blog.  It helps sustain the magazine.  It helps sustain the website.  It helps sustain our Washington bureau.  Basically, it helps sustain an operation big enough to fight back against the conservative noise machine.

So help us out if you can.  You can contribute via credit card here, and if you give more than $35 we'll throw in a subscription to the magazine.  If you prefer PayPal, hit the tip jar at the bottom of the post.  You'll help make the world a better place.

Feeding the Outrage Machine

| Tue Aug. 11, 2009 11:54 AM PDT

In his new book And Then There's This: How Stories Live and Die in Viral Culture, Bill Wasik talks to John Harris and Jim VandeHei, founders of Politico, about the kinds of stories they want to cover:

VandeHei mentioned the classic pseudo-event: a presidential press conference. At major newspapers like the Post, he said, "you feel this sense of obligation to lead your newspaper the next day with a story about what Bush said at the press conference, even if he didn't say anything that was all that revelatory, and despite the fact that it's pretty damn stale: most news consumers have not only consumed it, they've digested it and moved on."

He contrasted this with a recent Politico story that, he noted, the Post did not touch, that "ten years ago would have been confined to the inside pages of Roll Call": the revelation that Rep. Loretta Sanchez (D., Calif.) had quit the Congressional Hispanic Caucus and alleged that its chairman, Rep. Joe Baca (D., Calif.), had called her a "whore."

This story, VandeHei said, was "a perfect example of how media has changed. We put it upfront early on the webpage. Instantly it's linked to by Drudge and all the other blogs; Fox News is doing a story based on it; MSNBC is doing a story based on it; and then the next day, on the Colbert Report, he does twenty minutes on 'whore.' So you have just, from this perch, been able to reach significantly more people than I would have reached even at the Washington Post." The challenge for The Politico, he said, is "figuring out how to put things into that pipeline."

Well, good for Politico.  But what happens when everyone decides to quit covering the "boring" stuff and just follow the Politico model instead?  Is this really a world any of us want to live in?

But I guess what's most remarkable about this isn't that Politico was the first to popularize political gossip.  I suppose someone was bound to do it eventually.  It's the fact that VandeHei sees their primary task as "putting things into that pipeline."  Not just reporting and winning a reputation, even if it's only for gossip, but feeding the outrage machine.  Only if a story has done that do they consider it a success.  What a sad career choice for a couple of highly regarded journalists to have made.

Trojan Horses

| Tue Aug. 11, 2009 10:27 AM PDT

Alex Massie writes about Britain's much-loved-much-loathed NHS:

There are, I think, two essential truths in international health policy. No-one sees fit to copy the National Health Service and no-one sees fit to copy the American system.... The relevance of the NHS to American health care plans seems pretty limited anyway since, as best I can tell (though I try not to pay too much attention to these things) Obama doesn't actually plan on copying the NHS.

That last sentence really is correct, by the way.  It's true that some things aren't entirely what they seem: they're Trojan horses for something else, or maybe the camel's nose under the tent that will eventually lead to more fundamental reforms.  Both sides do this on occasion.  I, for example, happen to think that community rating (along with the cloud of regulations that accompany it) will eventually put private insurance companies out of business — or, at a minimum, turn them into little more than semi-public utilities.  I don't know how many other people agree about that, but you could certainly accuse me of pushing for community rating not just because I like it as a policy, but because I think it will eventually lead to more systematic reform of the healthcare industry.

But with the exception of a few outliers, the liberal community really, truly doesn't want a fully government owned and operated healthcare system like the NHS.  We want a government-funded healthcare system like Medicare or most of the world outside of Britain.  And unless I'm mistaken, this isn't a ruse in any way.  That's really what most of us want: basic care funded by taxes, with additional care available to anyone who wants to pay for more.  France and Holland, not Britain or Canada.

Changing Healthcare

| Tue Aug. 11, 2009 9:48 AM PDT

A reader emails to say he just came back from a town hall meeting in his district and came away wondering if Obama might have bitten off more than he could chew:

It occurred to me that one of the things that helps the opponents of health reform is the complexity of the issue — big omnibus bills give opponents all sorts of opportunity to deceive. Moreover, there's a tipping point with big bills: if you try to get everybody on board by giving everyone something they want in exchange for something they don't want, you can sometime get a big program passed. But if the various interests decide they're better off without the bill, then the enemies just accumulate.

Under the circumstances, sometimes it's better just to try and eat the elephant one bite at a time — a series of bill over the first term that would whittle things down to size:

An initial bill would provide for community rating and pre-existing condition protections. This bill would have the opposition of the insurance industry, but everyone else would be for it.

After you get that done — individual mandate, small business coverage requirements, assistance to those with lower incomes for purchase. Small business would be against this part, but all those insurance lobbyists would be on board.

This is a defensible position, but I think it's also an example of a "grass is greener" approach to political process that's much too common.  Basically, whenever something is in trouble, people start to think that it would have worked if only we'd approached it in just the opposite way.

So Clintoncare failed because it was written in the White House and dumped in Congress's lap.  Won't make that mistake again!  Opponents are vilifying cherry-picked provisions of the House bill?  A watered-down bipartisan compromise would have had a better chance.  A big omnibus measure is in trouble?  We should have broken it into pieces.

Maybe so.  But I think this overrates process.  The opposition is always going to oppose, and they're going to find a way to oppose effectively no matter what you do.  If the White House creates a bill, it was "written in secret."  If Congress does it, it's a pork-filled monstrosity.  Write a liberal bill and you'll lose centrist Republican support; write a compromise bill and you'll lose Democratic support.  Write a big bill and it's confusing; write a bunch of little bills and you expend all your political capital on trivia and never get anything done.

Good presidents understand process and use it to their advantage.  But one way or another, you have to have the votes.  And one way or another, healthcare won't really be reformed unless, eventually, we pass something big.  We've been passing piecemeal legislation for a long time, and it just hasn't added up to much.  So every 20 years or so we need to take another crack at serious reform, and every 20 years or so we're going to learn the same lesson: if the public is on our side, we'll be able to pass something.  If we can't get them on our side, we won't.

For my money, the current bills wending their way through Congress are about as small as you can get and still call them serious healthcare reform.  If we can't pass some version of what's on the table now, there's really no reason to think that Obama has the political capital to pass it little bits at a time as his popularity inevitably wanes throughout his term.  It's now or never.