Political MoJo

The Costs of Single-Payer

| Wed Feb. 1, 2006 3:55 PM EST

Economist Kash Mansori has a great post about the costs that would come with switching to a single-payer system in the United States. In some respects, a single-payer system would be more expensive than what we have now: people would end up consuming more health care, especially the 45 million who are currently uninsured. But on the plus side, these extra expenses would be outweighed by the cost savings that would come from eliminating a lot of the $400 billion we spend on administrative overhead and allowing the government to bargain down the price of services. Is there any evidence for this? Sure, look at Taiwan:

As another useful data point we can examine the case of Taiwan, a country that replaced a collection of different insurance schemes with a National Health Insurance program in 1995. The percent of Taiwanese with health insurance rose from about 60% in 1994 to 96% a few years later. It turns out that in Taiwan's case, the forces that would increase costs roughly balanced the forces that would decrease costs.
Moreover, providing preventive care to all people, especially those who are currently uninsured, would likely save money by preventing later, costlier hospital visits—it's much cheaper, for instance, to treat diabetes early on than wait for a patient to get rushed to the ER. According to the Institute of Medicine, covering all Americans continuously would save the country anywhere from $65 billion to $130 billion in better health outcomes. Note that this is more than the estimated $80 to $100 billion it would cost to cover the uninsured. On the surface at least, universal coverage makes economic sense.

The catch that's always mentioned, of course, is that some sort of single-payer system would force rationing of health care and stifle innovation. Innovation is a harder problem, but it's worth noting that we already do ration care—by income, by location, by age. But the case for switching to a system that would cost roughly the same, if not less, as our present dysfunctional mess, and would lead to universal coverage, has a lot going for it.

Advertise on MotherJones.com

A Pittance for Research

| Wed Feb. 1, 2006 3:39 PM EST

In his State of the Union last night, the president got all environmental on us and proposed a few million dollars in subsidies for clean-energy research. About $264 million, according to David Roberts of Grist—not nothing, but a pittance compared to the billions of dollars in subsidies that Congress is giving oil and gas companies to drill and explore the earth last year. (In a year that Exxon earned a record $36 billion in profit, no less.) Oh, and that also comes after last year, during which funding for carbon-free energy sources was cut 3.6 percent.

Sorry to get critical—yes, yes, the president was making a baby step towards some sort of decent goal for once in his life—but this really won't cut it. Dramatic climate change is on the way, and little half-gestures won't help change course. Meanwhile, the president's proposal to increase spending on federal research and development by an additional $6 billion was a good call, and genuinely needed—most of this basic research is responsible for some of the major inventions of our time, including a variety of breakthrough drugs and of course the internet, and the U.S. is falling behind other countries on this front—but the betting line is that the Republican-controlled Congress won't actually approve anywhere near that much. Oh well, I'm sure it made for a good applause line, and that's all that counts, right?

February 1st...

Wed Feb. 1, 2006 3:26 PM EST

Welcome to February, everybody. February reminds me of Walt Whitman, who wrote, "Do I contradict myself? Very well, then I contradict myself." That's because February is simultaneously National Snack Food Month and National Heart Month. Oh, and also National Children's Dental Health Month. All the best from Mother Jones.

Cracking Down on Protests

| Tue Jan. 31, 2006 7:48 PM EST

The Secret Service will have a much easier time breaking up protests and arresting protestors if the latest version of the Patriot Act passes, according to Fox News:

A new provision tucked into the Patriot Act bill now before Congress would allow authorities to haul demonstrators at any "special event of national significance" away to jail on felony charges if they are caught breaching a security perimeter.

Sen. Arlen Specter, R-Pa., chairman of the Senate Judiciary Committee, sponsored the measure, which would extend the authority of the Secret Service to allow agents to arrest people who willingly or knowingly enter a restricted area at an event, even if the president or other official normally protected by the Secret Service isn't in attendance at the time.Just to be clear, the Secret Service already has the power to haul demonstrators away on felony charges if they breach a "security perimeter" while the president or other VIPs are around. But now, apparently, that power's being extended to occasions when no one important is in the area. From the looks of things, the Secret Service could name just about anything they wanted a "special event of national significance" and lock up anyone who crashes. Why? What possible security purpose does this serve, besides clamping down on dissent?

State of the Union

| Tue Jan. 31, 2006 4:16 PM EST

Can't imagine why anyone would possibly want to watch the State of the Union, but it's tonight for those interested. Charlie Cook pointed out the other day that the only address in recent memory that was even remotely "important" was Bill Clinton's in 1998, when the president strode in after the Monica Lewinsky scandal had erupted and showed everyone that it was business as usual in Washington, life would go on, and there was no constitutional crisis in the offing. (Well, more specifically, the purpose of the speech was to show the media that life would go on; most of the rest of the country didn't actually think the affair was the end of the world.)

At any rate, E.J. Dionne has a great column today noting that whatever President Bush might say in his speech tonight about "boldness" and "vision" and "reform," it's been business as usual in the Republican-controlled Congress, where the upcoming budget vote will slash genuinely important programs for the poor while cutting taxes on the wealthy. (And increasing the deficit all the while—as it turns out, anti-poverty programs are relatively cheap, while tax cuts blow a big hole in the budget.) Dionne's right, there should be moral outrage over this.

There aren't really any new and dazzling ways to spin the GOP's disastrous budget, although we can note some of the consequences: among other things, the non-partisan CBO pointed out that as a result of recent Medicaid cuts, millions and millions of low-income Americans could lose their coverage or face higher payments. The indefatigable folks at the Center on Budget and Policy Priorities, as usual, have the gory details.

Vets for Congress

Mon Jan. 30, 2006 7:01 PM EST

Eric Massa is an interesting character. He's a naval veteran running for Congress as a Democrat in New York's 29th district. He was profiled at Mother Jones, along with other vets running for Congress, back in October and since then the meme has really taken off. Yesterday Massa posted at TPMCafe (where he's a regular contributor) in an effort to let the world know the vets-for-congress movement has now reached 53 Democrats. Massa is extremely bright and his campaign website has lots of content on tough issues, all thought through and written by the candidate himself. (He even has a blog.) He's running against an incumbent who barely won his last race—this puts Massa in a different position than most of his fellow veterans. A lot of the Democratic veterans are running in solidly Republican districts, where they hope their military background will make voters comfortable with voting for a Democrat.

Advertise on MotherJones.com

The Pentagon's Private Army

| Mon Jan. 30, 2006 6:57 PM EST

This seems like it should be bigger news. Congress has recently granted the Pentagon $200 million to aid foreign militaries, a sum which the executive branch can now spend without oversight from either the State Department or the legislature. That means the military can spend money training and equipping foreign armies without following constraints that require that the aid recipients meet certain standards, "including respect for human rights and protection of legitimate civilian authorities." And military leaders will now be able to set a small but potentially important aspect of foreign policy without input from the State Department.

Perhaps there's a case to be made that the old oversight rules were too byzantine, and, as administration officials argued to the Post, the old way of doing things was hindering U.S. attempts to provide security assistance in "crisis situations." But the opportunities for abuse here are pretty self-evident. Among other things, the Pentagon wants to use the funds for "fighting terror and bolstering stability" in Africa. But we know that the United States has fostered a "close intelligence relationship" with, for instance, the regime in Sudan that's currently responsible for genocide in Darfur, all in the interest of fighting terror. Is further assistance on the way? Is this really the sort of thing that demands less, rather than more, oversight?

What Baby Boom Crisis?

| Mon Jan. 30, 2006 4:28 PM EST

Ezra Klein puts up a few nice charts and graphs showing that, relatively, the retirement of the Baby Boomer generation simply isn't going to be the devastating demographic shift that many pundits make it out to be. Good stuff; and as a bonus, here's my favorite way to put the so-called "old-age crisis" in context. As we've heard many times, the future unfunded increases in spending associated with the aging of the population are going to require a tax hike of about 6.5 percent of GDP to close the gap. (Personally, I think it will be much less than that, since the problems with both Social Security and Medicare are wildly overstated, but let's say 6.5 percent.)

That sounds like a lot, but it's hardly unprecedented. Between 1950 and 1952, note, the federal tax burden jumped suddenly from 14.4 percent to 19 percent as a result of the Korean War, a leap in defense spending that was more or less permanent for the duration the Cold War. Now that increase came in just a few years—rather than gradually over decades, as would be the case to pay for Social Security and Medicare—and it was entirely manageable. The economy didn't implode. Life went on.

It would be nice to figure a way to curtail the cost of health care in the future, and obviously a lower tax burden is better than a higher one whenever possible, but even in the worst case, we're not talking about Armageddon here. We wouldn't even be up to European levels of taxation. As Max Sawicky has gone over in gruesome detail, bringing federal revenues back up to around 20 percent of GDP—only slightly higher than the long-term historical average—is perfectly adequate to maintain current spending levels and keep our debt ratios sustainable. Beyond that, thanks to the magic of productivity, those "overtaxed" Americans of the future will still be much richer in real terms than people are today. Slicing up a bit more of all that extra pie to ensure that the workers who brought this country to where it is today can have a decent retirement is a perfectly sensible way to go.

Irrationality in Politics

| Mon Jan. 30, 2006 3:25 PM EST

Is there a neurological explanation for blind partisanship? According to this press release, scientists, using fMRI scans, have found that when "committed Democrats and Republicans" are faced with criticism of their favorite politician, they show no increase in activity of the parts of their brains associated with reasoning. (Incidentally, or not, the subjects of the study were all men.) That's not all that surprising, really, although I wonder whether this holds equally for all education groups, or whether it's possible to train oneself not to do this. At any rate, one could note that a good number of media types who worship at the altar of "non-partisanship" tend to turn off the rational bits in their brains fairly frequently…

On a related note, economists Sendhil Mullainathan and Ebonya Washington recently put out a paper suggesting that voters have an irrational preference for the candidates they've just voted for. They found that twenty-year-olds who had voted in a particular election two years prior showed more polarization in their opinions about the elected candidates than did nineteen-year-olds who, incidentally, missed the chance to vote that year. (Assuming, of course, that there's no other reason why twenty-year-olds and nineteen-year-olds should have such different political views.)

Meanwhile, Senators who are elected in high-turnout presidential years are more polarizing figures among the public than those elected in off-years. That could partially explain why incumbents keep winning, and suggests that term limits, perhaps, could inject a bit more rationality into politics. Although if that's the goal, we're a fair ways off.

Substantial amount of AIDS funding goes to religious groups

| Sun Jan. 29, 2006 7:37 PM EST

There was a time in America when the above headline would not have aroused suspicion;; we would have expected a certain number of religious organizations to apply for and receive grants to help fight a serious syndrome that causes devastating disease and death. Religious organizations have taken an active role in promoting a number of social programs, from the Vietnamese resettlement effort to providing food for the nation's poor.

What makes the headline different this time around is the conflict between what is needed to overcome the AIDS virus, and what is taught by many of the religious organizations receiving grants. Take, for example, Catholic Relief Services, which was awarded $6.2 million to teach "abstinence and fidelity" in three countries. The group claims it offers "complete and accurate" information about condoms, but does not promote, purchase, or distribute them.

Or World Relief, a group established by the Natonal Association of Evangelicals. World Relief receieved $9.7 million to do abstincence work in four countries. Samaritan's Purse provides community education about AIDS, though not without education about Christianity, and World Vision, also operates an educational prevention program which "may include" information on condom use.

In other words, 23% of the White House's $15 billion AIDS package has gone to groups who either do not even mention the word "condom," or who mention it only as a last resort.

It is important to point out that the use of condoms is not a tidy solution to the problem of AIDS in poor countries:

Many men in Africa, especially South Africa, believe that having sex with a virgin will cure AIDS. This belief (a 3-year study of 28,000 men in South Africa showed that 1 in 5 of them believed in this "cure") has led to a rise in infant rape.

In South Africa, a woman is raped every 20 seconds.

In poor countries, girls and women are often forced into prostitution by poverty or family coercion.

In many cultures, the use of condoms in marriage indicates a lack of trust, yet in these same cultures, there is often a lot of sex outside of marriage.

To solve these very serious problems, there must be massive education, and strong programs to empower women. Rape victims, prostitutes, and adolecent brides cannot expect to have any success in suggesting the use of condoms or--in the case of the latter two groups--providing condoms to their sex partners. But condoms are part of the answer for family planning, for marriages in which AIDS education has taken place, and among young men and women who learn about what causes the spread of AIDS.

Though condom use cannot solve the problems of rape (including sanctioned marital rape), forced prostitution, and female powerlessness, it is a vital part of the solution once AIDS education and female empowerment have begun to take hold. Teaching abstinence to hundreds of thousands of potential rape victims, on the other hand, does nothing but further endanger the people it is supposed to be helping.