Undernews For 24 July 2009

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23 July 2009

PAGE ONE MUST

PUBLIC OPTION WOULD VARY BY ECONOMIC CLASS

Norman Solomon, Truthdig - Days ago, buried in a chart under the headline, "How the Health Care Bills Compare," The New York Times provided some cogent yet cryptic information in the category of "public plan."

A key Senate committee had just approved a bill with a public plan that would "compete with private insurers," the Times chart explained on July 18. The public plan "would provide 'only the essential health benefits,' as defined by the bill, 'except in states that offer additional benefits.'"

Meanwhile, the newspaper noted, "Democrats from three House committees are working on a single plan." Under that plan, "Different levels of coverage - 'basic, enhanced and premium' - can be offered through the public option."

Those few grainy sentences, quickly swept beneath the waves from oceans of media, referred to a disturbing aspect of "public plan" scenarios. If the ostensible goal is health care for all, then - at best - some of the "all" would end up being much more equal than others.

. . For the government to offer the public a multi-tier set of options for health insurance - in the words of The New York Times, "different levels of coverage" such as "basic, enhanced and premium" - is to imitate the approach of the corporate health care establishment.

After all, isn't it implicit that the government plan's "different levels of coverage," offered to the public, would be based on ability to pay?

THE HEALTH MANDATE MYTH

Individual mandates

John Geyman, MD, Physicians for a National Health Plan - With much fanfare, health insurance mandates were enacted by Massachusetts in 2006 and touted by many as an effective model to reform health care. After three years' experience, here is what the "Massachusetts Miracle" tells us about mandates and their costs:

- Only about one-half of the previously uninsured now have some coverage.

- The public "connector" established to implement the program has added another layer of 4 to 5 percent overhead without enough leverage to rein in costs of private insurers.

- As health insurance and out-of-pocket health care costs take up 15 percent or more of their family income, many people still forego needed care because of costs.

- The state has had to exclude many people from the program, the cost of subsidies (for those earning up to three times the federal poverty level) are much higher than anticipated, and the costs of health care continue to soar out of control (Massachusetts pays one-third more per person than the national average).

- In its budget crisis since the fall of 2008, in order to keep the program going, the state has had to cut safety net programs, including providers, emergency rooms, primary care, and chronic mental health services; and coverage of legal immigrants will soon be eliminated.

- In order to try to get a handle on soaring costs and over-utilization of health care, the state is now considering a plan to radically change how providers and hospitals are paid, eliminating the customary fee-for-service system and replacing it with some kind of risk-adjusted global payments.

Mandates are not a new idea. They have been tried in a number of other states, including California, Oregon, Pennsylvania and Maine. The results in Maine are no better than they are in Massachusetts. As a state with a large rural, poor and elderly population and an economy based on small business, employer-based insurance coverage is limited. The state enacted a law in 2003 with the goal of covering all 130,000 uninsured residents by this year. It has also failed:

- the plan now covers only a small fraction of the target population.

- the state had to cap enrollment due to financing problems.

- Most private insurers have left the state, and the dominant insurer has priced coverage in the individual market beyond the reach of most uninsured.

So we already know that mandates don't work as well as their supporters claim. They have not resulted in universal coverage in any state. They are complex, very expensive, not sustainable, and have unforeseen unintended consequences.

Yet an individual mandate that requires all, or nearly all, uninsured Americans to purchase health insurance is a basic part of all the proposals now being developed in Congress. Government subsidies will be provided for people below specified federal poverty levels, and those who still cannot afford insurance will be exempted. Under the House bill, a family of four earning less than about $88,000 a year won't have to pay insurance premiums that take up more than 11 percent of their income. Individuals will be penalized by fines if they do not have at least a minimal level of coverage. . .

The basic goal of a 2009 health care reform package is to address the problem of 46 million Americans without health insurance through a combined mandate on individuals and employers. The current House bill will cost $1 trillion over 10 years, but will still leave 36 million Americans uninsured, according to the CBO.

Based upon the poor performance of mandates in all states in which they have been tried, why is it that policy makers, politicians, and most stakeholders still support the concept of mandates? The basic answer, of course, is money. Insurers see nearly 50 million new enrollees, many subsidized by the government. The drug industry sees new profits for its products. Hospitals and physicians foresee many previously uninsured patients becoming insured. And many legislators benefit from corporate money flowing into their future campaign war chests.

Based on substantial experience at the state level, we can anticipate that "reforms" based on mandates will be very expensive (for both patients and taxpayers), add even more bureaucracy and complexity than we now have, fail to control costs and still not provide much additional access to care. In sum, if enacted as these bills are shaping up, these "reforms" will be policy failures but another bonanza for the medical-industrial complex

Employer mandates

Employer-sponsored health insurance dates back to World War II when the nation rapidly mobilized to a wartime economy. Facing a severe labor shortage and needing a healthy work force, employers had to compete for workers by offering higher pay and health benefits. IRS rulings freed employers from taxes on the costs of health insurance, and these benefits were not taxable for their employees.

We now have an almost 70 year experience with ESI, and that method of financing U.S health care has been steadily unraveling. Employers today are spending an average of about $10,000 a year for health coverage for each employee with a family of four. Premiums have gone up by 120 percent for ESI since 1999, nearly triple the rate of inflation and six times cumulative wage growth. Only three in five large employers now offer any kind of health care coverage, and many are cutting back or eliminating retiree health benefits. Smaller employers are abandoning ESI at a rapid clip. National surveys have found that the proportion of small businesses offering coverage dropped from 61 percent in 1993 to just 38 percent today.

So are employer mandates good health policy? If we base that answer on history and their track record, instead of ideology and wishful thinking, we have to say no. Employer mandates will not give us an effective way to control health care costs, which will only become a bigger burden on employers and make them even less able to compete in a global economy. Taking General Motors as an example, it has had to spend about $1,500 per car for health care, hardly competitive with manufacturers across the border in Toronto that spend one-fifth of that amount on health care within the Canadian single-payer system.

Employer mandates have been tried for many years in a number of states, and have never resulted in universal coverage or cost containment. The longest experience has been in Hawaii - 30 years - where initial gains in coverage later reverted to growing numbers of uninsured and higher health care costs. Later experiments with employer mandates, often combined with individual mandates, have been carried out in California, Connecticut, Massachusetts, Maine, Minnesota, New Mexico, Oregon, Vermont, and Wisconsin.

Over the years, employer mandates have usually been opposed by the business community, including conservative market advocates and the Chamber of Commerce. In the current debate over reform proposals, the business community is increasingly vocal in its opposition to the cost and burdens of an employer mandate. Flash points in the debate now focus on whether ESI health benefits should be taxed and what exemptions ought to be extended to small business.

Forty percent of the private U.S. labor force works for employers with fewer than 100 employees, who are represented by the National Federation of Independent Business. The small employer market is one of the most profitable markets for private insurers, but small employers find insurance premiums increasingly beyond their reach. According to the Kaiser Family Foundation, premiums for single workers in small businesses climbed by 74 percent between 2001 and 2008. . .

What American business desperately needs is containment of its health care costs and a healthy work force in order to compete in the 21st Century. It will not get that from "reforms" now being debated in Congress. If enacted after political compromises with the major corporate stakeholders, a bill will likely make the plight of American business, as well as the broader public, even worse.

Ironically, the goals of health care reform - cost containment, universal access, and improved quality of care - can be met by single-payer national health insurance, which would provide universal coverage and cost less than what employers and the public are paying now. But since that option would reduce corporate profits in a runaway market system, it is still not being considered by most politicians, beholden as they are to corporate money.

BOARDING HOUSE RETURNS TO SEATTLE

Seattle Times - Videre is brand new. The kind of housing it will provide is anything but. It's a rooming house. Older ones dot the city, especially in neighborhoods like the University District. But Seattle officials can't remember the last time anyone built a new rooming house from the ground up.

The rooms are small - about the size of a parking space - but the project's developers say they fit the budget and lifestyle of young adults who might be working as baristas or $12-an-hour clerks in big-box stores.

Tenants will get a cable-ready, furnished room with private bath with shower for around $500 to $600 a month, with all utilities and broadband Internet included.

They'll get a single bed, table, chair and refrigerator. They won't get a closet, a private kitchen - or very much space. The 46 rooms range in size from 90 to 168 square feet, including the bathroom, according to plans filed with the city.

Potter says many younger people now don't do much more than sleep in their apartments anyway. "You have a living room somewhere else," he says - perhaps a bar or coffee shop.

WHERE SOLAR MEETS THE ROAD

SOLAR POWER ROCKS PHOTO

Tree Hugger - Roads are teeming with possibilities for clean energy generation--they could be lined with small wind turbines, accompanied by solar arrays, even generate energy from speed bumps. And as this potential is growing in recognition, a number of states have jumped on board with some fascinating projects designed to harvest clean energy from their roadways.

According to Green Inc, a few states are already dabbling in roadside energy production. Last year, Oregon began a "solar highway" demonstration project with a 104-kilowatt ground-mounted solar array situated at the interchange of Interstates 5 and 205. The array powers about a third of the lights on the interchange. Massachusetts recently announced a plan to install a utility-scale wind turbine - big enough to power 400 households - on land adjacent to the Massachusetts Turnpike's Blandford Rest Area. . .

Researchers and designers are also toying with ways to generate power along roads, including the use of piezoelectric materials, energy producing speed bumps and integrating wind turbines into road barriers.

While some of these ideas are dubious at best, many offer intriguing possibilities for expanding the potential of the clean energy world.

FLOTSAM & JETSAM: WHERE BAD COPS COME FROM

Sam Smith

Whenever anything like the Gates incident arises, we spend an inordinate amount of time assessing blame and hardly any discussing remedies.

Calling someone a racist doesn't cure anything. In fact, racism is normal. That isn't to say that it's nice, pretty, or desirable. Only that suspicion, distrust, and distaste for outsiders is a deeply human trait. The anthropologist Ruth Benedict wrote that "all primitive tribes agree in recognizing [a] category of the outsiders, those who are not only outside the provisions of the moral code which holds within the limits of one's own people, but who are summarily denied a place anywhere in the human scheme. A great number of the tribal names in common use . . are only their native terms for 'the human beings,' that is, themselves. Outside of the closed group there are no human beings."

Many attempts to eradicate racism from our society have been based on the opposite notion -- that those who harbor prejudice towards others are abnormal and social deviants. Further, we often describe these "deviants" only in terms of their overt antipathies -- they are "anti-Semitic" or guilty of "hate." In fact, once you have determined yourself to be human and others less so, you need not hate them any more than you need despise the fish you eat for dinner. This is why those who participate in genocide can do so with such calm -- they have defined their targets as outside of humanity.

What if, instead, we were to start with the unhappy truth that humans have always had a hard time dealing with other peoples, and that much ethnic and sexual antagonism stems not from hate so much as from cultural ignorance and narcissism? Then our repertoire of solutions might tilt more towards education and mediation and away from being self-righteous multi-cultural missionaries converting yahoos in the wilds of the soul. We could turn towards something more akin to what Andrew Young once described as a sense of "no fault justice." We might begin to consider seriously Martin Luther King's admonition to his colleagues that among their dreams should include that someday their enemies would be their friends.

Even if racism played a major role in the Gates incident, it probably wasn't the only factor. For example, one reader asks if there wasn't the smell of a class divide in the confrontation between a Cambridge cop and Harvard professor, with the white guy on the lower end of the economic ladder.

The most common form of police misbehavior is bullying. The target need only be someone who is perceived as vulnerable, with blacks, gays and young teens all in the pool. Blacks are extremely common victims but they are far from the only ones.

As our policing has increasingly moved to a military model and with cops often being from the lower economic and social strata, the bullying approach has tremendous appeal. One's size and blanket of weaponry reorganize one's place in society and are tempting to use in full force.

Unfortunately, neither scolding nor paper regulations have much effect. If the officer in the Gates case were to be punished, it would probably just increase the hostility of other officers towards those perceived as weak and who have no access to the national media.

Having been briefly a federal law enforcement officer while in the Coast Guard and having covered the ethnically divided town of DC for many decades, this is a matter that has long fascinated me. If you strip away the cliches and watch actual behavior, you start to see things easy to pass unnoticed.

For example, the DC police department changed from having only one top level black officer and with white cops refusing to share their cars with black officers to a department run by a series of black chiefs. On average these chiefs did a better job than the white ones (including the current white woman) in part because they had an instinctive feel for creating better ethnic relations and the officers under their command soon learned the sort of behavior that was expected. I suspect, however, that it made another difference: it increased the respect black officers had for themselves and with which white officers treated black citizens.

Sometimes things slipped back, as when a bunch of white West Virginia officers were hired to overcome a shortage on the force. It wasn't that the West Virginia officers couldn't have been better; it was just that at the time no one really cared that much.

It is part of the liberal canon that wrong thinking people stay that way. In fact, people tend to behave the way they are trained to behave and the way those leading them tell them to behave.

Obviously, there will be exceptions but in a normal community these people become social rogues rather than the norm.

So the first way to get a good police officer is to have good lieutenants, captains and chiefs.

The second necessity, and one that is massively ignored, is good and continuous training and the self respect that it encourages.

It shouldn't stop at the police academy. If it does you end up with a cable TV version of law enforcement in which the cop drifts easily into the role of a bully.

I have argued for decades that every police precinct house and headquarters should have a lawyer - given the rank of captain or above - to be on hand to train the force, mediate conflicts and help officers do their job better.

I watch this in action at a Coast Guard district headquarters where I was stationed. A Lieutenant Commander was the legal officer, but he was much more. Enlisted personnel such as boarding officers would casually drop by his office to discuss problems they had encountered. He was right on top of every little legal issue that arose and he had the autonomy to act based on legal wisdom and not the district commander's say so.

Only a tiny number of police officers in this country have any access - let alone easy access - to good legal advice. Yet they are supposed to be first government officials enforcing the law. It is bizarre, dangerous and it doesn't work.

There would be a further advantage to such an approach. As police officers see themselves as well educated agents of our system of law, they would start to have more respect for themselves and, as a result, treat others better.

But as long we treat cops as society's hired bullies, we shouldn't be surprised by some of the results.

WHY DISORDERLY CONDUCT LAWS ARE OUT OF ORDER

Jacob Sullum, Reason - Indiana lawyer Joshua Claybourn notes that the Henry Louis Gates affair highlights the threat to civil liberties posed by laws prohibiting "disorderly conduct," the offense for which Gates was arrested. In Massachusetts, a person is deemed "disorderly," and therefore subject to a jail term of up to six months, if he

1) "engages in fighting or threatening, violent or tumultuous behavior," or

2) "creates a hazard or physically offensive condition by any act which serves no legitimate purpose"

3) "with purpose to cause public inconvenience, annoyance or alarm," or

4) "recklessly creates a risk thereof."

Claybourn (who, for what it's worth, is skeptical of Gates' charges of racism) says:

"This sort of definition is...similar to that found in most states, and in almost [every]instance it is fraught with vagaries, giving far too much discretion to police officers. In short, "disorderly conduct" can easily become a euphemism for whatever a particular police officer doesn't like. That kind of environment runs counter to fundamental ideals of the American system."

The danger of such discretion is clear from the report on Gates' arrest. Sgt. James Crowley, the Cambridge police officer who arrested Gates at his home after responding to an erroneous burglary report, claims the Harvard professor's complaints and charges of racism amounted to "tumultuous behavior" that recklessly created a risk of "public inconvenience, annoyance or alarm." How so? Crowley reports that Gates followed him from the house onto the front porch, where he continued haranguing the sergeant:

"As I descended the stairs to the sidewalk, Gates continued to yell at me, accusing me of racial bias and continued to tell me that I had not heard the last of him. Due to the tumultuous manner Gates had exhibited in his residence as well as his continued tumultuous behavior outside the residence, in view of the public, I warned Gates that he was becoming disorderly. Gates ignored my warning and continued to yell, which drew the attention of both the police officers and citizens, who appeared surprised and alarmed by Gates's outburst."

Notably, Crowley invited Gates to follow him, thereby setting him up for a disorderly conduct charge. "I told Gates that I was leaving his residence and that if he had any other questions regarding the matter I would speak with him outside the residence," Crowley writes. He claims "my reason for wanting to leave the residence was that Gates was yelling very loud and the acoustics of the kitchen and foyer were making it difficult for me to transmit pertinent information to ECC or other responding units." But instead of simply leaving, Crowley lured Gates outside, the better to create a public spectacle and "alarm" passers-by. The subtext of Crowley's report is that he was angered and embarrassed by Gates' "outburst" and therefore sought to create a pretext for arresting him.

The charge against Gates was dropped. But what are the odds that it would have been if Gates had not been a nationally famous scholar with many friends in high places, including the president of the United States? Instead of showing what happens to "a black man in America," the case illustrates what can happen to anyone who makes the mistake of annoying a cop.

ANOTHER OF THE DANGER OF PLACING FAITH ABOVE WORKS

TPM Muckraker - Meet Tennessee state senator Paul Stanley. He's a solid conservative Republican and married father of two, who according to his website is "a member of Christ United Methodist Church, where he serves as a Sunday school teacher and board member of their day school." . . .

Stanley recently sponsored a bill designed to prevent gay couples from adopting children. And when a Planned Parenthood official recently sought his support for family planning services for Memphis teens, Stanley told her, according to the official, that he "didn't believe young people should have sex before marriage anyway, that his faith and church are important to him, and he wants to promote abstinence.". . .

In a sworn affidavit, a Tennessee state investigator has said that Stanley admitted to having a "sexual relationship" with a 22-year-old female intern working in his office, and to taking nude pictures of her in "provocative poses" in his apartment.

Things started to unravel for Stanley, it seems, in April, when he received a text message reading:

Good morning sir, how are you this fine day? McKensie and I have been talking and I feel that I have a video and some pictures you might be interested in seeing. This is her boyfriend, that guy you met outside Walgreens.

That was the start of an effort by the girl's boyfriend to blackmail Stanley, which ultimately led to Stanley going to the cops. The boyfriend is now charged with trying to extort $10,000 from Stanley.

Stanley works as a financial adviser for the Stanford Financial Group, whose founder, Allen Stanford, has been charged with orchestrating an $8 billion scam. . .

CAN'T MISS PLAN FOR HEALTH REFORM

Jim Moss, Seminal

1) Cancel the health insurance of all our Senators and U.S. Representatives.

2) Give a debilitating disease to a member of each of their immediate families that is very expensive to treat.

3) Freeze all of their financial assets.

4) Lock them all in a room and tell them to figure out a solution

JOBLESS CHECKS DELAYED AS STATES STRUGGLE FOR CASH

NY Times - Years of state and federal neglect have hobbled the nation's unemployment system just as a brutal recession has doubled the number of jobless Americans seeking aid.

With millions of jobs lost and major industries on the ropes, America's array of government aid - including unemployment insurance, food stamps and cash welfare - is being tested as never before. This series examines how the safety net is holding up under the worst economic crisis in decades.

In a program that values timeliness above all else, decisions involving more than a million applicants have been slowed, and hundreds of thousands of needy people have waited months for checks.

And with benefit funds at dangerous lows even before the recession began, states are taking on billions in debt, increasing the pressure to raise taxes or cut aid, just as either would inflict maximum pain.

Sixteen states, with exhausted funds, are now paying benefits with borrowed cash, and their number could double by the year's end.

Call centers and Web sites have been overwhelmed, leaving frustrated workers sometimes fighting for days to file an application.

7-11 GROWING DESPITE RECESSION

LA Times - In a move that could nearly double its Southern California footprint, the 7-Eleven convenience store chain is taking steps to lease up to 600 new locations in the region.

The company hired commercial real estate broker CB Richard Ellis on Thursday to begin scouting locations for a planned seven-year expansion that would add to the 800 stores that 7-Eleven operates from San Luis Obispo County to the Mexico border.

7-Eleven, a Dallas unit of Tokyo-based Seven & I Holdings Co., said that by launching so many stores in the middle of a crushing real estate downturn it will save millions of dollars on rent.

Buoyed by an uptick in convenience store sales nationwide and support from its Japanese corporate parent, officials at 7-Eleven say they want to restore the empire that the company reigned over before gas stations and other retailers moved onto their turf.

BREVITAS

THINGS TO DO WITH THE LEGOS WHEN YOUR KIDS GROW UP
WAR DEPARTMENT

AMERICANS OPPOSE BOTH WARS

JUST POLITICS

Governing - The Detroit Free Press reports that Michigan Democrats are considering using the ballot measure process to push economic populism next year. The ideas: Hiking the minimum wage to $10 an hour for all workers; imposing a blanket moratorium on home foreclosures for 12 months; cutting utility bills by 20% across the board; requiring all employers to provide health care to employees and their dependents; • Hiking by $100 a week -- and extending for six months -- unemployment benefits, while expanding eligibility. The Republicans control the Michigan Senate, which is why it's tempting for Democrats to turn to the ballot to achieve their policy goals. But, electoral politics probably also is playing a role here. Democrats want to make sure their labor loyalists show up to vote next year, when control of the governorship and legislature is at stake.

ECO CLIPS

Tree Hugger - Back in May the initial applications for a 540 MW wind farm in the Shetland Islands were submitted. Now the Royal Society for the Protection of Birds has issued a formal objection to the plans on the grounds that local bird populations could be . . . The BBC reports that about 3,500 people have signed a petition objecting to the proposed wind farm.

OBAMALAND

USA Today - Whatever the impact on policy, there has been a transformation in views of the American president abroad. Confidence that Obama will "do the right thing in world affairs" was double that for Bush in China, triple in Japan and Mexico, quadruple in Jordan and Egypt. The contrast was even wider across Western Europe and in Turkey and Argentina. In France, 13% viewed Bush positively last year; now 91% express confidence in Obama. Bush fared better than Obama in just one country surveyed. In Israel, 57% expressed confidence in Bush in 2007; 56 express confidence in Obama now. . . Attitudes toward the United States continued to be dismal in some predominantly Muslim countries. Just 14% of those surveyed in Turkey and 16% in Pakistan had a favorable opinion of the U.S.

THE MIX

Copenhagen Post - In the US alone homosexual travelers spend an estimated $64 billion annually, and a recent study found that each dollar invested in homosexual tourism marketing generates $153 in revenue.

HEALTH CARE

Kaiser Family Foundation -Nearly a quarter of the nation's 45 million non-elderly uninsured are middle class. Most middle class Americans with insurance get it through their employers, a source of coverage that has been put in jeopardy by the economic recession. One in six middle class working-age adults report they or someone in their family has recently lost their job, and one in 10 lost health insurance. One third of middle-class working-age adults say that they or a family member have postponed needed health care or skipped dental check-ups in the past year because of cost.

OBAMA MET SECRETLY WITH HEALTHCARE INDUSTRY

SCIENCE

BBC - For centuries, scientists have puzzled over why the toucan's bill is so remarkably large - but now one team thinks it might have an answer. Writing in the journal Science, the researchers say that the toucan uses its enormous beak to stay cool. They used infrared cameras to show the bird dumping heat from its body into its bill, helping it to regulate its body temperature. The toucan has the largest bill of any bird, relative to body size. It makes up about one-third of its total body length.

FURTHERMORE. . .

Governing - Does a heart tattoo with "Mom" written inside portray a professional image? The Dallas Police Department doesn't think so. The personnel department is now drawing up an official policy on tattoos, according to a story in the Dallas Morning News. More and more officers have been sporting the body . . . The Dallas policy will require a cover-up, even if that means makeup or a skin-colored patch. Houston and Los Angeles are other cities that require that tattoos be hidden, despite the ever growing popularity of them in society at large.

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