Friday, August 21, 2009

Very strange...

I just got a robocall from Omaha, Nebraska. A male voice said, "Press one to hear a message about capitalism."

"Sure," I thought. "Why not?"

I pressed one, and heard, "America was founded on the principle of small government and allowing people to pursue their dreams. Keep capitalism strong in the USA."

That was it – nothing more.

The only capitalist I associate with Omaha is Warren Buffett, but, of course, a robocall phone bank can be anywhere and hired by anyone. I doubt the call came from Buffett, who is not known for wasting money on useless gestures.

If I were so inclined, what would the call's originator have me do to keep capitalism strong? Expand my stock portfolio? Set up a lemonade stand in my front yard? Send back my social security check in protest?

More likely I'm supposed to oppose the public option for health insurance reform; or, maybe, oppose new regulation of the financial markets. Maybe I should be supporting unlimited worldwide immigration so that labor markets can be internationalized as thoroughly as capital markets, or working to eliminate the unfair and uncompetitive tax advantages enjoyed by religious organizations.

There's capitalism, and then there's capitalism, after all. One way or the other, I think it's become fairly obvious that keeping it on a shorter leash might not be that bad an idea.

Monday, August 17, 2009


To nobody's great surprise, the Obama administration has backed off its support for a public option, suggesting that state level non-profit cooperatives would do the trick just as well. That, of course, is bullshit.

Just creating fifty-one (including DC) separate cooperatives presents an organizational nightmare, especially if it is left primarily to the states. They will be too small to negotiate effectively, will find it hard to find a sufficient number of doctors and hospitals to participate, and will provide no significant savings over the privates. Essentially self-insurance plans forced to accept everybody not cherry picked by the local privates, they'll be worthless, and bound to fail.

A public option, on the other hand – nationwide, and with a very large membership – cannot be marginalized or ignored. Despite Obama administration commitments, it may be able to drag additional concessions from big pharma. It also may be able to start the move towards outcome based rather than fee for service payments.

One only can hope that Obama's bag of political tricks includes more than "compromising" with those who want him to fail. It is pretty clear that the public option will be included in the House bill, even if health cooperatives are the best that can win sixty vote approval from the Senate.

One also hopes that the administration will work, however covertly, to get the public option reported out of the conference committee. If that happens, it will take only fifty votes in the Senate to pass the final bill – most of the media seems to have forgotten that the health care bill will be considered under the reconciliation process, and cannot be filibustered.

So, like everybody else, I'll wait and see what happens. This is the big one for Obama, so maybe he'll come through.

Wednesday, August 12, 2009

What 850,000 assholes don't know

Yesterday I got a robocall asking me to "just press one" in order to join 850,000 other Medicare recipients in a campaign to save Medicare Advantage. It went on for about two-and-a-half minutes, progressing from "surely you want to press one" to "IF YOU DON'T PRESS ONE YOU WILL DIE!!!"

Actually, I'm not on Medicare yet, and I won't need Medicare Advantage when I go on it because I'll have secondary insurance via my former employer. Of course, there was another reason I wasn't about to press one.

Unlike the 850,000 already signed on with the insurance industry's front group, I'm not an idiot.

I had a look at the Medicare Advantage plans available in my area. Most of them, naturally, are HMOs. If I correctly recall the Clinton era, the advantage of an HMO is greater efficiency, which makes it possible for the HMO to offer enhanced coverage for the same amount of money as the usual fee-for-service coverage. Other Medicare Advantage plans either use preferred provider networks (doctors willing to accept reduced fees for more business), or allow the insured to use "Any Willing Doctor" [emphasis added] – to wit, any doctor willing to accept reduced fees.

What those 850,000 assholes don't understand is that the government subsidy to the insurance industry for offering Medicare Advantage plans – roughly 14% – does not pay for additional services. It goes straight to insurance company profit margins. If the final health care reform bill includes a public option, the privates quickly will learn to do without their 14% markup.


My congressman punked out early, and did a health care teleconference instead of a town meeting. It was done well, but I still was disappointed – I wanted to get out there and mix it up with the local Republican crazies, waving my "Smart People for Single Payer" sign, and wearing my "Obama's not a Socialist, but I AM" button. Well, life is full of disappointments. Sigh.

Sunday, August 9, 2009

The Good News: despair?

Good news, everyone! Only 247,000 jobs were lost in July – and the unemployment rate dropped from 9.5% to 9.4%!

Those who have studied arithmetic may be counting their fingers, trying to figure that out. It takes 100,000 new jobs a month just to stay even with the flow of new entrants into the job market, so how can the unemployment rate have gone down?

The answer, of course, is a reduction in the size of the labor force. Some number of individuals substantially in excess of 347,000, it seems, are no longer looking for work – or so we are told, according to government surveys of households.

I have little to no confidence in the statistical analysis accounting for the reduction in the unemployment rate. Surveys? How many? Seems to me that, in earlier decades, people were considered "no longer actively looking for work" as soon as their unemployment benefits were exhausted. I don't recall hearing anything about a change in that accounting procedure.

Granted, plenty of those people must be pretty "discouraged workers" by now, but I still suspect most of them would accept a job if something decent were offered – which is to say, I suspect the labor force is substantially larger than we're being told.

Naturally, the drop from 9.5 to 9.4 will be good news to those who think economic activity is entirely a function of psychology – that "thinking positive" is all we need to emerge from the current morass. On the other hand, if a huge number of workers have fallen into such despair that they truly are no longer looking for work, "thinking positive" really presents some problems.

Friday, August 7, 2009

Obama confirms sellout

Billy Tauzin of Louisiana was a founder of the Blue Dog Democrats, but decided in 1995 that the Blue Dogs were way too liberal, and became a Republican. Later, he helped to "negotiate" the Bush administration's creation of Medicare part D -- the drug plan -- which specifically forbids Medicare administrators to negotiate prices with pharmaceutical companies or even consider re-importing lower-cost drugs from Canada.

Almost immediately after that towering legislative achievement, Tauzin left the House to become the leader of PhRMA, the drug lobby. Earlier this week, Tauzin was hopping mad. It seems that Democrats in the House had the audacity to think that the drug cartel ought to kick in cost savings somewhat greater than the eighty billion dollars over ten years which the Obama administration agreed to for the purpose of getting Harry and Louise on its side. Taubin insisted that the administration affirm the eighty-billion-dollar agreement.

Obama, who does not have his predecessor's flair for lying, confirmed the deal.

One of the real advantages of leaving the details of health care reform to Congress is that Congress does not have to go along with half-assed deals agreed to by the administration. One only can hope that Congress will do the right thing, and pass a bill that endorses negotiation of drug prices by Medicare, Medicaid, and the much maligned public option that had damned well better be part of the final bill.

I can't see Obama vetoing a health care bill, no matter how inadequate it turns out to be. Let's just hope whatever comes out of Congress is better than what we have now, and that both the Executive and Legislative branches show some guts. If a strong House bill and a weak Senate bill go to conference committee, the administration can strongly influence what comes out.

That's when we can find out if Obama actually has some liberal inclinations, or if he's just another unprincipled pol like Bill Clinton.

If it ever gets that far.

Mark Twain called it "the best Congress money can buy." We'll see.