Sunday, August 30, 2009

The Affordable Health Choices Act and the 4th CD.

America’s Affordable Health Choices Act would provide significant benefits in the 4th Congressional District of Washington: up to 15,200 small businesses could receive tax credits to provide coverage to their employees; 8,600 seniors would avoid the donut hole in Medicare Part D; 1,500 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $114 million in uncompensated care each year; and 118,000 uninsured individuals would gain access to high-quality, affordable health insurance. Congressman Doc Hastings [supposedly] represents the district.

• Help for small businesses. Under the legislation, small businesses with 25 employees or less and average wages of less than $40,000 qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 15,200 small businesses in the district that could qualify for these credits.

• Help for seniors with drug costs in the Part D donut hole. Each year, 8,600 seniors in the district hit the donut hole and are forced to pay their full drug costs, despite having Part D drug coverage. The legislation would provide them with immediate relief, cutting brand name drug costs in the donut hole by 50%, and ultimately eliminate the donut hole.

• Health care and financial security. There were 1,500 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill provides health insurance for almost every American and caps annual out-of-pocket costs at $10,000 per year, ensuring that no citizen will have to face financial ruin because of high health care costs.

• Relieving the burden of uncompensated care for hospitals and health care providers. In 2008, health care providers in the district provided $114 million worth of uncompensated care, care that was provided to individuals who lacked insurance coverage and were unable to pay their bills. Under the legislation, these costs of uncompensated care would be virtually eliminated.

• Coverage of the uninsured. There are 140,000 uninsured individuals in the district, 19% of the district. The Congressional Budget Office estimates that nationwide, 97% of all Americans will have insurance coverage when the bill takes effect. If this benchmark is reached in the district, 118,000 people who currently do not have health insurance will receive coverage.

• No deficit spending. The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals. This surtax would affect only 1,820 households in the district. The surtax would not affect 99.4% of taxpayers in the district.

Saturday, August 29, 2009

Is ‘Peak Oil’ Is a Waste of Energy?

Michael Lynch argues in the NY Times that Peak Oil may be one of those ever-receding mirages. But even if that is true, oil is not an infinite energy source. Nor is it carbon-neutral. Yet a comparatively low price for oil may buy us more time to move to more sustainable energies but at the price of continuing CO2 buildup.

Friday, August 28, 2009

Dr. Dean Ornish: A Pox on Both Your Houses

In this article Dr. Dean Ornish makes a good stab at finding the middle ground that the health reform opposition has, so far, been able to offer up. Basically it is a healthy dose of preventative medicine expenditure.

Planned Parenthood and the Pasco Planning Commission

There's at least one member of the Pasco Planning Commission seeking election to the city council. Todd Samuel knows that a successful no-vote to the Planned Parenthood clinic could be the kind of thing to win him that seat with the Pasco voters.

Unfortunately, the only grounds the commission has for a no-vote are not legal. To proceed would be to invite a losing and potentially costly lawsuit.

Don't you just hate that?

McMorris Rodgers and the Right Way

Representative Cathy McMorris-Rodgers writes in a Tri-City Herald article that health care reform must be done the right way. Her desire is that consumers have more options and that government-run health plans not dominate the insurance market.

She was willing to stipulate that that government options -- Medicare, Medicaid, Tricare and the Veterans Health Administration -- make up about half of the medical coverage in the United States, with the other half falling to the private sector.

Several people were on hand to dispute her view at the meeting.

I think Cathy has missed the real point and is just trying to find some way to justify her good-political-soldier opposition to the public option. The lack of competition isn't the problem. Currently insurance companies are competing by trying cherry-pick the pool of clients. They are protecting the interests of their shareholders by only covering people who can pay high premiums and make few claims. There is no profit to be made by accepting low income and high risk customers. There is nothing the government can do to make it any easier for insurance company to get into this business.

In the end she has no alternative to offer folks who would have to opt for public coverage other than to just continue watching the insurance industry ignore their needs.

By having a public plan we can eliminate medically-induced bankruptcy. We can provide insurance for people who insurance don't want.

By not having a public plan we can either continue to let people go uninsured (this is not a moral option). Or we can force insurance companies to cover less-profitable customers by regulation. Cathy can either be immoral or suffer unpleasant regulation.

What's a good Republican to do?

For a good play-by-play of the meeting see Michelle Dupler's excellent liveblog of the meeting.

Thursday, August 13, 2009

Representative Richard Hastings Speaks to TriCity Chamber of Commerce

[Editor's comments are in brackets]

He opened with a comment about the Snake River dams. Many in Idaho want the lower Snake River dams removed. Hastings will say no every time he can. There is a NOAA plan that has been brokered amongst almost all the interested parties: the tribes, hydropower producers, and hatcheries. It is called the 2008 biological opinion. Yet a few environmental groups oppose and have taken it to court and it looks to stay there for a while. Meanwhile salmon stocks continue to decline. The judge has doubts about the plan since it was produced under the Bush administration. [This is reasonable given how generally disconnected from reality this administration tended to be.] Before he proceeds he wants the Obama administration to weigh in. Hastings thinks that since the plan was produced under the Bush administration, it should be good enough and is afraid that Obama may take things in a completely different direction. [Like a good Republican his starting point is absolute distrust of Obama and then forward from there. So naturally he would like the case to just go ahead without hearing from Obama.]

The first national issue he brought up was the size of the federal deficit. [This is the current biggest thing on the right-wing talking points.] He proposes a formula in which there is a limit on the federal budget based upon a percentage of the GDP. He disagrees with basic Keynesian economics and believes that government spending should be limited more when the economy contracts. [This is disingenuous because he has supported irresponsible tax cuts when the economy was booming. He wasn't concerned about deficits then.]

The next is cap-and-trade as an energy policy. The fact that it is a method of taxation is what really bothers him. [Now what about those irresponsible deficits?] In the Northwest the major carbon emitter is the transportation system so the weight of cap-and -trade taxes would fall on inefficient fuel burners. [I presume that since most of his base tend to drive gas-guzzling SUV's this would seem like a burden on his constituency.] Then he drifts from cap-and-trade to energy policy. His favorite energy issue is to increase domestic drilling in ANWR, the outer continental shelf, and in the inter-mountain West. Bush moved to open up the OCS for drilling and Obama has put the brakes on that and on more intermountain exploration. [There seems to be no concern on his part about the actual goal of cap-and-trade, CO2 reduction.] He also sees this as another issue on which to bang his taxation drum. Doesn't think it is good for a recovering economy.

And finally to the last issue he addressed in his remarks, healthcare.
Hastings acknowledges that the bills remain works-in-progress but his position is simple. He is unequivocally opposed to this round of healthcare reform. He sees it as a direct path to a government-run healthcare system. The current system is good and only needs a few tweaks. Americans are living longer now than we ever expected. As a principle he thinks that there should be a strong relationship between doctor and patient without any third party between them. [He seems oblivious to how private insurance interferes with that relationship.] He says that if government gets too much involved in healthcare it will eventually evolve into the hated single-payer system. Hastings' rationale for opposing the public insurance option is that he doesn't think that the government has the experience necessary to be an insurance company. [Despite the federal employee insurance plan, the VA, and Medicare.] He is not comfortable with the uncertainty of the final cost figure. [Uncertainty about the cost of war didn't bother him a bit.] Hastings thinks that the size of the deficit should preclude a major effort like healthcare reform. [I guess he would rather pay later since healthcare costs are going to continue to go up with the status quo.] Half of the money needed for healthcare reform will come from increasing taxes on the richest 1% of the country. He interprets that to mean that businesses will be taxed more. It goes without saying that defenders of business find it synonmous with defending job production. The other half of the funding needed is to come from the reduction of waste and fraud. He doesn't like to see dollars wasted. [Except for the occasional completely unnecessary war.]

Hasting then launched into a discussion of the Medicare reimbursement rate formula. The current formula over-reimburses for urban areas. Since urban areas have more representation in the House this formula is unlikely to change. The proposed public healthcare option will use the same rates as Medicare. But the current Medicare rates lead doctors to limit the number of Medicare patients they have. With the public option even more providers will take a Medicare-like hit.

Hastings next point is a scenario in which those who opt for private insurance are forced to keep that insurance for 5 years. [This is a dark-side interpretation of the agreement with the insurance companies that prevents them from gaming their customers (dropping the risky ones for example). It also provides some stability for the insurance companies as things evolve to their final form.] Hastings is of the opinion that private insurance companies do a good job of delivering healthcare. Since it looks like a great number of people like the idea of a single payer system he assumes that it is quite likely that people will gravitate toward the public option. Instead he thinks it better for people to have many choices. He supports tax breaks to help people pay premiums. [Individuals may have choices but those are limited by what they can afford. The less money the fewer the choices. With the current system its businesses that get the choice since employees must take the insurance their employer provides. The tax break point assumes that people have money coming in to pay those premiums.] Hastings also wants doctors to be protected from frivolous lawsuits.

Hastings is not interested is reasonable debate on healthcare issues. Instead he sees the disruptions made by the hyper-vocal minority as the sort of debate that is useful.

Basically he feels no urgency to address healthcare issues and would like to defer it as long as possible. He makes noises about bipartisanship but the only bipartisan offer he has is to do nothing. He thinks the voice of the hyper-vocal misinformed minority is the true voice of the people. [He is happy to pay lip service to the will of the people as long as the people are properly subservient to the corporate power structure.]

Now some questions.
Q: What will be the impact on the elderly from the proposed healthcare reform?
A: Medicare is a reasonable system and people like it. But 90% have supplemental insurance to pay what Medicare doesn't. A bad thing in the proposed plan is the euthanasia program. [Hastings is a Deather.]

Q: Has the focus on the deficit been lost?
A: It looks like the focus is elsewhere. [Like avoiding a catastrophic depression.] He speaks of the current deficit as if it was Obama's idea since it took a big jump on his watch. The Bush deficits were not bad because they weren't as big as what has happened lately. [There is a question of sanity here. There is selective deficit outrage and no appreciation of the deregulation and lax SEC that were major contributing factors to the economic meltdown.]

Q: The majority of Americans want universal insurance and access. Do you support that?
A: People have universal access to insurance now [as long as they can pay for it and are able to shop for it. He ignores the people insurance companies exclude.] People have universal access to medical care if they go to emergency rooms. [Ignores the waste of ER resources and the potential for preventative care. Also ignores the fact that ER bill for such services and can force people into bankruptcy.]

Q: When are we really going to get out of Iraq?
A: We need to be successful against these radical Islamist terrorists. [Who were not in Iraq until we destroyed it.] The Middle East is safer with Saddam gone. [It's safer with Bush gone, too.] We really need to be successful in Afghanistan as well. It is in our interest to destroy the Taliban and rebuild the country. Short answer: who knows? [Hastings has the typical hyper fear about terrorists.]

Q: What if we go to a single-payer system and it doesn't work?
A: Hopes it doesn't come to that. Having choices is more important than actually getting healthcare for everyone. The worst case is that we get a system like Canada's. There would necessarily be some rationing of medical care.

At the end it was announced that Hastings had received the 2008 Spirit of Enterprise award from the US Chamber of Commerce for his support of issues friendly to business.

Monday, August 10, 2009

Get the facts

With all the misinformation being spewed by reform opponents here's a nice one-stop page for a Health Insurance Reform Reality Check.

Best Health Care in the World

We know we have the best health care system in the world when a right wing activist has to solicit donations for his medical expenses because he doesn't have insurance. Not to mention the hustling for a dandy out-of-court settlement in a frivolous law suit.

The wing nuts have a deep appreciation for the flaws in our system because they spend plenty of time trying exploiting those flaws for personal gain.