A Few Senators Away from Having Much Better Health Care

A Few Senators Away from Having Much Better Health Care By Paul Krugman
The Congressional Budget Office has looked at the future of American health insurance, and it works. A few weeks ago there was a furor when the budget office "scored" two incomplete Senate health reform proposals -- that is, estimated their costs and likely impacts over the next 10 years. One proposal came in more expensive than expected; the other didn't cover enough people. Health reform, it seemed, was in trouble. But last week the budget office scored the full proposed legislation from the Senate committee on Health, Education, Labor and Pensions (HELP). And the news -- which got far less play in the media than the downbeat earlier analysis -- was very, very good. Yes, we can reform health care. Let me start by pointing out something serious health economists have known all along: on general principles, universal health insurance should be eminently affordable. After all, every other advanced country offers universal coverage, while spending much less on health care than we do. For example, the French health care system covers everyone, offers excellent care and costs barely more than half as much per person as our system. And even if we didn't have this international evidence to reassure us, a look at the U.S. numbers makes it clear that insuring the uninsured shouldn't cost all that much, for two reasons. First, the uninsured are disproportionately young adults, whose medical costs tend to be relatively low. The big spending is mainly on the elderly, who are already covered by Medicare. Second, even now the uninsured receive a considerable (though inadequate) amount of "uncompensated" care, whose costs are passed on to the rest of the population. So the net cost of giving the uninsured explicit coverage is substantially less than it might seem. Putting these observations together, what sounds at first like a daunting prospect -- extending coverage to most or all of the 45 million people in America without health insurance -- should, in the end, add only a few percent to our overall national health bill. And that's exactly what the budget office found when scoring the HELP proposal. Now, about those specifics: The HELP plan achieves near-universal coverage through a combination of regulation and subsidies. Insurance companies would be required to offer the same coverage to everyone, regardless of medical history; on the other side, everyone except the poor and near-poor would be obliged to buy insurance, with the aid of subsidies that would limit premiums as a share of income. Employers would also have to chip in, with all firms employing more than 25 people required to offer their workers insurance or pay a penalty. By the way, the absence of such an "employer mandate" was the big problem with the earlier, incomplete version of the plan. And those who prefer not to buy insurance from the private sector would be able to choose a public plan instead. This would, among other things, bring some real competition to the health insurance market, which is currently a collection of local monopolies and cartels. The budget office says that all this would cost $597 billion over the next decade. But that doesn't include the cost of insuring the poor and near-poor, whom HELP suggests covering via an expansion of Medicaid (which is outside the committee's jurisdiction). Add in the cost of this expansion, and we're probably looking at between $1 trillion and $1.3 trillion. There are a number of ways to look at this number, but maybe the best is to point out that it's less than 4 percent of the $33 trillion the U.S. government predicts we'll spend on health care over the next decade. And that in turn means that much of the expense can be offset with straightforward cost-saving measures, like ending Medicare overpayments to private health insurers and reining in spending on medical procedures with no demonstrated health benefits. So fundamental health reform -- reform that would eliminate the insecurity about health coverage that looms so large for many Americans -- is now within reach. The "centrist" senators, most of them Democrats, who have been holding up reform can no longer claim either that universal coverage is unaffordable or that it won't work. The only question now is whether a combination of persuasion from President Obama, pressure from health reform activists and, one hopes, senators' own consciences will get the centrists on board -- or at least get them to vote for cloture, so that diehard opponents of reform can't block it with a filibuster. This is a historic opportunity -- arguably the best opportunity since 1947, when the A.M.A. killed Harry Truman's health-care dreams. We're right on the cusp. All it takes is a few more senators, and HELP will be on the way.

Bonehead Boehner falsely claim no stimulus contracts awarded in Ohio

Bonehead John Boehner falsely claim no stimulus contracts awarded in Ohio
Chris Wallace did not challenge John Boehner's false claim that stimulus contracts have not yet been awarded in Ohio. In fact, the Ohio Department of Transportation has awarded more than $83.9 million in contracts under the recovery act.


During the July 5 edition of Fox Broadcasting Co.'s Fox News Sunday, host Chris Wallace let stand House Minority Leader John Boehner's false claim that "[i]n Ohio, the infrastructure dollars that were sent there months ago," as part of the economic recovery package, "there hasn't been a contract let, to my knowledge. And the fact is is that I don't believe it will create jobs." In fact, in a June 15 update on the state's stimulus spending, the Ohio Department of Transportation (ODOT) stated, "Combined with the contracts awarded so far using funds from the American Recovery and Reinvestment Act, ODOT has awarded more than $83.9 million in contracts for work on 52 projects -- a combination of interstate, local roadway and bridge modernization projects."

O'Reilly fill-in Williams provides platform for global warming misinformation

O'Reilly fill-in Williams provides platform for global warming misinformation
Guest-hosting The O'Reilly Factor, Juan Williams did not challenge Bernie Goldberg's false claims about global warming.


During a July 1 O'Reilly Factor discussion about whether "the liberal media" are helping President Obama "advance his energy agenda by spreading global warming propaganda," guest host Juan Williams advanced falsehoods about global warming. Williams did not challenge Fox News contributor Bernie Goldberg when he falsely claimed that if journalists "did some real reporting, they would find out that in the past 10 years, the world temperatures haven't gone up." But climate scientists reject the idea that the fact that, in most datasets, annual global average temperatures have not surpassed their 1998 level is any indication that global warming is slowing or does not exist. Scientists have identified a long-term warming trend spanning several decades that is independent from the normal climate variability -- which includes relatively short-term changes in climate due to events like El Niño and La Niña -- to which they attribute the recent relatively cooler temperatures. Williams also did not challenge Goldberg's assertion that "this is déjà vu all over again. This is the 1970s, when journalists warned us of another climate, you know, catastrophe that was coming. That time it was global cooling. And they warned us of the coming ice age. They were wrong about that." But it is false to suggest, as Goldberg does, that in the 1970s there was a widespread scientific belief that the Earth was cooling that is tantamount to the current scientific consensus on global warming.

As Media Matters for America has noted, in a February 11 Guardian op-ed, Vicky Pope, the head of climate change advice at the U.K. Met Office Hadley Centre, wrote that claims about the pace of global warming based only on developments in the past 10 years or in the 1990s are not valid, "since natural variations always occur on this timescale." She continued, "1998 was a record-breaking warm year as long-term man-made warming combined with a naturally occurring strong El Niño. In contrast, 2008 was slightly cooler than previous years partly because of a La Niña. Despite this, it was still the 10th warmest on record." According to the Met Office, "Over the last ten years, global temperatures have warmed more slowly than the long-term trend. But this does not mean that global warming has slowed down or even stopped. It is entirely consistent with our understanding of natural fluctuations of the climate within a trend of continued long-term warming." This long-term trend can be seen in this graph of annual global average temperatures from the U.K. Met Office Hadley Centre

Fox News promotes global temperature decline falsehood

Fox News promotes global temperature decline falsehood
Several Fox News figures have used a purportedly "suppressed" EPA document to advance the falsehood that, in Steve Doocy's words, "for the last 11 years, temperatures had been dropping."


Following allegations that the EPA "suppressed" an internal document that was skeptical of climate change, several Fox News figures have advanced the document's false claim -- previously repeated by CBS -- that, in Fox News host Steve Doocy's words, "for the last 11 years, temperatures had been dropping." In fact, Doocy's claim simply is not true.

A draft of the EPA document stated in one of its "principal comments" that "[g]lobal temperatures have declined -- extending the current downtrend to 11 years with a particularly rapid decline in 1907-8 [sic]." The document went on to state that "[g]lobal temperatures have declined (Figure 1a) -- extending the current run of time with a statistically robust lack of global temperature rise to eight years (Figure 1b), with some people arguing that it can be traced back for 12 years."

In fact, as Media Matters for America has noted, annual global average temperatures have both risen and fallen over the past 11 years, and while there have been some relatively cooler years during that period -- including a decline in each of the past three relative to the year before -- climate scientists reject the idea that those temperatures are any indication that global warming is slowing or does not exist. Scientists have identified a long-term warming trend spanning several decades that is independent from the normal climate variability -- which includes relatively short-term changes in climate due to events like El Niño and La Niña -- to which they attribute the recent relatively cooler temperatures.

Sarah Palin An Economic Savant

Sarah Palin An Economic Savant
Palin Said Mortage Giants Are ‘Too Expensive To The Taxpayers.’ Speaking in Colorado Springs, CO, Palin said that Fannie Mae and Freddie Mac had “gotten too big and too expensive to the taxpayers.” The companies, however, aren’t taxpayer funded. [McClatchy News, 9/6/08]

Palin Left Wasilla $20 Million In Debt. As mayor of Wasilla, Palin cut taxes while simultaneously expanding the town’s operating budget by almost $2 million. She ended her term in 2002 with Wasilla $20 million in debt. [Anchorage Daily News 10/23/06; the Politico, 8/29]

Palin Instituted A Windfall Profits Tax On Oil Companies. In 2007, Palin raised taxes on oil company profits by $1.5 billion a year, enabling Alaska to double its oil revenue. However, in 2008 she said, “Windfall profits taxes alone prevent additional investment in domestic production.” [Bloomberg, 3/8; Seattle Times, 8/10; Governor's Office Press Release]

The seldom-seen devastation of climate change

The seldom-seen devastation of climate change

To provide some of that knowledge, Schmidt, a climatologist at NASA's Goddard Institute for Space Studies in New York, wrote a few accompanying essays and solicited several others from colleagues. The book emphasizes the complexity of the climate change problem, noting the wide range of greenhouse gases that engender warming (not just carbon dioxide but also methane, aerosols and more), the many ways we release them, and the varied regional effects they produce. Climate change is not a one-dimensional problem with a simple solution, so we need to grasp the totality of the global climate system.

Salon spoke to Schmidt about our inability to grasp global warming, the nature of climate science, and our prospects for a cooler future.

Why is it important to depict climate change visually?

The imagery associated with climate change often veers toward the overly dramatic. That isn't to say climate change is not dramatic. But people get the idea that climate change is all about polar bears and hurricanes. What we tried to do was to find images that showed the relationship between climate change and people and that brought out some of the long-term nature of changes and its complexity. Small things that happen because of climate change end up having big effects.

Weapons U.S. Number One Export?

Weapons U.S. Number One Export?
The phrase "Obama has a lot on his plate" is the understatement of the year. The president has a to-do list a mile long, and every day a new crisis (like the coup in Honduras) gets added to the list. Can we really fault him if he sneaks the occasional smoke?

But before he heads out to the presidential woods, one of the tasks still undone is to update and revise U.S. arms export policy. The last official version of U.S. arms export policy is from the Clinton years. In addition to the usual rhetoric about promoting regional stability, ensuring U.S. military superiority, and promoting "peaceful conflict resolution and arms control, human rights, democratization," Presidential Decision Directive 34 (February 1995) inserted a new consideration: "enhanc[ing] the ability of the U.S. defense industrial base to meet U.S. defense requirements and maintain long term military superiority at lower costs." In other words, a potential arms sale should be judged in part on whether it is good for weapons manufacturers.

Not every administration needs a formal export policy. Under the guise of the global war on terror, President George W. Bush fast-tracked weapons sales, released countries from arms embargoes, and pumped more money into foreign military aid. His policy was — in essence —sell, sell, sell, and he did it without issuing a formal policy statement.

But now, President Barack Obama needs to decisively break with Bush era practices. Unfortunately, so far the administration is opting for less clarity and more verbiage.
With Friends Like These

At a May 2009 Defense Writers Group convened by the Center for Media and Security, Undersecretary of Defense for Policy Michele Flournoy was asked "whether the Obama administration will follow the general policy of supporting exports?" and "do you anticipate any change in terms of where US arms will be sold?" Flournoy responded: "We don't have a sort of arms sale policy as much as more a sense of commitment to building partner capacity." But she asserted that the United States isn't going to "hawk" a given weapon system around the world. She said something similar a month earlier, at the Center for Strategic and International Studies: We "have a direct interest in helping our allies and partners build their capacity to be security contributors, to be able to step up alongside us in shoring up the international system."

Vice Admiral Jeffrey Wieringa, the head of the Pentagon agency that administers weapons exports, was blunter: "We sell stuff to build relationships."

But last year, the United States sold arms or military services to well over 100 nations. Can they all really be reliable security partners? If not, will the Obama administration shorten this extensive list of customers? And will it seek better ways to build ties to countries like Pakistan than sending them nuclear-capable F-16 fighters, which are more likely to be used against India than in fighting al-Qaeda or the Taliban?

Absent an explicit shift away from Bush administration policies, U.S. weapons sales are likely to continue to fuel conflict and abet human rights abuses. During the two Bush terms, the majority of U.S. arms sales to the developing world went to countries that our own State Department defined as undemocratic regimes and/or major human rights abusers. And over two-thirds of the world's active conflicts involved weapons that had been supplied by the United States.

One thing is clear. In the absence of a firm and clear policy, a lot of weapons are being exported. In fiscal year 2008, the foreign military sales program sold $36 billion in weapons and defense articles, an increase of more than 50% over 2007. Sales for the first half of 2009 reached $27 billion, and could top out at $40 billion by the end of the year. In contrast, through the early 2000s, arms sales averaged between $8-13 billion per year.