November 25, 2003

Medicare Redux

What is it that is despised by Ted Kennedy, Dick Gephardt, the Wall Street Journal, and Rush Limbaugh?

Trick question, you say. It must be something on the order of killing puppies in public. Or animal husbandry of the Biblically forbidden type. It would take something truly extreme, something really revolting and disgusting, to get those folks to agree on anything, no?

Well, yes and no--it's the new Medicare bill. Conservatives are outraged over this budget-buster, as are liberals. Why? Because the bill is less about solving a problem than it is about paying major campaign donors billions of dollars out of the taxpayer's pockets, as Howard Kurtz observes in today's WASHINGTON POST.

You don't solve the problem of extortionate pricing by taxing the public to raise the Danegeld. You do it by dealing summarily with the blackmailers. But when your blackmailers own your politicians, that's easier said then done. So instead, you pay the blackmailers more and tell your constituents you're doing it to make their lives better.

Just don't mention that you're making their children's lives worse, and mortgaging their future. The Republicans seem to have decided it's time to give up on small government and instead try to beat the records of previous administrations in expanding government, and with this bill they've done that nicely. As REASON magazine's Tim Cavanaugh points out, it's gotten awfully hard to tell the evil party from the stupid party lately. And should you be tempted to think it's actually a partisan thing, go back and re-read Kurtz's column again.

The lesson of history that seems to be going ignored here is that once you pay the blackmailers, they never go away.

November 18, 2003


A follow-up to Sunday's blog on the Medicare bill and the health care system, and on the Al-Qaeda/Iraq memo leak.

An editorial in today's NEW YORK TIMES that addresses universal health care in a fairly sane fashion--well worth your time to read. Followed by a frank piece on the monster that is the Medicare "Drug" bill, by E.J. Dionne, Jr. in the WASHINGTON POST. Also well worth your time.

The Universal Cure

Medicare Monstrosity

(Someone wanted to know why I said "Year 75" in the title of the health care piece. Answer: Because it's been 75 years since the invention of antibiotics, which I consider the most definitive date for the birth of modern medicine, and the beginning of the enshrinement of doctors and drugmakers as the modern gods of life and death. Some might argue for the introduction of antiseptic procedures, but there's no real firm date on that so I went the easy route.)

From Yahoo News/AP comes this first confirmation on the authenticity of the Al-Qaeda/Iraq memo leaked last week via the Weekly Standard, as noted here on Saturday.

Senate Panel Eyes Justice Dept. Leak Probe

No point in probing the leak unless the memo is actually genuine. QED.

Lastly, I'm not sure how people manage to get the email address I removed due to uncontrolled spamming, but the mail keeps trickling in even though the spam level dropped. I'll figure something out to restore email contact without it turning into a spambot spiderfest. I'm also going to get the comment function going again. As always, utter morons deleted, mindless rants ridiculed, thoughtful commentary and discussion greatly encouraged. And as always, my html skills remain on a par with my brain surgery talents and fiduciary prowess, so don't hold your breath too long, or expect anything flashy.

November 16, 2003

Medicare and more: Health Care Crisis (year 75)

News has leaked that the committee working on the Medicare prescription drug issue has reached "agreement in principle" on the basics of the proposal. It remains to be seen if the bill can pass the House and Senate, where the vote margin is razor-thin. Key legislators are not jumping on the bandwagon--yet.

The real problem with drugs in America (the legal kind!) and health care is not that they aren't covered by Medicare, but that they cost too much to begin with. The current legislation is not being driven by the public outcry over availability or price. Medicare recipients have complained for years about the lack of coverage, and nothing happened until the drug companies started losing revenues to overseas sales of drugs re-imported back into the United States. American drug prices are sky-high because drug companies use American sales to recoup their development costs (and pad their profits) on drugs while selling those drugs at much lower prices in other markets. In short, we not only pay for the drugs, as U.S. consumers we subsidize the low overseas prices that make Canadian internet pharmacies such a pain to the drug companies' bottom line.

But note that nothing came before Congress until the drug companies started to take that financial hit, and the political solution that has emerged is, predictably, not to address the pricing disparities and the reasons for them, but to directly and indirectly subsidize the drug companies' revenues, with the health insurance companies getting a slice of the action as well. We've already seen what "competition" within the health care insurance industry means. It means that insurance companies will "skim" the healthier patients off, excluding the sickest from private policies. So the taxpayers end up subsidizing insurance companies and drug companies, while those stuck in the government programs face declining benefits.

And in the meantime, more and more non-elderly taxpayers not eligible for ANY government-subsidized health care benefits are finding out that they can afford neither medical care nor health insurance. Sky-rocketing premiums are making insurance for family members so outrageously expensive that even if a worker is covered by an employer's policy, they often can not afford to have their spouse and children covered as well. This is the driving engine of the increase in the uninsured. More and more middle-class families are facing the choice of gambling for continued good health, or paying premiums that exceed their total monthly household bills. They make enough money that they're not eligible for government programs, but not enough to pay the insurance bill, which can easily exceed $1000/month for a family.

Greatly suffering are the middle-class self-employed, who must pay the full 15.4% portion of their Social Security and Medicare taxes instead of the 7.7 percent taken out of corporate paychecks (employers pay the other half), yet often can't afford to buy health insurance for themselves or their families. So the younger and more healthy workers caught in the squeeze are increasingly doing without insurance altogether, using their earnings for housing and other living expenses. Given the choice of effective poverty and being insured, or better disposable income and no insurance, they increasingly are choosing to do without insurance.

Not that being insured is any gaurantee of good treatment. Insurance policies are increasingly coming loaded with exclusions, restrictions, and high deductibles. Some conditions are not covered at all, or are covered so partially that insurance claims are woefully insufficient to cover the costs.

The solutions coming from Congress, for either Medicare or for general health care, don't even begin to address the real problems of runaway profiteering and skyrocketing costs. Beset by wealthy lobbys such as physicians, for-profit hospitals, and drug companies, the "solutions" proposed all fall into one of two categories: either taxpayers subsidizing for-profit health care, or forcing the healthy uninsured to pay for mandatory insurance in order to subsidize the less healthy.

A decade ago the Clinton administration ran head-first into the medical lobby while trying to promote a "National Health Insurance" plan that was doomed to fail, constructed to sneak in the actuality while still leaving enough monopoly power on the table to please the medical and insurance lobbies. It didn't work. Those lobbies are now more firmly entrenched in Washington than ever before, and as a result more and more Americans are going without health care so that the recipients of the public largesse can keep getting richer. There are no easy solutions. If we expect our health care system to continue to achieve breakthroughs, the incentives must be there. But right now, those breakthroughs are increasingly being paid for by reduced health among those who can afford it least, by the people who do without basic healthcare so that the well-insured and wealthier patients can have access to the best and most recent treatments. The money MUST come from those not paying into the system now, but forcing those who can't afford the basics to pay more in taxes for others who are already insured isn't the answer--and let us remember that the Medicare tax will sooner or later rise to cover the extra costs.

We are the only major nation that does not have national health insurance, and our system is breaking down. Health insurance used to be a fairly low-cost benefit for employers, but that's changed to the highest-cost benefit, and the nature of the job market has changed, as has the nature of the entire economy. Insurance must become "portable," attached to the person and not the job, or the system will simply break down, which it already shows signs of doing. National basic health care is coming, sooner or later. The questions we need to explore are what form it will take, and how we will pay for it?

November 15, 2003

Al-Qaeda and Iraq

I'd love to see some confirmation on this story! While the Dems seem to be doing their best to turn the Senate Intelligence Committee into an arm of the Democratic Election Committee, some of the folks on the SIC are bent on actually performing the mission assigned.

This story, if confirmed, would be a near-knockout blow to the anti-war Left, or at least that portion to whom facts rather than rhetoric actually still mean something. One of the great underpinnings of the new mythology of the Iraq invasion is that there was absolutely no connection between al-Qaeda and Iraq. While there were indeed some indications that Iraq had provided material support to AQ, the evidence was circumstantial. Kuwaiti passports from the first Iraq war (manufactured and matching records inserted into Kuwaiti records during the Iraqi occupation) turning up in the hands of AQ members, Iraq's "blind-eye" acceptance of the Dar Al-Islam camp, an AQ offshoot and ally, in northeastern Iraq, terrorist training camps in Iraq that were known to be used by Hezbollah and PLO, but not directly known to have been used by AQ.

Of course, no evidence will ever be good enough for the ideologically committed. Even if there had been direct involvement and support of AQ's 9/11 attacks by Iraq, the odds of any direct evidence existing would be small. Hussein is not a total idiot, and any direct communications would not have been either traceable or in writing. But the leaked memo, if confirmed, would bring the connection a quantum leap closer.

November 05, 2003


And that anti-spam email scripting trick didn't work, so email link is down again. Damn spammers. I love the good mail, don't mind the rants, even enjoy the real lunatics, but spam just drives me nuts, so....

November 02, 2003

The Dowdification of the Dead

I quit reading Maureen Dowd for anything but the acquisition of propaganda info last summer, when she intentionally mangled a quote by Bush in order to make it fit her agenda, and then failed to 'fess up to her manipulation. It was blatant--many papers around the county actually published corrections when Dowd herself refused.

In her NEW YORK TIMES column today, ironically titled "Pros at the Con," Maureen Dowd rants about the Bush administration spin on Iraq, using the "Big Lie" argument of which the Left has grown so fond. In her piece she uses a 1996 anecdote about then-editor of THE NEW REPUBLIC Michael Kelly writing a "very angry" letter defending TNR reporter Stephen Glass to illustrate her theme on how people can be suckered in to enabling the "Big Lie." Glass, of course, is the serial fabricator fired from TNR for making up sources and stories. Once again, Dowd's column is notable more for what it doesn't say.

Dowd brings up Kelly's purported defense of Glass and immediately notes Kelly's firing from TNR and Glass' firing by Kelly's successor, Chuck Lane, implying they are closely linked without quite saying so. And that's simply not true. Dowd never mentions that Kelly's defense of Glass is part of the upcoming movie on Glass--which raises the possibility that Dowd lifted her "anecdote" from the movie, and not from real life. Did Dowd manufacture her anecdote from the movie to justify her rant on journalistic fabrication? In the movie, Kelly reportedly calls and checks on the source before dismissing the complaint, a point Dowd doesn't mention.

Kelly was fired by New Republic owner Martin Peretz, a close friend of Vice-President Al Gore, in the fall of 1997 for his relentless criticism of the Clinton/Gore administration. Dowd merely notes he was fired after fighting with Peretz, vaguely implying he was fighting about Glass. During 1996, the year in which Dowd claims Kelly was defending Glass, Glass' work for TNR was apparently exemplary, and there was only one (published) complaint about his accuracy and sourcing. At the time he had nearly two years of work for both TNR and POLICY REVIEW. It was not until 1997, the year Kelly was fired, that Glass apparently began to fabricate his work wholesale, making up sources and events to punch up his stories. And it took Kelly's successor Chuck Lane the best part of a year to "out" Glass and cease publishing him. Glass wrote for and was published by TNR right up until May 1998. All of which makes Dowd's anecdote about Kelly's 1996 defense of Glass and Kelly's subsequent dismissal from TNR less than useful for the point she is trying to make, and illustrative of nearly nothing--except what it says about Dowd.

Could Kelly have stopped Glass earlier? Certainly. The complaints on Glass were starting to stack up during the summer of 1997, and close checking would have revealed his fabrications sooner, though the level of attention paid to Glass' veracity problems, both before and after Kelly's firing, can be gauged by the amount of time it took Chuck Lane to fire Glass. But also stacking up were Kelly's problems with Peretz, and his struggle to publish stories critical of the Clinton/Gore administration over Peretz's objections. One suspects Kelly was a bit distracted at the time.

In her column, Dowd says "It's bad enough to try to hide critical information when you can get away with it. It's really insulting to try to hide it when you can't get away with it. Those who go for the big con, who audaciously paint false pictures, think everyone else is stupid. They want to promote themselves based on the gullibility of others."

I agree completely. Kelly's work is on the record, as is Glass', and the timeline shows that in 1996 Kelly had little reason NOT to defend Glass, who appeared to be a promising young journalist stacking up an impressive resume. The reason for Kelly's departure from TNR is also on the record, and had nothing to do with Glass and everything to do with his pursuit of truth in the face of extreme opposition from TNR's owner and the Clinton/Gore administration.

Dowd also says, "This sort of airbrushing is tasteless, because it diminishes our war heroes instead of honoring them."

Once again, I agree completely. Michael Kelly died in Iraq pursuing the facts. Airbrushing his career with false colors diminishes his memory. We should be honoring him for his pursuit of the truth and the price he paid to bring it to us, not flinging mud at his coffin as Dowd has done.

As for Dowd, I hope that someday she mentions that her greatest inspirational source of righteous rhetoric is self-reflection on her own flaws as a journalist. But I'm not holding my breath.