Reform Rx: Health Care Summit Observations

President Obama uses food safety comparison

President Obama's response to Eric "Can't" Canter that used food and drug regulation costs resulting in safer food and drugs versus being able to get real cheap food and low cost drugs in the great wise efficient marketplace that would of course include dangers to the public. Money spent reforming and regulating health care is not money wasted that drives up taxes but rather an investment in health safety that saves lives.

Tom Harkin speaks to segregation

Senator Harkin made the very astute point that insurance risk pools are segregation based on peoples' health. He's right and that is why a robust public option or better yet single payer is the remedy to eliminate this form of segregation. Even if a majority have health insurance and are happy with their health plans, keeping a system that puts a minority at the "back of the bus" or not even allows them to "sit at the lunch counter" forms a moral impetus to reform health care. Furthermore, the legal establishment of subsidized high risk pools are wrong and would essentially be a "Jim Crow" law keeping the segregated "in their place".

President teaches ECON 101

In President Obama's closing remarks he made two economic points that market-worshiping Republicans need to take to heart.

First he likened buying power of a large group of that gives lower prices Americans to Wal-Mart and the opposite of that power being Mom and Pop stores with higher prices and lower selection. This represents the very same "markets can deliver" talk that conservatives always use. Yet they appear to reject this market mechanism. Will Republicans continue their doublespeak about markets?

Second the President directly challenged the myth of interstate insurance purchasing being an automatic "markets will deliver" solution. He aptly described how, based on credit card company practices of yore, how insurance companies would abandon states with fair regulations to set up shops in weak regulating, anything goes states in order to sell high deductibility, low benefit plans across state lines. This is the unregulated wild-west marketplace approach that conservatives doggedly contend efficiently delivers the best possible results. And it does: for stockholders but certainly not for consumers. Will Republicans continue to embrace even bad markets interests?

And for Maine: All rain, no Snowe

Our own Senator Snowe, who masquerades as putting constituents above party, was invited by the President of the United States to attend today’s to participate in today’s extraordinary public health bi-partisan effort. She refused. According to Fox:

But one of those Republicans who was involved in compromise talks will not be attending the summit. Sen. Olympia Snowe, R-ME, was invited by the White House, but the New England moderate politely turned the President down. Snowe’s spokesman, John Gentzel, told Fox it was because her leadership had not chosen her to attend.

Thus when it came to a choice of extraordinary opportunity to fight for her constituents, take a seat at the table, demonstrate the independence that she asserts is her mark, and place politics above party, Senator Snowe made the choice of absolute loyalty to, rigid obedience to, and unbending conformity to the party of NO over Maine citizens.

Populist Puppeteering

populist - pop•u•list (pŏp'yə-lĭst)
noun - a supporter of the rights and power of the people.
adjective -of or relating to populism or its advocates: a populist aversion to business monopolies.

Populist is the label hastily pasted on the rudderless tea party and the right-wing Republican hijackers of their anger by the shallow talking heads masquerading as the press. But is the stamp correct? For one perspective take the following short quiz:

1 – Destruction of a public option in health care reform available to a broad swath of our middle class working and poor populations in favor of big insurance company interests was undermined and defeated by:
A. Liberal Reformers
B. Conservative Activists

2 – Opposition to creating a Consumer Protection Agency to ensure that abuses of middle class consumers and investors by big financial market, banking, and marketing interests is being lead by:
A. Liberal Reformers
B. Conservative Activists

3 – Anti-government rhetoric being applied to thwart efforts to overhaul student loan programs by ending government subsidies for private lenders and protecting working class family and poor students from predatory lending abuses is being heard from:
A. Liberal Reformers
B. Conservative Activists

4 – Efforts to move forward on clean energy policies and environmental issues to benefit future generations of all Americans are most adamantly opposed by:
A. Liberal Reformers
B. Conservative Activists

5 – Protecting big corporations, special interests, and the wealthy contributing a graduated fair share of taxes that would provide the greatest good for all people is largely associated with:
A. Liberal Reformers
B. Conservative Activists

The problem with populism is that it is easily hijacked by those who adopt the rhetoric to further their own ends but never to lead angry activists toward concrete action that serves the people purported to be represented by a populist movement. The game plan comes straight from the Republican play book on divisive social issues and anti-tax market worship. The right wing is ready to ride on the tea party boat to harvest their votes. As many of these new activists dress up in colonial garb and wave revolutionary flags they should remember that the 1773 Boston Tea Party outcry of "no taxation without representation" was a principled opposition to corporate monopolies in league with a government that did not act in the best interests of the people. Liberals should engage individual tea party activists toward careful analysis of their working and middle class true interests to win them over from anger primed by rhetorical demagogues who will steal their votes to serve the wealthy conservative market-manipulating elites.

Aspiration or Abandonment

Perhaps it is a consequence of our time that “we the people” allow our politics and elected representatives to desert a core service to our society. Public education in the United States is a failure and it now primarily exists in a netherworld of directionless drifting and woeful defunding. A lack of commitment with an articulated vision is not expressed nor supported by any current stakeholders. American education is a ship of cut spars, with failing systems, anchorless, and drifting just prior to sinking.

For decades, the primary focus of education has not been improved evolution of the delivery of knowledge to propel our society forward but rather the shedding of educational concerns to pare down to a focus on the mechanics of funding. This is not to say that there has not been lip service and limp action using the language of caring about education; there is a wealth of such activity and some of it is genuine in its concern. But by and large all the talk about concentrating resources in the classroom, no child left untested, charter schools, and other varied “pop” education chatter have been driven by a desire to live (fund) within our means that we have decided, by the manner in which we prioritize our expectations, as being meager. We are starving education and are talking as if it were not so. “Putting our money where our mouth is” appears not to be a challenge we willingly rise to meet.

Yet there is a yearning for our children to have the best education and recognition that a global economy demands more of our forthcoming generations. There is a recognizable need for functional literate entry into adult society and an even deeper realization that our democracy benefits from an educated electorate. Yet the countercurrent flowing against our desires that we have paid most heed to is money. We have decided that education is too costly even as we say it is a top priority. We have decided that taxes to pay for education are too high as we unconvincingly say that teachers are underpaid. We prioritize military security borne from fear over that of societal security delivered by a superior educational system. When we allow the blind weight of budget cutting to fall heavily upon schools rather than taxing to meet our aspirations, we make a deliberate choice.

Local control of schools is long past its relevance from when a community banded together to give their children the blessings of an education. It has become a financing scheme for passing the bill to the pauper. The national government, largely without any significant role in direct basic education funding, makes rules that push costs down allowing it to control its financial deficits by allowing knowledge deficits. It refuses to tax with its broadest span of ability or prioritize its expenditures accordingly to fund education. It creates paper visions not backed by the full faith and credit of the United States. Our state governments in turn see the forest but clear cut the trees as they refuse to use their broader taxing authority to push away costs. Their self imposed or constitutional limitations to operate without deficits rely only on half of the budget equation when it comes to schools; expenses will be cut but revenues will not be raised to support education. Finally at the local level, where the taxing is most direct and most unequal, the pauper municipal or school districts face the voter who cries thief at what is seen as throwing money at dysfunction and there is dysfunction aplenty.

In Maine we have played our part in this sad theater. There is no core vision for education currently despite once being a leader in core curriculum development. As the wheels of finance came off the school bus, we abandoned all principle in fear of a tax revolt. A poorly conceived and ill designed scheme for school consolidation with cost cutting of administration as its sole true goal was ineffectively implemented. And now curtailment order after curtailment order given arbitrarily with out regard to neither harming education nor examining temporal revenue measures is wreaking destructive damage on our schools.

Throughout this Maine state story we have never addressed aspirations, articulated a vision, solicited opinion on educational delivery design, but only focused on our purse. Maybe a counterintuitive increase in administrators is needed to support teachers with more specialized resources from literacy specialists to human resource managers. Perhaps a well designed unified system operating under a powerful vision that adequately invests in education as a top priority from birth to adult training and enrichment might become the top enticement for creative people and families to live, work, and create work in Maine. Most discouragingly, we are making short-sighted definitive choices right now that a second grader in need of reading assistance will not get it, that a middle school student will not be introduced to the benefits of another language, that another high school sophomore will drop out, that access to higher education will be out of reach for someone, and that thousands upon thousands of our future potential citizens will have a poor education.

A pathway to having a renewed discussion on education and an emergence of leadership for educational excellence lies within this year’s Maine gubernatorial race. As voters and citizens we must press our national representatives to demand national vision on education, full funding of every mandate, and a more rational prioritization of education. At the local level, we need to expose the abandonment of principle forced upon us and identify the local stop gap measures that we can enact. However, a broader state conversation on establishing a genuine vision that meets our aspirations for the forthcoming generations could be best facilitated by a candidate for governor willing to lead on this issue with a focus on excellence and a willingness to forthrightly address the revenue commitments necessary to meet the investment challenge. Please step forward.

The Lesson

Many will draw many different lessons from the Massachusetts Senate election that sends Republican Scott Brown and not Democrat Martha Coakley to Washington. Both gloating and gnashing of teeth will echo across radioland, the blogosphere, and among the spinning-talking heads.

Consider the essential elements that all the opinion rendering and reporting regurgitation is excitedly racing toward en masse: Democrats are being repudiated for multitudes of reasons, a referendum with negative results for President Obama has occurred, health care reform is being rejected as a failure, fickle independents are but Republicans-in-waiting, and the evil forces of socialistic liberalism are in serious decline because true Americans are taking their country back. The spinners further offer the prescriptions that Democrats need to "dial it back", abandon health care reform, and figure out how to best respond to polls cited by the same spinners to retain meaningless seats of powerlessness.

Perhaps this ought to be the key question we reflect upon: Is the significance of electing Scott Brown to the US Senate a repudiation of the seat's former holder, Senator Edward Kennedy?

No.

We did lose this seat. Campaign tactics, political capital expenditure, election spending, and attack strategies are mere sideshows. We lost due to dissatisfaction and anger that is not simply pinned on a singular issue or the heat of the moment. And we were and are participants in our own vulnerability.

We err by almost always letting the opposition define us. We allowed the anger churned up by Republican obstruction and repeated false mantras about big government socialist elites gleefully cramming tax and spend schemes in the faces of average Americans define us. We then err again by becoming increasingly reactive which allows even more opportunities for the opposition to define us.

We need to define ourselves. We must explain why and how we would approach problems with genuine liberal solutions. We need to stop reading and reacting to polls and reject the news and opinion cycles running the show. We must reject "lowering our sights", "playing it safe", and "dialing it back". We need to forcefully place in discussion our deep concerns about health care, a financial class run amuck, workplace fairness, environmental ignorance, and other major issues. To most of these concerns, liberals intuitively know the answers from devising essential fair reforms to regulating fraudulent behaviors.

Above all we need to put forth a principled and convincing consistent moral vision that rallies our own adherents, delivers workable changes sought by many independents, and even reaches out to those who have bought into right wing anger before the real elites, the tax nor regulate-us-not financial class, betray their front line supporters once again. Solid principles can trump shoddy politics.

"The great adventures which our opponents offer is a voyage into the past. Progress is our heritage, not theirs. What is right for us as Democrats is also the right way for Democrats to win." Senator Ted Kennedy, Address to the Democratic National Convention, August 1980

Reform Rx: Giving health care a nose job

From the Wall Street Journal:

Perhaps it's not that America spends too much on health care, but that other nations don't spend enough.

This the conclusion of an opinion piece penned by Dr. Mark B. Constantian, a plastic and reconstructive surgeon from New Hampshire declaring that we have great health care by singing the same tired conservative hypnotic hymn:

Certainly some goes to inefficiencies, corporate profits, and costs that should be lowered by professional liability reform and national, free-market insurance access by allowing for competition across state lines.

The subhead on this opinion piece asks, “Isn't 'responsiveness' what medicine is all about?” The author seems to say that if we can deliver on one selective segment out of the vast array of health care performance indicators, and this one is dubious when it comes to results, then cost, quality, and other factors are minor matters. Perhaps all we need is a talented plastic surgeon to put a better face on US health care.

In Maine one has access to the full text of current and past articles in the WSJ. If the above online link is "locked", use Maine's virtual library: MARVEL ,to access articles with a state library card or by registering online.

Reform Rx - Private Options are the Future!

Not quite at Christmas but some Maine citizens could get a late present from Senators Snowe and Collins courtesy of their unyielding support of only private options.

AP update today:

Anthem Blue Cross and Blue Shield of Maine has proposed a 22.9 percent rate increase for two health insurance plans targeting individuals.

The filing comes as Anthem awaits a judge's ruling on an earlier rate case. Maine Insurance Superintendent Mila Koffman last spring denied Anthem's proposed 18 percent rate hike for its individual insurance plans. Instead, she approved a revised request for a 10.9 percent increase, which provided for a zero percent profit margin.

Clean Elections - Democracy's Essential Service

This morning A.J. Higgins reported on MPBN that the glut of candidates in the gubernatorial race threatens to drain Maine’s Clean Election Fund. One privately funded Democratic candidate commented that now was not the time to ask taxpayers to cut back on essential services in order to give money to political campaigns. This viewpoint presupposes an erroneous choice. Trying to score a political point by insinuating that properly funding clean elections will take away money from schools and nursing homes and hand it over to political operatives (i.e. opponents) is not a fair assessment of what public financing of elections are about.

Public financing of elections needs to take place in times when the state is flush with funds and in lean years to meet the goals of clean elections. Reducing moneyed interests or private funded campaign machine advantages to give wider opportunity for non-wealthy voices and office seekers to address the issues that affect our lives is not a luxury. Clean election funding is about protecting our democracy from unspoken quid pro quo expectations and providing equal access to the electoral processes. It is something that Democrats ought to stand behind through thick and thin. It is about leveling the playing field.

Maine has built a clean election model to be proud of with broad popular support and it is an essential service to Maine’s citizens that deserves to be protected in concert with many other essential services. We should be pleased that we have a large number of clean election candidates committing themselves to the reduction of money interests in the race for Governor. And we acutely need public financing in lean times to protect our elections from being bought during moments of economic weakness.

We need to reject the myth that Maine has bloated budget full of faceless bureaucrats and frivolous expenditures to hack away at to save taxpayers from being gouged with nothing in return. Maine has a both a temporary revenue challenge and a long term need to address revenue structuring. It is time to recognize that government is not a business nor at the unreasonable sole service of business but is a collection of vital public services, including public financing of elections, that deserve our creative energies and investment.