The irrationality of current GOP views is becoming clear, but also we are starting to get some perspective on where Conservative hatred of President Obama comes from. Skip to the bottom if you want to read only that.
Obamacare would be a conservative's dream solution for health care, if only it had been implemented by a GOP President rather than Obama. Obamacare was developed by the Heritage Foundation as a way to control costs by getting the uninsured into the system. It uses the principles of Transparency, Mobility and Choice. It does so by preserving the private health insurance sector and empowering individual choice once you are past the requirement that every individual be in the health insurance system. In fact, Representative Ryan's plans for Medicare are built on the principles of Obamacare. Some form of Obamacare is the base path to controlling healthcare expense which is a necessity for a stable fiscal picture.
The Conservative ire toward Obamacare is built on enmity toward anything the Obama Administration does and the base desire of the Conservative elite to oppose anything that provides use of public funding for women's reproductive health or even empowers a woman to have control over her reproductive health.
Source article for the above
On foreign policy, you would think Conservatives would have some balance in their thought as two wars without any revenue increases has certainly not been conservative from a fiscal policy standpoint. Yet, the GOP cannot change their policies to reflect the new world order. We cannot order a country to do things in a manner that fits our liking exactly. A democratic Egypt (or a democratic any other Arab country) cannot ignore its people when it comes to Israel's failure to allow the Palestinian's a state of their own. Reacting in a neocon manner to the killing of the American Ambassador to Libya would have provoked outrage and more violence against Americans instead of the Libyan people's peaceful disarming of the militias that provoked the violence that provided the cover for the Al-Qaeda attack. And how would we have known who to bomb in such a reaction that neocons would have approved of? The world is a complicated place and it takes thought, analysis and time to find a solution that meets the approval of the world.
Thomas Friedman today
So why are conservative's so angry with President Obama? For that, we read a book review of I AM THE CHANGE by Charles Kesler. The book review was written by Mark Lilla and here is the link.
Link
"Once upon a time there was a radical president who tried to remake American society through government action. In his first term he created a vast network of federal grants to state and local governments for social programs that cost billions. He set up an imposing agency to regulate air and water emissions, and another to regulate workers’ health and safety. Had Congress not stood in his way he would have gone much further. He tried to establish a guaranteed minimum income for all working families and, to top it off, proposed a national health plan that would have provided government insurance for low-income families, required employers to cover all their workers and set standards for private insurance. Thankfully for the country, his second term was cut short and his collectivist dreams were never realized. His name was Richard Nixon."
Nothing President Obama has proposed is quite as radical as what Nixon opposed. What conservatives are really angry about has nothing to do with President Obama exactly. They want to turn the country back into a society where the individual acknowledges and acts upon a personal responsibility to take care of themselves and the government provides no individual safety net. They see what is now a 90 year trend toward statism (having started under Woodrow Wilson) and they want to reverse it. They are angry that Republican Presidents like Reagan, Bush I and Bush II did not do more to reverse the trend. They are angry that their strategy of starving the beast by not raising taxes has only resulted in an inadequately funded government that now has a debt burden that they find scary and they worry that they are about to lose an election that will reverse that starving of the beast. They are angry about virtually anything that incubates the demise of the role for white males.
Now to go back to their philosophy of personal responsibility, I have no disagreement with it. People are responsible for taking care of their economics and health. But if that worked so well, why did the country have to develop social security and medicare, unemployment benefits, Medicaid and welfare? The answer is a modern industrial economy is a complicated place and complete self reliance didn't work.
In a capitalist society, companies do what is best for the shareholders. Workers are the respected until they are not needed and then they are cast off into society. Their value and self respect take a beating in such a process. They need a safety net to provide them the means to look for that next job in a proper frame of mind. Not every person is as tough as nails in their mental makeup.
As for why retirement entitlements are necessary, the answer is that no person can control the timing of their retirement to match when the markets will be doing well. Many less educated people are not good at saving or managing investments. They need a societal safety net that forces them to contribute from their earnings to that safety net. Those contributions fund a properly constructed retirement that smooths out the investment risk and allows individuals to benefit from the law of large numbers.
You would think after 90 years of losing, conservatives would adapt, but I guess there is always a philosophical battle to wage and things to modify around the margin, like the design of healthcare financing where conservatives won, but they cannot acknowledge that because then they would not have a shot at winning the election since even conservative white males don't want their health care changed and health care is all that they are angry about. They do not want to separate health care from employment and that is a necessity that is not in Obamacare.
Sunday, September 30, 2012
Saturday, September 29, 2012
This is really funny at the 2:45 mark
It was getting tedious even for a passionate political person like myself, but then it had me in stitches.
The disaster that awaits us if Mitt wins
The disaster that awaits us if Mitt wins
How Ironic
The Wall Street Journal reported into today's paper that the 1st authenticated perpetrator of voter fraud was found in Florida and hired by the Republican National Committee in a total of 5 states. Maybe instead of eliminating voters who have difficulty getting ID's, the state government's fixated on this should focus on old fashioned and illegal ballot stuffing.
More WSJ Musings.
France's new tax rate is too high. 75% does inhibit innovation. I think the dividing line should be 39% because with state taxes that gets close to 50% beyond which I think the tax rate is counterproductive.
Police and other's are using technology to photograph the license plates of every car passing by them. While I know this is legal, it does give me pause about the role technology plays in reducing our privacy. Yet, at then end of my thought process, I cannot oppose this as long as it is only used to find criminals and foster commerce. Privacy rules are one reason health care costs are so high because Dr's cannot share records with each other forcing them to repeat tests to find out results that are in another Dr's files.
Also, why on earth did a Border Patrol agent shoot across the border and kill a father having a picnic with his family? Of course, why would a family picnic near the border, but since it was in the WSJ which is not known to make up facts (except on the editorial page), I will accept this a a true story.
More WSJ Musings.
France's new tax rate is too high. 75% does inhibit innovation. I think the dividing line should be 39% because with state taxes that gets close to 50% beyond which I think the tax rate is counterproductive.
Police and other's are using technology to photograph the license plates of every car passing by them. While I know this is legal, it does give me pause about the role technology plays in reducing our privacy. Yet, at then end of my thought process, I cannot oppose this as long as it is only used to find criminals and foster commerce. Privacy rules are one reason health care costs are so high because Dr's cannot share records with each other forcing them to repeat tests to find out results that are in another Dr's files.
Also, why on earth did a Border Patrol agent shoot across the border and kill a father having a picnic with his family? Of course, why would a family picnic near the border, but since it was in the WSJ which is not known to make up facts (except on the editorial page), I will accept this a a true story.
Wednesday, September 26, 2012
A cost of living musing
Today I spent the day of atonement atoning for my year of poor golf shots and ending up shooting my best round of the year. 97 on a Par 71 with only a few readjustments of the ball to compensate for my inconsistent game.
What got me writing was two of my golf partners were in their 80's and both lived in Pelham, where I do. Both of these gentlemen were blue collar workers in their prime. One was a driver of 18 wheelers (tractor trailers for any readers outside the U.S.) and the other repaired TV's and computers. Yet, both earned income sufficient for them to save and live in a village with high taxes and a great school system. Today, the house that they have lived in for decades are worth between $600,000 and $750,000 and no one in their old profession could ever save enough to live in such a house.
I think I could explain how this came to pass but somehow it doesn't seem right that it did come to pass, nor do I have any idea how to get wages for such workers high enough to change it and I certainly don't want the price of housing to go much lower. That is a sad commentary on our economy.
What got me writing was two of my golf partners were in their 80's and both lived in Pelham, where I do. Both of these gentlemen were blue collar workers in their prime. One was a driver of 18 wheelers (tractor trailers for any readers outside the U.S.) and the other repaired TV's and computers. Yet, both earned income sufficient for them to save and live in a village with high taxes and a great school system. Today, the house that they have lived in for decades are worth between $600,000 and $750,000 and no one in their old profession could ever save enough to live in such a house.
I think I could explain how this came to pass but somehow it doesn't seem right that it did come to pass, nor do I have any idea how to get wages for such workers high enough to change it and I certainly don't want the price of housing to go much lower. That is a sad commentary on our economy.
Tuesday, September 25, 2012
Richard Cohen Nails Today's GOP
"In 1980 Ronald Reagan won the Republican nomination. He beat a future president, George H.W. Bush; two future Senate majority leaders, Howard Baker and Bob Dole; and two lesser-known congressmen. This year Mitt Romney won the GOP nomination. He beat aradio host, a disgraced former House speaker, a defeated Senate candidate, a former appointee of the Obama administration, a tongue-tied Texas governor, a prevaricatingreligious zealot who happens to serve in the House of Representatives and a cranky libertarian doctor. Where did all the talent go?"
This is the way to convince thinking voters that the GOP is balanced?
Here is the whole article if you are interested.
The Whole Article
This is the way to convince thinking voters that the GOP is balanced?
Here is the whole article if you are interested.
The Whole Article
Monday, September 24, 2012
Romney Doesn't Understand The Tax Code
Last night on 60 Minutes Romney said his tax rate was fair because the income was taxed at the corporate level. While he was correct that any dividend income had been taxed at the corporate level, he was incorrect when he stated that capital gains had been taxed at the corporate level.
I detest double taxation. Therefore, I believe that dividends should be tax free as the income used to pay them is after tax income from the corporation. Interest payments are tax deductible so it is appropriate for the receiver of interest to pay tax on it. And any capital gain or losses at the corporate level would be taxed and paid to investors as dividends. But capital gains for investors are made by buying a security at one price and selling it for another price. There is no taxation on those values because they occur from market valuation of corporate activity. Romney is obfuscating the truth when he advocates that capital gains have already been taxed at the corporate level. They have not!
Corporations pay no taxes on the capital gains and losses generated by their securities.
I detest double taxation. Therefore, I believe that dividends should be tax free as the income used to pay them is after tax income from the corporation. Interest payments are tax deductible so it is appropriate for the receiver of interest to pay tax on it. And any capital gain or losses at the corporate level would be taxed and paid to investors as dividends. But capital gains for investors are made by buying a security at one price and selling it for another price. There is no taxation on those values because they occur from market valuation of corporate activity. Romney is obfuscating the truth when he advocates that capital gains have already been taxed at the corporate level. They have not!
Corporations pay no taxes on the capital gains and losses generated by their securities.
Thursday, September 20, 2012
This Why I Read so Many News Articles
You never know when you will see a gem of a comment that is true and very revealing.
From E.J. Dionne.
"And Romney said not a word about all the redistribution upward in a tax code that favors investment over labor income. That’s why Romney pays federal taxes at a much lower rate than do many in middle class — and why, given his stress on the importance of paying income taxes, he might usefullyrelease a few more of his own tax returns."
Who are the moochers? Those who take advantage of 15% tax rates on capital or those who work hard all day for very little and pay 8.6% in FICA and Medicare taxes and may not be able to afford health insurance? Seems like the only hard workers in Romney case are people like me who have paid 28% to 39% to the Fed's, 7% to 9% to the States and 8.6% in FICA and Medicare, the latter two of which the GOP now want to take away from anyone younger than 55.
And while I am at it.
From Nicholas Kristoff
From E.J. Dionne.
"And Romney said not a word about all the redistribution upward in a tax code that favors investment over labor income. That’s why Romney pays federal taxes at a much lower rate than do many in middle class — and why, given his stress on the importance of paying income taxes, he might usefullyrelease a few more of his own tax returns."
Who are the moochers? Those who take advantage of 15% tax rates on capital or those who work hard all day for very little and pay 8.6% in FICA and Medicare taxes and may not be able to afford health insurance? Seems like the only hard workers in Romney case are people like me who have paid 28% to 39% to the Fed's, 7% to 9% to the States and 8.6% in FICA and Medicare, the latter two of which the GOP now want to take away from anyone younger than 55.
And while I am at it.
From Nicholas Kristoff
"When I was growing up in Oregon, it was Democrats who were typically the crazies. Gov. George Wallace (“segregation forever”) tapped into populist resentments in his presidential campaigns. Lyndon Larouche was a cult leader seeking the Democratic nomination.
Oregon’s senators then were Mark Hatfield and Bob Packwood, both Republicans of a kind that barely exist today. Hatfield was a strong opponent of the Vietnam War, and Packwood supported abortion rights. Oregon’s governor at the time, Tom McCall, was a Republican and a leading environmentalist.
I called up Packwood and asked him if he and Hatfield would be Republicans if they were starting over. “We both wondered about that,” he said.
Packwood noted that the Republican Party once attracted union support, black support, urban and bicoastal support."
I know RedStateVT doubts me, but I did used to be a Republican and I have not changed that much, the Republican Party has no room for my social views and belief that government has a role to play in providing the opportunity for social mobility and a safety net.
Wednesday, September 19, 2012
Musings on Wall Street Journal Articles
I am a day late with this, but I read the WSJ in the evening now. There were 3 articles worth noting yesterday.
China-Japan tensions. WTF, are they still doing arguing over some rocks that have just sat in the water forever when economic cooperation will bring more prosperity to both countries? I know prospective energy underneath the rocks, but negotiation is the way to prosperity. A JV between CNOOC and Nippon Oil perhaps.
Islamic birth rates are falling That creates opportunities to change our approach to dealing with the angry youth that is open to jihadist thoughts. Of course, it would help if Islam clerics would respect other religions while they demand respect for Islam. But I love this quote from Gerald Seib; "Perhaps more sobering of all, what should the unrest of the past week tell us about what to expect if U.S. or Israeli planes strike at the Islamic Republic of Iran." I pity any pilots who are shot down.
States seek a middle ground on Medicaid. Many GOP governors want to keep Medicaid at current income levels but move those with income between 100% and 133% of the maximum Medicaid income onto the Health Insurance Exchanges that they are fighting the setup of. This will move the expense into the Federal Column permanently. My question is why don't they just come out in favor of Medicare for all, that is where they are pushing this whether they want to admit it or not. And I would be in favor of that.
China-Japan tensions. WTF, are they still doing arguing over some rocks that have just sat in the water forever when economic cooperation will bring more prosperity to both countries? I know prospective energy underneath the rocks, but negotiation is the way to prosperity. A JV between CNOOC and Nippon Oil perhaps.
Islamic birth rates are falling That creates opportunities to change our approach to dealing with the angry youth that is open to jihadist thoughts. Of course, it would help if Islam clerics would respect other religions while they demand respect for Islam. But I love this quote from Gerald Seib; "Perhaps more sobering of all, what should the unrest of the past week tell us about what to expect if U.S. or Israeli planes strike at the Islamic Republic of Iran." I pity any pilots who are shot down.
States seek a middle ground on Medicaid. Many GOP governors want to keep Medicaid at current income levels but move those with income between 100% and 133% of the maximum Medicaid income onto the Health Insurance Exchanges that they are fighting the setup of. This will move the expense into the Federal Column permanently. My question is why don't they just come out in favor of Medicare for all, that is where they are pushing this whether they want to admit it or not. And I would be in favor of that.
More Thoughts About Romney's Statements
As I read other people's comments on Governor Romney's comments at the May fund raiser, I have been struck by how many people believe that he truly believes that the Earned Income Tax Credit, which was promoted by and expanded by the actions of 3 Republican Presidents (Ford, Reagan, Bush I), as well as the expansive use of Food Stamps by people whose income as fallen in this GOP generated recession, create a 47% base for President Obama that he cannot get to.
If he truly believes that, why is it that the states with the highest level of non-taxpayers and recipients of Food Stamps are in states that are almost certainly to vote for him. It illustrates a shocking misreading of who supports President Obama and who might be an independent that Romney might attract.
Also, his comments on the Palestinians highlights how in pocket of Netanyahu Romney is. I ask Governor Romney, just as I ask President Netanyahu, what is the solution if it not a Palestinian state? Are you going to kill all the Palestinian's? Are you going to create a mass eviction of them to other countries? Isn't the former what Hitler did to the Jews? Isn't the latter what the Egyptians did to the Jews 3000 (?) years ago. Does anyone expect such actions to create secure borders for Israel?
The West Bank Jewish settlements are a tremendous obstacle to a lasting peace. The Palestinians cannot clearly control the worst elements of their population and may be complicit in bad actions, but only if the Palestinians have a country with clear borders will they have the responsibility to deliver the normal things to their people, and they can only make such delivery possible through peace with Israel. If they fail to do so, they can be held accountable by both Israel and the Palestinian populations. But the Palestinians cannot get a consensus for peace while those settlements exist.
I don't trust Governor Romney to conduct a sensible foreign policy and I don't believe he can balance the budget without raising revenues. Furthermore, fair entitlement reform requires the War on Terror be paid for by an increase in revenues. Finally, I don't trust Governor Romney to support freedom on social issues with this Supreme Court appointments.
With those comments, I come out firmly that I will be voting for President Obama's reelection.
If he truly believes that, why is it that the states with the highest level of non-taxpayers and recipients of Food Stamps are in states that are almost certainly to vote for him. It illustrates a shocking misreading of who supports President Obama and who might be an independent that Romney might attract.
Also, his comments on the Palestinians highlights how in pocket of Netanyahu Romney is. I ask Governor Romney, just as I ask President Netanyahu, what is the solution if it not a Palestinian state? Are you going to kill all the Palestinian's? Are you going to create a mass eviction of them to other countries? Isn't the former what Hitler did to the Jews? Isn't the latter what the Egyptians did to the Jews 3000 (?) years ago. Does anyone expect such actions to create secure borders for Israel?
The West Bank Jewish settlements are a tremendous obstacle to a lasting peace. The Palestinians cannot clearly control the worst elements of their population and may be complicit in bad actions, but only if the Palestinians have a country with clear borders will they have the responsibility to deliver the normal things to their people, and they can only make such delivery possible through peace with Israel. If they fail to do so, they can be held accountable by both Israel and the Palestinian populations. But the Palestinians cannot get a consensus for peace while those settlements exist.
I don't trust Governor Romney to conduct a sensible foreign policy and I don't believe he can balance the budget without raising revenues. Furthermore, fair entitlement reform requires the War on Terror be paid for by an increase in revenues. Finally, I don't trust Governor Romney to support freedom on social issues with this Supreme Court appointments.
With those comments, I come out firmly that I will be voting for President Obama's reelection.
Tuesday, September 18, 2012
Why Even Government Unions Deserve Respect
This problem with Wisconsin is not what the GOP governor was trying to accomplish, it was the way in which he did it. All workers deserve respect and if the workers want a union, that union should be respected and negotiated with. I say that despite my personal belief that unions do not serve the interest of their workers well, but that only affects my unwillingness to be a part of a union and my career choice to not have that option.
Joe Nocera's column today is well worth reading.
Teachers are part of the solution, but how do we get there?
Joe Nocera's column today is well worth reading.
Teachers are part of the solution, but how do we get there?
Oh, Mitt; Reveal thy true inner self, Please!!
David Brooks column today is well worth reading given that he wants to support Romney but wonders what Governor Romney really stands for as I have been asking for months now.
David Brooks column 9/18/12
My particular angst with Governor Romney's statement is that 13% of his 47% are over the age of 65 and by definition on Medicare and probably receiving Social Security. They have worked a life time and paid through withholding income on which they paid taxes to receive these benefits in the future. That is hardly free loading and looking to the government for a handout. Add to that the working poor who work but make too little to pay income tax, but certainly pay sales and gas taxes and possibly real estate taxes, are they free loaders?
The GOP accuses the Democrats of dividing the country. But what has the GOP done. They refused to compromise on anything since President Obama was elected convincing the GOP supporters that President Obama is somehow a Muslim, anti-christian, foreign citizen, anti-capitalist, anti-freedom illegitimate President. They know that to not be true but they make untruthful statements all the time because they believe hatred will get them a victory in 2012.
Now many of those in the leadership doing this really want to just keep tax rates low so they have more money in their pockets. If the GOP really believed in efficient government would the Bush II administration have allowed financial regulators to become so ineffective that they could not see fraudulent behavior in mortgage securitization or in certain hedge funds?
The GOP believes in only one thing. Cut spending and lower my taxes. They don't really care if the working poor have good jobs as long as they are working and not on the dole. They don't care if poor people have access to affordable health care. They don't care if anybody other than themselves have access to health care because they can afford an insurance policy that costs $36,000 a year. That is the mentality that was on display by Governor Romney and his approving audience that May evening in Florida.
Now if only the Democrats can create little ad's that display this sentiment in a positive light for what they will do in the future to keep retirement benefits stable without bankrupting the government.
David Brooks column 9/18/12
My particular angst with Governor Romney's statement is that 13% of his 47% are over the age of 65 and by definition on Medicare and probably receiving Social Security. They have worked a life time and paid through withholding income on which they paid taxes to receive these benefits in the future. That is hardly free loading and looking to the government for a handout. Add to that the working poor who work but make too little to pay income tax, but certainly pay sales and gas taxes and possibly real estate taxes, are they free loaders?
The GOP accuses the Democrats of dividing the country. But what has the GOP done. They refused to compromise on anything since President Obama was elected convincing the GOP supporters that President Obama is somehow a Muslim, anti-christian, foreign citizen, anti-capitalist, anti-freedom illegitimate President. They know that to not be true but they make untruthful statements all the time because they believe hatred will get them a victory in 2012.
Now many of those in the leadership doing this really want to just keep tax rates low so they have more money in their pockets. If the GOP really believed in efficient government would the Bush II administration have allowed financial regulators to become so ineffective that they could not see fraudulent behavior in mortgage securitization or in certain hedge funds?
The GOP believes in only one thing. Cut spending and lower my taxes. They don't really care if the working poor have good jobs as long as they are working and not on the dole. They don't care if poor people have access to affordable health care. They don't care if anybody other than themselves have access to health care because they can afford an insurance policy that costs $36,000 a year. That is the mentality that was on display by Governor Romney and his approving audience that May evening in Florida.
Now if only the Democrats can create little ad's that display this sentiment in a positive light for what they will do in the future to keep retirement benefits stable without bankrupting the government.
Sunday, September 16, 2012
Explaining the Closeness of the Election redux
OK Students, here we go again and I hope it does not disappear again as I know I do not have another one in me.
My slowness in returning to this is indicative of what will happen in the future. I have returned to the workforce to seek my shot at returning to the 2%. I know, you are thinking who are they? Well they are the 1% and those working stiffs who fall just short of being in the 1%. I, fortunately, have spend most of the last 20 years earning enough to make it to the 2% but never made it to the 1% (except possibly for the year in which I got a boatload of stock in my last employer which became worthless so I don't count that).
I am basically working for the cost of health insurance plus my cost of commuting and not being at home for breakfast or lunch. I am also contributing a little to Medicare, social security and the income tax authorities to pay public servants, the park system, and help those who make less than I do.
However, it is eye opening to work for so little because I am earning 2x the poverty level. Once I buy an individual health care policy (because my employer cannot afford to buy it for me and keep me employed), I have only enough to cover the cost of commuting. So when I go buy a couple of weekend dinners in the grocery store, I suddenly find I have spent $120 which I have not made (thankfully, I have been a saver all my life and have savings to cover the cost of life). However, it puts into perspective, the challenge people who make less than I do have in covering the cost of life while saving any money for their elder years. Not to mention, why they create costs, that the rest of us pay for, in hospital E.R.'s when they need service and do not have health insurance.
How does this translate into the closeness of the election?
Well, the electorate is a complicated mass of interests. If only it were as simple as it was when we were growing up. Then it was, who will help business around the margin or, who will help workers around the margin.
Now it is filled with complex mixtures of who care about social issues above all else, who cares only about cutting taxes above all else, who cares about a strong military above all else and so on. Throw in a little hatred for the other side in terms of personalities and a belief that power is the force to rule by and thwart rule by and you have the political system in the U.S. of today.
The election is close because many people's minds are rooted in the economy they grew up in . They believe that somehow the U.S. can return to that economy and they believe that Washington can create policies that will return the U.S. to that economy. Less Taxes and less regulation for the Republicans and fair taxes and prudent regulation for the Democrats. However, it is not that simple.
The driving forces of economic growth in the 1990's were tax increases that balanced the budget combined with the peace dividend from the USSR's collapse combined with Federal Reserve success in reducing inflation. The tech bubble burst all that so Bush II's fiscal stimulus threw tax cuts shortened that recession, but then the War on Terror started and that boosted the fiscal stimulus by borrowing 100% of the War on Terror without raising tax revenues to pay for it. This created the housing bubble (along with a failure to regulate prudently) and when real estate bubbles burst, everyone loses.
Add to that the realization now that the productivity improvements in the private sector that have been generated over the last 20 years and raised pay for those who remain employed in the private sector have not been matched by productivity improvements in the public sector, but pay has gone up in the public sector. Now property taxes have reached their limits, municipalities cannot honor promises they made and people want a solution that stabilizes local finance. Many people are attracted to the belief that if you starve the beast of government by not allowing any tax increases you will force a solution. However, a near equal number of people believe government does good and should be paid for. They also believe transitions should be managed and gradual.
Now people are angry, disappointed, desperate in some cases and feeling lost by the system. That is why this election is so close and why it is so important that President Obama be reelected. I believe in managed gradual solutions. That is what is good for business, good for employment and good for people
There are limits on what the government can do. Real estate collapses take 5 to 10 years to work through. The U.S. is probably only half way through this mess. Yet, the realities of the fiscal framework require that a long term solution to restoring fiscal balance be found. It must include increases in revenues with a fix for entitlements. But you cannot fix entitlements without finding health insurance for the uninsured. I once remember a figure of something like $2,000 of health insurance premium goes to pay for the uninsured. So Medicare is paying $2,000 per retiree to cover the uninsured. That alone will not fix Medicare, but it will help.
My slowness in returning to this is indicative of what will happen in the future. I have returned to the workforce to seek my shot at returning to the 2%. I know, you are thinking who are they? Well they are the 1% and those working stiffs who fall just short of being in the 1%. I, fortunately, have spend most of the last 20 years earning enough to make it to the 2% but never made it to the 1% (except possibly for the year in which I got a boatload of stock in my last employer which became worthless so I don't count that).
I am basically working for the cost of health insurance plus my cost of commuting and not being at home for breakfast or lunch. I am also contributing a little to Medicare, social security and the income tax authorities to pay public servants, the park system, and help those who make less than I do.
However, it is eye opening to work for so little because I am earning 2x the poverty level. Once I buy an individual health care policy (because my employer cannot afford to buy it for me and keep me employed), I have only enough to cover the cost of commuting. So when I go buy a couple of weekend dinners in the grocery store, I suddenly find I have spent $120 which I have not made (thankfully, I have been a saver all my life and have savings to cover the cost of life). However, it puts into perspective, the challenge people who make less than I do have in covering the cost of life while saving any money for their elder years. Not to mention, why they create costs, that the rest of us pay for, in hospital E.R.'s when they need service and do not have health insurance.
How does this translate into the closeness of the election?
Well, the electorate is a complicated mass of interests. If only it were as simple as it was when we were growing up. Then it was, who will help business around the margin or, who will help workers around the margin.
Now it is filled with complex mixtures of who care about social issues above all else, who cares only about cutting taxes above all else, who cares about a strong military above all else and so on. Throw in a little hatred for the other side in terms of personalities and a belief that power is the force to rule by and thwart rule by and you have the political system in the U.S. of today.
The election is close because many people's minds are rooted in the economy they grew up in . They believe that somehow the U.S. can return to that economy and they believe that Washington can create policies that will return the U.S. to that economy. Less Taxes and less regulation for the Republicans and fair taxes and prudent regulation for the Democrats. However, it is not that simple.
The driving forces of economic growth in the 1990's were tax increases that balanced the budget combined with the peace dividend from the USSR's collapse combined with Federal Reserve success in reducing inflation. The tech bubble burst all that so Bush II's fiscal stimulus threw tax cuts shortened that recession, but then the War on Terror started and that boosted the fiscal stimulus by borrowing 100% of the War on Terror without raising tax revenues to pay for it. This created the housing bubble (along with a failure to regulate prudently) and when real estate bubbles burst, everyone loses.
Add to that the realization now that the productivity improvements in the private sector that have been generated over the last 20 years and raised pay for those who remain employed in the private sector have not been matched by productivity improvements in the public sector, but pay has gone up in the public sector. Now property taxes have reached their limits, municipalities cannot honor promises they made and people want a solution that stabilizes local finance. Many people are attracted to the belief that if you starve the beast of government by not allowing any tax increases you will force a solution. However, a near equal number of people believe government does good and should be paid for. They also believe transitions should be managed and gradual.
Now people are angry, disappointed, desperate in some cases and feeling lost by the system. That is why this election is so close and why it is so important that President Obama be reelected. I believe in managed gradual solutions. That is what is good for business, good for employment and good for people
There are limits on what the government can do. Real estate collapses take 5 to 10 years to work through. The U.S. is probably only half way through this mess. Yet, the realities of the fiscal framework require that a long term solution to restoring fiscal balance be found. It must include increases in revenues with a fix for entitlements. But you cannot fix entitlements without finding health insurance for the uninsured. I once remember a figure of something like $2,000 of health insurance premium goes to pay for the uninsured. So Medicare is paying $2,000 per retiree to cover the uninsured. That alone will not fix Medicare, but it will help.
Wednesday, September 5, 2012
I can't believe it. This blog was written and then disappeared.
Jim, it was my explanation of the universe. I don't understand why my rant from this a.m. didn't save. I no longer have the passion that I did then.
This one is having problems too. I may have to find a new blog service.
This one is having problems too. I may have to find a new blog service.
Health Care II
or maybe it is CXI.
Anyway, continuing my take away from the New Yorker article I wrote about yesterday.
Do not fear hospital combinations, loss of community hospitals, or the corporatization of medical practices. This is the part of the health care system where market competition will deliver cost savings to the economy. And it is a direct result of the Affordable Health Care Act seeking to begin a transition from pay for service to pay for outcomes. And repealing the Affordable Heath Care Act will delay the push toward this.
What will not drive this in any way is market competition in health insurance. Health insurance is a utility which is already regulated by government (usually a state). Meanwhile, Medicare does the same thing and spends less than 10% on administration. Private insurance companies spend between 18 and 20% on administration and have created a patch work system that leaves tens of millions of people outside the system while their costs remain in the system through their unpaid visits to the E.R.
We must find a way to transition to Universal Health Insurance (with everyone paying something, if they are working) and eliminating private insurance in a manner that is gradual so the employment shifts are not too dramatic on economic growth.
The costs that are breaking the back of the economy are in my mind and in no particular order:
(i) the elderly with dementia on Medicaid,
(ii) unproductive end of life care,
(iii) diabetes,
(iv) unnecessary medical tests,
(v) a failure to curb malpractice law suits,
(vi) pay for service rather than results, and
(vii) pharmaceutical solutions that are permanent and maybe fall into category ii.
I need to go to work.
Anyway, continuing my take away from the New Yorker article I wrote about yesterday.
Do not fear hospital combinations, loss of community hospitals, or the corporatization of medical practices. This is the part of the health care system where market competition will deliver cost savings to the economy. And it is a direct result of the Affordable Health Care Act seeking to begin a transition from pay for service to pay for outcomes. And repealing the Affordable Heath Care Act will delay the push toward this.
What will not drive this in any way is market competition in health insurance. Health insurance is a utility which is already regulated by government (usually a state). Meanwhile, Medicare does the same thing and spends less than 10% on administration. Private insurance companies spend between 18 and 20% on administration and have created a patch work system that leaves tens of millions of people outside the system while their costs remain in the system through their unpaid visits to the E.R.
We must find a way to transition to Universal Health Insurance (with everyone paying something, if they are working) and eliminating private insurance in a manner that is gradual so the employment shifts are not too dramatic on economic growth.
The costs that are breaking the back of the economy are in my mind and in no particular order:
(i) the elderly with dementia on Medicaid,
(ii) unproductive end of life care,
(iii) diabetes,
(iv) unnecessary medical tests,
(v) a failure to curb malpractice law suits,
(vi) pay for service rather than results, and
(vii) pharmaceutical solutions that are permanent and maybe fall into category ii.
I need to go to work.
Tuesday, September 4, 2012
More Health Care Musings
While I was riding the train to work this a.m., I was reading an article in the 8/13-8/20 New Yorker entitled Big Med in which the author, a Dr, analyzed how CheeseCake Factory ran its kitchens and compared that to the manner in which health care is delivered. I have not finished the article yet but as you might imagine he is discussing the need for care to be coordinated, fixated on delivering useful care in the most efficient fashion, and not surprising, illustrating the manner in which neither is being done presently.
On the more optimistic front, he has already stated that hospitals are becoming more like chain stores and, in response to prompts in ObamaCare, are starting to try and figure out how they do these things in a more efficient manner.
But then on my train, a man who could not get a seat (nor did I have one) suddenly collapsed. I saw the nurses, and maybe a Dr, on the train assemble and start to service the guy without any regard to malpractice concerns. I was shaken by my own lack of any useful knowledge as to how to help the individual other than stay out of the way and near tears that people who could help were there as fast as possible.
I then overheard some people discussing the situation later. They apparently knew the individual and were witness to the collapse. He apparently has Parkinson's Disease, but was not exhibiting the signs of it prior to the collapse. My thoughts at that point ran to the fact that when the EMS got him to an ER, he was going to be subject to all kinds of tests and some insurance scheme was going to pay for them. To What End? His Dr in the suburbs could probably tell them what specific tests to run and keep it simple. What should have cost the system $1,000 or so, will probably cost the system $10,000 or so. This what we need to find a way to end. Have the Dr's who know a patient consult with the Dr's who are treating the patient so patient history has an immediate effect on what is done for the patient rather than having to run a whole battery of tests to reconfirm the patient's status because they ended up in a different hospital.
On the more optimistic front, he has already stated that hospitals are becoming more like chain stores and, in response to prompts in ObamaCare, are starting to try and figure out how they do these things in a more efficient manner.
But then on my train, a man who could not get a seat (nor did I have one) suddenly collapsed. I saw the nurses, and maybe a Dr, on the train assemble and start to service the guy without any regard to malpractice concerns. I was shaken by my own lack of any useful knowledge as to how to help the individual other than stay out of the way and near tears that people who could help were there as fast as possible.
I then overheard some people discussing the situation later. They apparently knew the individual and were witness to the collapse. He apparently has Parkinson's Disease, but was not exhibiting the signs of it prior to the collapse. My thoughts at that point ran to the fact that when the EMS got him to an ER, he was going to be subject to all kinds of tests and some insurance scheme was going to pay for them. To What End? His Dr in the suburbs could probably tell them what specific tests to run and keep it simple. What should have cost the system $1,000 or so, will probably cost the system $10,000 or so. This what we need to find a way to end. Have the Dr's who know a patient consult with the Dr's who are treating the patient so patient history has an immediate effect on what is done for the patient rather than having to run a whole battery of tests to reconfirm the patient's status because they ended up in a different hospital.
Saturday, September 1, 2012
Health Care is a more complex issue than Politicians' Campaign Slogans
As usual, it is discussions of Health Care in this country that have me sitting here typing.
I could comment on how without Medicaid serving the poor we would have (i) Alzheimer's Patients wandering the streets tying up EMT people and ER's when they collapse in the street or bankrupting their children, and (ii) poor people going without medical care until they ended up in the E.R. without any ability to pay and the hospital having to give them service under a Federal Law passed by a Republican Congress and signed by Ronald Reagan. Of course, the cost of that is passed onto all of us with Health Insurance through higher hospital bills.
I have to admit that having had 1st hand experience with Medicaid and an Alzheimer's Patient, I recognize both the expense it represents to the system and the conflicts present in deciding what generational support arrangements and obligations there should be in place when there are children to do so. But that complex issue does not have any bearing on what to do with people who have no children and have dementia.
But what really got me to sit down here was the FDA approval of a new drug for men with advanced stages of Prostate Cancer. This drug will cost $7,450 per month and extends the life of its average taker from 13.6 months to 18.4 months. I know that while men are taking this drug it will encourage the drug researchers to investigate whether variations on it will extend life further or even potentially cure the cancer and there is value in that. But is $134,500 in incremental pharmaceutical expense ( and I am sure there is more expense than that for this regime) worthy when life is extended by 5 months?
If that allows a 55 year old man to see his grandson born or his youngest daughter married or sell his business so his wife has funds or any number of other reasons, perhaps. But couldn't a lot of this be accomplished anyway without spending $3.7 billion on this drug for the 28,000 men that die annually from Prostate Cancer?
The difficult question is how do we manage the cost of end of life care in an intelligent manner? How do we promote the discovery of drugs that help people continue life while we do not spend money on things that only continue life for a matter of months? The Medical System and Politicians must figure out how to answer this question. Otherwise, healthcare is going to either bankrupt the system or leave people dying in the gutters as they did in the Middle Ages.
I could comment on how without Medicaid serving the poor we would have (i) Alzheimer's Patients wandering the streets tying up EMT people and ER's when they collapse in the street or bankrupting their children, and (ii) poor people going without medical care until they ended up in the E.R. without any ability to pay and the hospital having to give them service under a Federal Law passed by a Republican Congress and signed by Ronald Reagan. Of course, the cost of that is passed onto all of us with Health Insurance through higher hospital bills.
I have to admit that having had 1st hand experience with Medicaid and an Alzheimer's Patient, I recognize both the expense it represents to the system and the conflicts present in deciding what generational support arrangements and obligations there should be in place when there are children to do so. But that complex issue does not have any bearing on what to do with people who have no children and have dementia.
But what really got me to sit down here was the FDA approval of a new drug for men with advanced stages of Prostate Cancer. This drug will cost $7,450 per month and extends the life of its average taker from 13.6 months to 18.4 months. I know that while men are taking this drug it will encourage the drug researchers to investigate whether variations on it will extend life further or even potentially cure the cancer and there is value in that. But is $134,500 in incremental pharmaceutical expense ( and I am sure there is more expense than that for this regime) worthy when life is extended by 5 months?
If that allows a 55 year old man to see his grandson born or his youngest daughter married or sell his business so his wife has funds or any number of other reasons, perhaps. But couldn't a lot of this be accomplished anyway without spending $3.7 billion on this drug for the 28,000 men that die annually from Prostate Cancer?
The difficult question is how do we manage the cost of end of life care in an intelligent manner? How do we promote the discovery of drugs that help people continue life while we do not spend money on things that only continue life for a matter of months? The Medical System and Politicians must figure out how to answer this question. Otherwise, healthcare is going to either bankrupt the system or leave people dying in the gutters as they did in the Middle Ages.
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