The bar...

Is simply higher for a minority then it is otherwise. I do not know why I forgot this. But today I feel sorry for the President. I wish he had not had the state of Hawaii release his "long form" birth certificate. It will only embolden the opposition.

The President has done more then any other, to prove his citizenship. Now he has asked the
state of Hawaii to wave its privacy laws.

The problem is, they will never stop. The main impulse behind the birther movement is bigotry. They do not believe he is legitimate. There is nothing that will dissuade him. Now they will ask for his college records, then his tax forms, probably even his children's birth records.

They will never stop.

-Cheers

Oh no that isn't racist.....

Yep. I am glad, that someone has these facts! I did not know I was on welfare!

Wow....seriously. Wow....

You know sometimes when you call someone racist...they are in fact racist.

-Cheers

Health Care is not like other products...

We here a lot, that we just need to open health care up to the "free market". That the "invisible hand", will do wonders for the health care market.

The problem is, as many have pointed out patients are not consumers (in the normal sense of the word). This is an excellent graph that gets to the kernel of the issue.

This graph was part of an excellent post on the subject here.

Shadowfax list 3 compelling reasons why health care expenditures are not like any other market. Amongst those reasons are:

1. health care is generally not a refusable or electable
2. asymmetry of information (doctors don't know how much a procedure will cost to a given consumer, consumers have no good way to judged varying costs between providers)
3. purchasing power is concentrated in the hands of a small number of "consumers".

While all of the points mentioned are important, the third one is perhaps the single most compelling one.

This is the wooden stake through the heart of the idea that consumer behavior can effect cost containment. The functioning of a free market is dependent on the ability of consumers to vary their behavior to force suppliers to compete. However, you and I can be as scrupulous and cost conscious as we like. We are not sick. (Well, I'm not anyway. I hope you're OK.) The driver of cost is the small fraction of people who have serious medical conditions. It's the old 80/20 rule writ large.

Though the data is a few years old, I doubt the distribution has changed. To emphasize, HALF of all health care costs in the US is concentrated in only 5% of the population, and 80% of costs are accounted for by the top quintile! (source: Kaiser Foundation PDF)

So the effect here is that with such a concentration of costs in such a small segment of the population, the ability of the larger population to move the market is highly restricted. You can make 80% of consumers highly price sensitive, but they can only affect a tiny fraction of healthcare spending. And for the generally well, their costs are probably those which are least responsible for the spiraling inflation. They're not getting $30,000 stents or prolonged ICU stays, or needing complex chronic disease management.

Conversely, those who are high consumers of health care simply cannot be made more price sensitive, since their costs are probably well beyond what they could pay in any event, and for most are well beyond the limits of even a catastrophic health insurance policy. Once you are told that you need a bypass/chemo/stent/dialysis/NICU etc, etc, etc, the costs are so overwhelming that a consumer cannot possibly pay them out of pocket. Since, by definition, these catastrophic costs are paid by some form of insurance, the consumer cannot have much financial interest in cost containment. For most, when they are confronted with a major or life-threatening illness, their entire focus shifts to survival, and they could care less about the cost. Further, many who are in this sick/expensive category have some diminished capacity with regard to their information gathering and decision-making.

So yeah, if ever there were an argument for some sort of single payer/hybrid/NHS style health care system this would be it. Individual "consumers" simply do not have the power to shift costs much, even with perfect information. You need a system which allows the entire market to be affected as a whole. Competition over state lines simply won't accomplish that.

-Cheers

For the last time Government is not like a household!

Seriously, it just a plain bad analogy. Ezra Klein does a great job of explaining why it is so bad.

When economic times are good, households should spend and invest more, while government should spend and invest less. When they’re bad, households need to cut back, and the government needs to step in. But as Karl Smith says, that’s not the only place where the analogy breaks down. Another — and one that’s increasingly relevant — is “not realizing your personal control over spending versus revenues is essentially the exact opposite of the governments control over spending versus revenues.”

Mr. Smith goes on to explain the different relationship governments and households have with revenue and spending:

Most middle class folks can cut back on their spending with relative ease. They probably won’t get sick, malnourished or injured from exposure as a result of spending cuts. What this means is that if revenues are running higher than spending – a necessary condition for building up debt – the most obvious choice is to cut spending. Therefore, as a rule of thumb people develop the notion that debt comes from living beyond your means...to the government, the exact opposite is true.

It is much easier for the government to raise revenue than to cut spending. Moreover, most of the movement in the deficit is tied to movements in revenue, not movements in spending. Thus the exact same reasoning that leads you to associate debt and spending in your personal life should lead you to associate debt and revenue for the government.

This is not to say that that government can not spend too much. But that the primary reason the deficit has grown so much over the last decade is mainly due to a massive drop off in revenue, Bruce Bartlett explains:

Revenues were 20.6 percent of GDP in 2000 and 18.5 percent of GDP in 2007, at the peak of the business cycle before the recession reduced them to 14.9 percent of GDP, where they have been for the last two years. (The postwar average is about 18.5 percent of GDP.) Without the Bush tax cuts – and those added by Obama – revenues would likely be more like 17.5 percent of GDP, which is where they were at the trough of the last three recessions.

If revenues had been 2 percent of GDP higher over the last 10 years, the federal debt would be about $2.5 trillion smaller. Instead of having a debt of about 60 percent of GDP last year, it would have been about 44 percent. And that doesn’t take into account all the interest that would have been saved that now adds about $60 billion to the deficit annually. Together, higher revenues and lower interest spending would have reduced last year’s deficit by one-third.

I know it won't stop people from saying it, but it is a bad analogy. Reality works the opposite of what is implied.

-Cheers

These days are still those days....

In honor of the anniversary of Jackie Robinson breaking the color barrier in Major League Baseball, I wanted to post something nice and reflective.

But as it seems to be the case these days, I am finding it increasingly hard to note the progress made. Instead focusing on the distance we still need to travel.

Two stories caught my eye this week:

Via Balloon Juice, Mickey Kaus is a Jackass. Now you might be wondering why someone would say that, here is the offending text in a blog post Mickey wrote about President Obama's badness as a politician:

Cost doesn’t go into why Obama managed to get to the top of politics without being all that good at it. The answer is distressingly obvious: Obama’s the biggest affirmative action baby in history.

Now this bothers me. It bothers me on a personal level. We are not talking about Flava Flav being the President, Jay-Z or even Al Sharpton. We are talking about a Harvard trained constitutional lawyer, who was a state legislator and then a U.S senator. Despite what you think of the Presidents politics, he earned his place in life. Fighting against the constant racial inequities that most individuals of a fairer heritage have no inkling of.

This is very personal to me. That someone who seemingly knows nothing of the individual he comments on or how he won his office would make such a comment is jaw dropping. That I have had people say similar things about myself probably doesn't help matters. Evidently because I am black getting into Northwestern/U of I is impossible with out the help of affirmative action.

The President is a Harvard trained constitutional lawyer, who was a state and national legislator. That hardly sounds unqualified. Bad at politics? That is completely possible. But an Affirmative Action baby? Not hardly. Implying such is the worst sort of bigotry out there.

Combine that with this and you don't have to wonder why minorities are quick see bigotry, or to comment that racial issues have not noticeably changed.

The Weekly has obtained a copy of an email sent to fellow conservatives this week by Marilyn Davenport, a Southern California Tea Party activist and member of the central committee of the Orange County Republican Party.

Under the words, “Now you know why no birth certificate,” there’s an Obama family portrait showing them as apes. (I won't post the picture, because I find it offensive)

I know that Mr. Robinson, would have just held his chin up, smiled and took it. Because that was
the only way he could get that door open for rest of us. He had to take it and endure, so that we all would even have the chance.

That is courage. I wish I had it.

The President has some of it. Sometimes it is easy to forget, the risks he has taken to get to the White House. The vitriol he has to take and endure, all the while keeping up that smile. So that the rest of us have a chance.

Savage his policies. He doesn't deserve this sort of attack.

-Cheers

Backing it up...

The other day the frustrations of the last couple of day boiled over into this post.

Some may have noticed that the President gave a speech this past week on the budget. It was a pretty good speech actually.

But consider me skeptical. I need to see some steel and fire out of the democrats. I need to see them willing to engage and argue for progressive aims. They may lose that argument, but they need to make it. Dr. Krugman sums up most of my feelings on the speech here.

To get my active support, that is what will be necessary. Make the Republican party pay for their fecklessness.

And since it is tax day this little chart for you all:

Yep, collectively we are paying way too much.

-Cheers

Enough is Enough....

I have been a fairly reliable supporter of the President and his Administration, but at what point does a person stop reacting to the fear of "Palin, Bachmann, or Newt" and actually hold their elected officials responsible?

The President has done an absolutely horrid job negotiating with a petulant GOP. He has shown no inclination whatsoever, to defend any liberal/progressive alternative, or even offer one.

Bipartisanship is no virtue in service to bad policy.

I am tired of the constant pre-capitulation on every issue. The GOP's plan is to destroy the democratic party and this administration. Look at who and what they target. If there is a
source of democratic support, they attack it, they defund it and if they can they try to outlaw it
(unions, "trial lawyers"/tort reform, ACORN, NPR, voter ID laws).

The president says and does nothing about this. Have to protect that brand after all.

Whether it was the budget deal, the tax cuts, or even the ACA all we ever get is increasingly a right wing frame on right wing terms.

I promise if I get a fund raising letter from OFA, I may have to slap someone.

I will vote, I always do. But unless I see some fire and steel from Obama and the dems, they need to just forget about my enthusiastic support.

The GOP has become a party of bullies, unless you are willing to stand up to them and make them pay a price for their actions they will continue what they are doing.

Don't like them playing "games" with budget? Stop. Fucking. Pre-negotiating. They want a far
right propsal? Then you slap down a far left one and then haggle from there. That is how negotiating works.

Not happy.

-Cheers

Safety Net? What Safety Net?

Personally I think it is time to call the Republican Party the "Let them Eat Cake" party. In the next day or so the Republican leaders in the House will release their budget plan.

Now until we have the specifics a few items have come to light and it seems that Republicans are going to try to privatize and voucherize Medicare/Medicaid.

Dr. Paul Krugman had this to say about what we know initially:

More when we have some details. But two key points:

1. Privatizing and voucherizing Medicare does nothing whatsoever to control costs. We’ve seen that from the sorry history of Medicare Advantage. I’m sure that the Republicans will claim savings — but those savings will come entirely from limiting the vouchers to below the rate of rise in health care costs; in effect, they will come from denying medical care to those who can’t afford to top up their premiums.

Oh, and for all those older Americans who voted GOP last year because those nasty Democrats were going to cut Medicare, I have just one word: suckers!

Ezra Klein talks a bit about it as well this morning:

The House GOP’s 2012 budget, prepared by Rep. Paul Ryan, will privatize Medicare, block grant Medicaid, and cost $4 trillion over a decade, reports Naftali Bendavid: “Republicans will present this week a 2012 budget proposal that would cut more than $4 trillion from federal spending projected over the next decade and transform the Medicare health program for the elderly, a move that will dramatically reshape the budget debate in Washington...The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills...Mr. Ryan’s proposal would apply to those currently under the age of 55, and for those Americans would convert Medicare into a ‘premium support’ system...The proposal would also convert Medicaid, the health program for the poor, into a series of block grants to give states more flexibility.”

First they targeted unions, now they come for the social safety net.

Targeting those who are the most vulnerable is the means and the ends of the modern Republican Party.

-Cheers

It's the Stupid....it Burns....

I have to say, this is probably one of the more willfully ignorant gambits the Republican Party has engaged in.

• 1) Plays on the public's inability to understand complex subjects.
• 2) Would make our current fiscal problems worse.
• 3) Mind-numbingly stupid.

Specifically this segment of the proposal:

Total outlays for any fiscal year shall not exceed total receipts for that fiscal year, unless two-thirds of the duly chosen and sworn Members of each House of Congress shall provide by law for a specific excess of outlays over receipts by a roll call vote.

This is what California has, pushed through during a republican administration many years ago. Do nothing to actually effect spending, while making it near impossible to raise revenue (taxes!). There is more stupid here that should be talked about, but my head is sore from banging it into my desk, while reading the actual document and then the 'objective' reporting on the subject.

So instead, Ezra Klein, Johnathan Bernstein, and Bruce Bartlett go to town on how this idea is just more of the stupid. From Ezra:

A world in which this amendment is added to the Constitution is a world in which America effectively becomes California. It’s a world where the procedural impediments to passing budgets and raising revenues are so immense that effective fiscal management is essentially impossible; it’s a world where we can’t make public investments or sustain the safety net; it’s a world where recessions are much worse than they currently are and the government has to do more of its work off-budget through regulation and gimmickry. I would like to say something positive about this proposal, say there’s some silver lining here. But there isn’t. This is economic demagoguery, and nothing more. It’s so unrealistic that it would’ve ruled all but two of the last 30 years unconstitutional, which means it’s so unrealistic that there has not yet been a Republican president who has proven it can be done. And that doesn’t just suggest it can’t be done: It suggests that when Republicans are actually in power and have control of the budget, they know perfectly well that it shouldn’t be done. They’re just pretending otherwise for the moment.

-Cheers