Tuesday, September 29, 2009

Kyl wants a Chinese menu for health insurance

Senator Jon Kyl (R, AZ) recently exclaimed "I don't need maternity care" as his reasoning for supporting his amendment to prohibit the government from setting minimum standards for certain insurance coverage. Essentially Kyl's argument was because I'm a man and will not get pregnant I don't need maternity care and requiring maternity care to be a basic benefit in a policy will make it more expensive. So, to keep health care costs down, insurer's should not be required to cover basic prenatal and maternity care. By that logic, if you can call it that, as someone who doesn’t smoke or drink I shouldn’t have to pay for coverage of lung cancer or emphysema or cirrhosis of the liver. Smoking and drinking alcohol are choices after all.

Let’s hear it Senator Kyl, how about not paying for treatment of Type II diabetes since over-eating is a choice? What about injuries caused by falling off a ladder, climbing on the ladder was a conscious choice? Then there’s artherosclerosis caused by the choice of a high cholesterol diet, I eat right I don’t need that either. Why not require that you be able to check off all the things you don’t want your insurance to cover because you don’t think you’ll have the need?

I think Senator Kyl nicely summarized the Republican approach to the health insurance crisis: I've got mine, too bad for you.

Saturday, September 19, 2009

Lamar Smith's Pants are on Fire

In Lamar Smith’s article in Wednesday's San Antonio Express-News he offers tort reform as the solution to the high cost of medicine. Tort reform is a red herring. Only from 4 to 7 % of those injured by malpractice even bring suit due to the high cost of litigation. Medical malpractice tort costs were $30.4 billion in 2007, we have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. Even if we eliminated malpractice insurance costs entirely it won’t substantially reduce the cost of health care in America.

Despite Congressman Smith's contention that Texas Tort Reform has brought back doctors and reduced costs; insurance companies did not drop their rates because of tort reform, instead the state’s insurance commissioner forced them to drop their rates. Shortly after the passage of the Medical Malpractice and Tort Reform Act of 2003, two major Texas insurance carriers requested increases in malpractice insurance rates. One, the Joint Underwriting Association, filed for a rate increase of 35 % for doctors and 68% for hospitals. Malpractice insurance rates did not increase only because the state insurance commissioner denied the request.

Contrary to the claims that defensive medicine drives up costs and tort reform would reduce the practice the CBO found that on the basis of existing studies as well as its own research, savings from reducing defensive medicine would be very small.

Friday, September 4, 2009

Is the outrage over the President's presentation to students just a tempest in a teapot?

We’re all upset by this latest outrage, I’ve been asking myself why the R’s are making such a stink about the President’s address to the students. Then I started thinking about what there is to gain from it. I’ve always been a bit socially awkward and therefore a little slow at getting the psychology of moving people so it took me a while to make the connections.

Having been reading a little history and looking at polling data I now believe that all the froth that’s been stirred up by the far right leadership regarding Obama’s birth certificate, the “death panels” and the presidential “indoctrination” speech to students are all about activating their base for the battles over health care, climate change/energy legislation and the 2010 election. The method is the same racial polarization also known as the “southern strategy” that Nixon and the R’s have used to great success in past elections. They’re using fear, the fear of the other to raise the intensity of their base and so far it’s working. Polling shows that not only is Obama’s approval down with the general public but it’s really down with “likely voters”. Who are likely voters, right now they’re Republicans because they’re activated.

If we allow ourselves to be distracted from the forest by the trees we will spend our time and energy constantly reacting to their efforts rather than putting out our own message. It’s important to get ahead of the wave or we’ll drown in the trough. We need to turn their weapon against them by using their tactics to activate our base. We have to remind our folks that the reason they went out and worked to get Obama elected was to change the status quo and that if they don’t get out and continue to work toward the goals he set forth on the campaign trail their prior efforts will be for naught.

I have no doubt that George Lakoff is correct that Obama’s team bungled the roll out of the health care reform program. I have no doubt that David Sirota is correct that the Democratic Party isn’t going to just get the things we elected them to do done without a progressive movement to push them into it. I have no doubt that Robert Creamer is correct that Obama is aware that if health care reform fails he probably will be a failed president. I have no doubt that many of you, myself included, will feel betrayed if health care reform doesn’t include a public option.

What we, as progressive activists, have to do is use the tools available to activate our base supporters because we know that only then will our legislators vote as we expect them to, only then will our President stick his neck out and demand a public option. The R’s play a deep game and they plan and work for the long haul, we’ve got to do the same thing.

I know that many of you are charged up about this most recent outrage, I’m certain that many less politically aware/interested folks are just as upset. We need to use that outrage to activate our folks. One possibility would be to hold a brief, hour long, rally in front of school board offices in ISD’s where the president’s address won’t be shown. We need petitions and folks writing to the school boards and administrators and writing letters to the editor. A gentleman I know is making DVD’s of the address and planning pizza parties with viewings of the “forbidden” presentation. We have to talk to our neighbors and when we find one that agrees we must urge them to make a call or write a letter.

Each person that we activate in this manner becomes more receptive to being activated again. The goal is not to somehow right the present wrong it’s to activate our base because if we don’t then the R’s have already won. They have succeeded in activating their base and are keeping them activated through repeated ridiculous spectacles. We need to put our heads together and develop a plan to not just counter the R’s but to beat them at their own game. If I were part of the Hispanic community I would certainly be shouting from the rooftops about our Senators voting against Justice Sotomayor. What votes or positions do you think will resonate with your family members, friends and neighbors? Is it appropriate to use party resources such as the Texas VAN in an effort to activate our base? I believe it is and it’s time we use it to phone bank and call Democrats asking for them to call school superintendents, call our Congressmen and write to the President.

Thursday, September 3, 2009

Fehrenbach repeats teabagger and secessionist rants as analysis

In T.R. Fehrenbach’s Sunday article, “The core questions might make you sick”, he cites three core questions and claims to answer them. Unfortunately Mr. Fehrenbach, who claims to be a historian, seems to be using teabagger propaganda as source material.

On the question of cost he states that any extension of benefits will be enormously expensive. If we assumed that those not presently covered by insurance were also getting absolutely no unpaid care he would be correct, but that’s not the case. Hospitals and doctors frequently provide services for which they aren’t compensated and therefore charge everyone else more to make up the shortfall.

On the question of benefits Mr. Fehrenbach states “Every country with cradle to grave coverage dilutes or rations care” and then goes on to say that “In Sweden, top specialists are usually available only to the political class or famous people.” How is that different than in the U.S. except you should add “the wealthy” to those who have the luxury to seek out the finest care?

Finally like the teabaggers and secessionists I’ve met at demonstrations Mr. Fehrenbach claims “Government can’t manage Medicare now – why trust it with greater responsibility?” What other entity in the U.S. spends health care dollars more efficiently than Medicare which achieves 95% while private insurance companies do no better than 70 – 80 %?

If Mr. Fehrenbach wants to lay claim to being a historian he’d do well to choose his sources more carefully.

Tuesday, September 1, 2009

SCUC ISD building mega-schools, not better schools

On August 11 the SCUC ISD Board of Trustees voted to dramatically increase the number of students new schools are designed to support. The recently built K-4 schools are designed for approximately 750 students, a size that is considered by the educational community to be significantly too large for the best educational outcomes, but new schools will be designed for 1210 students. Schools for grades 5-6 and 7-8 will jump to 1452 students and future high schools will go from 1500 to 2904.

The literature generally suggests that the greater the number of students on a campus the lower the educational outcome regardless of the whether or not the school is designed for the high number. The justification claimed the nearly 50% increase in size is cost savings in maintenance and operations. Studies show that while there may be small cost savings to be had in operations they are more than offset by the loss of educational quality.

While the board justifies jamming our kids into undesirable environments in order to reduce the need to raise taxes they look forward to building a large district football stadium and a 3500+ seat performing arts center. Then to add insult to injury the board approved the use of $300,000 in bond money that was saved from previous projects that came in under budget to buy electronic signs for the schools. If money is so tight we’re willing to accept lower educational performance why wasn’t that money spent to enhance our children’s educations?