Bill Scher's LiberalOasis

Home of the LiberalOasis Radio Show, Bill Scher columns and other liberal commentary

Month: March 2009 (page 1 of 2)

Serious Healthcare reform (part 1) – Where to start?

I’m still waiting for the debate to start. When are we, as Americans, going to get this debate started? Dem From CT has tried. He has posted some thoughtful information and questions on healthcare. Yet he has not drawn the type of overwhelming responses that would suggest that progressives are engaged.
Well, let me try to get this puppy started. Over the next several weeks, I will post a series of articles that will examine healthcare as completely as I can.
As a trauma surgeon, I bring a unique perspective to this discussion. I see all types of patients. Rich, poor, young and old. Everyone can be a victim of trauma.
So, is healthcare a right? I know that this starts arguments but it is time to have those discussions. This question is important because depending on your answer, it will change our approach. Let’s look at both sides of this argument.

Yes, healthcare is a right. When Thomas Jefferson wrote “life, liberty and the pursuit of happiness,” it was as if he was including Health. It is as clear as the nose on Jefferson’s face. If healthcare is a right then all Americans should be given adequate healthcare. This healthcare should be guaranteed by the state.

On the other hand, there is no way that Thomas Jefferson or any of the founding fathers thought about healthcare because doctors in the 1700s really didn’t do much. It is hard to put words into the mouths of our forefathers. So maybe healthcare isn’t a right. Maybe it is a privilege like driving a car.
I have no idea how our economy is going to grow if a significant portion of our workforce is worried about their health or have their finances tied up in health care. As we get older and work longer there are going to be more health issues in the workforce. Diabetes, hypertension and obesity are terribly expensive.

We’ve all seen the numbers and they are staggering. $2.1 trillion! This is a total pricetag of healthcare in the United States. We spend approximately 16% of our Gross Domestic Product on healthcare. Germany spends 10.9%. France, a country that many conservatives paint as a welfare state, shelled out only 10.5% of their Gross Domestic Product.

So, we’re spending a lot of money. A ton of money. I would argue with critics who say that healthcare in the United States is terrible. I think this is a complete distortion of the facts. Instead, healthcare in the United States is very spotty. Some people get excellent care. Some people are overtreated and others are undertreated. Now, we can point fingers at who’s to blame for those who are overtreated and those who are undertreated. We do know one thing for sure and that is 47 million Americans go without health insurance. It is almost a sure bet that many of these Americans are undertreated.
Let’s look at a very common scenario. As I tell this story, think about overtreatment and undertreatment and about the delivery of healthcare. Again, is healthcare a right or is it a privilege?

A 25-year-old male works as a stock boy at Wal-Mart. He’s never been to the hospital. He does not take any medications and he is healthy. He carries no insurance. While in the warehouse, he turns around quickly and hits his head on a metal pole. He is a little dazed but is not knocked out. He develops a bruise on his forehead. He asked his supervisor if he can go to the doctor. The patient presents to the emergency room complaining of a headache. The ER physician takes a thorough history and physical and only finds a bruise on the patient’s forehead. The ER physician orders a CT scan of his head. This scan is negative for any traumatic injuries. The patient is sent home with instructions to return to work as soon as he is able.

So? What do you think? 30 years ago, a patient with such an injury would not go to the emergency room. 20 years ago, the standard of care would be to examine the patient and if the patient does not have any specific signs of a head injury like nausea or vomiting, blurred vision or decrease in mental status then the patient would be sent home on aspirin or Tylenol. 10 years ago, because of the availability of CT scans and the wealth of information that physicians can get from CT scans almost all head injuries get scanned.
So what are your thoughts? Is healthcare a right? We have a golden opportunity to fix this system so that it works for every American. Let the great healthcare debate begin.

The LiberalOasis Radio Show: Media Still Lame Edition

Today at 10 AM ET, The LiberalOasis Radio Show was broadcast on WHMP-AM in Western MA. My special guest was Eric Boehlert of Media Matters for America, who analyzed the sad state of the traditional media in the Obama Era.
The audio podcast for the show is here: (iTunes / XML feed / MP3).
Video of the opening monologue is below, on the status of the budget and what it means for our efforts to secure health care for all and solve the climate crisis.

The Week In Blog: Teleprompter Edition

The latest edition of The Week In Blog is up at Bloggingheads.tv featuring TownHall.com’s Matt Lewis and myself discussing reaction to Sen. Specter’s EFCA flip-flop, conservative obsession with the teleprompter and the next steps for health care and the budget. Watch it below.
http://static.bloggingheads.tv/maulik/offsite/offsite_flvplayer.swf

The LiberalOasis Radio Show: Consuming Kids Edition

Today at 10 AM ET, The LiberalOasis Radio Show was broadcast on WHMP-AM in Western MA. My special guest was Adriana Barbaro of the Media Education Foundation, producer, director and writer of the new documentary “Consuming Kids: The Commercialization of Childhood”, which will premiere at Northampton, MA’s Academy of Music Friday night.
The audio podcast for the show is here: (iTunes / XML feed / MP3).
Video of the opening monologue is below, on the importance of confronting the obstructionist Blue Dog Democrats looking to undermine President Obama on his budget, health care and global warming strategy.
You can start fighting back this weekend by participating in the nationwide Organizing for America “Pledge Project Canvass” collecting pledges in support of President Obama’s budget priorities. You can also pledge online here.
Watch the opening segment below.

The Week In Blog: Blue Dog Edition

The latest edition of The Week In Blog is up at Bloggingheads.tv, featuring TownHall.com’s Matt Lewis and myself discussing the new Senate Blue Dog bloc, the AIG bonus backlash, Geithner’s prospects, and lingering splits in the GOP. Watch it below.
http://static.bloggingheads.tv/maulik/offsite/offsite_flvplayer.swf

Pakistan Update

The New York Times Headline says it: Pakistan Avoids Crises but Pitfalls Remain
Basically, Pakistan has oscillated between military rule and corrupt civilian leadership. Pakistan’s brave, real, and significant civil forces are not matched in their integrity by any facet of Pakistan’s political or military leadership.
A depressing irony of the last couple day’s events is that the politician with the most to gain is Nawaz Shariff. Steve Coll writes brutally about Sharif’s corruption, petty human rights abuses, and laziness in his amazing history Ghost Wars. It’s very funny to see Sharif playing the role of principled democratic leader considering his pedigree and record. Nonetheless he has been right about reinstating Chief Justice Chaudhry (who General Musharraf removed from the bench) since his return from exile. Whatever the case Standing with the lawyers will pay dividends for Sharif.
The Daily Telegraph calls for Taking Sharif Seriously. Yet, if you know Shariff you really don’t want him around. Is it possible for the Obama team to harness the genuine uprising of civil society in Pakistan wholeheartedly without losing a healthy skepticism of Sharif? Secretary Clinton’s reported hardball with Zardari is a good start. We need to stop looking for a Pakistani savior figure and get behind civil society fully.

It is always possible that the military could step in
. US policy makers have had an alarming tendency to feel almost relieved by military interventions in crisis situations. All I can say is listen to Tariq Ali and see how many of Pakistan’s most intractable problems stem from Zia Al Haq’s reign.
Remember the charming General Musharraf who promised to clean up the mess and ended up presiding over the near collapse of Pakistan? I don’t know how to do it but there must be a way to directly harness the energy of civil society in Pakistan without GIVING it to the same gang. Right now it is highly possible that the Pakistani people will have once again demonstrated amazing political courage only to have another mediocre thief rising their to the top.

The LiberalOasis Radio Show: Employee Free Choice Edition

Today at 10 AM ET, The LiberalOasis Radio Show was broadcast on WHMP-AM in Western MA. Our special guest was Pat Garofalo from the Wonk Room who explained the importance of the Employee Free Choice Act to prevent corporate interference in worker organizing and strengthen the middle-class.
The audio podcast for the show is here: (iTunes / XML feed / MP3).
I botched the videotaping of my opening monologue. But below is the video I referenced in my monologue, covering the exchange I had with the anti-Social Security, anti-Medicare “Fiscal Wake-up Tour.” And following that is my OurFuture.org blog post, “Waking Up The ‘Fiscal Wake-up Tour'” offering additional background and context.
[youtube http://www.youtube.com/watch?v=8u765nU3MCQ&hl=en&fs=1]
Waking Up The “Fiscal Wake-Up Tour”
by Bill Scher
March 12th, 2009
Social Security and Medicare opponent Pete Peterson funds through his foundation a “Fiscal Wake-Up Tour,” which characterizes itself as a non-ideological truth-telling presentation bravely warning the nation that Social Security and Medicare need drastic changes to save our children from crushing debt.
But the “Fiscal Wake-Up Tour” actually is the worst kind of ideological exercise, one that blindly follows a political position regardless of the facts.
We know that Social Security is basically structurally sound. We know that skyrocketing health care costs throughout the system are the primary fiscal threat. Yet the Tour refuses to follow the facts and adjust it’s views. (CEPR delivered a definitive take-down of the documentary of the Tour, “I.O.U.S.A.”)
I attended the Boston stop of the tour last night, and confronted the panel on its misinformation. Their responses only further proved my point.
You can watch our exchange at the bottom of this post, while I’ll explain their bizarrely dishonest and evasive responses.
1. Social Security benefits are non-fiction. Peterson Foundation CEO David Walker respond to my factual observation that Social Security will pay full benefits through 2049, by repeatedly insisting “There are no trust funds. It’s a fiction!”
But I didn’t say anything about the abstract concept of a “trust fund,” because the bottom line is the benefits will get paid. Quoting Dean Baker:

Under the law, SS is financed by a designated tax. The surplus over the last quarter century has been used to acquire more than $2.4 trillion in government bonds. According to the SS trustees, the bonds held by the trust fund will be sufficient to keep the program fully solvent until 2042. According to the non-partisan Congressional Budget Office, the program will be fully solvent until 2049. Both dates are far enough out that reasonable people need not panic, we have dealt with far more imminent SS shortfalls.

Walker grudgingly conceded the point, but then reverted to harping on the trust funds. When I interrupted to ask, “will full benefits be paid by the year 2049?” Walker responded: “2041, if you recognize the fact that the bonds are real but the trust funds aren’t.”
I reiterated, “The trust funds aren’t an issue if the benefits get paid,” to which he said again “there are no trust funds.”
Head, meet wall.
2. Health care costs, not Medicare costs. Prior to the above clip, it was interesting to see all the panelist recognize the reality that primary fiscal problem is skyrocketing health care costs — as this was the White House message coming out of the fiscal responsibility summit, strongly advocated by groups such as ours. It’s the plain reality.
This is a problem clearly driven by our private health insurance system, not by our government-run Medicare program. It certainly isn’t a problem in other nations with universal health care systems.
In fact, one the members of the Fiscal Wake-Up Tour, Isabel Sawhill from Brookings Institution, actually made this point. (Hers was the least awful of the presentations.) Her health care reform recommendations have absolutely nothing to do with Medicare, but propose comprehensive reform including universal coverage with cost controls. (You can download an earlier version of her PowerPoint presentation here.)
Yet the Tour’s proclaimed “rock star” David Walker continued to blithely assert that Medicare needed major changes, as if his Tour colleague’s presentation did not exist.
So when I pointed out that we just heard the exact opposite from Ms. Sawhill five minutes ago, Walker offered nothing but a blank stare.
3. Heritage for Socialized Medicine! Seeing Walker trapped, the Heritage Foundation tour member, and United Kingdom native, Stuart Butler stepped into the silence.
And after his earlier presentation effectively proposing more privatization of our retirement and health insurance systems, he had the gall to cite the UK health system as a reason to undermine Medicare: “I come from a country … which has a budget and has made decisions and set priorities in health care … We have a very different system here, which is totally open-ended.”
Stunned, I asked Butler if now Heritage is supporting national health care systems in England, France and Canada. He ignored the question.
Butler also shared Walker’s skill in using condescension to pretend the questioner said something he didn’t. He lectured to me: “So don’t kid yourself that … you can just sort of fix health care, like it’s sort of on some separate planet, that we don’t have to deal with the structure of the health care system.”
Well of course, that was my entire point!
But Butler, like Walker, then made the dishonest connection dealing with “the structure of the health care system” meant attacking “Medicare and Medicaid.” It does not, since Medicare and Medicaid are more cost-effective than the private health insurance system.
4. Priorities. The initial spat I had with Walker on the tape, regarding his boss Pete Peterson and the Bush tax cuts, is less central to these policy questions, but speaks to the underlying motivations of his Foundation and Tour.
Walker chose to bust me (and granted, I gave him the opening with a poorly worded question) and note the Peterson Foundation did not exist until recently, so how could it have opposed the Bush tax cuts? And besides Peterson himself and Walker did oppose the tax cuts at time.
However, my point was not about perfunctory opposition, but about priorities. Peterson and his posse can easily gain non-ideological currency by stating opposition to various things.
But what do they spend money on? What do they steer everything back to with rhetorical sleight-of-hand, no matter what the facts are?
Peterson could have spent $1M on ads opposing the Bush tax cuts. He could spend that money now supporting comprehensive cost-saving health care reform.
But he only chooses to spend it on attacking Social Security and Medicare, when they are in fact, not the underlying fiscal problem.
That speaks to blind ideology, which is what The Fiscal Wake-Up Tour is all about.
Watch the video of our exchange [above]. For an honest assessment of our fiscal challenges, check out this OurFuture.org podcast featuring Roger Hickey, Dean Baker, James Galbraith and Nancy Altman. Thanks to Anne Thompson for producing the video.

The Week In Blog: EFCA Edition

The latest edition of The Week In Blog is posted at Bloggingheads.tv, the last edition with Heritage Foundation’s Conn Carrol as my regular partner. We discuss blogosphere reaction to Ross Douthat joining the NY Times, possibilities of a second stimulus package, and the furious fight over the Employee Free Choice Act. Watch it below.
http://bloggingheads.tv/maulik/offsite/offsite_flvplayer.swf

The LiberalOasis Radio Show: Live Stream

Today’s taping of the LiberalOasis Radio Show is streaming live below. Video and podcast will be available tomorrow.

Some Stakeholdership

The Swedish Option is supported by a whole lot of people who know more then I do about economics and how to extricate us from the present crisis. It is worth remembering that Sweden’s approach to its banking crisis reflected a much broader social agreement in Sweden. Sweden is a Corporatist state. The Swedish option is reflects Swedish Social Democracy. Social democracies in Europe are structured differently amongst themselves.
Corporatist model brings all major stakeholders such as labor and management to the table where government mediates and synthesizes between competing claims and aims toward consensus on commercial and public targets. Aggressive government intervention with strong public dividend and then a return to more transparent private control is in keeping with the “Swedish Way.”
In the 1990s Communitarian “stakeholder” rhetoric enjoyed some popularity. Academics like Amitai Etzioni expressed an interest in addressing crime, community breakdown and education by bringing stakeholders together to forge solutions. But stakeholder strategies in the United States have never real gone beyond addressing things like graffiti. In the Corporatist model there is the potential for stakeholders to address large public and private institutions and play a policy role. I don’t know how this would look in the States. But I think you can’t look at the Swedish solution without looking at the Swedish way of doing things. I think there is some real potential for reviving and expanding the idea of stakeholdership.

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