Digby's Hullabaloo Posts

Keeping Them Honest

by digby

Bruce Webb discusses HR3200 and explains why it works and why it’s so superior to the Baucus bill even beyond the Public Option. And he homes in on one particular provision:

But here is the biggee, the single provision that guts the insurance companies current predatory model, the one you can bet they are most eager to kill. It is deliberately written to be innocuous but does more to control costs and insurance pool gaming than any other.

Sec 116 ENSURING VALUE AND LOWER PREMIUMS.
(a) IN GENERAL.–A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.

Under the current model insurance companies make money in two ways. One by insuring people who likely won’t need are and two by denying care to those who do need it. Their stated goal is to reduce their Medical Loss Ratio to as low a number as they can. Under Sec 116 this doesn’t work, the more successful you are at denying care or insuring people who don’t need it the bigger the rebate check has to be.

The key is getting the target MLR set at the right level, which is where the PO comes in, its MLR effectively establishes the level against which the private plans have to compete and so keeps the insurance company from gaming the Commissioner in an attempt to get a lower MLR (equals higher profits and dollars for exec compensation). But if pushed to the wall you could control insurance companies premium increases simply through strict application of the provisions of Sec 116.

Sec 116 = Premium and Profit Control. It is even more key to the long-term success of health care reform than the PO itself.

It sounds good to me. But as a non-wonk, political observer, I am still very, very, very leery of anything that 1) depends upon Washington “strictly applying” any provision that hurts insurance companies and 2) mandates that Americans write checks to private insurance companies. It may end up that way, but the politics are much harder than if you have a public option for people to choose — I’d even prefer that it was called something like Medicare Part X (or whatever,) so that there would be no question that the money was going into the pockets of the loathed insurance industry.

The NY Times gives us a hint about how the right is going to respond to the mandate and it isn’t pretty:

The requirement that everyone buy health insurance moved a step closer to reality last week — and possibly a step closer to being challenged in court.

Conservatives and libertarians, mostly, have been advancing the theory lately that the individual mandate, in which the government would compel everyone to buy insurance or pay a penalty, is unconstitutional.

“I think an individual mandate will pass, and I think it’s going to be very vulnerable because it exceeds Congress’s constitutional authority,” said David Rivkin, a lawyer who served in the Justice Department under Presidents Ronald Reagan and George Bush. Mr. Rivkin spelled out his argument in a recent op-ed article in The Wall Street Journal that he co-wrote.

“If you say the government can mandate your behavior as far as this type of insurance goes,” he said, “there will be nothing the government can’t do. They can control every single way in which you dispose of your income.”

Reform advocates will undoubtedly look back on all this and wonder if the politics of single payer would have actually been easier. In this particular respect, it almost certainly would have been. There’s no doubt that the federal government has the power to tax for certain benefits or compel payments to outside parties for certain optional privileges (like driving.) But whether it has the power to compel all citizens to pay money to particular private interests is an unknown. Who knows what the Roberts Court will decide on that?

Of course, if a public option is in place it’s a different argument altogether, isn’t it?

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Silicon Implants

by digby

This should be fun:

The battle for the Republican nomination to succeed Gov. Arnold Schwarzenegger took a nasty turn Saturday as a trio of Silicon Valley candidates tussled over fiscal plans and contender Meg Whitman’s apparent failure to vote until she was 46 years old.

Most aggressive was state Insurance Commissioner Steve Poizner, a mapping software mogul who called on Whitman to drop out of the race for the good of the party. The former chief executive of EBay, he argued, would lead Republicans to certain defeat in a general election, thanks to the civic indifference indicated by her voting record.

“There’s never been a person elected governor anywhere in this country with a voting record like hers,” Poizner said. “I mean 28 years of not voting at all, not even being registered to vote — meaning she had no intention of even voting — is something that will make her really not qualified.”

Whitman promptly rejected Poizner’s demand. “I can imagine that Steve Poizner would like me to get out of the race, and it’s not happening,” said Whitman, who has put more than $19 million of her personal fortune into the race.

This is just what California needs, more preening, millionaire, amateur politicians who haven’t a clue about how to navigate California’s dysfunctional system and think they can govern by just being their awesome selves. I guess the Republicans think Schwarzenneger’s been a big success.

Update: Didn’t Sarah Palin put the Alaska state jet up for auction on ebay? Maybe Whitman could take it to the next level by auctioning off the national parks and beaches. They’re closing them anyway, so might as well sell them to the highest bidder.

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For Me But Not For Thee

by digby

Let’s be sure to remind out Christian friends of this the next time any of them try to sell the lie that they don’t intend to encroach on others’ religious freedoms:

The organizers of a Muslim day of prayer scheduled to take place Friday in front of the U.S. Capitol have come under attack from some conservative Christians. The event, called “Islam on Capitol Hill,” is designed to highlight how U.S. Muslims can coexist with their fellow Americans. Hassen Abdellah, the lead organizer of the event, called on people to come to the Capitol to “pray for peace and understanding between America and its Muslim community.” But this week, some conservative Christians have called the event a threat to Christian values. In a statement, the Rev. Canon Julian Dobbs, leader of the Convocation of Anglicans in North America’s Church and Islam Project, warned that the service is “part of a well-defined strategy to Islamize American society and replace the Bible with the Koran, the cross with the Islamic crescent and the church bells with the Athan [the Muslim call to prayer].” Christian evangelist Lou Engle said the Friday event “is much more than a nice little Muslim gathering. It’s an invocation of spiritual powers of an ideology” that “doesn’t have the same set of values that our nation has had.”

As it turns out,the event went off smoothly — except for a few miserable cranks who refused to let the people worship in peace:

Across the street from the service, Christian protesters gathered with banners, crosses and anti-Islamic messages. One group, which stood next to a 10-foot-tall wooden cross and two giant wooden tablets depicting the Ten Commandments, was led by the Rev. Flip Benham of Concord, N.C.

“I would suggest you convert to Christ!” Benham shouted over a megaphone. Islam “forces its dogma down your throat.” A few Christian protesters gathered at the rear of the Muslim crowd, holding Bibles and praying.

We wouldn’t want that here in the land of the free, now would we?

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Saturday Night At The Movies

Tiptoe through the P-Patch: No Impact Man

By Dennis Hartley

“Yeah, but I mean, I would never give up my electric blanket, Andre. I mean, because New York is cold in the winter. I mean, our apartment is cold! It’s a difficult environment. I mean, our life is tough enough as it is. I’m not looking for ways to get rid of a few things that provide relief and comfort.” –Wally Shawn, from My Dinner with Andre.

I don’t know about you, but I’m with Wally. And Kermit the Frog. Because, dammit, it ain’t easy being green. Oh, I suppose I feel pretty good about myself when I toss the empty cereal box (made from post-consumer fibers and printed in soy ink) into the recycling bin, bring my reusable bag to the farmer’s market, or screw in a low-wattage compact fluorescent bulb, but does that mean I’m doing my part to reduce mankind’s carbon footprint? After watching the new eco-doc, No Impact Man, it would seem that my crimes against Mother Gaia are running a close second only to those of Captain Hazelwood.

Yeah, it would take another guilty liberal to make a guilty liberal like me feel, uh, guilty; and filmmakers Laura Gabbert and Justin Schein have succeeded in doing just that in their film, documenting the efforts of blogger/author Colin Beavan to spend an entire year making as little environmental impact as possible. Operating under the supposition that there are more than a few liberal minded, well meaning, self proclaimed “environmentally conscious” wags out there who don’t exactly practice what they preach (and humbly considering himself to be among them) Beavan set out to put his, uh, mulch where his mouth is. Beavan decided that if he was really going to go for it, he would have to convince his dazzling urbanite wife, Business Week writer Michelle Conlin (a classic New York neurotic) and their toddler to join in as well. So how does a family of Manhattanites pull this off without leaving their metropolitan cocoon? This paradox provides plenty of rich narrative compost for the filmmakers, and they cultivate it well.

Beavan’s strategy was to go whole hog; well, not literally, because he and his wife were apparently vegetarians already going in. But any food they were to consume in the course of the experiment would have to come from local growers (although, dwelling in the heart of New York City, they had to fudge the definition of “local” a tad). Much to Michelle’s chagrin, this meant no more Starbucks (the inevitable scenes dealing with her caffeine withdrawal angst, while initially amusing, begin to feel a little stagy). Electricity was right out, so they dutifully shut down the breakers in their apartment. Automated transportation was also nixed, only walking and biking allowed (elevators were also verboten). And lastly, they make what is arguably the ultimate sacrifice: no material consumption (during a thrift store visit, Michelle gazes wistfully at a used Marc Jacobs bag; the look on her face speaks volumes about the twisted pathos of consumer culture). When Beavan announces that toilet paper is off the list, the shit (ahem) really hits the fan.

Okay, despite the obvious “Dah-ling I love you, but give me Park Avenue” parallels, it’s not exactly Green Acres; after all, this is ostensibly a serious-minded documentary, not just going for the quick yuck. In fact, one of the more fascinating aspects of the film is its exploration of the outright hatred that Beavan receives from some quarters. In one scene, he mopes at his laptop, so befuddled and browbeaten by all the negative comments on his blog that he’s ready to just throw in the towel on the whole project (“Ah yes, Grasshopper, we bloggers must all suffer through that phase at some point,” I mused to myself, while thoughtfully stroking my imaginary Fu Manchu mustache). Ironically, some of his detractors accuse him of being the very creature that he set out to prove to himself that he wasn’t-one of the hypocritical “green fakers”. Even one of his consultants, an urban gardening expert who he has befriended, questions his sincerity. He proffers that Beavan’s wife writes for Business Week, “…for which millions of trees are cut down on a regular basis in order to promote the thoroughly fallacious propaganda that American corporate capitalism is good for the people.” He’s only getting warmed up. He concludes: “If it’s your contention that it evens out because she doesn’t take the elevator in your Fifth Avenue co-op…I have to say you’re either dishonest, or delusional.” Ouch!

The most pragmatic takeaway I got from the film was from one of Beavan’s more thoughtful observations. Perhaps the point is “…not about using as little as we can possibly use…but to find a way to get what you need, in a sustainable way.” The biggest question that remains is, why are some people so threatened by the very idea of “thinking green”? Beavan offers that perhaps it is “…the idea of deprivation that scares people the most” – which of course brings us back full circle to Wally’s lament from My Dinner with Andre that I quoted at the top of the post. Short of chucking it all and joining an Amish enclave, I think it’s possible to be eco-conscious and enjoy some comforts of modern technology without feeling guilty about being alive in the 21st Century. For Wally, it’s the idea of losing the use of his electric blanket. For me, it would be my DVD player. And my DVD collection. OK, and my cable service, and my DVR. I will happily sort out all my garbage, buy locally (when feasible) and avoid using my vehicle whenever practical, but you’ll only get my Universal Remote…when you pry it from my cold, dead hands.

Previous posts with related themes:

Top Ten Eco-Flicks.

(FYI: had to use Digby’s blogger account. But it’s me! —- Dennis)

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Barack Obama Is An Acorn

by digby

Susie Madrak coins the quote of the week:

ACORN is just the new wingnutspeak code for the ‘N’ word.

And if you don’t believe it, check this out:

Neiwert sez:

As you can see, the man — who identifies himself as Tim Jones — shouts after them: “ACORN! These people are ACORN!!! They are frauds!!! ACORN is fraud!!! Obama sucks! This woman sells signs for profit of ACORN!!”

It attracts more harassers, and it verges on the point of an outbreak of violence when the D.C. bicycle police show up and break up the scene.

Now, how does Jones claim to know that they are actually ACORN workers? He says he overheard a police officer ask them if they were selling for ACORN and the young woman — who appears to be a young teen — told the cop “yes.” The older woman tells him flatly they’re not from ACORN, but he keeps shouting it anyway.

[…]

The bigger question is: Why target African Americans when there are are hundreds of vendors at these things? And why assume that they have anything to do with ACORN?

Because, to the teabaggers, ACORN is synonymous with scary black people.

Apparently, the new target is Valerie Jarret. The fact that she’s black is entirely coincidental.

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Brief Observation

by digby

Reading through this NY Times poll, one can only conclude that there is a hard core 30 percent of people in this country who are just against anything they think the Democrats and Obama are for. It doesn’t even have to make sense. Fine, no surprise. These are the same people who thought George W. Bush was an appreciated genius.

But even more clear is that most people don’t have a clue about the details of anything. It’s a complicated world and it’s clear that they only have the vaguest impressions of what’s at stake. What they know at the moment is that health care reform is probably good but possibly bad, and that they are sick of being at war. Other than that, you can pretty much fill in the blanks.

I think the most important thing that’s happening right now is an angry, frustrated, frightened zeitgeist. You can feel it in your personal interactions and see it on the news. Society is a little bit unstable. The political factions that are best able to speak to that — for good or ill — are probably going to be the most successful.

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Mr and Mrs Moral Hazzard

by digby

This is just brilliant. For those of you who are wondering what the hell happened and is happening with the banking bailouts,(and why some people who should know are saying the system is “shakier than ever.”) Chris Hayes and Nomi Prins have put it together in a way that anyone can understand.

Here’s an excerpt:

Imagine a couple living in a three-bedroom house outside the Twin Cities. Call them Joe and Katie Hazzard. The Hazzards own a small off-track-betting (OTB) business and have some investments and a mortgage on their house. But business is terrible (no one has extra money to make bets); Katie recently lost her job; their investments have hemorrhaged value; and they can’t make their mortgage, car or credit card payments. So they ask their local bank for a loan. “No dice,” says the bank. “We can’t give you money to pay your debts because you’re no longer a good credit risk for us.” That’s more or less what happened to the banks last fall: they couldn’t and wouldn’t lend to one another.

Capital Injections and Direct Loans

So the Hazzards go to the Federal Bailout Bank, which says, “Here’s some money. Do with it what you want, and someday down the road, if and when you’re out of the woods, you’ll have to pay us back with a little bit of interest.” That’s roughly what the $700 billion TARP was: a direct injection of capital to purchase preferred shares, which is really more like extending a loan than making the investment the government said it was, with some very light strings attached.

But then Joe says that the handout isn’t enough. It turns out that not only does he own a gambling business; he has a bit of a gambling habit. Joe made big money in previous years betting on the New England Patriots to win the Super Bowl and figured he couldn’t go wrong placing the same wager again. But then Tom Brady injured his knee last year, and Joe got creamed. Inveterate gambler that he is, he’s doubled down on the Patriots this year, but he won’t be paid off (if, that is, the Patriots win) until later in the year. But Joe has a boatload of outstanding gambling debts he needs to pay now.

So the Federal Bailout Bank decides it’ll help out…

That’s just the beginning. It turns out that Joe has many more serious problems of which nobody was aware and at each stage of revelation, requires more funds from the government.

The parable doesn’t cover everything, which the article discusses at some length. But the point is that by propping up these banks they way they did — with little accountability and few requirements at the beginning, we have created a situation where they are doubling down on their bets with the full knowledge that the only risk they bear is on the upside. That’s very scary stuff.

And it doesn’t look like anyone’s likely to do anything to head that off:

Imagine if the Hazzards started using some of their easy money to hire lobbyists to make sure the Bailout Bank maintained its pro-Hazzard policies. Because that’s what’s going on. Banks are lobbying Congress very hard to maintain their setup. Just one year after the crisis, boasting record profits and on track for record bonuses, they are darkly warning that any new regulation could hamper growth.

Given the banks’ newfound publicly sponsored financial health, Washington has little incentive to rock the boat by proposing serious reforms. True, some necessary steps are being discussed by Congress: it’s important to have a Consumer Financial Protection Agency to counteract the damage caused by lax oversight, and higher capital requirements so that banks can pay for their own risk fallout. But the Fed should not be the premier risk regulator, nor should we believe that it will cap extreme bonuses–President Obama doesn’t even support a cap. Parts of the media are already reporting the end of the recession; Obama has moved to reappoint Bernanke, crediting him with keeping the country from a Great Depression, and has given tacit approval to the free flow of bank subsidies. The Treasury, headed by the man who was at the helm of the New York Fed when it nearly went down, is no less culpable for bad decisions.

I saw the Michael Moore film the other night (which I’ll write about later) and Moore was there. In response to a question by someone in the audience about Summers and Geithner he compared Obama to a banker who hires bank robbers to tell them where the security vulnerabilities are. He said he hoped that was the plan anyway.

I actually think it’s something else. I think they simply wanted to get things “back to normal” and trust that the “the market” will fix itself. (Wall street types are probably the world’s greatest believers in the magic of the market.)Booms, busts, bubbles and crashes are not a systemic problem to these people. For the most part, they all survive quite well personally — they have plenty of money to tide them over during the down turns from the times when they are swallowing fire hoses full of money when the markets are roaring. And the institutions they work for, which might possibly take down the entire system, are now 100% guaranteed by the US treasury, so they no longer face any serious risk at all. The risk all rests with the average person whose dreams are derailed when things go wrong and who can’t afford to try anything new because the personal cost is too high. Win win for the MOUs.

Many of these people at the top of the financial food chain are nothing more than gamblers with other people’s money who have a faith-based belief in the “free market” that will always save them in the end — and if that doesn’t work the government will. The problem is that they are also considered to be the experts who will save the system itself. It’s very hard to see why they would even if they could (and I seriously doubt they can.)

You’ll recall that the man who was allegedly the smartest man in the world, the Oracle of Rand himself, only recently found out there was a tiny little flaw in his free market, libertarian philosophy:

“I made a mistake in presuming that the self-interests of organizations, specifically banks and others, were such as that they were best capable of protecting their own shareholders and their equity in the firms,” Mr. Greenspan said.

Referring to his free-market ideology, Mr. Greenspan added: “I have found a flaw. I don’t know how significant or permanent it is. But I have been very distressed by that fact.”

Mr. Waxman pressed the former Fed chair to clarify his words. “In other words, you found that your view of the world, your ideology, was not right, it was not working,” Mr. Waxman said.

“Absolutely, precisely,” Mr. Greenspan replied. “You know, that’s precisely the reason I was shocked, because I have been going for 40 years or more with very considerable evidence that it was working exceptionally well.”

Problem solved. These banks and financial firms are now “too big to fail,” so their participants’ only self interest is in getting as personally rich as they possibly can. Which is what they always believed anyway. All hail Mistress Ayn.

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Truth In Advertising

by dday

So I’ve been working with Brave New Films on their Sick For Profit campaign, exposing the practices and rewards of the insurance industry. It’s been pretty eye-opening, and we have a lot more stuff coming in the next few weeks. But we also decided to have a light moment. A couple weeks ago Brave New Films asked for submissions to give CIGNA a more appropriate tag line than their current “A Business of Caring” (in the words of Adam Sandler from the old SNL sketch, “Who are the ad wizards who came up with this one?”). Over 1,600 entries later, we have whittled them down to a few gems.

At Sick For Profit, you can pick the best tag line or submit your own. Here are the front-runners so far:

A business of caring less
Walk it off
Coverage to die for
We deny. You die.
Patients try our patience.
Denying care, one patient at a time
We love you… to death
Your pain is our gain
We put the “Hell” in healthcare
Bend over

With the winning tagline, we’ll make CIGNA a new corporate logo, post it on Facebook, and send it to CIGNA execs. Which I’m sure they’ll appreciate.

Vote for your favorite today!

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Just In Case

by digby

Yesterday dday wrote about the now infamous Kyl Stabenow exchange on the finance committee in which Stabenow reminded Kyl that his mother probably could have used maternity coverage in her health policy.

But it’s useful to look at exactly what Kyl said and examine what it says about the Republican definition of insurance:

I don’t need maternity care and so requiring that to be in my insurance policy is something I don’t need and make the insurance more expensive.

At first glance, it would seem that Kyl is saying that anything that applies to women and not men, such things as uterine cancer,breast cancer, child birth etc, should not be in the universal package of benefits because John Kyl doesn’t need it and therefore, shouldn’t have to pay for it. But it’s actually something different.

It’s true that health insurance that covers women’s reproductive health is a little bit more expensive for men, who will not personally use it. One can argue that men are quite involved with women’s reproductive systems, but it would seem that a fair number of them only want to control those systems, not chip in to pay for the healthy functioning of them.

But this is really about something different. John Kyl (and people like Ashton Kutcher, who famously said he shouldn’t have to pay for fat people because he isn’t fat) apparently believe that they can predict the future and should only have to pay for the things from which they personally might suffer. It would be really neat if we could do that, but it’s not how the world — or insurance — works.

The whole point is that while some people are born lucky –Kyl for instance, who doesn’t have a nasty uterus to worry about, or Kutcher, who is blessed with good genes and a personal trainer— everybody, everybody, is vulnerable to catastrophic illness. And the costs of such illness are so great that anyone but the super rich is also vulnerable to financial catastrophe in that circumstance if they aren’t well insured.

It can happen to anyone. Patrick Swayze just died of pancreatic cancer. He was a health nut and an athlete who was never sick a day in his life until it happened to him. You cannot know if it will happen to you and you cannot be smug and self centered and insist that people shouldn’t have to pay for health costs they cannot possibly incur because there are a hell of a lot of diseases and accidents waiting to strike any of us down at any moment.

This notion that everyone who isn’t sick today is somehow morally superior, smarter or just plain better, and shouldn’t have to kick into the collective pool that protects everyone is the worst kind of immature thinking. The whole point of insurance is that there are millions of potential health problems out there, most of which we will not get. But among those millions of possibilities is probably at least one that we will get and more likely quite a few over the course of our lives. We just don’t know which ones. (If we did, this whole thing would be a lot easier to deal with, wouldn’t it?) Therefore, you have to have everybody put their money into a big pool to cover every eventuality.

Certainly, people should be encouraged to live healthy lives and be given as much support in doing that as possible. But there is no guarantee. And as Stabenow pointed out to Kyl, he may not personally need maternity care but everybody has a mother and she certainly does. And even the gorgeous Ashton could get heart disease diabetes, no matter how buff he is today. There are no guarantees in life. That’s why we have insurance (or pay taxes…) Just in case. Or as the Christians say, “there but for the grace of God go I.”

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Oh That’s Good News

by digby

This just gets better and better:

Neil Barofsky is the man who tracks the historic bailout known as the Troubled Asset Relief Program, or TARP. The 39-year-old special inspector general monitors a dozen separate bailout-related programs that now account for nearly $3 trillion in financial commitments.

[…]

During an interview with the Huffington Post Investigative Fund, Barofsky made some striking observations. Among them were:

1. He found hundreds of banks capable of tracking their use of the TARP money – despite claims by the U.S. Treasury that the task was impossible.
2. If the purpose of the TARP rescue was to increase lending, it has failed

Ok. Not surprising. Boondoggle. We all knew it was probably going to be one, right?

But what the hell is this?

3. The U.S. financial system, now dependent on bigger and fewer banks, is shakier than ever.

We knew they were just throwing as much money at the problem as they could, forcing institutions to take it even if they didn’t want it to obscure which ones were solvent and which ones weren’t, with the idea that even though there would be tremendous waste and fraud, it would stop the avalanche and allow the system to get back on track. Naturally, one would have assumed that they would have passed serious financial reform immediately in order to prevent a similar problem from happening again and that the whole sector would sober up (at least for awhile) and behave like responsible citizens.

But instead, it’s now “shakier than ever?” “Far more dangerous than it was before?” I guess that didn’t work out so well, did it?

Of course that makes perfect sense if the masters of the newer, bigger financial institutions go right back to gambling like a bunch of video poker addicts at an Indian Casino, knowing that if they were too big to fail before, they are definitely too big to fail now. Why wouldn’t they? The payoff is huge no matter what they do. Except the tens of million average working dopes whose dreams have been derailed and delayed, nobody paid any real price — and who cares about them?

The good news is that the congress is finally on the case with much needed oversight — they defunded ACORN.

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