I almost have to get out of my seat and clap at the absurdity of this news: Torture lawyer John Yoo has been given a monthly column at the Philadelphia Inquirer.
That’s a data point you’d expect at the end of a Vonnegut novel. So it goes.
Aside from justifying waterboarding and other forms of torture, aside from saying that terror suspects didn’t deserve habeas corpus because it costs too much, aside from willingly offering every argument to aggrandize executive power in ways that would make a monarch blush, aside from authorizing a torture regime that has led to multiple homicides, aside from a looming disciplinary report from the Office of Professional Responsibility, aside from potential war crimes trials in Spain, here is the latest handiwork from Yoo, designed to get him and his buddies off scot-free (clearly he didn’t need to worry):
A Bush administration attorney who approved harsh interrogation techniques of terror suspects advocated in 2006 that President Bush set aside recommendations by his own Justice Department to bring prosecutions for such practices, that the President should consider pardoning anyone convicted of such offenses, and even that jurors hearing criminal cases about such matters engage in jury nullification.
That advice came from John Yoo, a former attorney with the Justice Department’s Office of Legal Counsel and author of memos that served as a legal rationale for the Bush administration’s interrogation techniques. Yoo’s recommendations constitute one of the most compelling pieces of a body of evidence that Yoo and other government attorneys improperly skewed legal advice to allow such practices, according to sources familiar with a still-confidential Justice Department report.
I don’t think you need further evidence that Yoo and his cohorts knew what they did was wrong in the eyes of the law. Of course, to the media fraternity, that just means he’s “knowledgeable,” as it says in this explanation of Yoo’s hiring from the editor of the Inquirer opinion page:
John Yoo has written freelance commentaries for The Inquirer since 2005, however he entered into a contract to write a monthly column in late 2008. I won’t discuss the compensation of anyone who writes for us. Of course, we know more about Mr. Yoo’s actions in the Justice Department now than we did at the time we contracted him. But we did not blindly enter into our agreement. He’s a Philadelphian, and very knowledgeable about the legal subjects he discusses in his commentaries. Our readers have been able to get directly from Mr. Yoo his thoughts on a number of subjects concerning law and the courts, including measures taken by the White House post-9/11. That has promoted further discourse, which is the objective of newspaper commentary.
His most recent op-ed attacks President Obama for seeking “empathy” in his next Supreme Court pick. Obviously Yoo wouldn’t know anything about that.
Here’s Will Bunch:
But it’s not too late to change things. Last Sunday’s column by Yoo should also be his last, period. While Yoo is a free man who is thus free to utter his detestable viewpoints on any public street corner, the Inquirer has no obligation to so loudly promote these ideas that are so far outside of the mainstream. People should write the Inquirer — inquirer.letters@phillynews.com — or call the newspaper and tell them that torture advocates are not the kind of human beings who belong regularly on a newspaper editorial page, officially sanctioned. Journalists here in Philadelphia or elsewhere who wish to strategize on where to take this next should email me at bunchw@phillynews.com.
I’ll write the paper, but this really makes me sad more than anything. Not only has a substantial portion of the country accepted torture as a viable option, the scoundrels who authorized it, who debased this country, are not only likely to avoid any justice for the crimes they committed, but they’re getting op-ed columns to boot, a ticket into polite society. Despite the fact that Jay Bybee’s moral and ethical fitness can be fully questioned by his decision to allow torture committed in our name, he can just lobby his Congresscritters and elude accountability and sit on the federal bench in judgment of other Americans.
And here’s maybe the kicker to the whole thing – at least in Bybee’s case – federal judges can be held accountable in this country. It just happened yesterday:
A disgraced federal judge was sentenced Monday to nearly three years in prison for lying to investigators about whether he sexually abused his secretary.
U.S. District Judge Samuel Kent was sentenced to 33 months Monday. He was also fined $1,000 and ordered to pay $6,550 in restitution to the two women whose complaints resulted in the first sex abuse case against a sitting federal judge.
Kent could have received up to 20 years in prison after admitting to obstruction of justice, but prosecutors said they wouldn’t seek more than three years under a plea agreement.
“Your wrongful conduct is a huge black X … a stain on the judicial system itself, a matter of concern in the federal courts,” U.S. District Judge Roger Vinson said as he imposed the sentence. Vinson is a visiting senior judge called in from Pensacola, Fla.
Right after the verdict, this popped up in my email inbox, a joint statement from the Chair and Ranking Member of the House Judiciary Committee:
Unless Judge Samuel Kent immediately resigns, we intend to introduce a resolution jointly tomorrow to commence an inquiry into whether grounds exist to impeach him and remove him from office.
Are they trying to kill me?
I’m obviously not saying that a sex abuser doesn’t deserve this kind of treatment, but that for some reason, authorizing torture which led to detainee homicide doesn’t get the dander up in Washington in the same fashion. It makes a mockery of the phrase “moral obligation.”
I’ll Bet Your Carrots Get More Leg Room Than You Do
by tristero
How much of the food you eat earns more frequent flyer miles than a rock band on a gig-packed world tour? A lot more than you might think. The link is to a site called Global Grocer, in which you go food shopping, virtually. You “fill” your cart with stuff, and as you do, you learn the probability that the food you’ve chosen is imported. When you “check out,” the program calculates the overall odds that you’ve purchased at least some imported food. Much of the stuff I looked at had a 1 in 3, or better, chance of being imported, and my typical “shopping trips” averaged 96% odds, or better. And the trend is to import more and more basic foodstuffs.
As a newcomer to food policy, it seems to me that there are a host of complex issues that intersect in food distribution and delivery. This is not one of them. This kind of routine substitution of imported food for staples that can be readily found far closer to a consumer is insane. There simply is no simple reason to fly a carrot to a supermarket in New York when perfectly fine, perhaps tastier, carrots are grown within 100 miles of the city. Talk about carbon footprints!
Oh, you object, I’m neglecting economies of scale, the cost of domestic production, and that’s just for starters. Well, yes. All the more reason to carefully re-examine food and agricultural policies. It may not be feasible any time soon to see the large-scale social changes some imagine – like the great Mark Bittman, for whom I owe a hat tip for this link (and grateful thanks for such wonderful cookbooks and recipes). It’s not likely that in the next 5 or 10 years Americans will radically change their overly meaty diet to ameliorate global warming (although, admittedly, enough Americans have changed their diet to make “organic food” a supermarket staple, something almost impossible to imagine 20 years ago). What surely is feasible is a change in the elaborate web of subsidies, tariffs, taxes, and other incentives/disincentives that encourage the kind of madness that ships garlic from China to Madison, Wisconsin because it is cheaper than getting it from a local farm.
Apparently, this was making the rounds on the trading floor today. From CNBC:
viewers, search on youtube for inspector general. The title piece, “is anyone minding the store store at the federal reserve.” Elizabeth Warren is the inspector — excuse me, Elizabeth Coleman is the inspector general — and this cross-examination by representative Alan Grayson is just all over the floor. I’ll say no more. Check it out if you get a minute. thank you very much.
Michael Lind at Salon alerts us to the fact that tomorrow is cut social security day. Again:
On Tuesday, May 12, the trustees who oversee Social Security and Medicare will issue their annual report. I don’t know what will be in the report. But I do know what the response will be. Conservatives, libertarians and center-right Democrats will take whatever the report says as evidence that there is an “entitlement crisis,” which should require us not only to address spiraling healthcare costs (a genuine issue, affecting the private sector as well as Medicare and Medicaid) but also the alleged “crisis” of Social Security (an imaginary problem).
The coalition of libertarian zealots, Jeffersonian conservatives, center-right Democrats and bankers and brokers who would like to earn fees or commissions from the diversion of Social Security payroll taxes into IRAs recycles the same arguments against Social Security, rain or shine, boom or bust. They’ve been doing it for more than a quarter-century, ever since a couple of libertarians wrote up a guide for small-government conservatives on how to spread doubts about a popular, solvent and effective entitlement. These tried-and-true arguments will be dusted off and dragged through the media once again, after the latest Social Security Trustees’ report is published.
He goes on to list the various predictable bogus arguments, which you should review just so you know what coming. But he also informs us about a piece of the history of this of which I was unaware, and it’s fascinating:
In 1983, in the Cato Journal published by the libertarian Cato Institute, Stuart Butler, a transplanted British Thatcherite, and Peter Germanis published their manifesto “Achieving a ‘Leninist’ Strategy.” Small-government conservatives, they argued, should learn from Lenin, who sought to shape history rather than wait patiently for the inevitable evolution of socialism: “Unlike many other socialists at the time, Lenin recognized that fundamental change is contingent both upon a movement’s ability to create a focused political coalition and upon its success in isolating and weakening its opponents.”
Our two Leninist libertarians went on to argue: “First, we must recognize that there is a firm coalition behind the present Social Security system, and that this coalition has been very effective in winning political concessions for many years. Before Social Security can be reformed [destroyed], we must begin to divide this coalition and cast doubt on the picture of reality it presents to the general public.” Because the “political power of the elderly will only increase in the future,” Butler and Germanis argued that any plan to phase out Social Security should assure the elderly and near-elderly that they would get their benefits: “By accepting this principle, we may succeed in neutralizing the most powerful element of the coalition that opposes structural reform.”While pursuing a divide-and-rule policy to “neutralize” the elderly and other supporters of Social Security, the authors of the Leninist strategy called for libertarians to build up a counter-alliance consisting of institutions that could profit from the privatization of Social Security: “That coalition should consist of not only those who will reap benefit from the IRA-based private system … but also the banks, insurance companies, and other institutions that will gain from providing such plans to the public [emphasis added].” They continue: “The business community, and financial institutions in particular, would be an obvious element in this constituency. Not only does business have a great deal to gain from a reform effort designed to stimulate private savings, but it also has the power to be politically influential and to be instrumental in mounting a public education campaign.”In true cunning Leninist fashion, the opponents of Social Security would disguise their revolutionary goal by pretending to be interested only in modest, piecemeal reforms: “The first element consists of a campaign to achieve small legislative changes that embellish the private IRA system, making it in practice a small-scale Social Security system that can supplement the federal system.” Only when all of the pieces were in place — when the concerns of the elderly had been “neutralized” by reassuring words, when banks and other businesses seeking to cash in on Social Security privatization were part of the libertarian alliance, and when business-funded campaigns of “education” [that is, propaganda] had convinced most Americans that Social Security was untrustworthy, would the Leninist right reveal its true colors: “If these objectives are achieved, we will meet the next financial crisis in Social Security with a private alternative ready in the wings — an alternative with which the public is familiar and comfortable, and one that has the backing of a powerful political force.”
Now, the stock market crash has taken the wind out of those particular sails for the moment, but all they really need to do right now is push the idea that the deficit is the single biggest threat to mankind and that only by cutting “entitlements” can we possibly survive as a country. The “alternatives” will undoubtedly be ready and waiting. After all, the country has just added a trillion or so to that very deficit to keep wall street and the banks solvent. It’s a sweet deal all around.
Are we really going to have a hissy fit about Wanda Sykes making crude jokes about the fatuous gasbag now? Really? It’s inappropriate now for someone to joke about Limbaugh being the 20th highjacker? The guy who called the majority leader “Mullah Daschle?” Who called Obama, “Osama” about 7,320 times? Even Keith Olbermann is wagging his finger over this — the guy who names Limbaugh the worst person in the world virtually every night.
According to Keith, the problem isn’t so much what she said, it’s that she said it at the White House Correspondents dinner which is an inappropriate venue. These are very sensitive, important people, you know, and it’s rude to be rude in front of them. It embarrasses the poor souls to have someone make crude jokes about the crudest, most despicable man in politics. Why that should be, I do not know.
But Pat Buchanan gets to the heart of it: it was mean to the Republican Party. Attacking Limbaugh was attacking Republicans everywhere according to him. He wasn’t even there but he is the head of the GOP and And no matter what swill he puts out on his radio show to millions of people every single day, that just isn’t done.
The argument against torture is slipping away from us. In fact, I’m getting the sinking feeling that it’s over. What was once taboo is now publicly acknowledged as completely acceptable by many people. Indeed, disapproval of torture is now being characterized as a strictly partisan issue, like welfare reform or taxes.
Here’s a representative exchange from Chris Matthews today in a discussion of whether or not it’s a political problem for Nancy Pelosi to be seen as knowing about torture:
Chris Cillizza: There was a poll a week or two ago, an independent poll, a media poll that asked people whether what had gone on a Gitmo was torture and by a large majority people said yes. The next question was did they think that those techniques would be necessary in certain circumstances and a slimmer, but still more people said yes than no so you have this weird disconnect. People do think it is torture, but they feel like if it yeilds results that it’s the right thing to do, so this is tough especially as it relates to the Democratic Party base which clearly believes that this is something that is wrong, wrong, wrong.
Matthews: (to Harold Ford) … You seem to be suggesting you can’t be both tough as nails and at the same time looks as if you worry about human rights violations. Is that a problem or not?
Harold Ford: No I … Eric Holder said this best when referring to the Ted Stevens case in the aftermath when they said they wouldn’t move forward when they said the United States would not move forward. He said the most important thing in the justice department is not winning, it is justice.
So, in this sense, I think having the conversation about what happened at Guantanamo Bay, and I’m not as outraged as some about it, because I think some of those techniques were enhanced and might have risen to a level of torture, you have to remember when this was occurring, this was 2002 and 2003. The country was in a different place and a different space and if you were to say to me as an American, put aside my partisanship, that we have an opportunity to gain information that would prevent the destruction of an American city to prevent killings in an American city, and we have to use certain techniques, I’m one of those Americans who would have voted acertain way Chris in that polling that said it might have been torture, but I’m not as outraged.
Matthews: wait, wait. You are veering into Cheney country here.
Ford: no, no, no
Matthews: … the destruction of an American city? What evidence did you ever have that the enemy had a nuclear weapon that could blow up an American city? That’s Cheney talk. That’s what he uses to justify torture. We have no evidence that any enemy of ours had a nuclear weapon.
Ford: No, no. I said if thousands of people in America … we can play the game of associating me with one person or another. I’m just saying ..
Matthews: No but you said blow up an American city. What are you talking about?
Ford: In 2002, 2003, remember where America was. You remember our mindset. If the American people were told that there were those that might have been held at Guantanamo Bay that might have had information, after our country was attacked on 9/11, I’m certain that people would have wanted them to take those, take certain steps. I’m not arguing at all that there was evidence that that would have happened, yet Cheney has said that he hopes that all the data is released and then maybe we’ll have an opportunity to see that.
Now it’s true that Matthews challenged Ford, but as per usual he misses the point. He thinks the problem with Ford’s point is that he used the ticking time bomb scenario when what he actually said was that the country’s “mindset” determined the limits (or lack thereof) to what it could do. And ironically, Matthews off point challenge actually forced Ford to lower the stakes even more and admit that he thinks torture is justified pretty much any time people felt threatened.
Some of this probably Ford’s reflexive, phony identification with “the middle” which he perceives on this topic as being pro-torture on the basis of the poll Cilizza cited. And sadly, that poll is reflective of the fact that people are starting to feel that it’s not just ok to publicly support torture, but that opposing it is nothing more than dopey DFH politics.
Ford seems to think that Cheney’s call to release all the CIA info will prove that his nervous nsellie-ism will be validated. I’m not so sure. But, it doesn’t matter. If everyone but the “Democratic Base” has so lost all sense of decency that they think torture is a-ok, then I’m sure they won’t mind if it turns out that the torture didn’t work. They have bought into Cheney’s “one percent solution” which holds that even if there’s only a one percent chance that an America could be harmed the government must prevent it by any means necessary. It might not turn out to be real, and it could result in a terrible catastrophic blowback down the road, but nobody ever said we wouldn’t get our hair mussed. And today, we have the head of the Democratic Leadership Council endorsing the logic behind it.
One hopes this will make a difference, but I doubt it. Since polls are showing that half the country thinks torture is justified, mealy mouthed politicians everywhere will be rushing to join them. There’s nothing they hate more than being categorized with the DFHs.
We are in big trouble when torture becomes just another political football. It’s the kind of thing that turns powerful empires into pariah nations. Why anyone thinks it’s good for America for the world to perceive us as violent, pants wetting, panic artists who could start WWIII at the least sign of threat is beyond me. I certainly don’t feel safer.
I am honored that so many of you took the time to vote in the recent grassroots Straw Poll. Let me tell you, I and many others were paying attention. If I decide to run it will be in large measure because of the grassroots energy of so many people like you. Until I and my family make that decision, please accept my thanks and my best wishes as you continue be active participants in our people-powered democracy. Thank you so very much!
Krugman writes about the new health industry lobby initiative today and says much of what I was going to say about it. The first bell that started ringing in my head was the odd idea that these health care trade associations and business interests were “offering” to cut costs over the next ten years simply because they are good Americans, as one administration official characterized it. And not only are they doing it out of patriotic duty, when asked how their promises were going to be enforced, the administration said the media would do it. The fact that the medical industry is making this commitment publicly to the president of the United States somehow means they have to live up to their promise, which is so odd I don’t know quite what to say.
Having said that, I have to believe that the administration truly wants to reform health care. Its failure would be a serious blight on the administration’s legacy and hobble Obama in reelection so it’s impossible to believe they actually believe the industry is operating out of altruism and that the media is an adequate enforcement mechanism. So, this has to be some kind of kabuki, political strategy. The question is to what end?
Although the official line is that the industry just spontaneously approached the administration with this fully formed plan, the fact is that it greatly resembles what the insurance lobby has been pushing for some time. Michael Hilzik of the LA Times wrote about this last March:
The genius of modern marketing is pouring old material into new packaging. Over the years this has given us yogurt in tubes, prechopped salad greens in cellophane bags and, most recently, the health insurance industry’s new image as a friend of reform.
In December, the industry’s trade group, AHIP (for America’s Health Insurance Plans) revealed that it had experienced an epiphany and decided for the first time to support the principle of universal healthcare — insuring everyone in America, regardless of health condition. It described its change of heart as the product of three years of sedulous soul-searching by AHIP’s board of directors, who claimed to have “traveled the country and engaged in conversations about healthcare reform with people from all walks of life.”
As a connoisseur of health insurance lobbying practices, however, I withheld judgment until I could scan the fine print. What I found by reading AHIP’s 16-page policy brochure was that its position hadn’t changed at all. Its version of “reform” comprises the same wish list that the industry has been pushing for decades.
Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors’ and hospitals’ fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.
As for universal coverage, which is the goal of many reformers (if not yet the Obama administration), the industry will accept a government mandate to take on all customers, as long as all Americans are required by law to buy coverage.
Parsing the insurance industry’s stance on healthcare reform will be of paramount importance this year. President Obama’s healthcare forum on Thursday demonstrated that the administration and Congress are girding for a big push to remake a tattered employer-based system that has left more than 45 million people without coverage.
[…]
The insurance industry understands that at this moment, with the political establishment thinking reform, it pays to make nice. In a speech not long ago, Sen. Ron Wyden (D-Ore.), who has sponsored a bill that would unlink health coverage from employment but leave a role for insurance companies, warned the industry against trying to scuttle reform as it did under Clinton. “I told them, if you do what you did then, you may hold off reform for a bit, but you will hasten the day when there’s a government-run healthcare system,” Wyden said. The warning may have inspired AHIP Chief Executive Karen Ignagni to tell the Obama summit: “You have our commitment to play, to contribute and to help pass healthcare reform this year.” (On the coy and noncommittal scale, this statement rates a 10.0.)
Ignagni can afford to be gracious because no specific reform plan is yet on the table. But veterans of the last reform battle warn that the moment concrete proposals appear, the insurance industry will deploy in force to kill anything that threatens its profitability and freedom of movement, such as an expansion of public insurance programs or tighter federal regulations. No one should take the summit’s atmosphere of good fellowship as a harbinger of what lies ahead. “Everybody’s very ‘Kumbaya’ right now,” observes Jonathan Oberlander, a healthcare reform expert at the University of North Carolina.
The insurers think government intervention is fine if it applies to customers they don’t want. The way they put it in their reform plan is that we need a system that “spreads costs for high-risk individuals across a broader base” — the base consisting of all taxpayers, that is.
The industry says that it’s going to streamline their processes and do such things as “cost bundling” and build in new efficiencies industry wide that will result in savings, which is all to the good. The waste that goes into administrative costs is nearly criminal. But Hilzik points out something that should be obvious to all of us:
AHIP’s commitment to an improved healthcare system is skin-deep. It endorses the quest for lower costs, more efficiency, and the fair and impartial resolution of claims disputes. Achieving these ends always has been within the industry’s power, but it never seems to make any progress toward them.
For example, AHIP says it believes that “administrative processes should be streamlined across the healthcare system.” But at its member firms, the administrative complexity only proliferates. I know doctors who now have to split their working hours 50-50 between seeing patients and dickering with insurance companies over claims and preauthorizations — a vast increase over the time they spent on administrative chores a few years ago.
The industry talks a good game about marching for reform side by side with all healthcare stakeholders — patients, drug manufacturers, doctors and hospitals. Ignagni says her members will “come to the table with real proposals and solutions” rather than “the old-fashioned playbook of ads and 30,000-feet campaigns.”
Veterans of earlier healthcare battles justly wonder if the industry is merely trying to get in front of the parade, the better to lead it into a dead end.
The administration says this group hasn’t asked for anything in return, but it’s pretty clear that the thing they fear the most is the public option:
America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni told Schumer that AHIP “appreciate[s] how thoughtful you are working to reconcile all these different views” but insisted that private insurers would be unable to fairly compete with a Medicare-like public plan that did not have the capital reserves of private insurers or the ability to build networks of providers:
There are a significant amount of Capital requirements that we need to meet, Medicare would have failed the capital test right now and so that is a very significant dollar figure that would have to be imbued into this plan and I know you’ve thought about that. The third issue is the payment issue…it would take a very long time, for government to develop the infrastructure to negotiate with physicians. Government doesn’t have networks, can’t put together networks, the Disease Management program failed in traditional Medicare and we all know why—because there’s no predictability with respect to who’s coming through the doors to the physicians’ offices, etc.
But here, Ignagni’s sense of fair competition is itself unfair. Ignagni does not want a new public health insurance plan to have any inherent advantages, but she’s insisting that private insurers preserve their advantage to create provider networks and enter or exit markets as they wish, etc. As Schumer pointed out, “it’s sort of as if you’re saying well the public advantages we should get rid of, but the private advantages we should keep. Let them compete.” (Listen here).
The administration says that Obama still “likes” the public plan. But it’s pretty clear that it’s on the table. I’ll leave it to the wonks to explain why that is terrible or acceptable, but it’s certainly reasonable to assume that the industry is not coming forward with a plan in partnership without geting something in return. They know very well that if a public plan is enacted in competition that it will at the very least break their monopoly and force them to actually do what they promised to do today. I assume the administration knows all this and is planning some complicated strategy to outmaeuver these people. At minimum, they may be able to forestall any more “Harry and Louise” ads from the industry, which would be helpful. The emphasis on cost savings (even to the extent that this initiative is being sold as an answer to the burgeoning deficit!) has an upside and a downside. The upside is that the industry may be able to influence their Republican allies to not fully exploit the debt issue as the reason to block health care reform. The downside is that the emphasis on cost savings focuses the issue on money, which I have grave doubts will accrue to the reformers’ favor. It’s obviously part of the equation and has to be addresses and so maybe this is the best way to do it. But I’m skeptical. It certainly doesn’t help to have allies like Donna Shalala on MSNBC this morning saying:
In the 90s we had the money, but we didn’t have consensus. Now we have consensus but we don’t have the money.
And they have to be very, very careful that the Republicans (and the media) don’t exploit the “cost savings” by successfully characterizing it as “rationing.” (The industry letter proposing this new plan says things like “reducing over-use and under-use of health care by aligning quality and efficiency incentives,” which is very easily demagogued.) I hope the Dems are prepared for it.
I don’t mean to sound totally cynical. This is the most difficult issue out there by far. It’s hugely complicated with dozens of moving parts and a political system that is at best dysfunctional. But it seems to me that progressive activists have a job to do in this and that is to exert pressure on the politicians to keep their eye on the ball. The industry will do everything it can to insure that reform translates into their profits being protected. That’s their job. Ours is to insure that reform translates into universal, comprehensive health care for all Americans. (To that end, Move On is pushing the public plan and has been quoted saying it’s the most important issue they will deal with this year.) So, when dealing with these big business interests, skepticism must be our watchword. As much as the administration wants to spin these lobbyists as being good Americans who just want to help, I think it’s fairly clear that they work out of self-interest first. They would be fired if they didn’t.
Like Krugman, I think this is a good sign that everyone is very serious about pursuing reform. That Obama is putting his personal prestige on the line for it is meaningful. But all we can do is look at each piece of the puzzle with a clear eye and put it in its proper place on the board. And then hope it all comes together.
In what is being pitched as a major announcement, health industry groups are vowing to slow the growth of health care costs over the next decade, to accommodate President Obama’s reform strategy.
Reporting from Washington — Leading health industry groups have agreed to slow the explosive growth of healthcare spending, according to administration officials and others knowledgeable about the agreement.
Hospitals, drug makers and doctors, among others, wrote a letter to President Obama outlining their plan, which estimates $2 trillion in savings over the next decade.
The letter lacks much detail but suggests savings could come from simplified billing, restructuring the way hospitals are paid and using more information technology, among other steps.
Obama plans to promote the letter at a White House event today.
Although the agreement does not outline any industry commitments to accept specific reductions in revenue, it does signal continued engagement by powerful healthcare interests in the Obama administration’s effort to overhaul the nation’s troubled healthcare system […]
Signatories include the American Medical Assn.; the American Hospital Assn.; the Pharmaceutical Research and Manufacturers of America; the Advanced Medical Technology Assn., which represents device makers; America’s Health Insurance Plans, which represents insurers; and the Service Employees International Union, which shepherded the agreement.
Specifically, they want to reduce the annual spending growth rate by 1.5 percent, which translates into $2 trillion in the next decade. Like the article says, the letter is thin on specifics, preferring to instead talk about “encouraging coordinated care” and “addressing cost drivers” and “reducing over-use and under-use of health care.” Some of the reforms, like prevention and dealing with obesity and health IT, are familiar.
The positive development here, as Krugman writes, is that health insurers and the medical industry want to be part of a solution instead of committing themselves to blocking one. They believe that reform will happen with them or without them, and so they’d rather be around to influence the outcome. Another plus: in addition to agreeing to work with the Administration on reform, they appear to have accepted the basic economic arguments about how to bend the cost curve in health care.
How are costs to be contained? There are few details, but the industry has clearly been reading Peter Orszag, the budget director.
In his previous job, as the director of the Congressional Budget Office, Mr. Orszag argued that America spends far too much on some types of health care with little or no medical benefit, even as it spends too little on other types of care, like prevention and treatment of chronic conditions. Putting these together, he concluded that “substantial opportunities exist to reduce costs without harming health over all.”
Sure enough, the health industry letter talks of “reducing over-use and under-use of health care by aligning quality and efficiency incentives.” It also picks up a related favorite Orszag theme, calling for “adherence to evidence-based best practices and therapies.” All in all, it’s just what the doctor, er, budget director ordered.
However, I think there’s also reason to be skeptical. By committing themselves to lowering costs, these industry leaders are essentially committing themselves to lower profits, which is illogical unless they see that as a best-case scenario. AHIP and some of these other groups have every incentive to guard their profits while rejecting reforms that would cut into them too heavily. For instance, cost control could be a bargain in exchange for killing the public option. The lack of detail in the letter should not go unmentioned, either, and the Administration must make mandatory some changes to reduce costs rather than relying on these former enemies of reform to voluntarily reduce. Because “reducing over-use” of health care can mean a lot of things – denying care, for example, which health insurers are really good at. The White House had better put all this in writing and ensure that the effort is sustained.
I agree that there’s an absolute benefit to this, strictly in the sense of optics. Stakeholders are working toward reform rather than pushing against it. The conservative bullshit artists led by the discredited fraud artists Rick Scott, who are trying to demonize the Obama plan, have no friends this time around. But let’s verify these changes instead of accepting the industry offer at face value. And on the politics, emphasizing cost controls at the expense of choice and access to treatment in health care is not exactly a people-friendly message.
See also this potentially bigger breakthrough in financing for the health care plan, because these assumed cost controls still don’t get the reform out the door, dedicated revenue sources do. Industry-wide savings will not help the White House pay for a health care plan, because they won’t be factored into the final cost structure of the bill. More wonkery on this here.
Bob Schieffer does us all a great service in his commentary on Face The Nation yesterday by defining the Village’s version of a meritocracy – where people elevate in the DC community, not on the strength of their talent or brilliance, but whether or not they go to the right cocktail parties:
I had no problem with the Justice’s legal work. But as one who has lived 40 years in Washington, I’ll be honest: I didn’t care for his attitude.
He made it no secret that he hated the city, once describing his work as the best job in the world in the worst city in the world.
Another time he called life here “akin to an intellectual lobotomy.”
Really? Our nation’s capital? One of the most beautiful cities in the world?
Call me corny, but I have to confess, I’ve run into some pretty smart people here over the years, but then again I tried to get to know the city and its inhabitants. Who wouldn’t if you were going to live in a place? Justice Souter, obviously.
I’ve never known anyone who ever saw him outside the court. But now he’s leaving. I take it he won’t miss Washington – but my guess is Washington will hardly miss him.
Apparently we’re supposed to care that David Souter preferred hiking in New Hampshire to schmoozing with Bob Schieffer. It’s certainly colored the coverage of him. I remember multi-page spreads when Sandra Day O’Connor and William Rehnquist left the Court. Here, Souter gets the “if you didn’t like us then we didn’t like you” send-off.
In a certain sense, I relate this to the rapidly accepted conventional wisdom around Sonia Sotomayor as a dumb tokenist candidate for the Court, and the pervasive sexism that implies. To me, Jeffrey Rosen’s conflation of diversity with mediocrity just jibes with the Village’s conflation of chumminess with aptitude. Or even the conflation of pragmatism with wisdom. What matters to them are the relationships people make with them. Once you become a member in good standing you can do no wrong. And until you become one you can do no right.
