RIO GRANDE RIFT

Tale of Two Cities

2010-11-06T09:03:00.000-07:00

When circumstances convinced me several months ago that the time to leave El Paso had come, I moved to Denver. While the body can move intact, though, the spirit lags behind. Thus, the mental transition from the Rio Grande Rift to the Rockies has taken some time. Finally, a full understanding of why I had made that instinctive move came home, in the tale of how two cities – El Paso and Denver – fared on election night.

In El Paso, 24% of eligible voters – fewer than 1 in 4 – went to the polls. They voted to repeal benefits to same-sex partners of city employees, a policy affecting perhaps a couple of dozen people. They elected Dee Margo to replace Joe Moody, one of the state’s finest young legislators. Two out of three voters in my old home precinct on the west side voted a straight Republican ticket. Margo was one of 22 net gains for Republicans in the state house, bringing that body to a near two-thirds majority that promises to roll back health care reform in the State with the highest number of uninsured people in the nation, get tougher on crime (read build more prisons), and lower taxes in the face of a 25 billion dollar deficit. Good luck with that.

In Denver, 54% of eligible voters went to the polls in a more progressive mood. A constitutional amendment that would have granted “personhood” to a human zygote was defeated, as were three tax rollbacks that would have gutted state and local government. An initiative for opting out of federal health care reform also lost. All 9 state house seats and all 5 state senate seats for Denver remained in Democratic hands. Statewide, Republicans did take control of the House by a margin of one representative, who won by fewer than 300 votes, but the Senate survived with a Democratic majority. Denver, and the rest of the state, elected a Democrat as governor, over a Republican who saw Denver’s bicycle rental program as a UN conspiracy, and a third party candidate (Tom Tancredo) whose career has been built by demonizing immigrants. And in the closest high-profile race in the nation, Michael Bennett prevailed over tea-party favorite Ken Buck to help keep the US Senate in Democratic hands.

While Texas bleeds red, Colorado remains ambivalently purple. As El Paso languishes in a regressive political coma, Denver at least has a political pulse.

I’ve joined the Democratic Party of Denver and already have found myself chair of its Public Policy Committee. I wrote the position papers on the party’s web site that I would like to think helped defeat the ballot initiatives that would have been so destructive. Last Tuesday afternoon, I was one of hundreds of volunteers who went door-to-door to get out the last minute vote for Michael Bennet. In the end, he won by about 5 votes per precinct. I would like to think that I helped make that difference in my small plot of the political universe.

To all my activist friends who remain in El Paso to fight the good fight, my affection for you is exceeded only by my admiration. Those of us who have lived through tsunamis before know that the tide will turn eventually. Joe Moody, or someone like him, will return to the legislature in time, and at some point Texas will, of necessity, see that government must be more about “we”, less about “me” , and nothing at all about “tea.” For now, though – and probably for at least the next two years – the political picture in the Lone Star State is not going to be pretty.

Texas is the state of my birth, and El Paso was my adoptive home for 19 years, giving me experiences and friends that enriched my life forever. I will never forsake the state nor forget the city. I will fly the Texas flag from my hi-rise apartment in downtown Denver every March 2nd and April 21st. But for now, I just need to be in a place where I can get a little more political oxygen.

You need us, Mr. Gibbs

2010-08-11T17:47:00.000-07:00

President Barack Obama’s press secretary, Robert Gibbs, has hurt my feelings. He claims that the “professional left” doesn’t give the President enough credit for what he has accomplished – dwelling instead on what he hasn’t been able to get done. They won’t be satisfied, according to Gibbs, until we have Canadian-style health care and abolish the Pentagon.

I confess that, like Gibbs’ by his own admission, I too watch too much cable news, including what I suppose constitutes a healthy dose of the “professional left.” But unlike Gibbs, I hear the President being credited all the time with what he has been able to accomplish in the face of fierce Republican opposition and resistance from not a few Democrats.

Barack Obama wasn’t my first choice for the Democratic nomination, but when he won it, I went all out to help him win in the general election. When he made health care reform his top priority I cheered, made phone calls, and wrote thousands of words in support. Then, I swallowed my disappointment when he caved into pressure to drop the public option in order the get the bill passed, and supported with reluctance the final severely flawed product. Yes, a Canadian-style health care is exactly what many of us wanted, but we didn’t abandon the President when he abandoned us on that issue.

I have applauded the President’s draw-down of troops from Iraq, but watched with dismay as he has ramped up the war in Afghanistan. But never have I, or anyone I know, including any member of the “professional left,” ever advocated the dismantling of the Pentagon. That is a hyperbolic charge of the type I would expect from the unthinking right wing of the political spectrum instead of the spokesman for the President whom I’ve loyally supported.

This kick in the stomach to the President’s political base comes, admittedly, at a bad time for me. Yesterday, in Colorado where I now live (at the headwaters, if not the full rift, of the Rio Grande), my chosen candidate for the Democratic nomination for the United States Senate, Andrew Romanoff, lost to Michael Bennet, the incumbent senator appointed to the office two years ago because of his millionaire status and money-raising power. Bennet had never been elected to any office, while Romanoff had been a four-time state representative and speaker of the Colorado House.

Bennet raised three times as much money as Romanoff, mostly from corporate PACs and lobbyists. Romanoff took no money from PACs and raised over 90% of his money from the citizens of Colorado. Romanoff supports a single payer health care system and opposes the huge tax breaks that help give Big Oil its humungous profits. Bennet voted with bank lobbyists against legislation that would keep banks from getting too large to fail, and with oil interests to keep the tax subsidies they don’t need.

Despite the fact that Romanoff clearly stood for the principles we thought we were electing Barack Obama to stand up for, the White House intruded itself into Colorado politics by endorsing and campaigning for Michael Bennet. Now, the Obama administration is saddled with a Democratic candidate in Colorado, like its favored candidate in Arkansas, Blanche Lincoln (who certainly did her part to see that we couldn’t get anything resembling Canadian style health care) – both of whom stand a good chance of losing two Democratic senate seats in November.

Let me make it clear that I will vote for Michael Bennet, and that I hope Blanche Lincoln prevails, because losing those two senate seats to Republicans will only harden the degree of gridlock in Washington. And I’m sure I’ll be voting for Barack Obama in 2012. But I won’t work for any of these candidates the way I worked for Andrew Romanoff.

I am proud to support President Obama, and applaud his real accomplishments. I am not, however, about to refrain from constructive criticism, and don’t appreciate being insulted by his spokesman when I do. Canadian-style health care? You bet. Dismantle the Pentagon? Don’t be silly.

You need us, Mr. Gibbs and Mr. President. How about showing us a little of the respect that you have lavished in a well-meaning but obviously futile effort to win over your actual opponents.

A Better Way Forward for UTEP

2010-07-10T06:46:00.000-07:00

In the first post in this series, I questioned the rationale for the push to make UTEP a Tier One university. In this second post, I will offer a constructive view of the best way forward for UTEP, in the form of a six-point strategy.

1. Recognize that Tier One status is unachievable for the foreseeable future

It sounds nice, stokes the ego of administrators, and makes politicians look good, but the truth is that even a dedicated push toward Tier One status is very optimistically at best, a decade or more away for UTEP. In every category established by legislation enabling the state’s seven emerging research institutions to achieve National Research University status, UTEP lags behind Texas Tech, the Universities of Texas at Dallas and Arlington, and the University of Houston. UTEP’s research budget would have to double, its output of PhDs at least triple, and its endowment income increase many fold for it to be recognized as a credible Tier One University.

2. Accept that Tier One status is not necessarily the best type of University for El Paso

Even if Tier One were achievable, would it really be that good for El Paso? A Tier One University is highly focused on research, with as many resources as possible channeled toward graduate education and research productivity. That means that funds for undergraduate education take second priority to everything that supports the research effort. It means that faculty are recruited for their ability to obtain research grants instead of their interest in teaching. New faculty at Tier One universities expect high salaries, light teaching loads, and large start-up funds for their research.

To keep teaching loads light and undergraduate expenses low, undergraduates at Tier One universities are subjected to larger class sizes, many of which are taught by part-time faculty. Since mentoring undergraduate researchers is costly both in time and money, faculty are less inclined to direct research projects for undergraduates who survive the first two years of depersonalized education.

Furthermore, community outreach is the lowest priority of an institution focused on raking in as much research funding as possible. Attention to local problems and circumstances is proportional only to the extent that those issues are of interest to national granting agencies. The current emphasis on border security and bioterrorism plays nicely to UTEP’s current strengths, but once the fashions in research funding shift, the Tier One university will shift its focus accordingly.

3. Aspire to become a National Research University with a dual commitment to education and research

Universities are a great asset to the communities in which they are located. They stimulate the local economy and provide enhanced employment and educational opportunities. They promote diversity, raise social awareness, and provide cultural enrichment. This is especially true of major research institutions, which play a particularly important role in stimulating the local economy. For all these reasons, a research university of national stature would be a tremendous asset to El Paso, and should be pursued.

Not all research universities, however, are in the top tier. Most of the benefits cited above are achieved just as well by universities below theTier One level. Some of these objectives, in fact, are better achieved at the Tier Two level. MIT and Caltech are Tier One universities that contribute less to social awareness and cultural enrichment than Boston College or Cal State – Pomona, Tier Two universities in their same respective communities.

UTEP should certainly aspire to be a player on the national stage, including a major research contributor. It deserves to compete with its six sister institutions for the state funding that can be leveraged to lift it to a higher level. But that level doesn’t have to be Tier One. UTEP should aspire instead to be the model of a National Research University committed to excellence in both education and research. It should, in short, aspire to be a great Tier Two university.

Don’t expect your legislator or local elected official to run on a platform of making UTEP an excellent Tier Two University. And don’t expect UTEP’s administration to concede that Tier Two is the best fit for El Paso. “Tier Two” simply doesn’t have the same pizzazz, nor provide the same ego gratification, as “Tier One.” But “National Research University” not only sounds good but is an accurate description of what is both achievable and desirable for UTEP.

To make UTEP an even greater regional asset, the aspiration for national research achievement should be coupled with a dedication to excellence in education at both the undergraduate and graduate levels. This merges the classical roles of the university as a place where learning accompanies scholarly exploration, and the student is taught not only what is known but how to approach the unknown.

An aspiration such as this means that faculty will have to be recruited not just for their proficiency in research but for their commitment and ability to teach. The best of those faculty will not only be excellent classroom instructors, but skilled at the one-on-one mentoring that undergraduate research projects require.

Involvement of undergraduates in research is something that UTEP has long done well, though the increased pressure for research productivity has lately made inroads into this commendable effort. Those inroads should be reversed, and the commitment to undergraduate research should be elevated to a higher status and rewarded as it once was. The deplorable loss of the three biology professors who devoted themselves equally to research and education, as described in the first post in this series, should never happen at UTEP again.

4. Tighten admissions criteria, but partner with EPCC for maximize student access to higher education

UTEP has to raise its standards for admission, so that students are accepted who are ready for college, able to take advantage of a more rigorous course of study that will promote their ultimate success. Stronger students are faster learners and are better able to take advantage of undergraduate research opportunities. The net effect of admitting stronger students to begin with is a higher retention rate and greater success for UTEP’s students in graduate and professional schools, or whatever else they undertake. This will enhance the reputation of UTEP, raise its stature, and make it more appealing to students of higher quality, thus perpetuating a positive feedback cycle of stronger applicants, higher academic achievement, and greater long-term success.

UTEP’s administration has long justified its open-admissions policy on grounds that it enhances access to higher education. This argument is faulty on two scores. First, admitting more students that fail at a higher rate does neither the student nor the community any good. Secondly, the open-admissions policy at El Paso Community College (EPCC) ensures that every student is given a chance to succeed in college. Late bloomers, students not yet adept in English, and those needing remedial instruction in reading, writing, and math have the opportunity to begin at EPCC, which is better geared to provide the support that these students need. EPCC really is “the best place to start” for many students. UTEP should stop competing with EPCC for freshmen and sophomores, and work harder at ensuring a smooth transition for EPCC students who demonstrate their ability to do college work.

UTEP’s imposition of higher admissions standards doesn’t and shouldn’t mean that UTEP has to become as selective as Tier One universities. Many of the region’s high school graduates who couldn’t get in to Harvard or Princeton or the University of Texas at Austin nonetheless make stellar students, and UTEP should welcome them from the start. A Tier Two university will do fine with Tier Two high school graduates. But even a Tier Two university will falter if half of its freshmen don’t make it through their sophomore year of college.

5. Engage with the community and enhance public outreach

UTEP does a decent job now of pursuing projects and supporting programs that directly affect the lives of El Pasoans. This should be intensified. Because of their need to concentrate their attention and resources on basic research, Tier One universities tend to live up to their image as ivory towers apart from the real world that surrounds them. Universities below Tier One but attuned to their regional environment, as UTEP traditionally has been, are great assets, particularly in a community characterized by relatively lower incomes and educational attainment.

UTEP can be a force for positive change in several areas of particular importance to El Paso. One is in K-12 education. The Collaborative for Educational Excellence that partnered UTEP’s Colleges of Education and Science with both master and aspiring teachers in the region’s school systems was a major effort to link the expertise of college faculty with the dedicated efforts of teachers at the K-12 level, where a love for learning and a habit of academic success has to first be ingrained. Social science research, with the insights it can provide into the unique features of life in an urban, bicultural, bilingual community, should be another priority. Public safety and criminology, public health, and Borderland culture are also areas where UTEP has an opportunity to involve the community not only as subjects, but as benefactors, of its research efforts.

None of this is to diminish the importance of basic research. Even at universities below Tier One, basic research should be at the heart of a university’s mission, not only because knowledge for its own sake is a virtue, but because the practical applications of research can never be completely foreseen. But a major university with a regional emphasis can afford to combine its basic research mission with programs of practical importance and benefit to the community in which it resides, in a way that a Tier One institution seldom can.

6. Start acting like a mature, major university

If UTEP is serious about becoming a major university on the national stage, it should leave behind the trappings of the regional college it once was.

This includes first and foremost, discarding the outmoded and archaic administrative policies geared toward the lower-keyed demands of a primarily teaching institution. Most major state universities have established non-profit corporations to efficiently serve the particular purchasing, accounting, personnel, and travel needs unique to their research communities UTEP should follow suit.

From the beginning, UTEP’s administration has failed to appreciate the importance of reliable funding for Graduate Teaching Assistants at competitive stipends. UTEP loses many excellent prospects who would otherwise come to El Paso because they can get more financial assistance elsewhere.

Emblematic of UTEP’s lack of maturity is its quaint practice of having thousands of undergraduates walk across the stage to shake the President’s hand in graduating classes now grown so large that three separate commencements on the same day are needed to get everyone through the ritual. Most universities the size of UTEP or larger hold commencement ceremonies at the College level, where the number of students and time required to honor them can be kept to a manageable level.

El Paso is blessed with beautiful weather most of the year, making an outdoor baccalaureate service for all graduates in the Sun Bowl on a spring evening or winter afternoon an appropriate and memorable experience. The commencement speaker would only have to give one address (instead of the three now required), and the entire UTEP community could enjoy a final group ceremony that doesn’t stretch on for hours. Then, each undergraduate could receive his or her diploma in smaller ceremonies restricted to the College (Liberal Arts, Engineering, Science, etc.) in which their degree is earned. This is the way it’s done in the big time.

SUMMARY

Under President Natalicio’s leadership, UTEP has moved from its regional position as the descendant of Texas Western College to a position of being competitive as a research university on the national stage. At the same time it has tried to retain its regional focus and strong commitment to undergraduate education. Both are worthy objectives that will serve El Paso well, if a balance between the two can be achieved. The point of this post and the one preceding it is that no such balance can be retained if UTEP’s singular objective is to become a true Tier One University. On the other hand, UTEP is fully capable of become a nationally competitive university with a dual commitment to education and research. It needs to become more selective in the students it admits, and recruit faculty with a dual commitment to teaching and research. Its commendable outreach efforts should not only be continued but expanded. And it should adopt the administrative procedures and academic practices of mature, major universities.

The legislation that seeks to boost UTEP and six of its sister universities in Texas to national research status implicitly recognizes that Tier One is out of reach for all of them (with the possible exception of the University of Houston) for the foreseeable future. In the meantime, it seeks to help them all strive toward the next level of at least regional prominence in education and research. UTEP should pursue the opportunities made available by that legislation with vigor. Proclaiming itself on the road to Tier One, however, is neither accurate nor necessary for becoming a home town university of which El Paso can justly be proud.

A Nuanced View of Tier One for UTEP

2010-06-30T15:15:00.000-07:00

For over two years now, the easiest throwaway line in El Paso politics has been an enthusiastic endorsement of UTEP’s drive to become a Tier One university. As a former faculty member and department chair at UTEP, I have an intimate acquaintance with the issue. My experience at UTEP, as well as at other, actual Tier One universities, has left me with a more nuanced view of what the University and the politicians who control its fate ought to be striving for.

The Great Leap Forward

Make no mistake – I strongly endorse UTEP’s drive to become a university with a strong research focus. Not only does this provide a more envigorating environment for students, it stimulates the local economy and enhances the community in all the ways that the politicians say it will.

I was recruited to chair the Department of Biological Sciences in 1991, with a mandate to move that Department in a more modern direction. This was all part of a visionary plan by UTEP’s recently new President, Diana Natalicio, to move the university beyond its roots as primarily an undergraduate teaching college. UTEP had only two doctoral programs at the time, with a third (in Psychology) in the works. The infrastructure for research was marginal, and administrative practices were cumbersome and inefficient for competitive research efforts.

The Gap Between Rhetoric and Reality

Biology was slated to get the fourth doctoral program at UTEP, leveraged by a large grant from the National Institutes of Health that created the Border Biomedical Research Center. From the beginning, it was clear that UTEP’s administration had a poor understanding of what it would really take to transform a slow-paced, regional, undergraduate institution into a truly competitive research university. Over a decade of momentum was wasted while UTEP, lacking anyone prior to the present Provost who had been an administrator at a Tier One institution, gradually came to grips with what it would truly take to achieve the status of a national research university.

As one example, the budget for Graduate Teaching Assistants – an indispensible tool for recruiting quality graduate students and easing the teaching loads on faculty driven to compete for research grants – remained level in the College of Science from 1994-1999, when the big push for more doctoral programs was underway. In addition, purchasing, personnel, and other procedures remained archaic and unresponsive to the needs of researchers, who required the ability to get supplies quickly and recruit people with specialized skills.

Today, the picture has improved dramatically. An unprecedented building program is vastly expanding the infrastructure for research at UTEP, and administrative attitudes and procedures are much more enlightened about what it truly takes to advance to the next level. But the rhetoric from UTEP and politicians alike continues to outstrip the reality.

UTEP’s Place in the Race to the Top

The minimal traditional definition of a Tier One University is one at which research funding exceeds $100 million dollars per year. In 2008, the latest year for which information is available from the Coordinating Board for Higher Education in Texas, UTEP was receiving about $48 million for research annually. This is barely 9% of what the University of Texas at Austin took in, and less than the research budget for UT-Arlington ($50M), Texas Tech ($53M), or the University of Houston ($84M).

Other characteristics of Tier One include a substantial number of doctoral programs, a large endowment, and highly selective admissions standards for undergraduates. While UTEP’s doctoral programs have multiplied rapidly, it still lags well behind other Texas state universities below Tier One. UT-Austin conferred 890 PhDs in 2008. Comparable numbers were 262 by the University of Houston, 221 by Texas Tech, 153 by UT-Arlington, and 61 by UT-San Antonio. UTEP awarded only 35 doctoral degrees that year, less than 4% of the figure for a true Tier One institution, and only an eighth of the number awarded by the University of Houston, not yet considered a Tier One University.

UTEP’s administration clings to the notion that it can become a Tier One institution while maintaining essentially an open admissions policy (allowing anyone with a high school diploma and minimal academic credentials to enroll). UTEP’s acceptance rate is close to 90%, meaning that 9 out of 10 students who apply are admitted – a large percentage of whom are not ready for college, as indicated by the massive number of “developmental” sections of English and math offered, at a level so elementary that they don’t earn college credit. UT-Arlington, UT-San Antonio, Texas Tech, the University of Houston, and, of course, UT-Austin all have more selective admissions standards than does UTEP. Resources directed at remedial instruction are obviously not available for the support of research.

The argument being made here is not that UTEP is a weak university, unworthy of higher aspirations. On the contrary, seeking a larger role in the nation’s research effort is a worthy goal, and UTEP has made significant strides in that direction. And in fairness, UTEP has been on this track for a lot shorter time than institutions like the University of Houston and Texas Tech, so it makes sense (and is no indictment) that UTEP has a long way to go. But that is the real point. UTEP is nowhere near ready for prime time at the Tier One level, and won’t be for at least a decade. Administrators and politicians who talk as though Tier One is just around the corner are not only implying an overly-optimistic time line, but are short-circuiting a thoughtful discussion on what the university’s ultimate objective ought to be.

The Nature and Cost of Tier One

A Tier One University in the United States is one in which research is the supreme mission of the institution. Undergraduates are attracted to them by their status, and tend to do well because they are preselected for success; but undergraduates are far less important to such a university, and are accorded a smaller proportion of its resources, because graduate education and research are its priorities.

Research and graduate education are very expensive. All Tier One universities have therefore come to rely excessively on federal granting agencies, like the National Institutes of Health, National Science Foundation, and NASA, to foot the bill. The research grants awarded by those agencies are extremely competitive, so faculty are recruited for their ability to get grants, not teach undergraduates. They tend to come from Tier One institutions themselves, where teaching loads are light and undergraduates are the lowest priority. They arrive at their new faculty appointments expecting to have minimal teaching duties, concentrated at the graduate level. They also arrive expecting large start-up funds and commanding high salaries.

With fewer faculty available for teaching undergraduates, and with more money being poured into the graduate and research programs, undergraduates are turned over to low-paid part-time instructors. Thus, at a Tier One university, in the sciences and other basic courses like math and English, undergraduates will seldom encounter a full-time faculty member until well past their freshman year. That trend at UTEP is well underway – in 1992, over 70% of freshman biology courses were taught by full-time faculty members. This coming fall, full-time faculty have been assigned to only 20% of those courses.

The pressure to perform in research is relentless at a Tier One University, as would be expected of an institution dependent on highly competitive grants for its financial viability. In the late ‘90s, three professors in Biology received a national award for their creative design of freshman biology labs. All of them had active, funded research programs, but not at a level deemed high enough by a new Dean of Science bent of demonstrating his toughness, so two were denied tenure and the third left the university in disgust. Three of UTEP’s finest teachers were replaced by higher-priced professors who expected to have as little contact with undergraduates as possible.

A Matter of Semantics

Recognizing the different criteria used by different parties to define a Tier One university, the language of the legislation that seeks to boost seven state universities in Texas to the next level avoids the term “Tier One” altogether, referring instead simply to “National Research Universities.” This strategy implicitly recognizes that true Tier One status for most of the state’s universities will be out of reach for a long time to come.In the meantime, it is well and good for all of them to strive toward a more vigorous research posture, without necessarily striving for an unrealistic goal.

This common sense approach, conceived by State Senator Judith Zaffarini (D-Laredo), principle author of the legislation, is routinely disregarded by UTEP’s administration and El Paso politicians, who continue to talk about achieving “Tier One” with little understanding of what a true Tier One university is like and what it will take to get there.

What Does El Paso Want Its Hometown University to Be?

“Tier One” sounds nice. It feeds the ego of administrators, and provides politicians with low-risk, feel-good rhetoric. But is it really what El Paso needs?

If and when UTEP becomes a bona fide Tier One University, most high school graduates in El Paso will not be able to go there, and those that do get past the high selectivity barriers of a Tier One institution will see relatively few of the university’s prestigious professors until they get into graduate school.

UTEP’s admirable record of engaging undergraduates in research will decline, as the relentless emphasis on research productivity will make professors increasingly reluctant to devote any time or resources to undergraduates that could lead to more research productivity (hence research dollars) by directing that focus to graduate students and post-docs instead.

UTEP’s admirable ability to focus on Border issues will probably survive to a significant degree, but even that will be compromised by the pressure to chase after the dollars available for the latest trends and fashions in research – “translational” research and bioterrorism being the current examples in biomedicine.

Undergraduate education in most core courses will be relegated to very large sections taught by part-time faculty or foreign teaching assistants with a marginal ability to speak English. And certain experiences formerly available to undergraduates at UTEP – one of the features that made an undergraduate education at UTEP an exceptional experience – will be a thing of the past, as the drive for research dollars crowds out the ability to be innovative at the undergraduate level and to focus on individual students.

In the second part of this series, I will offer my constructive suggestions for what UTEP should become, as an alternative to the overblown drive toward Tier One.

I'm Tired

2010-05-05T10:45:00.000-07:00

Whichever side of the political spectrum you align yourself with, you doubtlessly get forwarded commentaries from friends and family on the other side of the spectrum. Most of the time, these amount to little more than diatribes worthy of a quick “delete”. Occasionally, some come in with a glimmer of thought and the suggestion of a possibility for finding common ground. What follows is one such commentary, with my responses paragraph-for-paragraph in italics.

I'm 63. Except for one semester in college when jobs were scarce and a six-month period when I was between jobs, but job-hunting every day, I've worked, hard, since I was 18. Despite some health challenges, I still put in 50-hour weeks, and haven't called in sick in seven or eight years. I make a good salary, but I didn't inherit my job or my income, and I worked to get where I am. Given the economy, there's no retirement in sight, and I'm tired. Very tired.

I'm tired of being told that I have to "spread the wealth" to people who don't have my work ethic. I'm tired of being told the government will take the money I earned, by force if necessary, and give it to people too lazy to earn it.

No one is advocating that wealth be spread to people who don’t have his work ethic. When the term is used, it refers to lessening the gap between the ultra affluent and those who for complex reasons largely not of their own choosing are ultra poor. Societies in which that disparity grows too large ultimately falter – the French monarchy prior to the revolution being a case in point.

I'm tired of being told that I have to pay more taxes to "keep people in their homes." Sure, if they lost their jobs or got sick, I'm willing to help. But if they bought McMansions at three times the price of our paid-off, $250,000 condo, on one-third of my salary, then let the left-wing Congress-critters who passed Fannie and Freddie and the Community Reinvestment Act that created the
bubble help them with their own money.

A mixture of good and bad points here. Have his taxes really gone up? Mine haven’t. We’re just adding to our national debt, because politicians don’t have the courage to raise taxes to pay for what we are spending. The implicit criticism of those who bought homes beyond their means is fair. “left-wing congress-critters” is a pejorative term – the type of generalization that betrays a conversation-ending bias. Freddie and Fannie Mae were not blameless in the collapse of the housing market, but they had far less to do with it than all the mortgage-bundling, excessive leveraging, exotic derivatizing, and reckless investing (including in the failure of their own instruments) perpetrated by the banks that both republican and democratic administrations allowed to grow too large, and a wall street culture of greed that administrations of both parties allowed to go unregulated. Why isn’t he tired of those?

I'm tired of being told how bad America is by left-wing millionaires like Michael Moore, George Soros and Hollywood Entertainers who live in luxury because of the opportunities America offers. In thirty years, if they get their way, the United States will have the economy of Zimbabwe, the freedom of the press of China, the crime and violence of Mexico, the tolerance for Christian people of Iran, and the freedom of speech of Venezuela.

I’m no great fan of Michael Moore, but I’ve never heard him say that America is bad, just that some of the ways we do things – like our dysfunctional deliver of health care and a profit-at-all-costs mentality – are wrong. The remainder of the paragraph is a diatribe without foundation. The greatest threat to freedom of speech and the press in this country in recent years has been the Patriot Act, which was rammed through Congress by the Bush administration with the complicity of both parties. Our greatest threats won’t come from Zimbabwe, China, Mexico, or Venezuela, but from caving in to our own fears and the voluntary relinquishment of the civil liberties on which our nation was founded.

I'm tired of being told that Islam is a "Religion of Peace," when every day I can read dozens of stories of Muslim men killing their sisters, wives and daughters for their family "honor"; of Muslims rioting over some slight offense; of Muslims murdering Christian and Jews because they aren't "believers"; of Muslims burning schools for girls; of Muslims stoning teenage rape victims to death for "adultery"; of Muslims mutilating the genitals of little girls; all in the name of Allah, because the Qur'an and Shari'a law tells them to.

Islam, like Christianity, is a multifaceted religion. The examples referred to are of course deplorable. He reads about them daily because Muslim extremests capture the headlines, while the vast majority of Muslims who do believe their religion is one of peace, and who live their convictions, don’t make headlines for doing so. Those atrocities don’t take place in the large Muslim communities of Detroit and Chicago, for example. It should also be noted that Muslims don’t have the corner on atrocities in the name of religion. It hasn’t been that long ago that Serbian Christians made a concerted effort to wipe out Muslims in Bosnia, and only a few centuries since Christian women were hanged for being witches by other Christians in North America. One assumes that he was (or would have been) tired of reading about those as well.

I'm tired of being told that "race doesn't matter" in the post-racial world of Obama, when it's all that matters in affirmative action jobs, lower college admission and graduation standards for minorities (harming them the most), government contract set-asides, tolerance for the ghetto culture of violence and fatherless children that hurts minorities more than anyone, and in the appointment of U.S. Senators from Illinois.

If the writer’s point is that race still matters, I can’t disagree. Affirmative action, in its original version, was never intended to make race a sole criterion. To the extent that it does become the only thing that matters, I agree that it shouldn’t. I think that the majority of Americans of all races wish that race didn’t matter. It is a difficult subject to talk about, much less do something about. All of us need to keep trying to find a way to have that dialog, and that includes getting past certain barriers of “political correctness.”

The writer's paragraph above is a good example of a lot that is wrong with our contemporary political dialog. It moves seamlessly (without the benefit of even a period) from a valid point about affirmative action to the completely unsubstantiated allegation that there is a “tolerance for the ghetto culture of violence and fatherless children.” I don’t know of a single person, minority or not, in or out of the ghetto, who condones a culture of violence. To the extent that our government policies deal ineffectively with violence and irresponsible parenthood, we need to change them, but change them on the basis of facts instead of unsubstantiated attitudes.

I think it's very cool that we have a black president and that a
black child is doing her homework at the desk where Lincoln wrote the Emancipation Proclamation. I just wish the black president was Condi Rice, or someone who believes more in freedom and the individual and less arrogantly of an all-knowing government.

I don’t see President Obama’s “arrogance” in advocating for universal health care coverage or taking measures that in all likelihood prevented a total economic collapse in this country, and possibly worldwide. The extent to which government should be the instrument of public policy and social change is a legitimate subject for debate. Assuming that a particular policy indicates “arrogance” ipso facto is just another one of those conversation stoppers that gets in the way of rational discourse. As for Condi Rice, she is an accomplished woman, but the bottom line is that 9/11 happened on her watch, after she had received warnings, admittedly veiled and probably “inactionable,” but a bunch of dots that she failed to connect nonetheless. That doesn’t mean I hold her personally responsible, or that I consider her “arrogant,” but I would suggest that if the term applies to Obama, it could apply to her with as much justification.

I'm tired of a news media that thinks Bush's fundraising and inaugural expenses were obscene, but that think Obama's, at triple the cost, were wonderful; that thinks Bush exercising daily was a waste of presidential time, but Obama exercising is a great example for the public to control weight and stress; that picked over every line of Bush's military records, but never demanded that Kerry release his; that slammed Palin, with two years as governor, for being too inexperienced for VP, but touted Obama with three years as senator as potentially the best president ever. Wonder why people are dropping their subscriptions or switching to Fox News? Get a clue. I didn't vote for Bush in 2000, but the media and Kerry drove me to his camp in 2004.

For the record, I believe the following: Every presidential inauguration in my memory has been excessive, but they’re paid for mostly from private funds, so as far as the taxpayer is concerned, it’s a mute point. I think that everyone, including both Republicans and Democrats, should engage in physical exercise, and that it isn’t a waste of time. Military records don’t impress me one way or another, unless there is hypocrisy involved. President Bush, to my knowledge, was not hypocritical about his, and he was unfairly treated by the media. Landing on an aircraft carrier in a navy jet and proclaiming “Mission Accomplished” was grandstanding, however. John Kerry is a genuine military hero, which can and has been amply documented. Sarah Palin is demonstrably unqualified to be President, but I thought Obama did not yet have enough experience in 2008 either, so I voted for his opponent in the primary in my state. People are switching to Fox news because they hear from that network what they want to hear. I listen to MSNBC because it favors my bias. I try to remember, however, that it is biased; and I listen to Fox and CNN to get a different biased view (from Fox) and a more neutral view (from CNN).

I'm tired of being told that out of "tolerance for other cultures" we must let Saudi Arabia use our oil money to fund mosques and madrassa Islamic schools to preach hate in America, while no American group is allowed to fund a church, synagogue or religious school in Saudi Arabia to teach love and tolerance.

I agree with the spirit of this comment, noting only that once we pay them money to feed our voracious appetite for oil, it is no longer our money, but theirs to do with as they please. I do wish that we didn’t have to buy their oil.

I'm tired of being told I must lower my living standard to fight global warming, which no one is allowed to debate. My wife and I live in a two-bedroom apartment and carpool together five miles to our jobs. We also own a three-bedroom condo where our daughter and granddaughter live. Our carbon footprint is about 5% of Al Gore's, and if you're greener than Gore, you're green enough.

Who told him he couldn’t debate the fact of global warming? He can debate it all he wants to, as far as I’m concerned. As a scientist, I can say with conviction that the data clearly indicate a long term trend toward a planet that is warming at a rate being accelerated by human activity. There are ways to mitigate global warming without lowering living standards, and in some ways by actually raising them. Let’s have that discussion.

I'm tired of being told that drug addicts have a disease, and I must help support and treat them, and pay for the damage they do. Did a giant germ rush out of a dark alley, grab them, and stuff white powder up their noses while they tried to fight it off? I don't think Gay people choose to be Gay, but I damn sure think druggies chose to take drugs. And I'm tired of harassment from cool people treating me like a freak when I tell them I never tried marijuana.

Drug dependence causes practically irreversible changes in the brain. To that extent, drug addiction is a neurological condition. No, there is no giant germ that forces a person to become addicted. There are social circumstances (not restricted to the ghetto) that promote it, and genetic predispositions that make some people more susceptible than others. But no one forces anyone to overeat, and there are genetic predispositions which lead some people to become overweight more than others, with considerable cost to society, but we don’t put them in prison for it unless they steal to eat. It is in the best interest of all of us not to demonize health issues that have a complicated mix of physiological and social causes. That doesn’t mean that we tolerate the destructive consequences of those conditions – drug-induced crimes, whether from cocaine or alcohol, should not be tolerated. In the long run, however, society will be better served at lower cost if we find a way to treat the conditions by addressing the social causes, dealing scientifically with the physical causes, and striving to rehabilitate rather than punish abusers of any substance. Finally, I don’t think anyone should be harassed for never having tried marijuana, anymore than those who have, should be.

I'm tired of illegal aliens being called "undocumented workers," especially the ones who aren't working, but are living on welfare or crime. What's next? Calling drug dealers, "Undocumented Pharmacists"? And, no, I'm not against Hispanics. Most of them are Catholic, and it's been a few hundred years since Catholics wanted to kill me for my religion. I'm willing to fast track for citizenship any Hispanic person, who can speak English, doesn't have a criminal record and who is self-supporting without family on welfare,or who serves honorably for three years in our military.... Those are the citizens we need.

Aside from the implicit assumption that an unspecified fraction of undocumented aliens (my attempt at a semantic compromise)are living on welfare or crime – which studies show constitute a much smaller fraction of undocumented aliens than of American citizens – this paragraph has some sensible suggestions for a path to citizenship with which I can readily agree.

I'm tired of latte liberals and journalists, who would never wear the uniform of the Republic themselves, or let their entitlement-handicapped kids near a recruiting station, trashing our military. They and their kids can sit at home, never having to make split-second decisions under life and death circumstances, and bad mouth better people than themselves. Do bad things happen in war? You bet. Do our troops sometimes misbehave? Sure. Does this compare with the atrocities that were the policy of our enemies for the last fifty years and still are? Not even close.

Any paragraph that begins with a pejorative term like “latte liberals” signals the reader that the writer is more interested in labeling than in thinking. Which is too bad, because the point of what followed the demeaning opening phrase merits consideration.

The term “latte liberal” is both ignorant and insulting. It’s ignorant because it makes the implicit assumption that liberals share a particular lifestyle that justifies turning a noun into an adjective to brand them. On its face, it is ignorant because it’s patently untrue; not every liberal likes lattes anymore than every conservative likes beer. I’ll bet dimes to donuts, in fact, that quite a few lattes are sold wherever the tea partyers congregate, just as many of my liberal friends like beer and stock car racing. The term is insulting because it is judgmental, linking a dietary preference to a political persuasion that the writer clearly abhors. He has a right to dislike lattes and disapprove of liberals, but making an unsubstantiated link between two things that have no cause-effect relationship shows only an intent to demean rather than enlighten.

On the substantive question of trashing the military, I have no idea who he thinks is doing that. Yes, there were those in the Vietnam era who condemned the soldiers along with the conflict. I did not agree with that then, and don’t now. The writer notes correctly that when people go to war, bad things happen. Those of us who criticized the military for allowing Abu Ghraib to happen are no less patriotic than the writer, and no less respectful of the vast majority of our military men and women who serve with honor, integrity, and courage. The fact of the matter is that Abu Ghraib has done more to recruit for and revitalize the terrorist cause around the world than anything, and it deserves to be condemned for the disaster it has been to our national image and our example of what a just society should be. The larger picture is that when a nation makes the decision to go to war, it has to know that a lot of innocent people, as well as combatants, are going to be killed, and atrocities are going to occur on both sides. Those of us who condemned the invasion of Iraq before it happened did so with the certain knowledge that bad things would happen, which they did. Was the cause worth it? The world may be better off without Saddham Hussein, but were all the lives and debt incurred by our nation and inflicted on theirs worth the price of buying them the right to engage in a civil war? We can disagree over that, but to condemn the war does not constitute trashing the military.

So here's the deal. I'll let myself be subjected to all the humiliation and abuse that was heaped on terrorists at Abu Ghraib or Gitmo, and the critics can let themselves be subject to captivity by the Muslims, who tortured and beheaded Daniel Pearl in Pakistan, or the Muslims who tortured and murdered Marine Lt.Col. William Higgins in Lebanon, or the Muslims who ran the blood-spattered Al Qaeda torture rooms our troops found in Iraq, or the Muslims who cut off the heads of schoolgirls in Indonesia, because the girls were Christian. Then we'll compare notes. British and American soldiers are the only troops in history that civilians came to for help and handouts, instead of hiding from in fear.

Fair point. If we could have avoided the abuses of Abu Ghraib and Gitmo, our cause would have been venerated even more by the rest of the world.

I'm tired of people telling me that their party has a corner on virtue and the other party has a corner on corruption. Read the papers; bums are bipartisan. And I'm tired of people telling me we need bipartisanship. I live in Illinois, where the "Illinois Combine" of Democrats has worked to loot the public for years. Not to mention the tax cheats in Obama's cabinet.

Is someone really telling him that their party has a corner on virtue? I’ve never claimed that mine does. As for bipartisanship, the logic of the point the writer is trying to make is obscure. If it is that one-party politics provides a fertile field for corruption, I agree. Which would seem to be an argument for two or more healthy political parties. Which would require government to be bipartisan, in order to get anything done.

I'm tired of hearing wealthy athletes, entertainers and politicians of both parties talking about innocent mistakes, stupid mistakes or youthful mistakes, when we all know they think their only mistake was getting caught. I'm tired of people with a sense of entitlement, rich or poor.

Well said.

Speaking of poor, I'm tired of hearing people with air-conditioned homes, color TVs and two cars called poor. The majority of Americans didn't have that in 1970, but we didn't know we were "poor." The poverty pimps have to keep changing the definition of poor to keep the dollars flowing.

Just when the writer is about to make a good point, he slams us with another pejorative term like “poverty pimps.” It is clear that he has a fondness for alliteration, but a decidedly lesser commitment to clarification.

I'm real tired of people who don't take responsibility for their lives and actions. I'm tired of hearing them blame the government, or discrimination or big-whatever for their problems.

Again, well said.

Yes, I'm damn tired. But I'm also glad to be 63. Because, mostly, I'm not going to have to see the world these people are making. I'm just sorry for my granddaughter.

I am too, but for different reasons. We need to work together so that our worst fears for the future don’t come true for either of us.

Robert A. Hall is a Marine Vietnam veteran who served five terms in the Massachusetts State Senate.

Thank you, Mr. Hall, for your service to our country. In my opinion, the cause you fought for was not in the best interest of our nation, but it was not your place to question the cause, once in uniform, and I honor whatever sacrifices you made in carrying out your duties.

I also respect your service as a state legislator. As such, you surely know that making public policy is complicated, and that in a pluralistic and democratic society where we all have a right to express our point of view, our views are frequently going to be in conflict. Those views do not deserve to be demonized, or ridiculed by facile and pejorative labels, or be dismissed or demeaned by either side. You have raised a number of valid points worthy of intelligent and tolerant discussion, which I would welcome.

A Public Option for Student Loans – What a Concept?

2010-03-31T07:48:00.000-07:00

The parallel could not have been more obvious, nor more totally ignored.

On Tuesday, President Obama signed the Health Care and Education Reconciliation Act of 2010, which includes provisions that cut banks out of the student loan program. This very large market has been subsidized wastefully by taxpayers for years, bloating the profits of banks and diverting vast amounts from actually benefiting students.

"We shouldn't be providing billions in taxpayer-funded giveaways to private banks. We should be providing an affordable, accessible college education to every American." That’s what the President said in signing the bill.

Substitute “health insurance” for “banks”, and “health care” for “college education”, and the statement would read “We shouldn't be providing billions in taxpayer-funded giveaways to private health insurance. We should be providing affordable, accessible health care to every American."

Congress finally woke up and realized that a middle man is totally unnecessary in getting loans from the federal government to students. When will it wake up and realize that a middle party is totally unnecessary in getting health care from the federal government to any citizen who needs it?

If cutting out subsidies to banks will redirect $68 billion to students, think how much money could be redirected to health care by applying the same reasoning. Under the health care reform legislation, billions of dollars in tax credits will be given to lower and middle class individuals so they can buy private health insurance that currently siphons off a third of the payments into profits and executive bonuses.

While it’s true that the new legislation will eventually limit the private health insurers’ profit margins to 15-20%, this is still over twice as much as overhead for Medicare costs. In other words, the public option would enable the redirection of a tremendous amount of taxpayer funds directly to health care by having a public option available.

Notice that no proclamation of an impending Armageddon accompanied elimination of the banks from the student loan program. Of course there were Republicans who protested that too many bankers would lose their jobs, as opposed to helping students, once the profligate subsidies to banks were eliminated. That’s like saying that eliminating the subsidies to private insurance companies for Medicare Advantage plans will cost jobs in the insurance industry, instead of saving the lives of patients.

No, the ramifications of reforming the student loan program went largely ignored. There were no cries of alarm about the federal takeover and socialization of student loans, despite the obvious parallel with public financing for health care. The Congress managed to do the right thing, without a single Republican vote.

Is it really so hard to believe that this Congress could actually pass a public option for health care if it really set its mind to it?

“A Decisive Step Forward”

2010-03-22T07:28:00.000-07:00

At 8:45 pm MDT last night, the House passed unchanged the Senate version of the health care reform bill, allowing it to go straight to the President for his signature. At 9:30 pm, the House passed a new bill aimed at fixing the more objectionable parts of the Senate’s version. Since all the fixes have to do with funding issues, the bill will be taken up under the Senate’s rules for “reconciliation,” which limit debate to a total of 20 hours, meaning no filibusters and no need to get a 60-vote supermajority. Only 51 senators are needed to pass a reconciliation bill, and more than that number have signed a letter committing themselves to do so. Health care reform will thus become a reality.

“This is not radical change,” as President Obama said, “but it is a decisive step forward.” Since I have been writing this blog, that is what I’ve been advocating – some sort of step away from the dysfunctional state of health care in our country, which provides health care for those who can afford it, much less to no care for those who can’t, and a rapacious, profit-making health insurance industry dependent on the illnesses, injuries, and misfortunes of others.

Notwithstanding predictions to the contrary by the more hysterical opponents of health care reform, it looks like the sun is going to rise after all in the east this morning; as I write this, day appears to be dawning over the Franklin Mountains outside my window. Furthermore, my guess is that democracy as we know it will still be operating throughout the day, and the harsh heel of totalitarianism will not be felt by nightfall, or tomorrow, or any day in the foreseeable future – at least not just because over 30 million Americans who currently do not have health insurance will eventually be able to get it.

In case you missed the 10 hour ordeal on C-SPAN yesterday (since UTEP and Kansas got knocked out of the NCAA tournament in its early stages, I didn’t have anything else to watch), those things about the end of freedom and democracy were actually stated on the floor of the House of Representatives. Then, in a twist that I found highly ironic, one opponent after another, stepped up to the microphone to announce, in these precise words, “I ask unanimous consent to revise and extend my remarks in opposition to this flawed health care bill.” In what was obviously an orchestrated event to delay the proceedings as long as possible, the Republicans came in waves, using the same wording over and over. Precisely. Just like robots. Like in Orwell’s “1984.”

This week the Senate will take up the reconciliation bill, to fix the unsavory aspects of its version of the legislation that it had to include in order to get the 60 votes before. Be warned that this will not be easy or pretty. The Senate has the capacity to turn any common-sense measure – anything that is good for all the people and not so good for the privileged few who have bought their way to influence – into a messy and still flawed piece of legislation. But this time, it’ll be a lot more fun to watch, knowing that the pompous righteousness of Joe Lieberman (I-CT), the heightened self-importance of Olympia Snowe (R-ME), the self-conscious agonizing by Blanche Lincoln (D-AR), and the blatant extortion by Ben Nelson (D-NE) will have no effect. We don’t need your votes any more, thank you very much.

So we could be in for another week or two of tortured rhetoric and chest pounding. Hopefully, the worst of the opponents – the protestors who cursed and spat upon elected representatives of the people on Saturday – will crawl back under their rocks. Maybe some of the aforementioned senators, now freed from their ability to thwart the course of history, will return to being the statesmen that some of them once were. In any event, while the final buzzer hasn’t sounded, no amount of fouling by the opposition is going to alter the final outcome.

Health care reform – highly flawed, inadequate, and imperfect as it is – will finally come to the United States of America.

Top 10 Reasons to Vote for the Health Care Reform Reconciliation Bill

2010-03-20T09:46:00.000-07:00

The reconciliation bill about to be voted on by the House this weekend is far from perfect. It represents a boon to the private health insurance industry, does not ensure that everyone will be covered, does not do enough to rein in the costs of unnecessary, defensive, and duplicative treatments, and, most regrettably, does not include a form of public health insurance for all, akin to Medicare, VA care, or Tricare.

Notwithstanding the severe deficiencies above, our representatives in Congress should be urged in the strongest terms to vote in favor of the bill. My top 10 reasons for support of this legislation are the following:

10. Provides significant support for community and mental health clinics, as the first line of defense for outpatient medical care that diverts patients from expensive and wasteful treatment in emergency rooms.

9. Reduces the national debt by billions of dollars over the first 10 years, and by over a trillion dollars in the second decade. This is the largest projected deficit-reduction bill that this Congress will consider.

8. Closes the “doughnut hole” in prescription drug coverage.

7. Significantly reduces federal subsidies to private insurance companies for so-called Medicare Advantage Plans, which provide little advantage and represent a monumental rip-off of taxpayer money for private profiteers.

6. Restrains the growth in health care costs by instituting weak but improved means of reducing fraud, waste and abuse.

5. Prohibits denial of insurance for preexisting conditions in children six months after enactment, and for everyone starting in 2014.

4. Mandates that a larger share of health insurance premiums go directly to patient health care instead of stockholder dividends and excessive executive bonuses.

3. Provides a step in the direction of a competitive health insurance market, by establishing health insurance exchanges for people otherwise lacking coverage. (While far short of the benefits of a public option, this will begin to make available to people outside the federal government, menu options similar to what members of Congress enjoy.)

2. Represents a major if imperfect step toward universal health care.

1. Consolidates into law the view that provision of affordable health care is an implicit and legitimate government responsibility. Everyone should have health care as a right, and should take responsibility for sharing in its expense.

Politics as Entertainment

2010-02-28T06:19:00.000-08:00

There are 31 members of the Texas Senate. Not a penny of state money gets appropriated, not a cent of state-wide tax is collected, not one law is passed or resolution considered, without the approval of at least a majority, and sometimes a supermajority, of those 31 seats at the table.

There are two contested races for the Texas state senate in the Democratic primary – both in West Texas, both reaching the Rio Grande rift. One is for District 19, which stretches from San Antonio to the Lower Valley, where Luis Juarez is challenging incumbent Carlos Uresti. The other is for District 29, covering most of El Paso County, where three candidates, José Rodriguez, Liza Montelongo, and Louis Irwin, are vying for the open seat being vacated by Eliot Shapleigh.

Given the importance of two contested senate seats, one would think that the focus of political attention on these races would be second only to the attention on the governor’s race. Not so. The number of stories in the El Paso Times and in El Paso Inc. on the two races has totaled exactly three. The Times didn’t even commission a poll on either race, though they have polled repeatedly and written numerous stories about the contest for County Attorney, State Representative district 76, and State Representative district 78.

Senate District 19 affects El Paso only marginally; that race will be decided in San Antonio and the western Hill Country. But the open seat for Senate District 29 is a totally El Paso County affair. But as far as the media have been concerned, it is either totally unimportant, completely uninteresting, or destined to a foregone conclusion.

The race for County Attorney features a competent and well-qualified but relatively new incumbent, Jo Anne Bernal, against an aggressive, highly-negative and confrontational veteran of slash-and-burn politics in El Paso, Theresa Caballero. Long-standing political factions and historic feuds are fueling the human interest story of this campaign, which has generated a great deal of heat but little light.

The contest for House District 76 in the Democratic primary pits incumbent Norma Chavez against an aggressive challenger, Naomi Gonzalez, who is running almost solely on Chavez’ well-publicized squabbles and social miscues with other members of the local delegation and the legislature. So much heat has been generated in this race, that actual physical confrontations have been precipitated at some of the rallies. The media have had a heyday over this political cat fight.

The Republicans have again decided to have a tiff in House District 78, to see who gets to try to knock off incumbent Joe Moody (unopposed in the primary on the Democratic side). The familiar candidacy of businessman Dee Margo is being challenged by entrepreneur Jay Kleberg, who recently settled in El Paso after running an ecotourism business for several years in Brazil. Kleberg is young, energetic, and relatively visionary, while Margo is well-connected and firmly established in conservative circles. Whether Margo can avoid a third electoral defeat against an attractive and motivated newcomer gives this race an interesting human interest angle.

The contest for Senate District 29 features three competent candidates, all with elective office experience, all with substantive ideas about state government, services, and taxation, and all committed to sticking with the issues instead of personalities. This is the kind of political contest that everyone says they want to see. This is what the local commentators and talk-show hosts say the voters need to focus on. This is exactly the type of race, both in style and substance, that the media should be highlighting, if we are to believe their sanctimonious admonitions.

But they don’t believe it themselves. At least their actions give no indication of it. The talking heads on local radio spend endless hours obsessing over who Caballero will or will not talk to, whose relative of Naomi Gonzalez kicked which family member of Norma Chavez (or was it vice versa?), and whether Dee Margo really will end up being a three-time loser. The human interest stories get all the ink and all the noise. The candidates trying to give politics a good name in the race for Senate District 29 are simply proving the adage that no good deed goes unpunished.

We have come to this point as a society, where reality and the reality show are indistinguishable. Merit is apportioned according to its entertainment value. Substance is of little import unless it can be dramatized. We have dumbed ourselves down that far.

One hundred and fifty years ago, politicians like Lincoln and Douglas would debate one another back and forth for three hours, and people would stand under a hot sun to listen to them. In our own electronic age, where information overflows and access is near-total, a 60-second soundbite is fast becoming a luxury, and soon will be regarded as too long-winded.

Members of the local media don’t really seem to care that much what our politicians actually think, nor are they interested in probing the philosophy that will inform the decisions that a candidate will make in office. What they really care about is the entertainment value of the candidate, and the ratings that said entertainment value can generate.

I believe that voters will take in the material they are given. I think the electorate, at some level, really does want to be informed, really does care about substance, and actually would like to cast ballots on a rational basis. If substance were given to them, they would act on it. But give them only entertainment, and that’s what they will feast on. What choice do they have?

Reflecting on health care reform, the morning after the morning after

2010-01-21T08:10:00.000-08:00

Deciphering the meaning of election results is much like reading tea leaves: we see in them what we’re prone to believe anyway. Their meaning can be murky and misleading, but elections do have the clarifying effect of calling us to account for our beliefs and assumptions at a precise moment in political time. Hence follows my reading of the tea leaves the morning after the morning after the tea party in Massachusetts.

The most telling observation about Senator-Elect Scott Brown’s victory over Martha Coakley is the number of people who voted for Democrat Obama in 2008 and for Republican Brown day-before-yesterday. Within that subset is the remarkable revelation that over 40% of them think that health care proposals pending in Congress do not go far enough toward real reform. With that in mind, I read the tea leaves as follows.

In our agonizing effort to get some kind of health care reform at almost any cost, we gradually but inevitably lost our soul.

In chasing what Rachel Maddow correctly refers to as the “mythical” 60 votes in the Senate, we gave up too much. The 60 votes were “mythical” in the sense that they were never there. The vainglory of Joseph Liebermann (I-CT), the underappreciated self-importance of Olympia Snowe (R-ME) , and the agonized waffling of Blanche Lincoln (D-AR), Mary Landrieu (D-LA), and Evan Bayh (D-IN) simply made that a bridge too far.

In our mortal fear of the filibuster, we acceded to blatant extortion – the most egregious being the total sellout to Ben Nelson (D-NE), who was offered full payment of Medicare to his state alone in perpetuity.

Perhaps the voters of Massachusetts did us a favor by pointing out the mendacity of mandating health insurance for everyone, without giving anyone the option of an affordable public plan.

Perhaps the independents who voted for both Obama and Brown saw more clearly than the rest of us what a pathetic capitulation to the health care industry the pending bills had become.

Maybe the election of Scott Brown will knock some sense back into the health care debate.

In pointing to all these failings by those who had begun to advocate health care reform at any price, I do not exempt myself. While not backing down from my general stance of political realism, including the conviction that politics is the art of eating the unpalatable at times just to keep the nutrients flowing, I realize now that the time has come to halt the retreat.

So what does that mean?

My first impulse was to repeat what I have been advocating for some time – namely, let the House and Senate reconcile their bills as best they can, then invite the opponents in the Senate to mount a filibuster and simply endure it, betting that the country will hold the filibusterers responsible for bringing government to a halt for the sake of preserving multimillion dollar bonuses for the health insurance CEOs.

On reflection, though, I think the voters will only be further dispirited by that tactic, and will declare a pox on the houses of all elected officials, throwing out both the good and the bad with the bath water.

I am now coming to the conviction that it’s time to break up this legislation into individual pieces. Starting with the most popular elements – those on which there appears to be near-universal agreement, like prohibitions on exclusion for pre-existing conditions – an effort should be mounted to get bipartisan votes that will clear both chambers easily. Then attempts to deal with the more controversial issues can be bitten off, one at a time.

Republicans need to be brought genuinely into the process. While their protests of exclusion were never either accurate or honest, they did claim to hold some positions that Democrats really should embrace, such as federal tort reform provisions and enabling interstate commerce of health insurance. If they then still insist on saying "No," at least their bluff will be have been called.

Finally, those difficult issues that involve financing, including provisions for a public option, can be taken up under the rules for Reconciliation, which do not allow for filibusters. Even those may be subject to cloture votes on preliminary procedural votes, but at least the odds will be stacked a little more in favor of winning passage in the end.

What will come out of this process is something far less than many of us had hoped. But it should also result in something less than the majority of voters are telling us they fear.

That’s what I see in the tea leaves on this morning after the morning after the tea party in Massachusetts.

400 years from being the center of the universe

2010-01-17T17:42:00.000-08:00

The beautiful conjunction of Jupiter with the crescent moon earlier this evening reminds us that this week marks precisely the 400th anniversary of the night when Galileo first ascended to the rooftop of his villa in Florence, Italy, and pointed his telescope toward Jupiter, the brightest planet in the nighttime sky. What he saw that night revolutionized our view of ourselves and our place in the world.

Galileo Galilei was born in 1564 in Pisa Italy. His father was a musician, and encouraged his son’s predilection for mathematics, but hoped he would pursue the more lucrative field of medicine. After Galileo had completed 4 years of study at the University of Pisa, including some courses in the medical curriculum to please his father, he chose the more intellectually challenging though lower paying position of lecturer in mathematics at his alma mater. As the father of a son who has chosen to make his living by being a philosopher, I can relate to the dad.

Two world views

At the time of the European Renaissance, there were two competing world views of the Universe. The first was the establishment position advanced by Aristotle and taught with mathematical rigor by Claudius Ptolemy. This was an Earth-centered world in which all the celestial bodies circled about the Earth – the moon and sun and each of the “wandering stars” or planets moving in concentric planes at increasing distances from a stationary Earth, with the fixed stars occupying the highest, most distant realm.

The second, less orthodox but equally old view, dating from the time of Pythagoras, viewed the sun as the center of all worlds – with the Earth and other planets, then the fixed stars, rotating around it. Both views recognized that the Earth, moon, and sun were spheres. Both assumed that orbits were perfectly circular, and, the Aristotelian view in particular, emphasized the imperfection and mutability of the Earth, but held that all celestial objects, being nearer to the spiritual realm, were manifestations of perfect harmony and unchanging constancy.

In 1543, the year of his death, the Polish cleric Nicolai Copernicus had published his monumental tome demonstrating with mathematical rigor the logical superiority of the sun-centered, or Pythagorian system, as it was then labeled, over the Ptolemaic view.

When Galileo began to lecture at the University of Pisa, he held to the party line, teaching the Ptolemaic structure of the universe. He enjoyed almost immediate success in applying mathematical calculations and an experimental approach, something his Aristotelian colleagues frowned upon, to the study of mechanics and motion. His reputation spread, and he was offered a Lectureship at the University of Padua in the city-state of Venice. At this point – he was 28 at the time – you could say he had become the equivalent of a tenure-track Assistant Professor.

At Padua, his ground-breaking advances in physics continued. As they did so, he became increasingly impressed by the strengths of Copernican astronomy, and the weaknesses of the Ptolemaic system. An excess of humility not being one of his virtues, he was outspoken and eager to debate and defend the Copernican world view at every opportunity, often with biting humor, devastating logic, and more than an occasional touch of arrogance. This did little to promote his popularity.

In the summer of 1609, he learned of a toy-like curiosity that was all the rage in France. A Dutch lense grinder, Hans Lippershey, the previous year had fabricated a tube with lenses arranged so that they made distant objects look much closer. Galileo was in Venice when he heard that a foreigner had shown up with a version of the instrument, in hopes of interesting the Venetian Senate in its purchase. Fortunately, Galileo had a friend in Venice who persuaded the Senate to hold off its purchasing decision until Galileo could provide a much superior instrument, which he did. Then, as now, it pays to have contacts in high places.

The Senators were astounded and amazed at Galileo’s demonstration that one could see the approach of an enemy ship two hours before it appeared on the horizon to the naked eye. The Senators promptly put in an order for the gadget, and more importantly, doubled Galileo’s salary AND gave him a life-time appointment at the University of Padua. Tenure at last.

What Galileo saw

By the fall of 1609, Galileo had improved the instrument to 20 times greater than its original power. As night was coming earlier by January, he turned his telescope – the term by then being used – toward the sky. His first surprising discovery was that the moon was littered with mountains, valleys, and rough terrain – far from the perfectly smooth orb expected by Aristotelian theory.

Another discovery was that all the planets appeared to be spheres, in marked contrast to the fixed stars, which remained only points of light. Furthermore, the nearest planet, Venus, was seen to pass through phases ranging from full to partial to very little illumination – a series of transitions that made no sense in the Ptolemaic formulation. At last, Galileo felt he had direct evidence in favor of the Copernican view.

On a night in the second week of January, 1610, he turned his telescope toward Jupiter, the brightest of the distant planets. Already accustomed to seeing many more stars in the sky than the naked eye could perceive, he noted that Jupiter seemed to sit in a cluster of newly-discovered stars, curiously arranged in almost a straight line. When he looked the next night, though, the stars had changed their positions radically, relative to Jupiter. As he repeated his observations over a succession of nights, he realized that the “stars” kept changing their relative positions. This was not possible, if they were indeed part of the pantheon of fixed distant stars. In fact, what he was observing, he came to realize, was a group of small moons circling around Jupiter.

This was huge, because it showed definitively that not all bodies rotate around a fixed Earth at the center of the universe. Furthermore, if the moon is not a perfect sphere, then maybe the moons of Jupiter aren’t either. Not only was the terracentric view of the world scientifically inaccurate, but the Greek notion of harmony and perfection in the celestial sphere did not hold up, bringing into question the distinction between the earthly and celestial provinces, and maybe even blurring the line between the physical world below and the metaphysical world above.

Galileo would go on to many new revelations, including discovery of double stars, the fact that the Milky Way itself is a collection of discrete stars, and that all the “fixed” stars are much further away than anyone had imagined.

Ships to sail among the stars

As a 16th Century visionary wrote “When ships have been built to sail among the stars, men will come forth to sail them.” And so we have, to the moon for the first time 40 years ago this past July, and in a seemingly endless shuttle back and forth between low-Earth orbiting capsules and space stations and laboratories since the 1980s.

So what of those Galilean moons first seen four centuries ago, and the wonders of other worlds discovered by later explorers of the nighttime sky? While space craft with humans aboard have not ventured past the moon – we seemed to lose our vision and our lust for adventure in the self-indulgent ‘80s, the booming ‘90s, and the angst-riddled and partisan plagued decade we’re now bringing to a close. But a form of sailing ship has persisted, not one that ferries human passengers, but as craft that carry an extension of our senses in the form of cameras, and particle sensors, and chemical analyzers. These robotic explorers have continued the quest that Galileo began, revealing wonders beyond even his fertile imagination.

Among the robotic fleet of ships we’ve sent into space, none has proved more revealing than the Voyager spacecraft, an instrument package about the size of a living room couch. There were two of them, launched in tandem 16 days apart in the late summer of 1977. The mission of the voyagers was to fly past, photograph, and collect data from all four of the gas giant planets and their moons. Galileo himself could not have known what wonders they would reveal.

Exotic Worlds

When Voyager 1 photographed the innermost of Jupiter’s moons, Io, in March of 1979, it revealed a moon looking more like a pizza than a planet, with a surface overrun by calderas, lava fields, and technicolor plains of ash and sulfur.

Would Europa, the next moon to be encountered, look like Io? Voyager’s message back to Earth was an emphatic NO. Europa was already known to be the brightest object of its size in the solar system. As Voyager approached, Europa appeared not only bright, but far smoother than either the Earth’s moon or Io had shown to be. At closest approach, the reality turned out to be stranger still. Sure enough, Europa was pretty smooth, but it looked like a highly fractured crystal ball – crisscrossed by an incredible network of strange linaments, with ample evidence of fractured plates, chaotic terrain, and frequent resurfacing. Measurements of electrical field distortions, and the appearance of chemical deposits erupted onto the surface, suggested the possibility of a global ocean beneath the frozen surface – a conclusion now agreed to by the majority of planetary scientists.

With Io and Europa turning out to be about as similar as an apple and an orange, what would Ganymede and Callisto, the third and fourth moons out from Jupiter be like? Voyager showed Ganymede to look a lot like Europa, but with broader streaks and more craters, suggesting Europa-like geology, but with an older, more stable surface. And Callisto appeared to be the oldest and least active of all, with many more craters and almost no linaments or fractured plains.

Life on the Galilean Satellites

What about the possibility of life on any of these far away worlds?

Is it possible that the undersea worlds of Europa, Ganymede, and Callisto teem with marine-like ecosystems, evolving in the same region of the solar system, but each in its own way? Could there be boundaries between torrid lava and frozen substrate on Io, where microbes at least huddle at the midpoint between fire and ice, much as thermophilic bacteria ring the hot springs found on our own planet?
We don’t know, of course. But the point is, we can find out if we have the will to do so.

Already, the creative visionaries of our own time are thinking of ways we can reach into the depths of those enticing moons Galileo first glimpsed four centuries ago. The limits to our endeavor are not technological, though the challenges are formidable, and not conceptual, though our understanding is still quite limited. The only thing stopping us from reaching for the stars is the will to do so.

If Christ were here today

2009-12-25T11:38:00.000-08:00

I’m not a theologian. But having been raised – even immersed, one might say – in the Christian tradition, I have a sense of what Christ would think about some of the issues that confront us, if he were walking among us on this, the day we traditionally celebrate as his birthday.

There are some things about our society that would surely please him. A world in which slavery no longer exists, the expected life span has been doubled, and infectious diseases have been brought under control would be a pleasant surprise.

The wars and insurrections that rage across the globe would not surprise him, as he lived in a time when Rome ruled the world by force of arms. He would, though, I think be confused by how many of those struggles seem to be predicated on religious pretentions and ethnic strife, rather than quests for territory and material gains.

The one territorial dispute he would understand – the struggle between Israel and Palestine – he would lament. As a Jew, he would empathize with the struggle of his people for a homeland of their own. But I think he would question why so many others were expelled from their homelands to make Israel possible, and why a way can’t be found for Jerusalem to be shared by the people of his ancestry, the followers that he would spawn, and the devotees of the prophet Mohammed, who would follow largely in his footsteps several centuries later.

Of the New World he would know nothing, of course, so the vibrant secular states of the Western Hemisphere would doubtlessly amaze him. I suspect he would applaud the multi-ethnic, racially mixed society that, on the surface, comprises the United States. He would probably be more impressed with Brazil, which has mixed races and ethnicities more thoroughly than we have, but he would give us points for effort and good intentions.

Digging beneath the surface a bit, he might be distressed at the degree of racial friction and ethnic strife that still exist in this country, as elsewhere. His ministry, as I read it, was all about seeing the worth of every human being, beyond their skin color, place of birth, or gender.

He would probably be appalled at the gap between the haves and the have-nots in our contemporary world – a gap between rich and poor much greater than what he knew. Wealth would not impress him; he didn’t have a lot of kind words for the rich. So year end bonuses in the millions of dollars for those who make money mainly by moving money around is something he could hardly understand

On the other hand, he was not inherently opposed to material acquisition. Indeed, he thought it better to invest money than to bury it. But, a carpenter by trade, he more likely would be identifying with the laboring class, and be most sympathetic to the poor and downtrodden.

Thus, on the one hand, he would probably be impressed with the social safety net that our society has created: social security and Medicare for the elderly, Medicaid and food stamps for the poor, a Job Corps and unemployment benefits for those out of work.

On the other hand, he would be puzzled by the people’s reluctance to pay for these programs. The notion that the only good tax is a lower tax, as though no taxes at all would be the best of all worlds, would have little resonance with a man who advocated rendering to Caesar (the government) what was Ceasar’s (needed by the government to pay for the role it plays), while reserving to our churches and ourselves what we can do in the spiritual and personal realms to help ourselves.

The master healer of his times, he would be really confused by the uproar over our health care system. As one who charged nothing for his services, the high cost of health care in our country would be appalling. To be fair, he didn’t have to pay for four years of medical school, hire nurses, or buy x-ray machines in order to cure leprosy, but the notion that health care is a profit-making enterprise would strike him as odd, at best.

What would surely be totally inscrutable to him is the fact that in order for us to be healed, we have to pay a third party who skims 30% of our premiums off the top to pay exorbitant executive salaries and stock dividends, then pays our personal healer with the 70% remaining (or not, if the third party can find the slightest excuse not to do so).

To make matters worse, our ability to invoke the services of this third party lasts only as long as our job does; out of work and we’re out of luck for getting healed, unless we can pay for it ourselves, which often we can’t because we’re out of work in the first place, or have the misfortune to have to stay in a hospital which charges us tremendous fees, in part to cover their extensive marketing campaign to get us to come to their place of business to undergo our pain and suffering.

He presumably would be aware of the attempts now underway in our Congress to fix this system. Doubtlessly he would be amused by the political gamesmanship, posturing, and hypocrisy that goes on in our legislative bodies, but this would be nothing new to a man who was used to dealing with Pharisees and other self-important persons.

Most incongruous to his ear would probably be our acrimonious debate over immigration. To be sure, national boundaries are more rigid and important than they were in his day, but nothing is more consistent in his ministry than the message that the stranger among us deserves to be housed and fed and clothed. Sure, the legal complexities of who can go where from what point of origin and do what are complications of the modern world, and simple admonitions to be charitable toward the stranger in our midst will not resolve this difficult conundrum. But surely, he would think, our search for a way to accommodate newcomers to our land, as our ancestors all once were, could be carried out with a little more common sense and sympathy.

On balance, I think Christ would feel a little disoriented today, and would hardly recognize the acts and admonitions carried out in his name.

George had it right

2009-12-21T06:35:00.000-08:00

If anyone needed an explanation of why George Washington thought political parties would be a disaster for the country, they need only look at the cloture vote in the Senate last night that brought debate on the health care reform bill to an impending halt on Christmas Eve night.

There are 40 Republicans in the U.S. Senate. There were 40 votes against ending the debate, which has been going on for nearly a year.

Can anyone truly believe that all 40 Republicans were voting on principle instead of party? Was there really not enough reform in a bill that extends health care coverage to over 30 million Americans for not a single Republican to support it?

Perhaps my Republican friends would turn the question around and ask me, was there truly not a single one of the 58 Democrats or two Independents who found enough flaws in the bill to vote against it?

My answer is – and I mean this – that , in this case at least, Democrats voted on principle and Republicans voted for no reason other than to achieve petty party advantage.

To be sure, the Republican criticism that the bill does too little to control costs is valid. So is the charge that a number of free-market measures to increase competition in the health insurance marketplace could have been included that weren’t. And as I’ve argued before, the Democrats’ unwillingness to entertain even cosmetic attempts at tort reform, delivers the Republicans a powerful debating point on a silver platter.

Some of the other Republican arguments amount to nothing but crocodile tears. Their outrage over the concessions made to Senators Ben Nelson (D-NE) and Mary Landrieu (D-LA) ignores the fact that the votes of those two senators were made decisive only because the Republicans voted en masse against everything, leaving a few Democrats and the prima donna Independent of all times, Joe Lieberman (I-CT), in position to wield an unconscionable amount of leverage.

Sure, the vote was along party lines in both parties. Technically, that can be explained by the fact that, on principle, Democrats tilt toward sympathizing with the needs of people who lack health care over the privileges of profit-making corporations, while Republicans are biased toward free-enterprise markets over the needs of individual consumers.

If there were ever a compelling need for government to protect the interest of vulnerable consumers, it would be the way that health care is rationed under our current system to only those who can afford it and are currently employed, or who belong to an entitlement group (Medicare, veterans, the military).

If there were ever a profit-bloated industry making money off the misery of others, it is the health insurance corporations, which spend about 30% of premium incomes on lavish executive salaries, stockholder dividends, and lobbying (none of which are required by Medicare, Tri-care, Medicaid, or any other government-run program). Their stock prices, by the way, reached a 52-week high on Friday.

So Democrats vote for the consumers, and Republicans vote for the well-endowed.

Readers of this column know that generally I avoid doctrinaire positions and confrontational language like this, but on this issue, those are my honest feelings and I don’t know a gentle way to put it.

The opponents of health care reform have no concept of gentility. In August, they bussed in thugs from all over the country to turn what should have been rational discourse at town hall meetings into shouting matches. Throughout the fall, they perpetuated myths of the most outlandish nature – from death panels, to pulling the plug on grandma, to comparisons between Obama and Hitler. In December, with more decorum but no less malevolence, they employed in the chambers of Congress every diversionary tactic and bald-faced lie they could think of to delay final passage. But they failed.

That the ultimate failure by opponents of health care reform to kill the bill came along party-line votes is no surprise, but is a great shame, for it only reflects the degree to which we have become polarized in this country. The Republican party has moved so far to the Right, that it has pushed those of us who would like to think of ourselves as reasonable and balanced progressives to the Left, just so the country could somehow hold on to the Center.

Wouldn’t it be a lot better if we all voted just for principle instead of party? We would still end up somewhere in the Center – more of our citizens would have health care, the insurance industry would still be in business (with executive bonuses perhaps at 1 or 2 million instead of 10 or 20 million), government would provide a safety net for the vulnerable but wouldn’t control the enterprise, and we could regain our faith in the ability of the country to act together for the collective good of all.

That’s all George Washington would have asked for.

Crime and Punishment

2009-12-20T06:47:00.000-08:00

I have a friend, we’ll call him Rick, who made a terrible mistake when he was 24.

He solicited a prostitute, had consensual sex with her, then got in a fight with her over the price and beat her up. She then accused him of rape.

He deserved to go to jail for beating her up. He knew that. So when his court-appointed lawyer talked him into copping a plea, Rick agreed. He thought he was pleading guilty to battery, but in fact he pleaded guilty to rape, and was sentenced to 45 years in prison.

After 20 years and a master’s degree earned behind bars, he was paroled. Being labeled a sex offender made it nearly impossible to get a job, but he finally found work as a tutor at a half-way house, met a wonderful woman with young sons, and married her.

They joined our church. Rick got involved in the community, and was a model citizen. He confessed his criminal past in public one morning, asked for forgiveness which was granted, and tried to move on. But the frustration of so many doors closed to a labeled sex offender grew.

Depressed one night over the wasted years of his life, he struck up a conversation with a woman at a bar who turned out to be an undercover cop. She accused him of soliciting. He claimed he only wanted to talk. It didn’t matter – he was back in prison without a trial or hearing. Parole officers can make that happen.

He paid a lawyer the little money he had, but the lawyer did nothing. Heroic efforts by two other women who had become family friends finally got him out after two years.

One day parole officers came to his wife and told her if she didn’t wave her right to a search warrant at any time, her husband would go back to prison, so she signed.

A few weeks later when Rick was at work, they showed up unannounced, ransacked the house, and found a pornographic video in the closet of one of his stepsons that Rick had no idea existed.

He was returned to prison without a trial or hearing, where he sits today – parole officers can do that. Rick is an educated man trying desperately to do good, convicted of rape though not a rapist, labeled a sex offender but posing no threat to anyone.

Sexual assault is a serious crime, and society must be protected, but there has to be a better way to distinguish the truly dangerous from the wrongly accused. And that decision shouldn’t be left to parole officers, or anyone else who behaves like a bully just because they have the power to do so.

Time to kill the bill? Not just yet.

2009-12-18T05:42:00.000-08:00

As a perennial optimist to what my friends and family sometimes regard as an annoying degree, I am growing pessimistic about the chances that a bill on health care reform worth signing will survive the legislative slaughterhouse in the Senate.

The AFL-CIO and other major labor backers of the legislation are now on the verge of calling for killing the pending legislation. Most significant of all, Howard Dean – former Democratic Party Chair, physician, and untiring advocate for health care reform, has said it’s time to give up this round, and start over.

I have about reached the tipping point myself in thinking that what’s left of the bill in the Senate does more harm than good. But not quite – in part because we’re not yet to the final round.

For the time being, I’m taking the other tack. Pass anything out of the Senate that can be passed. Make Joe Lieberman king for life, Ben Nelson the czar of reproductive rights, and Olympia Snowe the queen of “catch me if you can.” I don’t care. Just get it out of the Senate, to the final round.

Then the House and Senate will have to blend the flawed but acceptable version from the House with whatever monstrosity comes out of the Senate. It isn’t inconceivable that something worth passing would be crafted by the House and Senate conferees. If it doesn’t, kill the bill then. If it does, let the Republicans and Lieberman and Nelson kill it. That way, the blood will clearly and finally be on their hands.

What I’d like to see; but what we will see

2009-12-16T07:10:00.000-08:00

Health care reform legislation is moving too fast for Sen. Olympia Snowe (R-ME), isn’t punitive enough for women who wish to exercise their legal right to reproductive choice for Sen. Ben Nelson (D-NE), and isn’t what Sen. Joseph Lieberman (I-CT) says he wants this week.

Take those three senators out of the equation and truly meaningful health care reform would pass out of the Senate in a heartbeat. Even with them sticking to their vows of obstruction, it could still pass once the majority breaks a filibuster that the minority, with the help of the three recalcitrants, seems intent on mounting.

So this is what I would like to see happen.

I would like for Majority Leader Harry Reid (D-NV) to call their bluff and move to invoke cloture (cut off debate). When cloture fails, I would like for him to let the 40 Republicans and 2 other obstructionists take the floor and start talking.

I would like for Leader Reid and the rest of the Democrats to have the courage to stand on the floor as long as the debate proceeds.

I would like to see Sen. Snowe talk right into the night on Christmas eve, explaining why the attempt to pass a national health care bill first proposed by President Theodore Roosevelt is moving too fast.

I would like to see Sen. Nelson hold forth on Christmas morning about why a woman should be denied the right to use her own money to terminate a pregnancy after she has reached such a difficult decision in consultation with her family, physician, and religious advisor.

And I would like to see Sen. Lieberman spend all Christmas afternoon explaining why he used to be for universal health care but is against it now, why 10 days ago he was open to a Medicare buy-in provision but 5 days ago had decided the country couldn’t afford it even before the CBO makes such a determination, and just in general how gratifying he finds the experience of being THE MOST IMPORTANT PERSON IN THE WORLD to be.

Then, through Christmas night and the days to follow, I would like to see at least any one of the senators favoring passage to stay on the Senate floor at all times, so that when finally the Republicans and their allies have enraged the country enough by bringing the government to a standstill that they have to relent, a proponent of passage will be on the floor to move for a vote.

That is not what we will see, however.

As of this writing, it looks like what we will see is a senate bill devoid of any public option and devoid of any buy-in. It will probably pass out of the Senate with 60 votes on the 23rd or 24th of December. Every member of Congress will then go home until after New Year’s. In early January, conferees between the House and Senate will meet. The conferees may try to insert an anemic public option of some sort, but that will probably fail. A bill without the public option will pass in the House by a two or three vote margin and in the Senate with 53 or 54 votes total. The President will sign it and claim a victory.

Former Governor and Democratic Party Chairman Howard Dean is one of my heroes. His steadfast leadership on health care reform has been an inspiration. Thus it is with great reluctance that I find myself in disagreement with him over whether it’s time to kill this bill. I think it is not.

The bill the President will finally sign will be an ugly piece of legislation – far short of what the majority of us want, and totally inadequate for what we need as a country. But it will have some reforms that are more that trivial.

This legislation is no longer about health care; it’s only about health insurance reform, and a weak version at that. But it is reform, and it will help. And most importantly, it represents something well short of the victory that the malignant health insurance industry had hoped for. If for no other reason, that is reason enough to pass it.

Breaking news more good than bad

2009-12-09T07:12:00.000-08:00

Now we know what was going on behind closed doors. A “gang of ten” senators (5 liberals, 5 conservatives) were taking the public option out of the Senate’s health care reform bill, in an effort to gain enough support to overcome a Republican-led filibuster.

The news is not as bad as it might seem, though, because the compromise alternative appears to include lowering the age of eligibility for Medicare to 55, and expanding the eligibility for Medicaid (though preliminary news accounts differ on whether the latter survived the conference). For the two affected groups – seniors between 55 and 65, and everyone under 150% of the poverty level – this would bring a single-payer, government-funded program into the mix.

Those of us who have preferred a single-payer system all along have reason to be heartened. This is actually much better -- again, for the affected groups -- than the anemic public option plans in either the Senate or House version of the health care reform bill. And it has the further advantage of building on an existing, successful government program rather than putting a new one in place.

Other good news coming from the compromise deliberations includes the following potential provisions: (1) allowing health insurers to sell policies nationally, thereby challenging monopolies in local markets; (2) providing access to a health insurance exchange through the Office of Personnel Management which provides lawmakers with their menu of health insurance choices; and (3) requiring insurance companies to spend 90% of their income on health benefits, bringing their administrative costs almost in line with Medicare.

Preliminary news accounts are also saying that the Medicare expansion provision will kick in as early as next year, rather than four years down the road under the current version of the public option.

The bad news – and it is far from insignificant – lies in the fact that everyone younger than 55 who is not eligible for Medicaid has been left out. With no public option available to them, and the mandate that they must purchase insurance, they are poised to be prime victims of the predatory private health insurance companies.

Hope for the younger middle class lies in two directions. First, if insurers really do come up with nationwide, non-profit policies for those otherwise unable to obtain insurance through their employers, affordable insurance in the private market place may be available to them. Secondly, if downward expansion of Medicare eligibility to age 55 works well (and it should, because these younger seniors should pay in more and take out less), the political momentum for extending Medicare for all should be increased.

All of this information is very tentative. Senate Majority Leader Harry Reid (D-NV) is appropriately withholding details until the Congressional Budget Office (CBO) has had time to assess the cost. Thus, we aren’t sure of what the provisions actually are, when they would take effect, or what, if anything, would trigger them. So stay tuned to the RioGrandeRift – your best source for informed news and commentary on the progress toward health care reform.

Behind Closed Doors

2009-12-05T07:38:00.000-08:00

“No one knows what goes on behind closed doors.” So wrote Kenny O’Dell in the classic country and western song made famous by Charlie Rich in 1973. It describes quite nicely what’s going on in the Senate right now.

For reasons unclear to many of us -- but probably comprising a mixture of honest conviction, limelight addiction, and fear of an agitated constituency whipped up by President’s Obama’s critics desperate to make him look bad at any cost -- a number of Democratic and all Republican members of the United States Senate are determined to stonewall the public option in the senate’s pending health care reform bill.

Behind closed doors, Majority Leader Harry Reid (D-NV) is trying to cobble together some kind of compromise language that will get the 60 votes needed to avoid death by filibuster. This is not a transparent process. It can’t be. The stakes are too high, the egos too prickly, the situation too fluid.

It’s important to keep the focus on the end game. The semi-end game is to get a bill voted out of the Senate, that can go to conference with the House, so that a single bill can then go back to each house of congress for a final vote.

The House bill has a respectable (if far from perfect) public option already. The Senate bill needs to have a whisper, a wink, or a nod toward a public option as well, to ensure that some form of public option makes it into the final bill, which will not be subject to further amendment. My guess is that the whisper, wink, or nod will be one of the following:

1. Public option by trigger. That is, there will be no public option up front, but one would be invoked if the private health insurance industry fails to deliver health insurance at an affordable price for all. This could win over Sen. Olympia Snowe (R-ME) and possibly her colleague, Susan Collins (R-ME). It might not be all that bad, either, because the private health insurance industry is almost certain to fail, and the public option will be triggered automatically. The downside to this option is the delay, but the short term pain of no public option will probably be followed by the certainty of getting it eventually.

2. Public option by opt-out or opt-in. This would mean that each state would decide to participate or not. I haven’t heard any Democrat or Independent say they absolutely will not support a bill that gives states the option to not participate in the public option. The downside here is that some states might still leave their citizens without health insurance. In Texas, that would mean at least 1 out of every 4 people. On the other hand, it brings the public option to a more local level, where leverage could be more effective, and where alternatives, like public clinics, can be more creative.

3. Semi-private co-operatives, which would look and feel like public options, but would not be funded by the government. The downside to these is that every economist and disinterested analyst who has looked at this alternative feels that it is highly likely to fail, for lack of a critical mass. Again, this might not be so bad, if it is coupled to an alternative, like a trigger, that invokes a public option eventually.

Never underestimate the creativity of the legislative process. I said months ago that what is going to transpire through the fall and early winter is not going to be pretty. But as long as the debate is still joined, momentum for reform is being maintained. What’s going on behind closed doors is the relentless effort to keep that momentum going.

Cloture invoked! Health Care Reform Moves Forward

2009-11-21T17:44:00.000-08:00

“A Yes vote says to America, I know the issue is important to your family, and to our country, and the Senate should at least talk about it.” With those words, Senate Majority Leader Harry Reid (D-NV) implored his Senate colleagues to invoke cloture, meaning a vote to allow the debate on health care reform to go forward.

They responded by voting to do so by a margin of 60-39. Sixty votes were required for passage. The vote was announced by Sen. Chris Dodd (D-CT), who was presiding at the time, at 8:08 pm EST (6:00 pm MST) this evening, Saturday, November 21, 2009.

That clears the way for debate and amendments to the bill to begin after the Thanksgiving recess. It will take good fortune and hard work to get a bill passed out of the Senate before the end of the year, but momentum has shifted in favor of those who see health care reform as the defining domestic issue of our time.

Momentum Building for Cloture Vote on Health Care Reform

2009-11-19T06:23:00.000-08:00

The Senate is inching ever closer to passing a health care reform bill that really is reform. By now everyone agrees that the key vote is on cloture (stopping a filibuster against beginning debate), and the signs are positive that cloture will succeed.

Senate Majority Leader Harry Reid (D-NV) unveiled the Senate’s version of health care reform on Wednesday night. Since the Senate Committee on Health, Education, Labor, and Pensions (HELP) and the Senate Finance Committee had shared jurisdiction, and each voted out its own version, the two versions had to be merged for debate by the whole Senate. Reid has now done that.

All 40 Republicans and several Democrats in the Senate are opposed to a public option, but the merged bill includes it, with an opt-out provision for states which choose not to participate. While every Republican is committed to blocking the bill, the Democrats and Independents might just barely have the 60 votes needed for cloture. The positive signs are the following:

1. Sen. Ben Nelson (D-NE), one of the staunchest conservadems who is opposed to a public option, nonetheless gave a strong indication yesterday that he will not support a filibuster to prevent the bill from moving forward. “If you don't like the bill, then why would you block your own opportunity to amend it?" he said.

2. Sen. Kent Conrad (D-ND), another conservadem concerned primarily with cost, signaled his willingness to move forward by complimenting the Majority Leader’s efforts. “I was very impressed by what Senator Reid has done," Conrad said.

3. Senators Mary Landrieu (D-LA) and Blanche Lincoln (D-AR) remain non-committal, but Landrieu reportedly is concerned mainly about getting enough local perks, and Lincoln faces a tough re-election campaign next year, including the certainty of a primary opponent if she kills health care reform. Majority Leader Reid said last night he is “cautiously optimistic” that cloture will be invoked on Saturday, and Sen. Charles Schumer (D-NY) was even more definite that “our (Democratic) caucus is united.” That is Senate-speak for “we really think we’ve got the votes.”

4. What about Sen. Joe Lieberman (I-CN), the self-appointed crusader against giving Americans the choice of public health insurance? On the Rachel Maddow show last night, Sen. Tom Harkin (D-NE) flatly stated that Sen. Lieberman would not vote to block debate on the bill. Such a definitive pronouncement by one Senator about how another one will vote is extremely rare, and never uttered unless the vote is a sure thing.

Sen. Max Baucus (D-MT) had to fly home earlier this week to attend to a family emergency. His absence would make the cloture vote fall short (unless Sen. Snowe, D-ME, decides that history is calling her anew after all). But if he’s back in Washington by Saturday, and no other Democrat gets in a car accident or is caught in the wrong hotel room at a bad time before then, the cloture vote should prevail.

Getting the bill to the Senate floor for debate is the toughest hill to climb. After that, just 51 votes are needed to report a bill out of the Senate, then the House and Senate versions will be merged in conference into the final bill for debate in both the House and Senate.

Rep. Bart Stupak’s (D-MI) restrictive anti-abortion language adopted by the House will probably be stripped from the final conference bill, back to the status-quo (the "Hyde Amendment", which prevents public funds from being used for abortion, but doesn’t stop private plans from covering it). While Stupak had previously bragged that he would block any bill that didn’t include his restrictive language, he has had to scale back his number of committed opposition votes from Democratic abortion opponents to 15 or 20. That’s not enough to stop passage in the House.

Once the conference bill is brought back to the Senate, another filibuster could be threatened, but once cloture has been invoked for the first time, it’s highly likely to succeed in another round on the same issue again.

As Sen. Schumer has said, no one can count votes better than Sen. Reid. So if the Majority Leader is “cautiously optimistic” that health care reform is ready to be debated and ultimately passed, the American public can afford to be so as well.

Reflections on the Day After Veterans Day

2009-11-12T16:20:00.000-08:00

Yesterday on Veteran’s Day I placed our American flag in its bracket at the front of our house, so it could wave all day in honor of the sacrifices our military men and women and their families have made throughout our history. I do this on every national holiday, but on Memorial Day and Veterans Day, I do it with sadness.

Flying the flag on our military holidays is first and foremost a symbol of gratitude for those who have died, or been injured, or made homeless, or otherwise disregarded by a nation more anxious to glorify the generic soldier than to meet the needs of the real individual, or to question why we asked them to risk life and limb in the first place.

Flying the flag on our military holidays is for me also a reminder of waste, and a call to question why we think that war is an answer to any but the gravest provocation. The biggest throw-away line we hear on days like yesterday is how thankful we are to our armed forces “for keeping us free.”

War has made or kept us free precisely three times in our history. The first was the Revolutionary War, which made us an independent state, truly free from Great Britain. The second was our own Civil War, which freed the slaves. The third was World War II, which undoubtedly saved us from subjugation to cruel and foreign dictators.

Every other war or conflict our nation has engaged in has had little effect on our freedom. Most were needless; the rest either misguided or mishandled. Let’s do the roll call.

The war of 1812 was the consequence of bungled diplomacy. Great Britain, still smarting from the loss of her North American colonies, provoked us into an ill-advised conflict that was a stand-off at best. It gave us Andrew Jackson, but neither enhanced nor diminished our freedom.

The Mexican-American War in 1848 was largely provoked by our military forces in the contested territory south of the Nueces River in Texas. It followed inevitably from Mexico’s humiliating loss of Texas because of Santa Ana’s vainglorious folly at the Alamo and Goliad, as I’ve written previously. Mexico was certainly complicit, anxious to whip up its own nationalistic fervor, knowing full well it had little chance of winning. The war fulfilled our dreams of manifest destiny by extending the nation from sea to sea, but made us in no sense more free. Mexican citizens in the newly acquired territories who were promised the right to keep their land but had it taken from them anyway, in fact, suffered a loss of freedom.

The Civil War freed our nation from the scourge of slavery, and that is the one good thing to come of the war. Other than solidifying the concept of federal supremacy, little else can be reckoned as a positive consequence of that war, especially for the South which went into it with visions of gallantry, glory, and overconfidence, only to reap economic stagnation and resentment lasting a century.

The Spanish-American War was arguably the most trumped-up excuse for territorial acquisition (Puerto Rico, Guam, and the Philippines) in our history – a war whipped up by the sensationalistic advocacy journalism of William Randolph Hearst. To be sure, the war was confounded by liberation struggles both on Cuba and in the Philippines for freedom from Spain, but the freedom of American citizens was never even threatened. Ironically, our victory in that war led to military action against freedom-fighters in the Philippines.

The ghastly waste of millions of lives in World War I in the name of nationalistic fervor that accomplished nothing but lay the seeds for World War II has been well documented many times over. Our involvement in that war was of marginal significance, and perhaps was unavoidable. Our freedom was never at stake, however. And revulsion to the war fed an isolationist tendency that left us woefully unprepared for World War II.

No reading of history can cast doubt that World War II was a conflict of true necessity. The horrors that unfolded in Europe provide a reasonable prognosis of what would have happened to us, had we been conquered by either Germany or Japan. I’ve often envied my parents’ generation, for having had a war they could feel was really necessary. I’ve never had that experience.

The Korean War came to us, not the other way around. It was precipitated by pompous leaders on both sides of the dividing line between North and South Korea, each wanting to reunify the country on their own terms. In coming to the defense of the South when the North invaded, we saved them from certain defeat and absorption into the regressive totalitarianism that North Korea has remained.

However, as David Halberstam documents in sad detail in The Coldest Winter, thousands of American lives were lost due to unpreparedness, poor leadership, lack of material support, and arrogance. 54,000 American soldiers had died by the time the cease-fire was signed in 1953. The South Koreans were free, the North Koreans were not, and no one was more or less free in the United States – just as they had been in 1950.

Vietnam, even more than Korea, was a civil war with anti-colonial overtones. Our leaders tried to sell it as a Cold War conflict, long after it was obviously something much more complicated and not anything that we understood very well. Nor did it have anything to do with keeping us free. When the North Vietnamese finally triumphed in 1975, it didn’t diminish our freedom in the slightest, though domestic controversy spawned by the conflict took a generation to abate. Vietnam, incidentally, then went to war with China, our supposed communist adversary.

The Persian Gulf War was justified as necessary to stop the spread of tyranny in the Middle East. Saddam Hussein, the dictator we loved to hate, made it easy by invading Kuwait. As an elected official at the time, I actually got to vote on that war. The Newton MA Board of Aldermen on which I served debated a non-binding resolution on the use of force against Iraq. I voted with the majority against authorizing our government to go to war, in lieu of giving diplomacy more time to deal with Hussein’s aggression. In retrospect, more diplomacy probably would not have worked, but I’m still proud of that vote against the rush to war.

That vote at least presented a tough choice about the necessity of using force with arguable merits on both sides. Our invasion of Iraq in 2003, on the other hand, was nothing but an inexcusable vendetta by a President and his advisers bent on finishing a job they felt the President’s father had failed to do. Before it started, I told anyone who would listen that it would kill thousands of Iraqi’s and Americans (an underestimate as it turned out) and lead to nothing but ongoing civil and religious wars (which it has; though temporarily in abeyance, they will resume once we are gone for good.)

Now we are considering whether to ramp up yet another land war in Asia -- this time in Afghanistan, which poses no more security risk to us than Yemen, Somalia, or Saudi Arabia, amidst a culture we little understand, for a cause that remains obscure. Of course the Taliban are terrible, but they don’t affect our freedom. The body bags will keep coming home, though, as long as we send our military on a poorly-defined mission that they are essentially incapable of completing successfully while serving as targets in a population that considers them foreign occupiers.

We must maintain a strong military, in the event that another military state threatens us. But short of that, preservation of our freedom will have little to do with the exercise of military force. Threats to our freedom from terrorists must be countered by effective intelligence and the cooperation with other nations and agencies that make it possible. Internal threats to our freedom from those who would take away our Constitutional rights in the name of heightened security need to be met by renewed focus on our highest values, not our basest fears.

None of this should be interpreted as lack of respect for our military or a failure to appreciate what individual soldiers have done. When I fly the flag on Veterans Day, I mourn the lives lost or injured in every war, from 1812 to Vietnam, whether I thought the war necessary or not. I just wish I could raise the flag more often in memory of causes that were truly worthy of the price our veterans have paid.

"What a Night!"

2009-11-07T22:50:00.000-08:00

Just before 9:00 pm MST this evening (Saturday, November 7, 2009), a vote began on the floor of the House of Representatives on final passage of the ‘‘Affordable Health Care for America Act,’’ the consensus version of Health Care Reform before the House. Passage required 218 votes, cast electronically within a 15 minute window.

By 9:05, the vote was 213 in favor, while the votes of 9 Democratic congressmen were still outstanding. With crunch time just minutes away, those of us who had been crusading on this issue for years had no hope that any Republican would vote in favor of it. So we needed 5 more votes, and knew they had to come from the 9 Democrats who had not yet voted.

By 9:06, we needed 3 more votes out of 7 still not cast. Finally, at 9:07 the 218th Democrat voted in favor of the historic legislation, putting it over the top with about five minutes to spare. By the time the period for voting closed, 219 Democrats had voted in favor; 215 Republicans had voted in opposition.

Then, as a huge sigh of relief was let out by progressives across the land, a lone Republican, Joseph Cao – a new representative from Louisiana – in an act of either total confusion or decided courage joined with Democrats to make the final vote bipartisan, 220-215.

For the first time in the history of the Republic, one of the two houses of Congress had passed a bill enabling, in principle, affordable health care for almost every American. Already, 40% of people in the United States have access to quality health care – either free of charge or at an affordable cost from the government, through the Veterans’ Administration, TriCare for military personnel and their families, Medicare, or Medicaid. The provisions of this bill would push that to more than 96%.

The bill is a pretty ragged piece of legislation. The public option is badly flawed, but at least it’s there. Freedom of choice is not nearly as extensive as it should be. The bill raises eligibility for Medicaid, which is good because it means more low-income people will be included, but it’s bad in the sense that it imposes an added financial burden on the states.

Those of us who believe strongly that the gut-wrenching decision of if and when to terminate a pregnancy should be between a woman, her family, her physician, and her religious convictions, had to swallow a bitter pill, when an amendment offered by Bart Stupak (D-MI) was added to the bill, prohibiting a woman who receives any federal tax credits for health insurance from buying a policy, even at her own expense, that covers abortion. As the final tally would show, this amendment, which goes even beyond current law, was the price that had to be paid for passage.

Democrats also continue to abandon the moral high-ground by including in the bill incentives to states that remove caps on medical malpractice awards. Thus, states like Texas, whose tort-reform laws have significantly lowered the cost of malpractice insurance for doctors, would not be eligible for the incentive because awards for non-economic (punitive, or “pain and suffering”) damages are capped. The ample donations from trial lawyers, which overwhelmingly go to Democrats, may have something to do with that.

So the bill is far from perfect. But passage in the House is extremely significant, because it establishes a baseline for bargaining with the Senate. Even if the Senate, for instance, passes out a bill that does not include a public option, the conferees between House and Senate will have to consider putting it in, because the House has already voted for it.

Now the focus shifts to the Senate. While the two senators from Texas continue to wander in the wilderness on this issue, well cared for by a menu of affordable health plans provided to members of Congress while the state they represent has the largest uninsured population in the nation, we can only take heart in the fact that after they miss their appointment with history, no one will remember their names.

Attention instead will focus on those conservadems who may or may not allow debate to take place – senators like Mary Landrieu (D-LA), Blanche Lincoln (D-AR), and Ben Nelson (D-NE). Landrieu and Lincoln have been making hopeful signs that they will not support a filibuster. Joe Lieberman (I-CN) has said at one time that he won’t block debate, and at another that he might – so who knows? Nelson, at this point, is the biggest wild card.

Perhaps tonight’s vote will give wavering senators the sense of momentum they need to at least let the issue be debated on the floor of the Senate. Once that hurdle is cleared, a bill of some sort – one that in all likelihood will be more good than bad – will be voted out and the real, ultimate legislation will be crafted by the conference committee. Then and only then will we know what the actual law will look like.

Nancy Pelosi began her press conference this evening after the final vote with “What a night!” It was clearly relief as much as exhultation. But what a night, indeed!

On Senators as Beauty Pageant Contestants

2009-10-31T11:43:00.000-07:00

It’s gut check time once again for proponents of health care reform, as another wild and wooly week has left us scratching our heads over what, exactly, our elected officials are thinking.

It started well enough, with majority leader Harry Reid’s announcement that the HELP and Finance Committee versions of health care reform had been merged into a single bill ready for floor debate in the Senate. We were heartened to hear that it included a public option. True, states could opt out, but everyone realizes they won’t, and if that’s what it would take to get enough votes for passage, it would be a price worth paying.

Before we could savor a vision of even distant victory, Sen. Olympia Snowe (R-ME) announced that history wasn’t calling her quite yet after all, and that she would vote to keep debate from proceeding. The next day, Sen. Joe Lieberman (I-CT) announced (not in these exact words) that he would likely throw coffee in the face of his Democratic colleagues who had allowed him to keep his chairmanship of the Homeland Security Committee despite his support of the Republican candidate for President, by voting against proceeding to debate on any bill that included a public option. Before the dust had settled in Hartford, where health insurance companies that have given Lieberman hundreds of thousands of dollars are headquartered, Sen. Evan Bayh (D-IN) proclaimed that he too might vote, not only against the final bill, but even against cloture (letting it proceed to debate). Tom Harkin (D-IA) then jumped in and said, in effect, that Joe Lieberman better think long and hard about what he’s threatening to do.

On Thursday, Bayh issued a statement “clarifying” his position by saying it was very unlikely that he would in fact vote against debating the bill, leaving Lieberman the lone non-Republican senator threatening to join a filibuster against reforming health care. Bayh, by the way, also assured us that the fact that his wife Susan sits on the Board of Directors for Wellpoint, one of the biggest profit-making health insurance companies in the world, as well as the boards of three pharmaceutical firms, has absolutely no influence on his position.

So what are we to make of this? Jane Hamsher, founder of the progressive blog Firedog Lake, explained it all on the Rachel Maddow show Thursday night. In case you missed it, I’m going to paraphrase her as follows, with great regret that I didn’t think of putting it this way myself first. Be warned that what follows might merit a rating somewhere in the PG range.

We err in assuming that the US Senate is the model of an august deliberative body, Hamsher explained. Better to liken last week’s events to the way a beauty pageant unfolds.

On the first day, the contestant from Nevada (Reid) proclaims how happy she is just to be there. On day 2, Miss Connecticut (Lieberman) thinks she’s not getting enough attention, so she whips her top off beside the pool in front of the judges. On the third day, Miss Indiana (Bayh) gets jealous and takes her top off too, whereupon the grown-up contestant from Iowa (Tom Harkin) gives Misses Connecticut and Indiana a scowling look, proclaims that she is not amused, and tells the girls to get their clothes back on.

The purpose of the metaphor above is not to denigrate either senators or beauty contestants. Having never been in a beauty contest, I can only imagine the ego ups and downs that go with seeking ultimate success in the judgment of others. And no one who has not been in elective office can appreciate the multiple and constant pressures that bear on politicians who somehow have to satisfy the passions and opinions (both informed and uninformed) of their constituents to stay in office.

The real point is that the comparison between the U.S. Senate and a beauty pageant is more than trivial. Like beauty contestants, senators need attention. A lot of what is said and done in Congress is all about seeking attention for the purpose of exercising power, which often includes the threat of wielding power.

In the words of Jane Hamsher, Joe Lieberman is a vain man, who enjoys being a contrarian. As one of the Senate’s only two Independents, he relishes the prospect of being the one vote that could make or break a major piece of legislation – as does Sen. Snowe, who can’t decide whether history is calling her or not. But power and the threat of its exercise cut both ways. Sen. Lieberman has a chairmanship that his colleagues could take away, if they become sufficiently annoyed with him (as Sen. Harkin has not-so-subtly warned). If he ends up being the single vote that sinks health care reform, you can bet that his chairmanship will be gone.

So let’s recap majority leader Reid’s calculation that started off last week. He decided to bring forth a senate bill that includes a public option because he calculated that he has the votes to get it to the floor for debate. Once there, a lot of things can happen, including amendments, changes, or even just public relations spins that will make it possible for Lieberman and the other Conservadems, and maybe even Republican Senators Snowe and Collins to decide that history really has called on them to do the right thing.

At the end of the process, the public option may be weaker than it is in either the pending House or Senate versions. But I predict it will be there in some form. And I predict the bill will pass, because there just won’t be that many senators willing to miss standing on the stage in the limelight when the curtain comes down.

Health Care Reform: Not Here Yet but Now Inevitable

2009-10-27T12:03:00.000-07:00

Health care reform is on the horizon at last.

Those of us who see this as the number one domestic priority of our time can exhale. We’ve been holding our breaths as week after week, the Party (Republican) of No has declared health care reform dead; as the Party (Democratic) of Yes We Can has courted first three Republican Senators, then just one, for the merest hint of bipartisan collaboration, only to be totally rebuffed in the end; and as most of the pundits declared the public option on life support, only to report now in amazement that it has risen from the dead.

Regular readers of this space know that I’ve thought all along that, if Democrats will hold their ground, health care reform with some form of public option, can pass. Yesterday, majority leader of the Senate, Harry Reid (D-NV), turned that prediction into a potential reality by announcing that the bill to go to the floor of the Senate will include provisions for a public option, with the qualification that individual states have the right to opt out.

I say “potential” reality, because final passage of a bill for the President’s signature is a long way off. Weeks of debate, and hundreds of motions, amendments, and parliamentary maneuvers lie ahead. None of the (now) two bills before Congress – the House and Senate versions – will survive in the form they are in today. But the news this morning is that, barring totally unforeseen circumstances, we can see what the outline of the final bill will be like.

First, we know there is overwhelming support for 80+ per cent of what is in both versions. That includes truly meaningful reform of health insurance regulation, broadened coverage that will reduce (though not eliminate) the vast number of uninsured, and some measures to begin reigning in costs. In none of these areas is the legislation nearly as strong as it should be, but it goes further than we’ve ever gone before.

Second, we can be confident this morning that some version of a public option will be in the final bill. I don’t believe that Senator Reid would have decided to bring a bill to the floor if he didn’t have the votes to get it passed. Senator Olympia Snowe (R-ME) has voiced her disappointment that a public option has been included. That suggests that the conservadem Senators Lincoln (D-AR), Nelson (D-NE), Landrieu (D-LA), and Bayh (D-IN) have signaled to the majority leader that they will not vote against cloture, thus giving Reid the 60 votes he needs, even without Snowe’s, to proceed to an up-or-down vote requiring 51 in favor of passage.

The Opt-Out provision is purely cover for the conservadem’s (and maybe even a couple of Republicans) on the final vote. Including the public option is so popular with the electorate, that it’s hard to imagine any state legislature opting out of what by 2014 will almost surely be highly popular. But it gives conservatives the cover they need to vote for a bill which includes badly needed reforms, in spite of the vocal minority of their constituents who see the public option as The Source of All Iniquity and The Way to Bring Obama Down.

Opposition to health care reform is fading, but far from gone. Sadly, we can expect no help from our two senators in Texas. They’re on the wrong side of history, but have been for a long time. The majority of Democrats, however, are going to deliver what the American people want and need – an end to the scandal that the strongest economic power in the world has not yet found a way to provide affordable health care for all its citizens.

Pro and Con on Constitutional Amendments for Texas

2009-10-23T07:10:00.000-07:00

Below is a brief summary of each of the amendments to the Texas state constitution that appear on the ballot for November 3, 2009. The summary of what each amendment would do is followed by a brief statement from proponents and opponents. Then my own opinion is given in italics.

I am not highly confident in the wisdom of most of my tentative decisions on these amendments, so I welcome feedback that could change my mind.

Proposition 1: Authorizing city and county financing to buy buffer areas near military installations (HJR 132).
This would allow a municipality or a county to issue bonds and notes to finance the purchase of buffer areas or open spaces adjacent to military installations. The buffer areas would be used to prevent encroachment or to construct roadways utilities, or other infrastructure to protect or promote the mission of the military installation. The municipality or county may pledge increases in ad valorem tax revenues for repayment of the bonds or notes.

PRO: Protects military installation from encroachment; preserves economic benefit of installation
CON: Could increase local tax burden. Also, not clear how encroachment threatens function, and why this would be a local responsibility.

I am generally not in favor of measures that could raise property taxes beyond their already high levels. Nor do I understand how “encroachment” threatens the function of a military base. If it would, it ought to be a federal responsibility to prevent it. I am inclined to vote NO, but my friend in San Antonio says it’s a real problem there, and I suspect the amendment is aimed primarily at Bexar County. Since ultimately, taxes would need the approval of elected officials, I may end up voting YES.

Proposition 2: Requiring appraisal of residence homesteads based on homestead value (HJR 36#1).
This would authorize the legislature to provide for the taxation of a residence homestead solely on the basis of the property's value as a residence homestead, regardless of whether the property may have a higher value if it were used for other purposes.

PRO: Exempts homesteads from “highest and best use” over-valuation
CON: Reduces capacity to raise local revenue; hurts school funding in tax-poor communities

This is a common-sense adjustment to the law that prevents homeowners from being faced with skyrocketing property tax assessments just because some future commercial value for their land might be higher than what it is actually used for at present. I will vote YES.

Proposition 3: Allowing state enforcement of uniform property appraisal standards (HJR 36#3).
This would require the legislature to provide for the administration and enforcement of uniform standards and procedures for appraisal of property for ad valorem tax purposes. It allows statewide standards to override local standards of valuation

PRO: Makes valuations across the state more uniform, and presumably more fair
CON: Diminishes local control of valuation practices and criteria

A lot of time, money, and grief are wasted over disagreements about property values. A sensible solution to me would be that a property be valued precisely according to what the buyer paid for it, for as long as that buyer owns it. Valuation boards, protestations, and politics could be taken out of the assessment process. But that’s not the system we have, so until my more sensible plan is adopted, adjustments to the process that make it more fair and consistent across the state make sense, I suppose. At the moment I’m leaning weakly toward YES, but would welcome a good argument for “no.”

Proposition 4: Establishing the National Research University Fund (HJR 14#2)
This would establish the national research university fund to provide a source of funding that will enable emerging research universities in this state to develop into major research universities. The amendment would require the legislature to dedicate state revenue to the fund and to transfer the balance of the existing higher education fund to the national research university fund. This amendment would further require the legislature to establish the criteria by which a state university may become eligible to receive and use distributions from the fund.

PRO: Provides funding source for incremental steps that six Texas state universities, including UTEP, can take toward becoming “national research universities”
CON: By abolishing the Higher Education Fund, it may take resources away from state colleges not among those designated as eligible to become national research universities.

This is a technical adjustment to provide funding for a good plan that will help make the next tier of our state universities, including UTEP, Texas Tech, and UTSA, more competitive nationally, which will enhance their economic value to their communities as well as their research potential. My vote is a strong YES.

Proposition 5: Allowing Consolidated boards of equalization for appraisal districts (HJR 36#2)
This would authorize the legislature to allow for a single appraisal review board for two or more adjoining appraisal entities that elect to provide for consolidated reviews of tax appraisals.

PRO: Allows rural counties to pool limited expertise for Appraisal Review Boards
CON: None

This will be a help to low-population communities where the number of residents knowledgeable and qualified to serve of review boards is limited. Consolidation of such boards makes sense. I will vote YES.

Proposition 6: Renewing Veterans' Land Board bond authority for land and mortgage loans (HJR 116)
This would authorize the Veterans' Land Board to issue general obligation bonds, subject to certain constitutional limits, for the purpose of selling land and providing home or land mortgage loans to veterans of the state.

PRO: Allows ongoing authority for issuance of these bonds, without requiring reauthorization every legislative session. Federal law caps the amount that can be authorized.
CON: None

This will reduce the frequency with which the Legislature has to renew its approval, which is essentially a technical matter. Federal law protects against the potential of over-extension. This deserves support, so I will vote YES.

Proposition 7: Allowing members of the Texas State Guard to hold civil office (HJR 127)
This would allow an officer or enlisted member of the Texas State Guard or other state militia or military force to hold other civil offices.

PRO: Corrects a constitutional oversight that allows members of other military groups, but not the Texas State Guard, to hold another civil job or office simultaneously with their military office
CON: None

This corrects a technical oversight. Members of the Texas State Guard deserve the same rights as those of all the other military entities. I will vote YES.

Proposition 8: Authorizing the state to contribute resources to veterans' hospitals (HJR 7)
This would authorize the state to contribute money, property, and other resources for the establishment, maintenance, and operation of veterans’ hospital in the Lower Rio Grande Valley.

PRO: Promotes establishment of a VA Hospital in a part of the state where one does not exist.
CON: Would appear to create a precedent in which local governments compete with one another through matching funds for new VA Hospitals, which ought to be a federal responsibility.

The need for a full-service VA Hospital in the Lower Rio Grande Valley is compelling, since the nearest one in San Antonio is over 250 miles away. Caring for our veterans should be a federal responsibility, though, and I’m reluctant to see communities get into competition with one another by offering local incentives, which increase the burden on local taxpayers. El Paso, for instance, needs a full-service VA Hospital as well, but this amendment would not give El Paso the same opportunity, and even if it did, I don’t think it’s a good idea to decide where VA Hospitals should be located on the basis of local perks. With reluctance, I’m inclined to vote NO.

Proposition 9: Establishing a right to use and access public beaches (HJR 102)
This would define what is a state-owned public beach. The public, individually and collectively, would have an unrestricted right to use and a right of ingress to and egress from a public beach. The amendment would authorize the legislature to enact laws to protect these rights.

PRO: Enshrines existing law giving the public access to beaches as a Constitutional right.
CON: Encroaches on property rights of owners, and makes it harder to adjust laws concerning beach-front property in the future.

While totally in support of keeping our beaches public, I am sympathetic with the view that existing law does that adequately and that enshrining it in the state constitution will make it harder for courts to adjudicate ambiguous situations. Nonetheless, in the wake of the very substantial changes to beaches caused by Hurricane Ike in the Galveston area, language in the amendment would clarify the boundaries of public beaches. At this point, my support for public beaches is very strong, but my vote for this amendment is only a weak YES.

Proposition 10: Allowing board members of emergency services districts to serve four years (HJR 85)
This would authorize the legislature to provide that members of the governing board of an emergency services district may serve terms not to exceed four years, instead of the currently allowable two year limit..

PRO: Promotes stability and continuity, and allows for benefit of newly acquired expertise to extend over a longer period. It also shields members from excessive political influence, due to longer terms
CON: Reduces accountability for very important public functions. Elections are non-partisan, so concern about over-politicalization is misplaced.

Longer terms for members of non-partisan boards on balance makes sense. But I understand the contrary argument. I’m inclined to vote YES unless someone can talk me out of it.

Proposition 11: Restricting use of eminent domain to taking property for public purposes (HJR 14#1)
This would provide that the taking of private property for public use (“eminent domain”) is authorized only if it is for the ownership, use, and enjoyment of the property by the State, its political subdivisions, the public at large, or by entities granted the power of eminent domain, or for the removal of urban blight. The amendment would prohibit the taking of private property for transfer to a private entity for the purpose of economic development or to increase tax revenues. The amendment would also limit the legislature's authority to grant the power of eminent domain in the future unless it is approved by a two-thirds vote of all the members elected to each house.

PRO: Strengthens eminent domain law by making it a constitutional requirement that the taking be for “possession, occupation, and enjoyment” of the taking entity (i.e. the public).
CON: Creates huge gray area subject to court interpretation of “possession, occupation, and enjoyment.” Could act as a magnet for litigation.

This is another amendment that enshrines existing law into the state constitution, thereby possibly leading to excessive and unnecessary rigidity. But eminent domain is a powerful right of government that needs to be restrained. While an awful lot of stuff in our state constitution doesn’t belong there, precluding the potential abuse of eminent domain probably does merit constitutional protection, so I will vote YES.

Rick Perry and Bernie Madoff

2009-10-15T16:38:00.000-07:00

When confronted by a reporter with the fact that over half the working people in Hidalgo and Cameron Counties in the Lower Valley have no health insurance, Gov. Rick Perry’s response was to claim that health care reform legislation would “bankrupt this state.”

State Senator Eliot Shapleigh (D-El Paso) nailed it when he retorted, “Rick Perry advising on health care is like Bernie Madoff advising on family savings.”

Perry claims the reform legislation would add $3 to $6 billion dollars in mandated charges to the state budget, mostly to cover increased Medicaid eligibility. Medicaid has always been a shared federal/state responsibility. It seems that secessionist-leaning, states’ rights advocate Gov. Perry finds this particular state responsibility not to his liking.

Fair enough. One can debate the wisdom of having the states pay for such a large share of Medicaid. But where has Perry been over his three terms as governor? “In those 10 years, he kicked over 230,000 kids out of CHIP, 500,000 kids out of Medicaid, sent nearly $1 billion in Texas CHIP money back to D.C., presided over 91.6% increase in health care premiums and led Texas to dead last in citizens who have health insurance,” Shapleigh pointed out.

We know where Shapleigh stands, and those of us who see the need for health care reform to be the leading civil rights issue of our age are fortunate to have him representing us.

The people of Brownsville and San Benito are not so lucky, as their State Senator and two Representatives sat silent through Perry’s remarks and failed to challenge them afterwards.

We have every reason to believe that the five State Representatives from El Paso County – Joe Pickett, Chente Quintanilla, Norma Chavez, Joe Moody, and Marisa Marquez – will not be equally silent. To varying degrees, they’ve come down on the progressive side of issues like health care, social services, and civil rights. As the election season nears, though, we need to be sure that meaningful health care reform is near the top of their agendas.

Why is this a state issue? To be sure, all the focus has been on the legislation being crafted at the federal level. But eventually, a bill will be passed, hopefully by the end of the year, and then the states will be involved for sure.

First, there will be considerable obligations passed on to the states, with budgetary consequences as Perry correctly points out. More importantly, the bill will almost surely fall well short of stemming the hemorrhage in health care suffered by the 1 in 4 Texans who lack insurance, and the much larger number who are abused, limited, or underfunded by their health insurance policies.

I previously proposed a cost-effective system of state run clinics for outpatient, pediatric, and postnatal care that would provide a safety net for the underinsured. Other ideas are badly needed and worth considering. No one has a monopoly on the single best solution. But sitting silent and doing nothing is not an option at the federal level this year, nor will it be at the state level in 2011.

When History Calls

2009-10-13T21:34:00.000-07:00

Tuesday was a good day for health care reform.

The Senate Finance Committee reported out its version of reform legislation by a vote of 14 to 9. It was deeply flawed – a huge bonanza for the insurance industry, falling well short of universal coverage, and lacking a public option. But the bill got out of Committee; and for this step in the process, that was a victory.

There were three pleasant surprises in the final vote. The first, and most highly publicized, was that of Olympia Snowe (R-ME). There was great mystery and speculation concerning whether she would break ranks with the rest of the Republicans on the Committee, all of whom voted against the bill. In her speech shortly before the final vote, she said, “When history calls, history calls.” Beyond this seemingly trite truism is a profound fact: history was indeed calling for courage and for action, and the nine Republicans who voted No came down on the wrong side of history.

The second “surprise” was the Yes vote of Blanche Lincoln (D-AR). In the end, I couldn’t believe that she wouldn’t support it, but wasn’t confident enough to predict it publicly. As one of the most outspoken and critical of the Conservadems, her vote was far from a sure thing. Her speech was touching, though, in pointing out that a flawed bill is better than doing nothing, and she wasn’t going to be part of a Congress that refused to come to grips with the gravest domestic problem facing the American public over the long term.

Finally, it was more a relief than a surprise to see Ron Wyden (D-OR) and Jay Rockefeller (D-WV) vote in favor of the bill. Like Sen. Lincoln’s vote, theirs could not be taken for granted, but for the opposite reason – they had been threatening to vote against the bill because it wasn’t liberal enough. In the final analysis, they too admitted that a bill, though badly flawed in their view, had to come out of Committee to move the process forward.

So the play continues to follow the script. The last committee with jurisdiction in either house has now reported out a bill, clearing the way for the next messy part of the process – the melding together of this Finance Committee bill with the more liberal version from the Senate Health, Education, Labor, and Pensions (HELP) Committee.

The good news is that the Finance Committee is the most conservative of the five committees charged with crafting the final legislation. Whatever the outcome of negotiations from this point forward, the product will not be less progressive than this FinCom version. Since all the versions from the other committees include a public option, the chances that a public option in some form will make it into the final legislation are reasonably good.

Had any three of the four senators whose votes were in question before Tuesday decided to vote No, the bill would have failed to be reported out, and health care reform may well have died for this session of Congress. We can all be thankful that when history called on Tuesday, Senators Snowe, Lincoln, Rockefeller, and Wyden, along with 10 other Democrats, chose to answer that call in favor of the American people, even as the 9 negative Republicans rushed to the microphones to sadly trumpet their choice to come down on the wrong side of history.

Walking the Dog

2009-10-06T00:43:00.000-07:00

While the health care debate is temporarily in a hiatus, as Max Baucus (D-MT) gives the Republican members of the Senate Finance Committee more time to find new ways to say No, perhaps this would be a good time to write about something different. Accordingly, here is the second of my three losing entries to become a columnist for the El Paso Times.

When you stop and think about it, walking the dog is a moving experience in more ways than one.

For starters, there’s humor to be had wherever this ritual plays out. The other day, I met a lean guy in running shorts jogging with a toy dog of a strain I didn’t know, but on the dignity scale it ranked somewhere between a poodle and a rodent. Its short little legs took about 27 steps for every stride of its master. The result was a leisure jog by the man, and a blur where the legs of the dog must have been.

At the other extreme, a fairly common sight is the young woman, frail and 5 foot-4, being dragged down the street by a couple of huskies the size of land rovers. Her body bent backwards at a 45 degree angle, you feel that any moment she’s going to be jerked airborne by the two powerful steeds at the end of her leash.

On occasion, I feed a golden retriever and release her from the house for bathroom breaks twice a day, while her owner, my friend, is out of town. The other day, I decided to take the dog for a walk as a special treat. The moment we left her yard, she was straining at the leash, sniffing this, sprinting over to that – finding joy in every little bird dropping and discarded piece of paper or plastic bag, racing from one odor to the next like each was a marvelous revelation. I was the one leaning back this time, wondering how those little women hold on to the beasts that drag them about.

A dog has well over 1200 genes that code for nothing but distinct odor receptors. That means that more of a dog’s genetic makeup is devoted to smell than to any other function.

I love to watch a dog riding in a car with its nose sticking out a barely open window. I try to imagine what it would feel like to smell 1200 odors coming at you at 40 miles an hour. For a dog, it must be ecstasy.

Why do dogs love walking their masters so much? Is it the few minutes of excitement they get every day in an otherwise boring life that gives them such a thrill? Or is it just that it takes so little to make their day? Getting bathroom breaks just twice in 24 hours, of course, has got to be a pleasure in itself if that’s all you get.

Maybe we love our dogs so much, because we see in them the creature we wish we could be more like: finding satisfaction in the pleasure of the moment, grateful for the richness of life as it comes at us in the immediate currents of the air around us, oblivious to the burden of yesterday’s failures or anxieties about tomorrow. Maybe the dogs we walk are giving us a lesson in how to live.

Health Care Reform Proceeding as Scripted

2009-09-30T07:03:00.000-07:00

The health care reform melodrama played out another scene yesterday according to script, as the Senate Finance Committee voted down amendments by Jay Rockefeller (D-WV) and Charles Schumer (D-NY) that would have added the public option. This was expected. “The play’s the thing,” however, and it’s far from over.

It has long been obvious that the Republicans will fight health care reform almost (but not necessarily all the way) to the end. All the Republican “no” votes, therefore, were expected. What wasn’t clear was how many “Conservadems” would join them. As it turned out, Max Baucus (D-MT), Blanche Lincoln (D-AR), Kent Conrad (D-ND), Bill Nelson (D-FL), and Thomas Carper (D-DE), voted “no” also on Rockefeller’s amendment. Only Baucus, Lincoln, and Conrad voted against Schumer’s amendment.

Worthy of note is the fact that Baucus, Lincoln, and Conrad are all from “purple”, or conservative-leaning states where distrust of government runs deep. For the time being, they are warding off potential primary opponents by leaning to the right.

The argument by Baucus that he “is constrained not to support” the public option, even though he claims to favor it personally, because it lacks the 60 votes to pass the Senate is somewhat disingenuous for the following reason.

That longed-for number of 60, which everyone agrees is the preferable target, is the number of votes required to invoke cloture in the Senate, or cut off debate, thereby stopping a filibuster. Only 51 votes are actually required to pass the bill. So these are the Acts in the melodrama yet to come.

First, a bill needs to be voted out of the Senate Finance Committee. It will not include a public option.

Next, the Finance Committee bill and the Health, Education, Labor, and Pensions (HELP) Committee bill need to be merged for a final vote in the Senate. The HELP bill includes a public option. If a bill comes out of that conference without a public option, an amendment to include one will surely be offered on the Senate floor. At that point, opponents have the choice of mounting a filibuster, which would require 60 votes to stop, or they can decline to support a filibuster while retaining their right to vote against the final bill. The actors to keep an eye on in that scene will be the Conservadems; will they really vote against the Democratic party leadership and oppose cloture (support a filibuster)? It seems unlikely to me, since they can claim they’re in favor of an up or down vote and therefore support cloture, while still voting against the final bill when the time comes to cover their conservative backsides.

Let’s assume for the moment that cloture fails, and a filibuster ensues. Then the Republican and Conservadem coalition will be the focus of the public’s outrage that Congress has been brought to a standstill by a minority of legislators (including some Democrats), just because they want to save the health insurance industry’s 40% overhead, high profit margins, and extravagant executive bonuses. I really don’t think a filibuster will last. But the Democratic leadership will have to be willing to call their bluff and take the risk. Showtime for courage will be in order.

The more likely Act to follow, in my view, is that cloture will be invoked, and the Senate will pass a bill that includes the public option, with 51 or more, but not a lot more, votes. The 40 Republicans will probably vote “no” unanimously, and some Conservadems will vote “no” as well, but up to 8 of them can go that way without killing the bill.

At this point, a Senate bill and the House bill will have to be merged. Both will have a public option, so the drama will include more technicality than substance. Eventually a bill with a public option will be sent to the President.

But let’s consider a more pessimistic prognosis. Assume I’m wrong about the Senate getting it right, eventually. What if the Senate passes a bill without the public option? Then the bill will go to conference with the House, and with a majority of votes in favor of the public option in both houses of Congress, it’s hard to see how a bill could come out of conference without the public option.

Nonetheless, pursuing still further the worst case scenario, assume the bill has no public option and can’t garner 60 votes in the Senate to cut off debate. The final option is the reconciliation process. This means that the whole health care reform bill will be cast as a budgetary item, which only requires 51 votes for approval.

If even that fails, then each legislator will have to decide whether they can support a health care reform bill that lacks a public option – as each of us will have to decide how we will urge them to vote. As of now, I lean toward supporting a bill, even without the public option because of the substantial reforms that everyone agrees will be in the bill; but I will be gravely disappointed, and will reserve final judgment till that last Act is underway.

The more likely scenario is that a bill that includes the public option will finally go to both houses for a vote. Then, the Conservadems and Republicans can decide if they want to oppose, in the final analysis, what a clear majority of the American people want to see passed. My hope is that half the Conservadems and two or three Republicans, having covered their conservative backsides with earlier procedural votes, will then vote “yes” on the final product, sending it to the president and bringing our long and painfully drawn-out play to a successful conclusion.

Baucus bill a dud, but not all bad

2009-09-18T08:14:00.000-07:00

Now that the Senate Finance Committee’s bill has landed in draft form, it’s pretty much the turkey that progressives expected it to be. The Chairman’s (Max Baucus, D-MT) version, set for debate and vote within the committee next week, was released two days ago.

Leading the disappointing features of the bill is the lack of a public option – a government-financed program for health care. The bill does expand Medicare coverage modestly, and in that sense expands a public program of health care. It also provides $6 billion in start-up funds for non-profit health care co-ops. But the Congressional Budget Office (CBO) predicts that the co-ops will have little impact because, as currently drafted, they are not likely to be widely utilized or competitive.

A second disappointing feature of the bill is that it won’t accomplish universal coverage. The draft version itself estimates that the number of insured Americans will only reach 94% (from the present 83%), leaving close to 20 million legal residents without coverage. My guess is that that’s an underestimate. The bill mandates that individuals purchase health insurance, which typically costs several thousand dollars per year, but levies a penalty of only $400 per year for those who don’t. Too many people, I fear, will choose the cheaper option of paying the penalty, leaving them uninsured, detracting from their market power to spread risk and therefore lower costs, and leaving the expense of their emergency health care in the hands of the taxpayer, as it now is under the current broken system.

A third problem with the bill, which is a philosophical more than a practical objection, is that it so obviously benefits the health insurance industry directly. It mandates that more people buy insurance, but does little else to reign in the costs of that insurance up to premiums as high as $8,000 per year.

Notwithstanding these objections, there are some positive points in the bill.

Like all the other versions pending in Congress, the Baucus bill requires that insurance exchanges be set up that would provide a range of options for the individual to choose from (just as members of Congress enjoy). Insurers who participate in the exchange – and the prospect of a large pool of customers provides them incentive to do so – would have to (1) accept all applicants, (2) not deny coverage on the basis of preexisting conditions, and (3) not vary premiums on the basis of the health of the insured. These features alone are a huge improvement over the current, abusive practices.

Also in its favor is that the bill truly appears to be deficit-neutral, meaning that it will not add to the deficit over the long run. This is significant in undercutting the Republican allegation that health care reform will add to the national debt, making it harder for them to mount a filibuster against it in the Senate. The CBO estimates the net cost at about $500 billion over 10 years, considerably below the cost of the Tri-Com Bill in the House and the other Senate (HELP Committee) bill. Of course it does so by limiting subsidies to middle-income individuals well below the cost of the actual insurance and by providing no public option. The major source of revenue offsetting the cost of the program will be a surcharge on premium insurance plans – those costing more that $8,000 per year ($21,000 per family). Unions don’t like this, but this is what Obama has advocated, and I personally think it’s a move in the right direction.

I also believe, in contrast to some of my liberal friends, that a withholding tax surcharge on individuals (not to exceed 13% of income) is not such a bad thing. I have long believed that all of us need to face up to the need to pay for health care, in proportion to our ability to do so – not only as a public responsibility, but as incentive to buy into the program.

Don’t get me wrong. I would vastly prefer a public option (preferably a single payer plan) financed from general revenues. But those general revenues have to be augmented by taxes to be deficit-neutral, and being deficit-neutral in the long run is essential for avoiding a national economic catastrophe. So in the meantime, mandating that all of us pay into the system, provided that subsidies are available to ease the burden on those at low income levels, is a reasonable thing to do.

On balance, the bill deserves support. It has a number of strengths that represent an improvement over the status quo. It still requires debate, and may be amended in a more favorable way before being voted out of the Finance Committee. Once it has been, then reconciliation with the better version from the HELP Committee can proceed.

The House now appears likely to pass a bill that includes the public option. Whether the Senate is able to do so is questionable. Ultimately, though, the House and Senate have to come to agreement on a single bill to send to the President. I hope the public option is part of it. But even if it isn’t, I continue to maintain that some bill is better than none. I reserve the right to change my opinion when the details become clear, but for now I think that cause for optimism remains.

With all its deficiencies, the Baucus version of the Finance Committee bill is not all bad, and certainly provides a basis, at long last, for moving forward.

Health Care Reform, the Morning After

2009-09-10T07:08:00.000-07:00

From the earliest years of the Republic, the fundamental divide in American politics has been over the role the government should play in the lives of its citizens. National defense, interstate commerce, and treaties with foreign powers are clearly subjects appropriate for collective governmental actions. The free exercise of religion, freedom of speech, and of the press, are clearly rights reserved to individuals beyond the reach of governmental regulation. In a complex world, nearly everything in between is subject to legitimate debate over whether the need at hand calls for personal, hence individual, responsibility, or whether it is a public, hence collective, responsibility of government.

The central question in the debate over health care reform has always been, or should have been, whether health care is an individual (hence private) or collective (hence public) responsibility. There are those, myself included, who feel that access to health care for all without regard to economic condition is implicit in the preamble to our Declaration of Independence (since good health is a prerequisite to an “inalienable right to life”), is inherent in the stated purpose of our Constitution (“. . . to promote the general welfare”), and is explicit in Article I, Section 8.1 of the Constitution, which gives Congress the power to “. . . provide for the national defense and the general welfare of the United States.”

Reasonable people can disagree over the extent to which our founding documents charge the government with the collective responsibility of providing health care for its citizens. If we can at least agree that the argument should be over whether, how much, and by what process our collective responsibility will mesh with our personal obligations and the role that private enterprise should play in health care delivery, we will have made progress.

I am heartened the morning after President Obama’s landmark speech on health care reform because, at long last, he has clearly and explicitly made this the issue. In case you missed it, the critical passages were the following:

“Our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited.”

If we do not act now through the “leavening hand of wise policy,” our economy will suffer increasingly from the crushing cost of health care; and the profit-driven motives of insurance companies, hospitals, doctors, and lawyers will exploit the vulnerability to injury and disease that we all share as an inevitable part of the human condition.

That said, the details of the role and mechanism by which the government will reform our system of health care delivery remain undecided. But the end game is near. Everyone agrees that 80% of the proposed reforms are acceptable to a broad bipartisan coalition of elected officials and the American people. The fight over the last 20% centers mainly on whether the government (the people collectively) should make available a non-profit form of health care provision or financing.

I am further heartened this morning by the President’s restated support for a health insurance exchange that includes a non-profit public option. I would rather see it enacted immediately instead of taking the four years to be phased in that he called for. And I would have preferred that he call for it to be built specifically on existing public programs that are highly successful, like medicare and veterans’ health benefits. But we need to understand where he’s coming from. These details are matters of legislation, now at a delicate stage of negotiation, and not entirely under his control. As I and others have pointed out, the Finance Committee of the Senate holds the key, and the chairman, Max Baucus (D-MT) has promised that a bill will be voted out, with or without Republican support, by the middle of the month.

Once the Finance Committee bill is sent to the Senate floor, the reconciliation process can begin. Be warned that the process will be messy. For those of us who insist on a robust public option, and would have preferred a single payer system, disappointment lies ahead. But despair is not called for. I am more confident than ever that something will pass the Congress, and whatever does will almost surely be an improvement over what we have now. And it will provide a base to build upon.

There are things I would have called for that the President didn’t. There are weaknesses in the approach he advocates, both tactical and philosophical, that I think will prove problematic. Perhaps I will write about them in the coming days. But for now, overall, I feel pretty good the morning after.

Eunice and Edward

2009-08-30T00:42:00.000-07:00

Eunice Kennedy Shriver and Edward M. Kennedy, sister and brother, died 14 days apart – she at the age of 88, he at the age of 77. In a family plagued by more than its share of early deaths, they lived, in the words of country-and-western singer Moe Bandy, till they were too old to die young.

For the 13 years I lived in Massachusetts, Ted Kennedy was my senator. John F. Kennedy had been my first political hero, but when Ted was elected to the Senate in 1962, I thought he was too young for the job. I never met him personally, but have him linked indelibly to a moment of high excitement in my life. That was the first landing by a human on the moon.

In the student lounge of a dormitory in Boulder, Colorado, I watched spellbound with a roomful of fellow scientists as Neil Armstrong stepped onto the moon that Sunday evening of July 20, 1969. About 40 hours earlier, the tragic accident that led to Mary Jo Kopechne’s death in Kennedy’s car had occurred on Chappaquiddick Island. The lowest point in Kennedy’s life had coincided with one of the greatest feats in human history, and the attention span of the nation was torn between the two events.

A tragedy of that magnitude could have ruined a lesser person, and questionable behavior was still to come in his private life, but Ted Kennedy would in time become a worthy public servant. Working tirelessly and effectively as a legislator for improvements in education, the work place, and especially health care, he would live long enough to outlast his youth and honor the office he held.

My contact with Eunice, though brief, was more direct and personal. My wife and I worked for three years at the Eunice Kennedy Shriver Center for Mental Retardation in Waltham, Massachusetts – one of many centers around the country partially endowed with funds from the Kennedy family.

One day Eunice stopped by the Center to see what her money had bought, and to chat with the scientists who were trying to learn more about the causes and cures for mental retardation – by then the mission to which she had become devoted. That she had taken the time to come talk to us and thank us for our work was a gesture of kindness we'll always remember.

Her husband, Sargent Shriver, had founded the Peace Corps and run for Vice-President. He had taken time out from his busy schedule to come with her. Between the two of them, they had already accomplished more than many presidents, and that was 30 years ago.

All of us have flaws, if not as big as Ted Kennedy’s worst ones. And all of us have great potential, if seldom matching the accomplishments of Eunice and Sargent, or of Ted at his best.

But here’s the difference. Most of us manage to trumpet our achievements in public, while keeping our flaws cloaked in private. The Kennedys never had that luxury. We know how they failed in excruciating detail, but we know they succeeded in making the world a better place as well. Each of us can now decide which of their legacies we will remember, and how we will keep the hopes they nurtured alive.

My Kingdom for a Dunkin' Donuts

2009-08-28T06:40:00.000-07:00

A few months ago I submitted three essays in the competition by the El Paso Times to find a new local columnist. I never heard back from them (historically, the El Paso Times has had difficulty finding my name and number in the phone book). Since they have recently announced not one, but four winners, I can safely assume I didn't make the cut. What follows is the first of my three non-winning entries.

I’m a person of habit. For years I would stop at the Subway shop on N. Mesa and Cincinnati for a sandwich on my way home from work at UTEP on Friday nights, then stop at the Dunkin’ Donuts across the street on my way in for a half day of work at my office on Saturday mornings.

One Saturday a couple of years ago, I drove up to the Dunkin’ Donuts to be greeted with the tragic news that it had gone out of business. A few months later the site was leveled, and a couple of months after that a sign appeared announcing that a new branch bank would soon be coming to the site for my convenience.

I don’t know about you, but a bank hasn’t brought me a sense of convenience, ever. When ATMs were finally introduced into El Paso a decade after I had first encountered them in my former home in Massachusetts, I was momentarily relieved to note the arrival of the modern age in the Borderland; but escalating fees and hidden charges quickly dampened my enthusiasm.

Then, when I watched my 401(k) lose a third of its value last year in the collapse of the creative financial instruments that bankers had devised to enrich themselves, I found myself much more than inconvenienced.

The news that my treasured Dunkin’ Donuts was being replaced by yet another bank, enlarging the string of banks that are thicker than thieves from the downtown skyscrapers to the edges of the city in all directions, was an ugly insult added to a bad injury.

New construction is now complete at N. Mesa and Cincinnati. A building apparently geared for retail, built in the Bhutanese architectural style that appears to be a mandatory marketing device in the vicinity of UTEP, now stands where someone used to arrive at 5:00 in the morning to make the donuts. But I note that the bank sign has disappeared. Perhaps the bank has been devoured by the recession it helped create. Or maybe it’s just a cruel joke – a Trojan bank hidden in the belly of the Bhutanese beast, waiting to erupt when the economy revives.

This isn’t personal. While I can’t claim that some of my best friends are bankers, I can say that I have a cordial acquaintance with one or two of them. And the one who talked me out of paying off my mortgage last year with my investment account when it was worth half again more than it is today, is a nice enough guy. But a convenience, he isn’t.

For the time being, the Subway at the corner of Mesa and Cincinnati survives, and I continue to patronize it while I can. Since my retirement, I no longer work on Saturday mornings, and eating fewer donuts is probably better for my cholesterol. But right now, I firmly believe the world would be a better place if there were more Dunkin’ Donuts and fewer banks.

Questions I would ask if I were there

2009-08-24T23:53:00.000-07:00

I wasn’t able to attend Congressman Reye’s Town Hall Meeting on health care reform at the Ray Pearson Forum last week-end. I don’t know how many, if any, of the following questions got asked and answered. I hope that these are among the points that he will address at the meetings that I understand are upcoming:

QUESTIONS ABOUT THE DRAFT FORM OF HB3200 ON HEALTH CARE REFORM

Is there anything in the proposed legislation that would force someone with health insurance to give up their current policies?

Medicare and Veterans’ Health Insurance account for close to 40% of all health insurance. Those are public plans. Do you hear widespread complaints from your constituents about those government-financed programs?

Private health insurance premiums have doubled in the past five years. Have medicare premiums risen that much?

Do public plans like Medicare deny coverage on the basis of pre-existing conditions?

Given the fact that seniors are overwhelmingly satisfied with Medicare, why can’t we just expand that program to anyone who wants to buy into it? Wouldn’t allowing younger people to participate in it make the program more solvent, since they would consume less health care for the same amount of premium payments over a longer period of time than seniors?

We spend roughly twice as much on health care as other industrialized nations. Why is that, and is the quality of our health care that much better?

Health care costs are rising three times faster than wages. What measures in the proposed legislation are designed to rein in these rapidly rising costs?

If Medicare, or any other public option were made available, would people be required to buy into the public plan?

Are there measures in the proposed legislation to make insurance more portable, so that if I lose my job I won’t automatically lose my insurance?

While it’s true that wealthy foreigners sometimes come to the US for treatment by specialists, at which our country excels, do you know of anyone clamoring to drop their health insurance under the French, German, British, or Canadian systems in favor of buying private health insurance in this country? (I don’t! Whatever complaints foreigners have about their systems, I’ve never had a single one tell me they wish they lived under the American system of health care.)

Is there anything in the pending legislation that would restrict anyone’s access to treatment, or “ration” health care?

Enabling doctors to own the labs that conduct the tests they order, or the hospitals in which they do their surgery, would appear to be a conflict of interest. Does the proposed legislation deal with that problem, as one step toward controlling costs?

Is there anything in the pending legislation that necessarily would force private insurers out of the market?

Does the proposed legislation have any provisions for tort reform, to reduce the incentive to practice wasteful defensive medicine? If not, why not?

What's in a "sliver?"

2009-08-23T12:12:00.000-07:00

Much ado has been made by the Talking Heads about President Obama’s statement that the Public Option is just a “sliver” of the overall health care reform bill. The usual over-interpretation of this remark is that the President is backtracking from his support of the public option.

Not necessarily. The ignition system is just a sliver of a car’s electrical network, but without it, the car won’t start. The flaps are just a sliver of an airplane’s wing, but without them the plane can’t take off or land.

The public option is a “sliver” of the whole bill in the sense that it is only one component, and one small part, proportionately, of the overall legislation. That doesn’t mean it isn’t important; and to say that it’s just one of many components is not equivalent to denying that it’s essential.

What the White House truly believes may be another matter. I continue to view the President’s strategy as both cautious and cagey. Remember that this is a man who frequently quotes Martin Luther King’s observation that “the arc of history is long.” He has more patience than we do. He knows that a few words here, a negotiating point there, might be just enough to get a very controversial piece of legislation passed. So he’s not going to be dragged into drawing lines in the sand prematurely.

Whether the President will eventually draw those lines, if he has to, remains to be seen. While he is obviously hoping for the best, I earnestly hope he is preparing for the worst, which means the time may come when he says , “The chance for bipartisan action has passed, the time to vote is now, and so, to all the Democrats who control both the House and Senate, Are you with us, or against us?”

Until that time arrives, those of us who strongly feel the public option is a critical piece of health care reform need to keep the pressure on to have it included. But it’s o.k. to say that it’s just one part of a larger piece of important legislation.

Moving On

2009-08-17T22:43:00.000-07:00

The backlash has finally begun to set in against the yellers and screamers and rude interrupters of town hall meetings and hearings intended to inform the public about health care reform. They overplayed their hand and are paying the price in resentment from the majority of the people who want their elected officials to be able to answer their real concerns without being shouted down. Op-ed writers and bloggers across the land have blasted the assault on the democratic process that these bullying tactics have represented (Click here for my commentary on the issue).

The media seem finally to be tiring of having the circus instead of the substance be the story. Today’s headlines proclaim that now the issue is the public option. That’s progress. On the other hand, reports that President Obama may be weakening in his resolve for the public option is not good news.

My take on it is not that pessimistic, just yet. Recall that I have argued previously in this space that the Senate Finance Committee is the rate limiting step. If that committee can report out a bill of any sort, it will have to be combined with the one from the Senate HELP Committee, then that hybrid will need to be reconciled with HB3200, around which all the sound and fury has swirled. Of a total of five committees with jurisdiction, four have emphatically included the public option. So once the bills get to reconciliation, chances are moderately good that the public option will survive.

A generous interpretation of the signal from the White House is that the President is simply doing everything he can to keep those 2 or 3 Republican senators on board long enough to get the bill out of the Finance Committee. If, in spite of the President’s conciliatory tone and the will of 4 out of 5 Congressional Committees, the public plan isn’t a part of the legislation that reaches the floor, that will be the time to draw the line in the sand. I remain convinced that the Republicans will reap the whirlwind if they try to filibuster health care reform to death. In the meantime, we can help by continuing to insist on inclusion of the public plan, to counter the massive effort by the health insurance lobby that desperately wants to kill it.

I previously predicted that August was going to test our will, and so it has. The propaganda has been intense and the process unnerving. But the first assault has been beaten back. Now we need to take heart and keep moving on. If our President has the courage to make good on his promise of Change, and the Democratic majority in both houses of Congress has the will, the votes should be there to get this done – with a public option.

Truth v. fiction: a line-by-line analysis of lies about the House health care reform bill

2009-08-08T10:15:00.000-07:00

Among the multitude of lies and distortions about plans to reform our broken health care system now abroad in the land is a widely-disseminated document that purports to show the evils of H.B.3200, the tri-committee bill in the House to overhaul health care. If you find anyone left in the country who wants to have a rational debate about health care, a good place to start is with the truth about what the bill actually says. Toward that end, I have analyzed the line-by-line critique and made corrective notes after each allegation. These are too lengthy and technical to be used as talking points, but hopefully will provide anyone with an open mind toward health care reform with helpful background information.

Note that this document was based on a draft form of the bill only. The final version has not yet gone to the House floor for a vote. Also bear in mind that two Senate bills will have to be voted on, which differ somewhat from this one as well. My comments are in italics

Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!

Sec 102 beginning on p.16 says that you can keep the plan you have as long as your insurer does not change the rules, like raising the premium on your risk category. It also allows you to add dependents to your existing program if you want to. It says nothing about your having to take a similar plan, and makes no reference whatever to a government option.

Page 22: Mandates audits of all employers that self-insure!

Sec 113(b) is continued on p.22. It directs that a study be conducted on the nature of employers and businesses that buy coverage as opposed to those who don’t (self-insurers). The study will collect data on the number of employees, the solvency of the companies, etc, and compare private insurance with self-insurance plans. The purpose of this is to deal with the concern that the new reform regulations might drive some employers (especially smaller ones) to try to self-insure themselves – a move that often leaves their employees underinsured. In short, its purpose is to detect and correct any negative effects of the reform package, not to penalize those who self-insure.

Page 29: Admission: your health care will be rationed!

Sec 122(c) is continued on p.29. There it lists the maximum co-payments that individuals ($5,000) or families ($10,000) would be required to make per year under any plan. It also prohibits co-payment charges for wellness and preventive medical care. It therefore is a limit on a person’s financial liability, not a limitation on their care.

Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)

Sec. 123, beginning on p.30, establishes a “Health Benefits Advisory Committee”. This committee will be made up of a wide range of health care providers, insurers, and consumers. Their role is to recommend what standards of care must be covered by all plans, private or public. The purpose of this provision is to take decisions about health care that require professional judgments and consumer preferences out of the political process. In this respect, it is intended to serve much as the Securities and Exchange Commission does in regulating the stock market, and the Federal Reserve does in regulating banking practices. All objective observers of our current system agree that one of its greatest weaknesses is the lack of minimal standards for what private insurers must cover, or, for that matter, how the great variation in Medicare and Medicaid reimbursements across the country is determined. There is nothing in this section that says the Committee “will decide what treatments and benefits you get”—it will only make recommendations on what insurance plans must cover. Note that under the present plan, the consumer is at the mercy of whatever their provider decides to cover.

Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice.. None.

The role of the Health Choices Commissioner is to (1) enact and enforce standards that all insurance plans have to meet, as opposed to the current system where each plan can arbitrarily decide who and what it will cover; (2) establish the health insurance exchange so that consumers have greater choice of plans; and (3) determine the eligibility requirements for receiving subsidized health insurance. In subsequent amendments to the bill, the eligibility for subsidies has been scaled back somewhat, to reduce the ultimate cost of the program. There is nothing on p.42 or anywhere else in Sec. 142 that says the Commissioner “will decide health benefits for you.”

Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.

Sec. 152, beginning on p.50, prohibits discrimination on the basis of anything (like race, ethnicity, gender, family status, etc.) that doesn’t relate specifically to medical condition. It says nothing about free health care services. Furthermore, Sec. 246 on p.143 explicitly prohibits the participation of undocumented aliens: “Nothing in this subtitle shall allow Federal payments . . . on behalf of individuals who are not lawfully present in the United States.”

Page 58: Every person will be issued a National ID Healthcard.

Sec. 1183A calls for the collection of data on financial eligibility for assistance, “which may include utilization of a machine-readable health plan beneficiary identification card” (p.58). This is part of the effort to move toward electronic data-processing for all patients. Medicare and social security recipients already have identification cards, and must present them to receive benefits. All drivers must carry a driver’s license with a photo and other personal information on it. Travel to a foreign country requires a passport that contains a photograph and personal information. Many other examples could be given to show that a health care identification card, if it is enacted, would hardly be unusual. But this section does not mandate a national i.d. card.

Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.

No. Paragraph (C) on p.59 only enables patients to make their co-pays or receive their rebates by electronic transfer, just as many of us receive Social Security payments and tax refunds now. Nothing in this section gives government “access to all individual bank accounts.”

Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (example: SEIU, UAW and ACORN)

No they will not. Sec. 164 starting on p.65 establishes a reinsurance program for those who retire after age 55 but prior to their eligibility for Social Security. It doesn’t mention anything about unions, community organizers, or any of the examples. The word “ACORN” does not occur anywhere in the bill.

Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.

True. All plans must meet minimum requirements that do not abuse the insured. Overcharging, denial of claims, denial of applicants for alleged or real pre-existing conditions, and other abuses by private health care insurers are among the litany of problems motivating this legislation.

Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)

No. What Sec. 203(b) says on p.84 is that any private health insurer who participates in the Healthcare Exchange must offer the Basic Plan of minimal coverage. Private insurers are free to offer enhanced plans and any other features they like, including any that would make them more attractive than a public plan, as long as they provide the Basic Plan of coverage. If they can compete better outside the Healthcare Exchange, they are free to do so.

Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens

Nothing on p.91 refers to aliens, illegal or otherwise. Some older citizens of foreign birth feel more comfortable talking about sensitive matters such as health issues in their most proficient language. Also, private insurers, as well as the rare unscrupulous health care provider, may take advantage of patients less proficient in English by getting them to approve documents and procedures that they don’t fully understand. This provision is intended to guard against such abuses.

Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.

Sec. 205 beginning on p.95 specifies only that outreach, particularly to vulnerable populations (like children and the mentally ill) be made “. . . through means such as the mail, by telephone, electronically, and in person.” It makes no mention of ACORN or Americorps. This is another gratuitous reference to ACORN for purely inflammatory reasons, with no basis in fact.

Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.

No. What this section says is that persons eligible for Medicaid who do not choose a plan from the Health Care Exchange, will automatically be enrolled in Medicaid. Should they choose to purchase their own private insurance plan, they are free to do so.

Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.

All this section says is that the decision of the HHS Secretary with regard to payments to health care providers from the Public Plan are not subject to judicial review. Private insurers are free to charge whatever they want, and health care providers are free not to treat patients insured by the Public Plan. If this provision were not enacted, private insurers would immediately sue the government (taxpayer) to force higher insurance rates and limit benefits to levels that are profitable to them but not necessarily beneficial to patients.

Page 127: The AMA sold doctors out: the government will set wages.

Sec. 125 only specifies on p.127 that doctors who treat patients under the public plan will be reimbursed according to rates negotiated between physicians and the government. Physicians are free to charge whatever they want to those insured under private plans, or paying fees-for-service.

Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.

What this section actually says is that employers who provide insurance must enroll their employees in the plan that is least expensive for the employee. There is no requirement that this be the Public Plan, though the tacit assumption of this particular “criticism” is that the Public Plan will be the most economical. Bringing down the cost of health insurance is a major purpose of the legislation, and is the main reason that the health insurance industry is so opposed to it.

Page 146: Employers MUST pay healthcare bills for part-time employees AND their families.

If the employer is required to provide health insurance (small employers are excluded), they must provide the same benefits to part-time employees, in proportion to the extent of their part-time employment only. There is no reference to paying for the healthcare of the employee’s family.

Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll.
Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll

These are payments made by employers who choose not to provide any health insurance, not just the public option, to their employees. They can avoid this payment if they provide their employees with any plan, private or public, that ensures the baseline level of health care.

Page 167: Any individual who doesn't have acceptable healthcare (according to the government) will be taxed 2.5% of income.

The requirement that everyone have health insurance, or pay a tax surcharge in lieu of insurance, is based on the principle of fairness. Under our current system, the health care of the uninsured is paid for by a hidden tax of about $1,100 a year that those of us who have insurance pay in higher premiums, and by direct taxes that everyone else pays to hospital districts, counties, and other taxing entities that have to take care of the uninsured. It is only fair that everyone take part in paying for health care. They can do it either by having health insurance, or by paying into a pool that covers expenses for the uninsured.

Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).

Non-resident aliens are exempt from the penalty tax because they are not required to purchase or have health insurance (though they may choose to do so). But they are also not eligible for the subsidies that low-income citizens will receive to help pay for their health insurance.

Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.

No; this is a gross exaggeration. Sec. 431 on p.195 says only that income tax records, of the type we all routinely have to provide in determining eligibility for everything from scholarships for our kids to Social Security benefits, must be provided to help determine the level of subsidies for which an individual should be eligible. Clearly, proof of income is a reasonable requirement in determining how much help a person needs to meet the requirement for health care coverage – otherwise, the invitation to fraud is obvious. No financial records need to be provided if no subsidies are given; and the bill refers only to income and tax records, not to all financial records, and not to personal records.

Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that.

The context of the statement on p.203 makes it clear that the imposed tax will not be counted as a tax for purposes of making a mathematical calculation in another section.

Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."

The wording of paragraph (c) on p.239 is admittedly byzantine, but a careful reading of it reveals that this section has nothing to do with reducing services. Its purpose is to modernize the reimbursement calculations for physicians, to encourage them to provide better health care for Medicaid patients.

Page 241: Doctors: no matter what specialty you have, you'll all be paid the same (thanks, AMA!)

This section says nothing about paying doctors. It simply specifies that the procedures a doctor performs will be categorized by the procedure, not by the doctor’s specialty. If a surgeon were to run a blood test, they would be reimbursed for running a blood test, not for taking out your appendix.

Page 253: Government sets value of doctors' time, their professional judgment, etc.

Subsection (L) on p.253 simply says that the Secretary of HHS can set up a process for evaluating the value of different procedures for purposes of fairly reimbursing doctors. Under the present system, health insurance companies make that determination in their own interests, and not necessarily in a fair and equitable manner.

Page 265: Government mandates and controls productivity for private healthcare industries.

This section doesn’t mandate or control anything. It simply sets up a mechanism for incorporating how changes in the productivity of health care delivery affect Medicare reimbursements. Maximizing productivity is a hallmark in the private sector, and an essential element of bringing down health care costs.

Page 268: Government regulates rental and purchase of power-driven wheelchairs.

This is a technical clarification of what equipment can be reimbursed under already existing law. It doesn’t introduce any new regulations.

Page 272: Cancer patients:Kiss your ass goodbye!... welcome to the wonderful world of rationing!

Sec. 1145 starting on p.272 empowers the Secretary of HHS to adjust payments to cancer hospitals that are charging more than other hospitals delivering comparable care. It is a protection against fraud, abuse, and price-gouging of patients at their most vulnerable time. Nothing in this section even approaches a discussion of “rationing”, which is obviously a buzz word intended to inflame the discussion and distort the actual meaning and intent of a provision intended to protect both the patient and taxpayer.

Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.

Private for-profit hospitals make money by keeping their beds filled. With an excess of private hospital beds in many cities, the incentive to keep patients hospitalized unnecessarily is strong. Sec. 1151 beginning on p.280 provides a mechanism for limiting the ability of hospitals to charge patients for excessive and unnecessary hospital stays. Recognizing their tattered reputation over this issue, the American Hospital Association actually lobbied for this provision in testimony before Congress.

Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.

For the reasons indicated above, paragraph (C) on p.298 lists readmissions to hospitals as one of several factors that should be studied in considering reimbursements. It does not mandate anything or penalize anyone.

Page 317: Doctors: you are now prohibited from owning and investing in healthcare companies!

The practice of referring patients to a health care facility (or service) which is owned in part by the doctor making the referral is an obvious conflict of interest with great opportunity for abuse at least, and fraud at worst. It is one of the practices that has greatly escalated the cost of health care, especially in smaller communities where physicians are often invested in local real estate and health care services. This section addresses that form of abuse. It does not prevent the investment by doctors in healthcare companies or facilities that does not create a conflict of interest that favors the investor at the expense of the patient and taxpayer.

Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.

No, it does not prohibit hospital expansion. It only regulates the investment in hospitals by doctors who stand to gain by admitting their patients to those hospitals. This is a cost-control and anti-trust measure, aimed at protecting the patient from excessive charges.

Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.

There is no mention of ACORN or any other specific community group anywhere in the bill. nor does it provide for “paying off” anyone. This is another gratuitous attempt to demonize the meaning of community input (which could be from anyone) and to inflame the discussion.

Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.

Outcome-based measures have nothing to do with “rationing,” and nowhere is either the word or anything that could be construed as rationing even mentioned. Furthermore, the outcomes-based measures are to be used in evaluating the effectiveness specifically of Medicare Advantage Plans, which siphon off millions of taxpayer dollars to private for-profit insurance companies. Medicare Advantage payments to private insurers are a major contributer to the upward spiral in Medicare costs. The illogical reference to “rationing” is obviously a further attempt to inflame the discussion and play on the fears of the public.

Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.

Yes, the government can disqualify those Medicare Advantage Plans which are not complying with the rules required to keep them eligible for the massive federal subsidies they receive. This is another effort to eliminate the waste of taxpayer money. There is no mention of HMOs on p.341.

Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals. << Does this apply to any of you???

This section merely clarifies the open enrollment period for certain types of special needs patients. It makes no restrictions on their enrollment within the period for open enrollment.

Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).

Augmenting traditional healthcare through healthcare by phone is a useful and effective way to lower healthcare costs. This section establishes a committee of physicians and other health care professionals outside the federal government to advise the Secretary on matters pertaining to telehealth. It doesn’t add anything to government bureaucracy, which in any event, is much less extensive and abusive than the bureaucracy in private health insurance companies.

Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.

Sec. 1233, beginning on p.424 and extending over several pages, provides that patients can receive optional consultations concerning their right to determine what life-sustaining efforts should be used if they become incapacitated, including the right to expend every effort to keep them alive under all circumstances. It also provides that consultations be given to patients concerning the advantages of designating powers of attorney and planning how their financial affairs will be handled upon their death. The so-called “order” for end-of-life treatment (such as a living will) is something the patient orders, not the government. Most people feel that making end-of-life preparations is wise. This section provides that a qualified professional can be reimbursed for helping them do so.

Page 430: Government will decide what level of treatments you may have at end-of-life.

This is blatantly false. Only the patient (or their legally-designated power of attorney) can make such a decision. The relevant passage states an appropriate order is one which, “. . . effectively communicates the individual’s preferences regarding life sustaining treatment. . .”

Page 469: Community-based Home Medical Services: more payoffs for ACORN..
Page 472: Payments to Community-based organizations: more payoffs for ACORN.

More gratuitous falsehoods. There is no mention of ACORN or of payoffs to anyone.

Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.

Yes, marriage and family therapy will be covered. To say that the government will therefore be intervening in your marriage is like saying the surgeon who removes your inflamed appendix is interfering with your digestive system.

Page 494: Government will cover mental health services: defining, creating and rationing those services.

The bill expands coverage for mental health services, and defines what will be covered, as all private health insurance plans which cover mental health do. There is no mention of rationing. The use of this term is, again, a gratuitous distraction aimed at feeding fear.

It could be worse; health care reformers take heart

2009-08-02T10:56:00.000-07:00

Congress has adjourned for the August recess without voting for health care reform. While this is disappointing, it could be worse.

In its final act before the recess, the House Energy and Commerce Committee passed a bill (save for a few straggling amendments to be considered in September) by a vote of 31-28. Every Republican on the Committee, who the previous day had passed up the opportunity to do away with government-funded Medicare, voted against the bill.

This was the third and final committee with jurisdiction in the House to vote out a bill, leaving only the Senate’s Finance Committee to report out its version. That hasn’t happened because the chairman, Max Baucus (D-MT) is still trying to get three Republican senators to join the effort. He may not succeed, but I see the continuing effort to do so as good, because even one or two Republicans who will support health care reform will lessen the chances of a filibuster in the Senate.

Not that a filibuster will be the end of the world. If opponents of health care reform are that eager to kill it, and think they can survive the wrath of an electorate that overwhelmingly supports reform, let them try. We’ll just have to hope that our allies in Congress have the spine to stand up to them and call their bluff. Our need for reform has become so desperate, that it might be worth shutting the government down to get it done.

Unless you were watching the Energy and Commerce Committee deliberations on Friday, which I was (I know; I need to get a life), you may have missed an important bit of news. When Anthony Weiner (D-NY) introduced an amendment to replace the bill under consideration with a single-payer option (“Medicare for all”), Chairman Waxman informed him that Speaker Pelosi has agreed to allow the single payer option to be offered on the floor of the House after the break. That is very good news, because it means that those who support the elegant logic, simplicity, and superiority of a single-payer system will get to have that possibility debated and voted on before the nation as a whole.

The single-payer plan will probably not prevail. But it gives us something to galvanize around during August and forces the issue onto the table. By having the “extreme” option of a single payer as a possibility, the chances of getting a more progressive bill that provides real reform, even if it isn’t perfect, will be improved.

In the meantime, batten down the hatches – the media blitz in August is going to be intense. Expect all the lies, distortions, and fear-mongering that the money of the health insurance industry can buy. Better yet, just go on vacation; then come back in September refreshed and ready to blitz the media and our representatives with encouragement to say Yes We Can to real health care reform at long last.

Regaining Our Voice

2009-07-31T12:18:00.000-07:00

Yesterday was a good day for proponents of national health care reform, as the voices of reason were back in the air.

Senator Chris Dodd (D-CT) gave an impassioned and articulate defense of the Senate Bill that has come out of the Health, Education, Labor, and Pensions (HELP) Committee. The House Progressive Caucus announced a list of over 50 members who insist that any reform bill must have a robust public option to gain their vote. Rep. Anthony Weiner (D-NY) introduced a bill, tongue in cheek, to do away with Medicare in the House Energy & Commerce Committee. Surprisingly, given their vocal opposition to “government-run health care,” not a single Republican supported it. And finally, the Blue Dog Democrats seem ever so gradually to be climbing aboard the inevitable train of progress.

Knowing that fear is more powerful than hope, opponents of reform have ratcheted up the scare tactics. Rep. Virginia Foxx (R-NC) stated on the floor of the House that the government would order the end of life for seniors. Commercials have started running with the claim that reform will finance Planned Parenthood abortions but deny needed surgery (Not true – none of the bills deals with abortion, and only private insurance companies find ways to deny necessary surgery). And, to hear opponents tell it, a public option that competes with private insurers, with their multimillion dollar executive compensations, 40% administrative costs, and bonuses to employees who find new reasons to deny claims, will end democracy as we know it.

If there was bad news yesterday, it was the announcement by Senator Max Baucus (D-MT) that his Finance Committee will not be able to report out its version of the bill before the August break. While that does give opponents a chance to hammer away at selected provisions of the bills that aren’t yet ready to be voted on in Congress, it also gives us a chance to counter the lies and distortions being put out by the health insurance industry and the elected officials being lobbied to the tune of $1.4 million a day.

Suggested talking points for August include the following:

IF a senior tells you they fear government-financed health care, ask them if they are ready to turn in their Medicare card for the 800 number of a private insurer.

IF a veteran tells you they don’t trust the intrusion of government into their health care, ask them if they’re ready to give up their veterans’ health insurance.

IF a business man or woman tells you they think the government is unfair competition for their private health insurer, ask them when it became government’s responsibility to ensure a multimillion dollar compensation package for their private insurer’s CEO.

IF someone argues that public financing of health care will cost jobs, ask them if they know how much market share American auto manufacturers have lost to European and Asian companies that make cars without the need to pay health care for their employees because their countries have public health care plans.

IF your pro-labor friend (which many of us are) insists that employer-provided plans make public options unnecessary, ask them what they’ll do for health insurance if they lose their job.

IF anyone claims that we have the best health care in the world, ask them why we rank so low in infant mortality and have life expectancies far below the best in the world.

IF a libertarian friend tells you the government should stay out of health care, ask them why they don’t hire their own police force and fire department.

IF anyone argues that private enterprise can do a better job than the government in any endeavor, ask them if they want Blackwater and KBR taking over the defense of the nation.

Where are our voices?

2009-07-29T12:20:00.000-07:00

Yesterday I watched C-SPAN as long as I could stand it (30 min) while 20 opponents gave one 1-min speech after another on the House floor in opposition to health care reform. During that stretch, only two proponents took the floor to offer a counter view.

The opponents told lies (“Reform is another word for government takeover”). They distorted the facts (“Medical care will be rationed”). They mischaracterized the plan (“Obamacare is socialized medicine”). They even tried to sow fear (“The government will kill seniors”)!

Meanwhile, the voices of our Representatives were nowhere to be heard. Perhaps they were back in their offices, trying to strike a deal that will bring the bill to the floor for a vote without gutting everything about it that would bring true reform. Or maybe they’re so confident that the battle for health care reform that’s been waged since Teddy Roosevelt first proposed it a century ago is a done deal, that they don’t need to counter the lies, distortions, and fear-mongering from the opposition. Whatever their explanation, it better be good and it better be right.

The vast majority of the American people who want health care reform now, including the right to a public option, may not be that forgiving at the polls next year – even of our current allies, if others more committed to the fight come along.

The Truth About Canadian Health Care

2009-07-27T13:02:00.000-07:00

One of the great frustrations that those of us who believe that citizens of the United States desperately need and fully deserve Health Care Reform frequently encounter is the argument by opponents that the Canadian system is dysfunctional and amounts to socialized medicine. Now American citizens who live in Canada and have experienced both systems are fighting back. A group calling for the Democrats Abroad Canada (DAC) action plan makes the following points:

BENEFITS OF CANADIAN HEALTH CARE SYSTEM

It’s less expensive: It’s well known that Canada spends less of its budget on health care than the U. S. does, but anti single-payer propaganda says that Canadians pay more taxes. What they leave out is the chunk of money Americans pay to their insurance companies. If you add that amount to taxes you would find that, in sum, Canadians pay less.

No bureaucracy gets between you and your doctor: Despite propaganda from U.S. insurance companies, the Canadian system does not force patients to go through the government to get to their doctor. In fact, it’s pretty old-fashioned: you choose a doctor and make an appointment, show your health insurance card, and that’s it. If your doctor thinks you need to see a specialist or get further tests, he/she does not have to consult an insurance bureaucrat. If your specialist thinks you need an operation, you get it – without a stack of forms to fill out.

It’s user-friendly. Unlike the U.S. system, you don’t have to fear that an illness will strike you or a loved one and lead you into bankruptcy. You don’t have to master the minutiae of co-pays and all of the methods the insurance companies use to outsmart their clients. Just that lack of stress is a health benefit in itself.

Employers: The pro-insurance propaganda says that most people get health care through their employers. What about the people who lose their jobs, or are afraid to quit and try something else? They live in fear. Also, it is often said that small businesses provide the largest percentage of jobs in America. Many simply cannot afford health care for their employees.

Proof that the Canadian system works: Since l966, when national health care was voted in – strongly opposed by the Canadian Medical Association - it has been considered one of the most important benefits of living in Canada. “Don’t mess with health care” is a message that Canadian politicians have been getting for over 40 years. Any candidate for national office who wants a U.S.-style system would lose - no doubt about it. This is not to say that there’s no room for improvement – even in the best of systems, there’s room for refinement. And when a system is under-funded or mismanaged, it’s not going to work as well as it was meant to.

Health Care Reformers Take Heart

2009-07-24T05:35:00.000-07:00

Now is not the time for the faint of heart in the drive for health care reform.

While Senate Majority Leader Harry Reid has declared that a bill will not come out of the senate before the August break, the polls appear to show that public support for reform is waning, and the Republicans are openly calling for defeat of any effort at reform, the majority of Americans who need and want a workable health care system they can afford could be excused if they feel discouraged. But that would be reading the wrong signs in the status of the current debate.

The fundamental fact remains that Congress is in agreement on the broad principles of the Obama plan: expand coverage, control costs, preserve choice.

Delaying Senate action till September is not all bad. It simply means that Finance Committee Chairman Max Baucus (D-MT) needs more time to win support within his committee for a means of financing a reform bill that can pass the Senate. The Finance Committee bill is the key to the whole ball game, as agreement has essentially been reached on the Tri-Committee Bill from the House, and the Health, Education, Labor, and Pensions (HELP) Bill in the Senate has been voted out.

The lack of a final version of the reform package is the reason that public opinion polls appear to show slippage in support. It’s not because the public doesn’t want reform; it’s that the people are confused and frustrated at the lack of specifics. Once the details are voted out by all the committees, then reconciled between the House and Senate, advocates of reform (the majority of the American people) can galvanize around a unitary positive action for Congress to take, in contrast to all the scare tactics the opponents of reform will throw at it.

Democrats have the votes to pass a bill for the President to sign. That’s actually the unstated concession behind the Republican strategy of Just Saying No – they admit they’re going to lose in the long run. If Baucus can win over just a couple of Republicans, the bill can pass without having to break a filibuster. If he can’t, Democrats will simply have to summon the guts to force the Republicans to make good on their filibuster threat. Every poll shows that under that scenario, the American public would blame the Republicans for blocking the health care reform the country desperately needs, and the GOP can ill afford to lose even more seats in 2010.

As Obama has often said, if it were easy it would have been done by now. But it will be done. Now is the time for advocates of reform to dig down deep and keep climbing the hill toward the goals that everyone says they support: expanded coverage, lower costs, and preservation of choice. Who really wants to vote against that?

No Need for Alarm: Mayo Critique of Public Plan Makes Valid Points

2009-07-20T10:47:00.000-07:00

Now that a consortium of efficient health care providers, like the Mayo Clinic, cited frequently by proponents of health care reform as a model for the future, have written a letter critical of the House Tri-Committee plan for reform, proponents may feel a sense of alarm that a valued potential ally is deserting the fight. Alarm is not really warranted, though, for two reasons.

In the first place, a careful reading of the letter reveals opposition, not to the public option per se, but to “a public option with rates based on medicare” (my italics). This is a valid concern; medicare reimbursement rates will probably be unsustainable if a medicare-like public provider becomes the leading payer, as many of us would like to see. That is why cutting reimbursement rates instead of increasing revenue through taxation or other means is a weakness of the current measures before Congress. But it shouldn’t be considered a fatal flaw.

In the second place, the other two criticisms – one objecting to the huge geographical disparities in medicare reimbursement rates, and the second citing insufficient rewards for the quality as opposed to the quantity of health care – are also valid.

This critique by potential allies in the quest to reform health care may be seized upon by opponents of reform. Progressives can’t let those opponents use these valid points as ammunition against reform. Rather, this is an opportunity for those of us committed to reform, to join with the Blue Dog Democrats and conservatives in their call for greater emphasis on cost controls, to support the medical community in seeking more realistic and equitable reimbursement levels, and to support the effective providers, like the Mayo Clinic and Intermountain Health, in their call for legislation that rewards quality more than quantity.

First, the bills have to be voted out by both the House and the Senate, then get sent to conference, where the tweaking and fixes can best take place. In the meantime, we can’t let opponents get away with mischaracterizing some valid criticisms of the pending legislation.

On the Constitutionality of Health Care

2009-07-06T13:05:00.000-07:00

In response to my post on 1 July 2009 (“Can opponents of health care reform explain to me why. . .”), one reader e-mailed me directly several comments, which I would like to share, and to which I would like to respond, in the spirit of perpetuating a dialog on this important issue.

I had asked rhetorically why “health care provided by the government is socialism but national defense isn’t?” to which the reader commented: “Our Constitution provides for national defense; it is silent on healthcare I think”

True, but the question was why a system of health care provided by the government can be criticized for being “socialistic” while national defense provided by the government is not “socialistic.” The obvious reference here is to critics of government-provided health care who condemn it as socialistic, as though to label it as such is a self-explanatory condemnation – disregarding the fact that many services and rights provided at government expense, such as raising and paying for an army, and paying for the medical care of its personnel and dependents, are no less “socialistic.”

I had also asked rhetorically why “the U.S. Postal Service and FedEx can co-exist, but private insurers can’t tolerate a public alternative?” to which the reader suggested that the Constitution is likewise silent on post offices.

Actually, Article I, Section 8, Paragraph 7 gives Congress the right to establish post offices. This is a picky point (I had to look it up myself). The larger issue, and the purpose of my rhetorical question, was to point out to those who criticize a public option for financing health care as being unfair competition for private insurers, that the publically-funded U.S. Postal Service and privately-owned delivery services like FedEx co-exist quite nicely. They do so, however, by serving different segments of the market. The U.S. Postal Service provides a basic level of mail delivery that is available to everyone at relatively low cost. FedEx provides expedited delivery and tracking options for a higher cost, for which some customers in specific circumstances are willing to pay.

I actually think this could be a good model for health care delivery. We the people, through our government, should provide a minimal level of basic health care for everyone, financed from the public treasury (for which we should indeed pay taxes, and which the majority of people polled say they are willing to do, especially if it saves them from the high cost of private insurance). Those who want extra treatment, or elective medical procedures, or special perks added onto their basic level of publically-funded health care can pay private insurers for the privilege.

I had further asked rhetorically why “police and fire protection are a right but health care is a privilege?” to which the reader commented, “ . . . I would argue police and fire protection are services, not rights”

The distinction I was drawing was that those who insist on health care as a profit-making industry implicitly regard it as a privilege, while expecting police and fire protection to be provided by government as a public responsibility, hence a service to which they have a right. Police and fire protection are indeed services (see my post on 15 June 2009), but they are provided by government as needed without regard to what extent an individual is able to pay for them, which implies that we consider them rights available to all citizens. Again, the larger point is, why do we consider some services like police and fire protection to be public responsibilities, while other services like health care (without which the welfare and safety of all citizens is likewise threatened) are not considered public responsibilities?

Another comment made by the reader was “Yes, education can be public, but is anyone truly satisfied with public education?” to which I would respond that, yes, there are some great public school systems doing an excellent job overall of educating our children. And, yes, there are some public schools doing a poor job; but is everyone truly satisfied with the postal service, or the EPA or the CIA? Whether people are satisfied or not with government-funded programs is not the point of this discussion. The point is whether education and the postal service and the EPA and the CIA and a basic level of health care for all Americans should be public rather than private responsibilities.

Finally, in response to my quoting from the Declaration of Independence, in order to document the principles on which our nation was founded, the reader commented that “The only rights we truly have are those enumerated in our Constitution.”

Actually, the 11th Amendment states that “The enumeration in the Constitution of certain rights shall not be construed to deny or disparage others retained by the people.” So the real question is, what constitutes the other rights that ought to be retained by the people collectively? The Constitution does not mandate a Social Security System or NASA or the FBI or the FAA, but we as a people through our elected representatives have declared that we value the services provided by those agencies as legitimate government functions to be paid for by all of us collectively. The question is simply whether access to a basic level of health care should also be one of the collective responsibilities that we share.

No Wonder They Fear a Public Option

2009-07-01T08:43:00.000-07:00

If anyone wonders why health care costs so much in this country, a good place to start looking is the private for-profit health care industry. CEOs at 8 of the nation’s 10 largest health care insurers and providers last year averaged $15.6 million dollars in compensation each.

Those CEOs, their total compensations (salary, plus bonuses, stock options, etc.) and their companies were as follows, according to Forbes:

$30.2M – H. Edward Hanway (CIGNA)
$21.8M – David B. Snow (MEDCO HEALTH)
$20.9M – Dale B. Wolf (COVENTRY HEALTH CARE)
$20.1M – Michael B. McCallister (HUMANA)
$16.7M – Jay M. Gallert (HEALTHNET)
$ 5.8M – Trevor Fetter (TENET HEALTH CARE)
$ 5.2M – Wayne T. Smith (COMMUNITY HEALTH SYSTEMS)
$ 4.0M – Stephen J. Hemsley (UNITED HEALTH GROUP)

Can opponents of health care reform explain to me why . . .

2009-06-21T15:50:00.000-07:00

. . . health care provided by the government is socialism but national defense isn’t?
. . . police and fire protection are a right but health care is a privilege?
. . . public health insurance is unfair competition for private insurers, but the Army isn’t unfair competition for Blackwater?
. . . education can be public but health care has to be private?
. . . government-financed health care imposes a bureaucrat between my doctor and me, but private insurance plans are free of bureaucratic intrusion?
. . . the U.S. Postal Service and FedEx can co-exist, but private insurers can’t tolerate a public alternative?
. . . an average salary of $14 million a year for the CEOs of the top eight private health insurance companies doesn’t add more to the cost of health care than the $200,000 a year that top Medicare administrators make?
. . . college professors with 8 years of higher education and 4 years of postdoctoral study get paid a salary regardless of how many students enroll in their classes, while a doctor with 8 years of higher education and 4 years of postdoctoral practice gets paid for each instance of service provided?
. . . the government can build a public post office in every zip code in the nation, but can’t provide a public clinic without threatening the private enterprise system?
. . . members of congress get to choose between a variety of public and private health care plans, but I don’t get the same choices they do?
. . . waiting a few days for elective procedures in a state-run system like Canada’s is an intolerable case of “service denied”, while the failure of the poor to get medical attention at all because they don’t have insurance and can’t pay fee-for-service is not a greater denial of service?
. . . 40% of every health care dollar can go to administration and profits for private insurers, but the 10% administrative costs of Medicare is unacceptable government inefficiency.
. . . the Declaration of Independence says that our inalienable rights include “life, liberty, and the pursuit of happiness” without telling us that life and health are available only on a fee-for-service basis?

Tier 1 for UTEP?

2009-06-17T05:35:00.000-07:00

Below is a Letter to the Editor of the El Paso Times that I wrote in response to their editorial advocating Tier 1 status for UTEP last August. It’s a complicated issue that I intend to explore in greater depth in this space soon. For the time being, this gives a preview of my position.

Seeking Tier 1 status while also providing a student-centered education with open-door admissions are both worthy goals for UTEP. Unfortunately, they are mutually exclusive.

There is not a single national model of a Tier 1 university that also focuses on undergraduates with minimal admissions criteria. This is because the scientists and scholars required to be competitive at the Tier 1 level have neither the motivation nor time to concentrate on the classroom, nor can the university divert its resources from research support to educating the masses.

There are certainly models of excellent research universities that value and support undergraduate education while conducting good research on their regional problems and opportunities. UTEP itself has been one of the best such models.

If UTEP’s administrators really think it should become a Tier 1 university, they are right to call for a massive infusion of money and about a decade of time. But undergraduate enrollment will have to be severely curtailed, and those that are admitted will have to be taught mostly by teaching assistants and part-time instructors until their last few semesters, while professors recruited for their research talent devote their time to graduate courses and writing grant proposals.

El Paso Legislators: Response to David K

2009-06-16T16:27:00.000-07:00

The following was my response to a critical review of El Paso’s legislative delegation published by David Karlsruher on 3 June 2009. David K claimed that our local representatives accomplished basically nothing in the 81st Legislative session just ended.

Your judgment is too harsh, David K, even if you make a few valid points. Tier One for UTEP was a pipe dream from the start, but progress toward a national research university is a worthy goal that will be helped by the bill that did pass, painting a roadmap for all the contending universities in the state to follow. Eliot Shapleigh authored an earlier version of that legislation (SB1564), and argued vigorously for the framework, if not the final version that he felt (correctly) disadvantaged UTEP. He also authored a bill (SB202) that makes it easier for doctors to get provisional licenses in underserved areas like El Paso, in answer to your question about agenda item 5.

Joe Moody and Marisa Marquez did a lot more than “weather their fists” in their first session. Moody’s rider to appropriate money for a visitors’ center at our state park shouldn’t be trivialized; visitors’ centers greatly amplify the value of our natural resources. Moody passed important bills relating to victims’ rights in cases of domestic violence (HB2236) and making it easier to prosecute street gangs and threats against children (HB2187). Marquez got bills passed to improve the treatment of pregnant inmates (HB3654) and tighten building codes for new construction in colonias (HB2833), on top of her herculean effort in getting the ethics bill (HB2301) passed.

Joe Pickett was noted for his public squabbles and qualified successes as Chair of the House Transportation Committee, but less publicized for his admirable passage of a bill (HB1462, co-authored with Moody) to grant 5 hours of leave per month for state workers to volunteer as advocates for foster children, and his unsuccessful attempt to divert money from the proceeds of “Choose Life” vanity plates to the Department of Protective and Family Services instead of to anti-abortion groups.

Chente Quintanilla’s bill (HB739) to tighten education requirements to peddlers of medicare related products is worthy of more respect than your humorous reference to it accords. Even Norma Chavez, as always, coupled her monumental pettiness with some good legislation, like the addition of job incentive programs (HB2169).

Yes, there was squabbling and embarrassment galore, and the egos of politicians are never too deep beneath the surface. That doesn’t mean they don’t accomplish something. The fact that they were able to get anything done, in a fiscally constrained session largely immobilized by the polarizing pseudo-issue of voter identification, is in fact commendable.

Texas Needs Public Health Care Clinics

2009-06-15T08:40:00.000-07:00

A shorter version of the following appeared as a guest editorial by Louis Irwin in the El Paso Times on May 18, 2008.

Health care inequities across ethnic and economic boundaries exist in this country because we treat the delivery of health care like a consumer commodity instead of a protective service.

Phones, cars, and houses are commodities. We choose them from a large selection to suit our individual tastes and needs. We pay for them one at a time. Competition in the marketplace generates a variety of products, and rightful profit for their producers.

Policemen, firefighters, and the army provide protective services. As everyone is vulnerable to crime, fire, and foreign enemies, we share the risks and pay for protection collectively through our taxes. The role of government is to ensure our basic right to public safety, not to make a profit.

Injury and disease, like threats to public safety, are risks that affect us all. Protection from them should be a basic right. But in this country, pain and suffering are opportunities for profit – from doctors paid a fee-for-service, to hospitals that market aggressively for shareholder profit, to insurance companies that reward agents for denying claims, to lawyers who live off the mistakes of all the above.

The cost of health care is driven mainly by the high technology and drugs on which modern medicine depends; but excessive marketing by drug makers, and advertising by clinics and hospitals that compete for patients to deliver profits to stockholders, inflate that cost. The insurance industry adds a third party payer, whose need to earn a profit for shareholders plus excessive red tape adds another 40% to the health care dollar. To make matters worse, the practice of tying health insurance to employment has made it non-portable for the patient and an economic burden to the employer.

One way to achieve real reform in the delivery of primary health care is to combine the training of personnel with establishment of community-based outpatient clinics staffed by nurse practicioners, physicican’s assistants, and technicians under the supervision of a senior physician. These primary and emergency health care teams across the state would make up a Texas Medical Corps, consisting of health care professionals who would work for one year at a livable but modest salary in exchange for each year of tuition deferment during their training at a public institution.

The community clinics would be placed in existing public facilities, like high school infirmaries or firehouses. Any legal resident would be eligible for minor emergency or outpatient care, and visitors could be treated for a modest fee.
The cost of this community based health care would be lower than the present fee-for-service system, because the clinic facilities would already exist and the health care providers would be paid modest salaries as payback for their state-funded education. Since insurance would play no role in the delivery of health care at community clinics, another third or more of the primary health care expense would be saved.
T
he program would be funded from revenue generated in a manner determined by the Legislature. For instance, employers, now freed of the need to provide health insurance for employees, could pay somewhat more in taxes to support the Texas Medical Corps. Everyone would pay an additional tax to support the program as well, but such a tax should be tied to ability to pay (income) rather than to property, which is already overtaxed in Texas. Whatever the additional cost to the taxpayer, it would be less that the cost of private health insurance (typically a thousand dollars or more a month for family protection).

Health insurance could still play a role, for those willing and able to pay for private policies. These could cover amenities like private hospital rooms, personal physicians, elective surgery, and other optional benefits. But since this type of insurance would not have to be provided by employers, the health care burden would largely be lifted from them, stimulating economic growth and enabling higher wages.

Programs like the La Fe Clinics and the Wainwright Family Resource Center in Northeast El Paso already provide models of community-based health care here. These programs provide valuable out-patient and preventive health care to our large population of citizens who cannot afford the commodity-based health care delivered by profit-driven providers. If such programs were extended to every community, with access to everyone, primary health care would finally become the basic human right that it should be.

WHY I AM DOING THIS

2009-06-15T07:18:00.000-07:00

I moved to El Paso in 1991 from Massachusetts, where I had been a college professor of biology and a biomedical researcher in the Boston area, and an elected official in the City of Newton. I was recruited by the University of Texas at El Paso to be chair of Biological Sciences

There were only two doctoral programs at UTEP then, and my major task was to continue UTEP’s momentum toward a nationally-recognized research university by adding a doctoral program in biology. With the help of my colleagues, I did so, and helped created the Border Biomedical Research Center in the process.

After 8 years, I resigned as chair to devote my efforts to teaching and research.
By 2008, I had worked in academia and research for 40 years. The disturbing loss of John Kerry in 2004, spurred largely by fundamentalists with a narrow social agenda in spite of George Bush’s failure to keep us safe and deliver the compassionate conservative society he had promised, aroused my ever-present political interests from sideline observation to activism. Feeling it was time to put my decades of experience as a scientist, educator, and politician to work for the good of society, I decided to run for public office.

I ran for State Representative in the Democratic primary in 2008 but lost. It then occurred to me that all this experience might be of some use to a current office holder. Now retired, I offered my services to several of the political figures I admired – John Kerry, Hillary Clinton, the new senators from Colorado and New Mexico – Mark Udall, Michael Bennett, Tom Udall – the new Congressman from southern New Mexico, Harry Teague, and my own Congressman, Sylvester Reyes. All I aspired to was a lowly staff position, perhaps to help with constituent mail, and I offered to do so as an unpaid volunteer. Mark Udall and Harry Teague acknowledged receipt of my letter, but never followed up. None of the others, including Sylvester Reyes, replied in any way.

Thus spurned by the voters and by members of Congress who had no use for my talents or experience, but still finding myself energized by the issues of the day, I decided the only thing left was to start my own blog. Now cured of the notion that the world is waiting and anxious to hear what I have to say, I have determined that I will say it nonetheless. If anyone reads and reacts to my observations about science, education, the state of our health care, social issues related to crime, drug abuse, punishment, and religion, the wonders of space exploration, the history of our nation, state, and region, or the politics that impinge on all these topics, I will be gratified. But history has taught me not to be overoptimistic about that. I am reconciled to the fact that just writing about it may have to be its own and only reward.