With the President giving a speech before a joint session of Congress tonight, I'm going to push back the conclusion my analysis of the Republican plan to eliminate (or save, if you prefer) Medicare. I'll also be discussing last night's Republican debate, and more generally my opinions on the Republican field, in the near-future.
The President's speech tonight, along with yesterday's debate, which was the first to include front-runner Texas Gov. Rick Perry, marks the true beginning of the 2012 election. President Obama will be laying out proposals to increase jobs. If the "leaks" are to be believed, he will be proposing somewhere between $300 billion and $500 billion in new spending and tax cuts for things like an extension of unemployment benefits, a payroll tax cut extension, job training, school construction, and infrastructure spending. I haven't seen any specifics on how he will propose to pay for this spending, but it is likely it will include closing some tax loopholes as he advocated during the debt ceiling fiasco.
He will essentially be daring the Republicans to vote his proposals down. Republicans have spent the last 3 years villifying Obama and his policies, so it seems fairly likely that they'll oblige him in this dare. Given that Republicans have been attacking policies they used to support (which we'll be discussing more in depth in future posts), it will be politically untenable for them among their own base to vote for hundreds of billions in new spending.
Once they are on the record as voting down a jobs bill, Obama will be able to go to voters and make a surprisingly good case that he's done all he can on jobs and the economy, given the relative lack of power he has on economic matters vis-a-vis Congress.
-The recent downturn in job creation corresponds fairly closely to the draw-down of the original stimulus spending.
-The CBO estimates the stimulus bill meant there are now 1.3 million to 3.3 million more jobs than there otherwise would have been.
-Some liberal economists, such as the New York Times' Paul Krugman, argue that the stimulus should have been bigger, but since the vote in the Senate barely beat a Republican filibuster, it is unlikely that he could have gotten a bigger package passed.
-Depending on the analysis, the spending cuts forced through by Republicans during the deficit debate, along with failing to extend payroll tax cuts and unemployment insurance, will cost as many as 1.8 million jobs in 2012.
-The things he is reportedly proposing tonight would have been fairly non-controversial just a few years ago. Refusing to go along with things like infrastructure spending, job training and tax cuts for workers will make it much easier for Obama to lay the blame for the economy at the feet of Republicans in Congress.
Thursday, September 8, 2011
Wednesday, September 7, 2011
Hiding the costs of cutting
(Very long post. The take home point is that the Republican plan to modify/replace Medicare will result in massive increases in out-of-pocket expenses for beneficiaries, because private insurance is just straight-up indisputably more expensive than Medicare. In order to be able to cover these increased costs, each of us would have to start saving thousands of dollars a year starting today to make up the difference. So why not just pay more in Medicare taxes, the increase of which would be less than the amount we would have to set aside should Republicans get their way?)
In my previous post, I discussed that, since most voters don't know how the federal government spends money, Tea Partiers were able to get into office on a vague pledge to "cut spending", without ever being specific about what spending would be cut. After they got into office, besides some invectives hurled at budgetarily-trivial organizations like Planned Parenthood and NPR, their main budgetary proposal was Wisconsin Rep. Paul Ryan's "Path to Prosperity". Its main cost savings come from changing traditional Medicare into a system oddly enough quite similar to Obamacare. Instead of being a government-run, subsidized health insurer, Medicare would give seniors vouchers with which they could purchase private insurance on government-run exchanges, just like Obamacare. While it would decrease government expenditures on health care, it would increase health care expenditures overall and vastly increase costs for seniors. That means that current workers, who of course are tomorrow's seniors, would have to immediately start paying thousands of dollars a year in a hidden "tax" to make up for the supposed "savings" Republicans want to impose.
As currently constituted, Medicare offers subsidized insurance. The total cost of insurance is made up of both government subsidies and seniors' out-of-pocket expenses. The Republican plan, which all but 4 Congressional Republicans voted for, would not change anything for anyone already on Medicare or anyone 55 or above. That is, if you're 65 years old and get into Medicare before 2022, it doesn't change anything. According to the Congressional Budget Office (.pdf) and the Kaiser Family Foundation (.pdf), the average Medicare beneficiary, under current law, would get about $8,000 in subsidies in 2022 and have to pay about $6,200 out-of-pocket every year, for a total cost of about $14,000 a year.
Under the Republican plan, seniors would instead get a voucher for $8,000, the same as the government's cost in 2022 under current law, and purchase private insurance via a government-run exchange. The CBO estimates that a plan providing similar benefits to Medicare via a private insurer would cost a bit over $20,000 a year, or over $6,000 more than a traditional Medicare plan. This is because, with Medicare's bargaining power, they are able to pay lower reimbursement rates to doctors and hospitals. Because the federal government's contribution stays at $8,000, the out-of-pocket cost for a senior in 2022 would be over $6,000 higher than they would pay out-of-pocket with traditional Medicare.
The savings for the government come via limiting the rate at which the voucher's value increases over time, as well as by pushing back the age at which citizens qualify for the voucher (going from 65 in 2022 to 67 in 2033). Instead of the current system, where the government's cost increases in step with the rise of health care costs, the Republican plan would index increases in the govenment's cost to overall inflation, which historically is well below inflation in health care costs. This means that the percentage of seniors' health care costs which are paid by the government will decrease over time, as the voucher increases in value more slowly than health care costs go up. The CBO also projects that the difference in price between a traditional Medicare plan and a similar private plan will continue to increase over time. So people younger than 55 would get an even worse deal than today's 55 year olds.
So let's look at how much a 55 year old today would have to save in order to cover the increased costs in their retirement. All the calculations are my own, and I'd be happy to share more details if anyone cares:
-The Social Security Administration projects that a person who turns 65 in 2022 can expect to live 19 years.
-In order to pay $6,240 more out-of-pocket, per the Kaiser projection, for each of those 19 years (which is a very kind assumption, as the actual out-of-pocket cost will increase faster than inflation), assuming a 5% return on investment, would require a nest egg of $77,764 at age 65, which would be spent down to $0 over the next 19 years
-In order to have a nest egg of $77,764 by age 65, again assuming a 5% return on investment (which is also very kind and very close to the average 5.3% rate of increase of the Dow over the 20th century, given the current return on a 10 year government bond of about 2%), a current 55 year old would have to save just over $5,200 a year, or $100 a week, starting today to not lose ground.
-If you drop the expected rate of return on investment to 3%, which again relative to the 10 year T-bill is kind, a current 55 year old would have to save just over $7,000 a year, starting today, to not lose ground.
-When you consider that health care costs have increased by 4.9% in real terms over the past 4 decades, which means that health costs have gone up faster than the Dow increased in the 20th century (4.9% real is actually more than 5.3% nominal, which doesn't include inflation), it is likely that younger workers will get an even worse deal than current 55 year olds. They'll have more time to save up their nest egg, but in real terms they will have to save/deposit even more to make up the difference.
All of this boils down to the fact that Medicare, due to its massive, bordering-on-monopsony power to control reimbursement rates, is more effective at limiting costs than private insurance. If your goal is to limit health care costs for the government, the Republican plan is one way to go. But if your goal is to limit overall costs, which at the end of the day is what matters, then it's a big step in the wrong direction. Instead of paying thousands more a year into individual accounts to pay increased out-of-pocket costs in our retirement, we would be better off to pay more than we currently do into the Medicare system.
In the next post, we'll discuss why Republicans' claims that privatization will actually decrease costs, which seem to be largely based on their misinterpretation of the effects of Medicare Part D (Medicare prescription coverage), are flawed.
In my previous post, I discussed that, since most voters don't know how the federal government spends money, Tea Partiers were able to get into office on a vague pledge to "cut spending", without ever being specific about what spending would be cut. After they got into office, besides some invectives hurled at budgetarily-trivial organizations like Planned Parenthood and NPR, their main budgetary proposal was Wisconsin Rep. Paul Ryan's "Path to Prosperity". Its main cost savings come from changing traditional Medicare into a system oddly enough quite similar to Obamacare. Instead of being a government-run, subsidized health insurer, Medicare would give seniors vouchers with which they could purchase private insurance on government-run exchanges, just like Obamacare. While it would decrease government expenditures on health care, it would increase health care expenditures overall and vastly increase costs for seniors. That means that current workers, who of course are tomorrow's seniors, would have to immediately start paying thousands of dollars a year in a hidden "tax" to make up for the supposed "savings" Republicans want to impose.
As currently constituted, Medicare offers subsidized insurance. The total cost of insurance is made up of both government subsidies and seniors' out-of-pocket expenses. The Republican plan, which all but 4 Congressional Republicans voted for, would not change anything for anyone already on Medicare or anyone 55 or above. That is, if you're 65 years old and get into Medicare before 2022, it doesn't change anything. According to the Congressional Budget Office (.pdf) and the Kaiser Family Foundation (.pdf), the average Medicare beneficiary, under current law, would get about $8,000 in subsidies in 2022 and have to pay about $6,200 out-of-pocket every year, for a total cost of about $14,000 a year.
Under the Republican plan, seniors would instead get a voucher for $8,000, the same as the government's cost in 2022 under current law, and purchase private insurance via a government-run exchange. The CBO estimates that a plan providing similar benefits to Medicare via a private insurer would cost a bit over $20,000 a year, or over $6,000 more than a traditional Medicare plan. This is because, with Medicare's bargaining power, they are able to pay lower reimbursement rates to doctors and hospitals. Because the federal government's contribution stays at $8,000, the out-of-pocket cost for a senior in 2022 would be over $6,000 higher than they would pay out-of-pocket with traditional Medicare.
The savings for the government come via limiting the rate at which the voucher's value increases over time, as well as by pushing back the age at which citizens qualify for the voucher (going from 65 in 2022 to 67 in 2033). Instead of the current system, where the government's cost increases in step with the rise of health care costs, the Republican plan would index increases in the govenment's cost to overall inflation, which historically is well below inflation in health care costs. This means that the percentage of seniors' health care costs which are paid by the government will decrease over time, as the voucher increases in value more slowly than health care costs go up. The CBO also projects that the difference in price between a traditional Medicare plan and a similar private plan will continue to increase over time. So people younger than 55 would get an even worse deal than today's 55 year olds.
So let's look at how much a 55 year old today would have to save in order to cover the increased costs in their retirement. All the calculations are my own, and I'd be happy to share more details if anyone cares:
-The Social Security Administration projects that a person who turns 65 in 2022 can expect to live 19 years.
-In order to pay $6,240 more out-of-pocket, per the Kaiser projection, for each of those 19 years (which is a very kind assumption, as the actual out-of-pocket cost will increase faster than inflation), assuming a 5% return on investment, would require a nest egg of $77,764 at age 65, which would be spent down to $0 over the next 19 years
-In order to have a nest egg of $77,764 by age 65, again assuming a 5% return on investment (which is also very kind and very close to the average 5.3% rate of increase of the Dow over the 20th century, given the current return on a 10 year government bond of about 2%), a current 55 year old would have to save just over $5,200 a year, or $100 a week, starting today to not lose ground.
-If you drop the expected rate of return on investment to 3%, which again relative to the 10 year T-bill is kind, a current 55 year old would have to save just over $7,000 a year, starting today, to not lose ground.
-When you consider that health care costs have increased by 4.9% in real terms over the past 4 decades, which means that health costs have gone up faster than the Dow increased in the 20th century (4.9% real is actually more than 5.3% nominal, which doesn't include inflation), it is likely that younger workers will get an even worse deal than current 55 year olds. They'll have more time to save up their nest egg, but in real terms they will have to save/deposit even more to make up the difference.
All of this boils down to the fact that Medicare, due to its massive, bordering-on-monopsony power to control reimbursement rates, is more effective at limiting costs than private insurance. If your goal is to limit health care costs for the government, the Republican plan is one way to go. But if your goal is to limit overall costs, which at the end of the day is what matters, then it's a big step in the wrong direction. Instead of paying thousands more a year into individual accounts to pay increased out-of-pocket costs in our retirement, we would be better off to pay more than we currently do into the Medicare system.
In the next post, we'll discuss why Republicans' claims that privatization will actually decrease costs, which seem to be largely based on their misinterpretation of the effects of Medicare Part D (Medicare prescription coverage), are flawed.
The long-awaited return of The Political Doctor!
Hello again, friends! After a long layoff during which I completed my Pediatrics residency and getting a job back home in Akron, it's time once again to fire up the computing machine and share my political thoughts with the world! Aren't you lucky?!
Let's begin again by returning to my "What is everyone so angry about" series. In Part 1 and Part 2, we discussed the distortions and outright lies that Republicans were using to demonize the President as an un-American Marxist in order to provide cover for refusing to negotiate with him. Now we will discuss why voters are so vulnerable to these tactics.
The average voter is woefully misinformed and/or ignorant about the federal budget.
Some facts before we begin. Here's a rundown of where the money actually goes. Highlights include 67% of spending going to Social Security, Medicare/Medicaid/CHIP, defense spending, and interest on the debt. Another 14% goes to safety net programs like unemployment insurance, food stamps, low-income housing assistance, school lunches, and such.
In a poll in November 2010, when the Tea Party made their historic gains in Congress and state legislatures, Americans were asked what percentage of the federal budget they thought went to foreign aid, and then what percentage they think should be spent. The median responses were that 25% of the budget (which would work out to about $900 billion/year) was sent to other countries, and that an ideal amount of aid would be 10%.
The actual percentage of the federal budget for foreign aid is less than 1%.
When it comes to military spending, most voters vastly underestimate how much we spend. The defense budget for 2011 is about $719 billion(.pdf). This represents about a fifth of the total federal budget and is about 7 times the amount spent by any other country. A Rasmussen Reports survey from earlier this year finds that only 25% of voters think that we should spend even 3 times as much any other country and 40% think we should spend less than that. Reducing our military spending to only 3 times the next closes country would save us $400 billion a year and would result in 10-year savings of around double the savings agreed to in the budget battle last month.
Since my last post, I called into a nationally-syndicated right-wing radio show, The War Room, to correct the host on the amount of spending on earmarks. He said several times during a rant that there are "hundreds of billions wasted on earmarks", when in fact the actual number is about $16 billion a year.
A poll(.pdf) from March 2011 shows that voters believe, on average, that 42 cents of every federal dollar are wasted. Wasted!!! A stunning 60% of voters think that our deficit problems can be eliminated by simply eliminating "waste, fraud and abuse". As mentioned above, the vast majority of government spending is in popular programs like Medicare, Social Security and defense, which voters consistently say they don't want to be cut (.pdf).
To the average voter who belives these falsities, it would be pretty easy to become frustrated and angry with President Obama for not doing more to cut the "waste, fraud and abuse", which of course no one would miss. Republicans capitalized on this anger by running a vague campaign in favor of "spending cuts". Voters, the media and their Democratic opponents never provoked Republicans to get specific about where they would cut, so they were able to skate into office without taking politically-bold stands about which popular programs (Medicare, Social Security, etc.) they would cut.
In my next post (which won't be 17 months from now, I promise!), we'll discuss the Paul Ryan budget (.pdf), which would replace the current Medicare program with vouchers, or, if you prefer, premium supports. Sneak preview: it would result in a huge cost increase for future seniors who, as current non-senior workers, would essentially have to pay a new tax today to save for their increased future costs.
Let's begin again by returning to my "What is everyone so angry about" series. In Part 1 and Part 2, we discussed the distortions and outright lies that Republicans were using to demonize the President as an un-American Marxist in order to provide cover for refusing to negotiate with him. Now we will discuss why voters are so vulnerable to these tactics.
The average voter is woefully misinformed and/or ignorant about the federal budget.
Some facts before we begin. Here's a rundown of where the money actually goes. Highlights include 67% of spending going to Social Security, Medicare/Medicaid/CHIP, defense spending, and interest on the debt. Another 14% goes to safety net programs like unemployment insurance, food stamps, low-income housing assistance, school lunches, and such.
In a poll in November 2010, when the Tea Party made their historic gains in Congress and state legislatures, Americans were asked what percentage of the federal budget they thought went to foreign aid, and then what percentage they think should be spent. The median responses were that 25% of the budget (which would work out to about $900 billion/year) was sent to other countries, and that an ideal amount of aid would be 10%.
The actual percentage of the federal budget for foreign aid is less than 1%.
When it comes to military spending, most voters vastly underestimate how much we spend. The defense budget for 2011 is about $719 billion(.pdf). This represents about a fifth of the total federal budget and is about 7 times the amount spent by any other country. A Rasmussen Reports survey from earlier this year finds that only 25% of voters think that we should spend even 3 times as much any other country and 40% think we should spend less than that. Reducing our military spending to only 3 times the next closes country would save us $400 billion a year and would result in 10-year savings of around double the savings agreed to in the budget battle last month.
Since my last post, I called into a nationally-syndicated right-wing radio show, The War Room, to correct the host on the amount of spending on earmarks. He said several times during a rant that there are "hundreds of billions wasted on earmarks", when in fact the actual number is about $16 billion a year.
A poll(.pdf) from March 2011 shows that voters believe, on average, that 42 cents of every federal dollar are wasted. Wasted!!! A stunning 60% of voters think that our deficit problems can be eliminated by simply eliminating "waste, fraud and abuse". As mentioned above, the vast majority of government spending is in popular programs like Medicare, Social Security and defense, which voters consistently say they don't want to be cut (.pdf).
To the average voter who belives these falsities, it would be pretty easy to become frustrated and angry with President Obama for not doing more to cut the "waste, fraud and abuse", which of course no one would miss. Republicans capitalized on this anger by running a vague campaign in favor of "spending cuts". Voters, the media and their Democratic opponents never provoked Republicans to get specific about where they would cut, so they were able to skate into office without taking politically-bold stands about which popular programs (Medicare, Social Security, etc.) they would cut.
In my next post (which won't be 17 months from now, I promise!), we'll discuss the Paul Ryan budget (.pdf), which would replace the current Medicare program with vouchers, or, if you prefer, premium supports. Sneak preview: it would result in a huge cost increase for future seniors who, as current non-senior workers, would essentially have to pay a new tax today to save for their increased future costs.
Thursday, May 6, 2010
What is everyone so angry about? Part 2
As discussed in part 1, conservative media repeatedly portray Obama as a socialist in order to provide cover for not negotiating/compromising with him. In addition to portraying deficits and spending as out of line with historical norms (despite being in line with Bush's last months and CBO projections at the start of his Presidency), they frequently cite the federal government taking a partial ownership in banks and car companies as a condition for saving those companies from extinction with billions of dollars of taxpayer dollars. What Hannity & Co. miss, with these claims, is that it was noted Socialist George W. Bush who required banks give stock to the government in exchange for a bailout, and that doing anything else would have required either a second Great Depression or a massive giveaway to Wall Street.
There was a legitimate debate around the time of TARP (the bank bailout bill) about whether or not taking an ownership stake in companies was a good idea. Just about everyone agreed that letting the banks go out of business would destroy the economy. It was also widely agreed that government cash was the only way that these companies would be kept from closing their doors. Numerous prominent Republicans supported taking ownership in bailed-out banks, including the Bush White House, Senate GOP Leader Mitch McConnell, House GOP Leaders John Boehner and Eric Cantor, along with 89 other House Republicans and 32 other GOP Senators. You can't call Obama a socialist for taking over banks without putting the same label on the GOP. Theirs was not the socialistic goal of achieving government ownership of production; it was to save our (mostly-) capitalist economy.
This claim that Obama took over banks also rings somewhat hollow as he, ya know, wasn't President then.
When Obama actually was President, he applied the same logic that Bush and the GOP leadership (and then-Sen. Obama) did with TARP in bailing out GM and Chrysler. Bush had already allocated billions of dollars to save the two. Obama followed Bush's deal with the banks that, if the federal government was going to share in the risk of loss of billions of dollars, that they should get a share of the potential profits as well.
Another problem with the "Obama-as-Socialist" meme is that he's so bad at it, were that his actual goal. Under Obama's administration, the government has sold back most of the stakes it took in banks, and GM has repaid billions of its debt. His supposed socialist takeover of our health care system expands private insurance much more than it expands government-run plans. In one breath, they criticize Obama as a Socialist who is out to lead a government takeover of the banks, and in the next breath, they say he is in bed with them. They'll twist reality in any way necessary to attack Obama and de-legitimize his policies.
One of my biggest beefs with the Tea Party and the conservative media is that they overemphasize critiques of Obama policies without properly acknowledging the alternatives to those policies. The only alternatives to Obama's action regarding partial ownership of GM and Chrysler were either letting the companies fail by refusing to help them, which would have destroyed millions of jobs, or to give the corporations something for nothing, giving them billions without asking for anything in return. Those alternatives, of course, don't look as good on a sign at a rally as a picture of Obama with a Hitler mustache.
I hold out hope that as November approaches, conservatives will be forced to say what they will do if returned to power, instead of just what they oppose. Opposing Obama's deficits and spending is all well and good in the abstract, but you can't slash the deficit or lower taxes without specific ideas about what spending to cut. As we'll discuss in Part 3, Tea Partiers, and Americans in general, are susceptible to such vague rhetoric because they have no idea what the government actually spends taxpayers' money on. As Americans become more interested and educated during the upcoming campaign, they will more carefully consider alternatives to Obama's policies, and those policies might not look so un-American anymore.
There was a legitimate debate around the time of TARP (the bank bailout bill) about whether or not taking an ownership stake in companies was a good idea. Just about everyone agreed that letting the banks go out of business would destroy the economy. It was also widely agreed that government cash was the only way that these companies would be kept from closing their doors. Numerous prominent Republicans supported taking ownership in bailed-out banks, including the Bush White House, Senate GOP Leader Mitch McConnell, House GOP Leaders John Boehner and Eric Cantor, along with 89 other House Republicans and 32 other GOP Senators. You can't call Obama a socialist for taking over banks without putting the same label on the GOP. Theirs was not the socialistic goal of achieving government ownership of production; it was to save our (mostly-) capitalist economy.
This claim that Obama took over banks also rings somewhat hollow as he, ya know, wasn't President then.
When Obama actually was President, he applied the same logic that Bush and the GOP leadership (and then-Sen. Obama) did with TARP in bailing out GM and Chrysler. Bush had already allocated billions of dollars to save the two. Obama followed Bush's deal with the banks that, if the federal government was going to share in the risk of loss of billions of dollars, that they should get a share of the potential profits as well.
Another problem with the "Obama-as-Socialist" meme is that he's so bad at it, were that his actual goal. Under Obama's administration, the government has sold back most of the stakes it took in banks, and GM has repaid billions of its debt. His supposed socialist takeover of our health care system expands private insurance much more than it expands government-run plans. In one breath, they criticize Obama as a Socialist who is out to lead a government takeover of the banks, and in the next breath, they say he is in bed with them. They'll twist reality in any way necessary to attack Obama and de-legitimize his policies.
One of my biggest beefs with the Tea Party and the conservative media is that they overemphasize critiques of Obama policies without properly acknowledging the alternatives to those policies. The only alternatives to Obama's action regarding partial ownership of GM and Chrysler were either letting the companies fail by refusing to help them, which would have destroyed millions of jobs, or to give the corporations something for nothing, giving them billions without asking for anything in return. Those alternatives, of course, don't look as good on a sign at a rally as a picture of Obama with a Hitler mustache.
I hold out hope that as November approaches, conservatives will be forced to say what they will do if returned to power, instead of just what they oppose. Opposing Obama's deficits and spending is all well and good in the abstract, but you can't slash the deficit or lower taxes without specific ideas about what spending to cut. As we'll discuss in Part 3, Tea Partiers, and Americans in general, are susceptible to such vague rhetoric because they have no idea what the government actually spends taxpayers' money on. As Americans become more interested and educated during the upcoming campaign, they will more carefully consider alternatives to Obama's policies, and those policies might not look so un-American anymore.
Wednesday, April 28, 2010
What is everyone so angry about? Part 1
Anyone who listens to 2+ hours of conservative talk radio a day like I do can tell you that the Republican Party is defined above all by anger. What's frustrating being a liberal listening to these shows is that the vast majority of that anger is based on claims which are demonstrably false. Over the course of the next several posts, I'll show that Conservative claims that Obama exploded the deficit, that he "shoved ObamaCare down our throats", that we are overtaxed, that Obama is a socialist gobbling up banks and car companies, and that the solution to the deficit is spending cuts are all based on clearly incorrect ideas.
We'll start with Sean Hannity's daily claim that "Obama quadrupled the deficit!" Whenever Hannity is challenged on his frequent claims that Obama is a radical socialist, Hannity trots out this deficit lie as seeming proof of Obama being something peculiar and unprecedented in history. Other presidents have raised or lowered the deficit, the argument goes, but Obama QUADRUPLED it.
Portraying Obama's policies as out of line with any other administration in history is necessary for the conservatives' strategy of resisting absolutely everything the Democrats try to do. You can't refuse to compromise with your opponent unless they are seen as so extreme that even meeting them half-way would be a radical change. Convincing people that Obama quadrupled the debt goes a long way to making him too extreme to be bargained with.
Here's the calculation one has to do to arrive at "quadrupling". In February 2008, Bush's White House projected a deficit for the 12 months from October 2008 through September 2009 to be $407 billion. This number didn't include any of the $150 billion being spent in Iraq and Afghanistan that year, which as part of accounting tricks used to keep the headline deficit number artificially low, were funded via supplemental bills. $407 billion's a dishonest start, but at least it's a start.
In February 2010, Obama projected total debt for Fiscal Year 2010 of $1.6 trillion. As you might be aware, $1.6 trillion divided by $400 billion is 4. A talking point is born.
Of course, kind of a lot happened in the two years between the two budget projections (i.e., guesses about future deficits). Massive unemployment, which led to both a decrease in tax revenue and an increase in demand for government services, along with lost wealth exploded the deficit in the last months of Bush's presidency. In January 2009, before Obama took office, the Congressional Budget Office was projecting a deficit of between $1.2 and $1.3 trillion.
By the time Obama took office, we were losing ~800,000 jobs per month. Obama and the Democrats chose to follow good ol' Econ 101 Keynsian policies, by increasing deficit spending to spur growth in the economy. And so, the projected deficit bumped up by about $400 billion. Which is a lot. I'm not trying to convince you that Obama has been a deficit hawk. But it's only half the increase in the budget deficit that occurred under Bush.
It's much easier to refuse to negotiate with a Marxist than a Keynsian. To try to portray him as the former, Hannity and other conservatives cherry-pick numbers to arrive at claims that are removed from reality. They try to do this in order to further stoke the anger among the Tea Party. As we'll continue to discuss throughout this series, this anger is based on ignorance and misinformation, and is certainly not an appropriate basis for a political party.
We'll start with Sean Hannity's daily claim that "Obama quadrupled the deficit!" Whenever Hannity is challenged on his frequent claims that Obama is a radical socialist, Hannity trots out this deficit lie as seeming proof of Obama being something peculiar and unprecedented in history. Other presidents have raised or lowered the deficit, the argument goes, but Obama QUADRUPLED it.
Portraying Obama's policies as out of line with any other administration in history is necessary for the conservatives' strategy of resisting absolutely everything the Democrats try to do. You can't refuse to compromise with your opponent unless they are seen as so extreme that even meeting them half-way would be a radical change. Convincing people that Obama quadrupled the debt goes a long way to making him too extreme to be bargained with.
Here's the calculation one has to do to arrive at "quadrupling". In February 2008, Bush's White House projected a deficit for the 12 months from October 2008 through September 2009 to be $407 billion. This number didn't include any of the $150 billion being spent in Iraq and Afghanistan that year, which as part of accounting tricks used to keep the headline deficit number artificially low, were funded via supplemental bills. $407 billion's a dishonest start, but at least it's a start.
In February 2010, Obama projected total debt for Fiscal Year 2010 of $1.6 trillion. As you might be aware, $1.6 trillion divided by $400 billion is 4. A talking point is born.
Of course, kind of a lot happened in the two years between the two budget projections (i.e., guesses about future deficits). Massive unemployment, which led to both a decrease in tax revenue and an increase in demand for government services, along with lost wealth exploded the deficit in the last months of Bush's presidency. In January 2009, before Obama took office, the Congressional Budget Office was projecting a deficit of between $1.2 and $1.3 trillion.
By the time Obama took office, we were losing ~800,000 jobs per month. Obama and the Democrats chose to follow good ol' Econ 101 Keynsian policies, by increasing deficit spending to spur growth in the economy. And so, the projected deficit bumped up by about $400 billion. Which is a lot. I'm not trying to convince you that Obama has been a deficit hawk. But it's only half the increase in the budget deficit that occurred under Bush.
It's much easier to refuse to negotiate with a Marxist than a Keynsian. To try to portray him as the former, Hannity and other conservatives cherry-pick numbers to arrive at claims that are removed from reality. They try to do this in order to further stoke the anger among the Tea Party. As we'll continue to discuss throughout this series, this anger is based on ignorance and misinformation, and is certainly not an appropriate basis for a political party.
Tuesday, April 27, 2010
Oklahoma mandates rape before abortion
Today, Oklahoma's legislature passed a law which forces a woman to have a vaginal ultrasound showing her fetus before she is allowed to have an abortion. If you've never had the pleasure of having or at least watching a vaginal ultrasound, let me describe for you the ultrasound probe.
See, you can get a better picture of the fetus if you put an ultrasound emitter into the vagina, where it's closer to the uterus. Some engineer somewhere many years ago had to figure out the best shape to use to enter a vagina. Nature had the same problem and created an erect penis, and our engineer wound up inventing a similarly-shaped device. Having a vaginal ultrasound means getting this penis-shaped probed placed in your vagina. It's fairly unpleasant in a medical setting, as you might imagine. But it gives you a better picture than a traditional ultrasound which places the probe on the woman's abdomen, and sometimes it's medically necessary to get a REALLY good look at a fetus (or gynelogical cancer, or anything else you'd want a good look at).
At the hospitals where I've trained, like hospitals everywhere, they're concerned about passing infections from patient to patient. When it comes to vaginal ultrasound probes, they had to find something to cover the probes as they're being used. At my hospitals, they use condoms. Regular ol' off-the-shelf Trojan condoms.
So Oklahoma just mandated by law that a medical professional put a condom over a penis-shaped object and insert it in a woman's vagina, whether she likes it or not, before that woman can have an abortion.
Government-sanctioned rape; it's not just for war-torn African countries anymore!
As a medical doctor, it strikes me as quite unethical for gynecologists and ultrasound technicians to participate in this. Hopefully the American Congress of Obstetricians and Gynecologists (ACOG) will provide support to its members who don't want to go along with mandated rape.
See, you can get a better picture of the fetus if you put an ultrasound emitter into the vagina, where it's closer to the uterus. Some engineer somewhere many years ago had to figure out the best shape to use to enter a vagina. Nature had the same problem and created an erect penis, and our engineer wound up inventing a similarly-shaped device. Having a vaginal ultrasound means getting this penis-shaped probed placed in your vagina. It's fairly unpleasant in a medical setting, as you might imagine. But it gives you a better picture than a traditional ultrasound which places the probe on the woman's abdomen, and sometimes it's medically necessary to get a REALLY good look at a fetus (or gynelogical cancer, or anything else you'd want a good look at).
At the hospitals where I've trained, like hospitals everywhere, they're concerned about passing infections from patient to patient. When it comes to vaginal ultrasound probes, they had to find something to cover the probes as they're being used. At my hospitals, they use condoms. Regular ol' off-the-shelf Trojan condoms.
So Oklahoma just mandated by law that a medical professional put a condom over a penis-shaped object and insert it in a woman's vagina, whether she likes it or not, before that woman can have an abortion.
Government-sanctioned rape; it's not just for war-torn African countries anymore!
As a medical doctor, it strikes me as quite unethical for gynecologists and ultrasound technicians to participate in this. Hopefully the American Congress of Obstetricians and Gynecologists (ACOG) will provide support to its members who don't want to go along with mandated rape.
Tuesday, February 24, 2009
"State of the Union" Live-Blog
Welcome back to the Doctor's Office in scenic Pittsburgh, PA. I've been meaning to getting back to the blog, and the President's pseudo-State of the Union speech seems as good an entry point as any, so here goes. As usual, I'm watching on MSNBC:
8:58 - Unprofessional move by Chris Matthews, taking a huge whack at Bobby Jindal, the Louisiana Governor, who is giving the GOP response to the President's speech. Says he's "not at all impressed with Jindal". Way to make MSNBC look ridiculous!
9:00 - That reminds me, and just skip to the next one if you don't watch MSNBC kind of a lot, but are you as annoyed as I am with that ridiculous "Hardball" commercial where Matthews says "I hate to teach politics to the experts, but it's fun." in just the jerkiest way possible?
9:04 - Whilst they're still introducing people, let me point you over to an article on fivethirtyeight.com written by a Berkeley linguistics professor about Obama's use of language as unconscious persuasion.
9:08 - Can't they cut out all the slowly introducing people while everyone just sort of mills about and shakes hands with people they've worked with in Congress for 20 years? Isn't there a huge economic crisis y'all could be working on?
9:10 - It's weird, but I still don't really think of Obama as the President. Like, my first-hundredth-of-a-second "how do you think of Barack Obama?" reaction does not include being President. He's still a candidate in my mind.
9:13 - Did Orrin Hatch just grab Obama by the back of the neck? I know he meant it as a friendly gesture, but the man is President!
9:14 - Damn, while typing I apparently missed Hillary kissing Obama (presumably on the cheek). Oh the perils of live-blogging
9:15 - The applauding continuously while the "star" thanks everyone in an attempt to quiet them is strangely "Tonight Show"-ish.
9:16 - Once again Obama steps on a line. He was supposed to wait for Speaker Pelosi to introduce him, but instead started right in on the first few words of his speech.
9:18 - Oh thank God, MSNBC has the opinion meter thingy where two on-screen lines represent how much Obama or McCain voters "like" what he is saying! Now I don't have to worry about forming my own opinion
9:19 - It is oddly hypnotic, though
9:20 - Let's see how smart McCain voters are. He's setting up to trash Bush's policies. I wonder when McCain voters realize it.
9:24 - OK, he didn't go at it nearly as hard as I thought he might. But he definitely gave a few jabs that went unnoticed
9:25 - Aw, look at Joe act all surprised and embarrassed after being complimented by the President. It's like he didn't know it was coming.
9:27 - He's trying to be more optimistic tonight than he's been previously, emphasizing not the "we're in trouble" and more on the "we won't be forever".
9:29 - So why are people worried about nationalizing banks? These banks, by all laws of capitalism, should have gone out of business. But the government stepped in and kept them afloat. So why should people get to keep their shares of a company which should have gone out of business? The only moral argument for people being rich is that the market determined their value to be that high. The market dictates that people who had millions of dollars in Citigroup, AIG etc should have lost their entire investment. So why are we worrying about wiping out the fake "value" of their investment?
9:33 - My oh my, but that opinion meter graph is distracting
9:34 - It's fun when there's a partisan issue that only the Democrats stand up and applaud for. Then you can see a stark representation of their dominant majority in Congress.
9:37 - It's so bizarre to have a President who argues for government, and not calling it the problem.
9:39 - Maybe this is a sign I watch too much sports, but Pelosi is killing Biden at starting standing ovations. Is Biden injured?
9:41 - All this bailout stuff has totally crushed my sense of the value of money in politics. When Obama mentions $15 billion a year for green energy research, my first response is "hmmpf! chump change..."
9:43 - I always thought they rehearsed when to burst into applause. Like, someone would go through the speech with the VP (and Speaker, if they're all the same party) and figure out when to stand up. Pelosi clearly has her own agenda.
9:44 - Isn't it ridiculous that whatever spellchecker this site uses still doesn't recognize "Pelosi" or "Obama"?
9:46 - Thoroughly uninspiring section on health care. I don't have anything to say about it.
9:49 - Having as your national goal reclaiming the highest percentage in the world of the population with college degrees doesn't quite have the inspirational cache of sending a man to the moon
9:51 - He's starting to overuse the "no red or blue states, on the United States"-"not a Democratic issue, not a Republican issue, but an American issue" construction.
9:53 - Oh, in case you didn't hear, the White House announced today that, instead of having all our troops out of Iraq in 16 months, as Obama aimed for during the campaign, he will now aim to have all combat troops out in 19 months. Damn
9:56 - Nice job pointing out the ridiculousness of the Bush policy to not include the costs of the wars in Iraq and Afghanistan when calculating the deficit. That's hundreds of billions of dollars a year that they just didn't include on the supposed "bottom line".
9:57 - Of course, it is not without advantage to Obama to make this change. It's rhetorically easier to double a trillion dollar deficit than triple a half a trillion dollar deficit
10:00 - How sad that I'm glad to hear the President say we don't torture and to believe him. How was that not always a given?
10:05 - Bland, "inspirational" section here. Not really much to say
10:06 - ...so let's talk some more about the audience reaction lines. McCain's voters have pretty consistently been higher than the Obama voters' line. I guess the redliners are trying to be bipartisan or something.
10:08 - In the audience, Ohio Sen. looks like he just had a stroke.
10:09 - He really is pushing hard for the stimulus and budget being mostly things he wants to do anyway (health care, green energy, etc.). Starting out his term going for a home run. OK speech without any particularly memorable moments.
10:13 - Getting ready for Jindal. I honestly don't know why the opposing party always does these. It's pretty much impossible to invent a juxtaposition that makes you look shittier than comparing yourself while standing in an empty office to the Leader of the Free World addressing a joint session of Congress.
10:15 - And Matthews comes around again to dump on Jindal before he even speaks. I really would like it if MSNBC would make at least some effort to separate their opinion people from their news people.
10:24 - Did someone just say "Oh god" under their breath as Jindal came on? Was that Keith?
10:25 - Having never heard him talk in this setting before, I can tell you that my first impression is that he's not very good at this. Neither conversational nor formal. Just kinda silly and fake.
10:29 - Neither he nor Obama have had much in terms of specifics. Such a shame
10:32 - As a doctor, I can tell you that we already have a system where decisions are NOT made by a patient and their doctor. Insurance companies have a lot of say. To state that universal care would ruin a pure patient/doctor relationship is ridiculous
10:33 - Obama voters are not feeling the obligation that McCain voters were to support the other guy. Much lower blue scores for Jindal than red scores for Obama
10:36 - Not great. Nothing memorable from either. I don't think anyone will remember tonight on either side.
8:58 - Unprofessional move by Chris Matthews, taking a huge whack at Bobby Jindal, the Louisiana Governor, who is giving the GOP response to the President's speech. Says he's "not at all impressed with Jindal". Way to make MSNBC look ridiculous!
9:00 - That reminds me, and just skip to the next one if you don't watch MSNBC kind of a lot, but are you as annoyed as I am with that ridiculous "Hardball" commercial where Matthews says "I hate to teach politics to the experts, but it's fun." in just the jerkiest way possible?
9:04 - Whilst they're still introducing people, let me point you over to an article on fivethirtyeight.com written by a Berkeley linguistics professor about Obama's use of language as unconscious persuasion.
9:08 - Can't they cut out all the slowly introducing people while everyone just sort of mills about and shakes hands with people they've worked with in Congress for 20 years? Isn't there a huge economic crisis y'all could be working on?
9:10 - It's weird, but I still don't really think of Obama as the President. Like, my first-hundredth-of-a-second "how do you think of Barack Obama?" reaction does not include being President. He's still a candidate in my mind.
9:13 - Did Orrin Hatch just grab Obama by the back of the neck? I know he meant it as a friendly gesture, but the man is President!
9:14 - Damn, while typing I apparently missed Hillary kissing Obama (presumably on the cheek). Oh the perils of live-blogging
9:15 - The applauding continuously while the "star" thanks everyone in an attempt to quiet them is strangely "Tonight Show"-ish.
9:16 - Once again Obama steps on a line. He was supposed to wait for Speaker Pelosi to introduce him, but instead started right in on the first few words of his speech.
9:18 - Oh thank God, MSNBC has the opinion meter thingy where two on-screen lines represent how much Obama or McCain voters "like" what he is saying! Now I don't have to worry about forming my own opinion
9:19 - It is oddly hypnotic, though
9:20 - Let's see how smart McCain voters are. He's setting up to trash Bush's policies. I wonder when McCain voters realize it.
9:24 - OK, he didn't go at it nearly as hard as I thought he might. But he definitely gave a few jabs that went unnoticed
9:25 - Aw, look at Joe act all surprised and embarrassed after being complimented by the President. It's like he didn't know it was coming.
9:27 - He's trying to be more optimistic tonight than he's been previously, emphasizing not the "we're in trouble" and more on the "we won't be forever".
9:29 - So why are people worried about nationalizing banks? These banks, by all laws of capitalism, should have gone out of business. But the government stepped in and kept them afloat. So why should people get to keep their shares of a company which should have gone out of business? The only moral argument for people being rich is that the market determined their value to be that high. The market dictates that people who had millions of dollars in Citigroup, AIG etc should have lost their entire investment. So why are we worrying about wiping out the fake "value" of their investment?
9:33 - My oh my, but that opinion meter graph is distracting
9:34 - It's fun when there's a partisan issue that only the Democrats stand up and applaud for. Then you can see a stark representation of their dominant majority in Congress.
9:37 - It's so bizarre to have a President who argues for government, and not calling it the problem.
9:39 - Maybe this is a sign I watch too much sports, but Pelosi is killing Biden at starting standing ovations. Is Biden injured?
9:41 - All this bailout stuff has totally crushed my sense of the value of money in politics. When Obama mentions $15 billion a year for green energy research, my first response is "hmmpf! chump change..."
9:43 - I always thought they rehearsed when to burst into applause. Like, someone would go through the speech with the VP (and Speaker, if they're all the same party) and figure out when to stand up. Pelosi clearly has her own agenda.
9:44 - Isn't it ridiculous that whatever spellchecker this site uses still doesn't recognize "Pelosi" or "Obama"?
9:46 - Thoroughly uninspiring section on health care. I don't have anything to say about it.
9:49 - Having as your national goal reclaiming the highest percentage in the world of the population with college degrees doesn't quite have the inspirational cache of sending a man to the moon
9:51 - He's starting to overuse the "no red or blue states, on the United States"-"not a Democratic issue, not a Republican issue, but an American issue" construction.
9:53 - Oh, in case you didn't hear, the White House announced today that, instead of having all our troops out of Iraq in 16 months, as Obama aimed for during the campaign, he will now aim to have all combat troops out in 19 months. Damn
9:56 - Nice job pointing out the ridiculousness of the Bush policy to not include the costs of the wars in Iraq and Afghanistan when calculating the deficit. That's hundreds of billions of dollars a year that they just didn't include on the supposed "bottom line".
9:57 - Of course, it is not without advantage to Obama to make this change. It's rhetorically easier to double a trillion dollar deficit than triple a half a trillion dollar deficit
10:00 - How sad that I'm glad to hear the President say we don't torture and to believe him. How was that not always a given?
10:05 - Bland, "inspirational" section here. Not really much to say
10:06 - ...so let's talk some more about the audience reaction lines. McCain's voters have pretty consistently been higher than the Obama voters' line. I guess the redliners are trying to be bipartisan or something.
10:08 - In the audience, Ohio Sen. looks like he just had a stroke.
10:09 - He really is pushing hard for the stimulus and budget being mostly things he wants to do anyway (health care, green energy, etc.). Starting out his term going for a home run. OK speech without any particularly memorable moments.
10:13 - Getting ready for Jindal. I honestly don't know why the opposing party always does these. It's pretty much impossible to invent a juxtaposition that makes you look shittier than comparing yourself while standing in an empty office to the Leader of the Free World addressing a joint session of Congress.
10:15 - And Matthews comes around again to dump on Jindal before he even speaks. I really would like it if MSNBC would make at least some effort to separate their opinion people from their news people.
10:24 - Did someone just say "Oh god" under their breath as Jindal came on? Was that Keith?
10:25 - Having never heard him talk in this setting before, I can tell you that my first impression is that he's not very good at this. Neither conversational nor formal. Just kinda silly and fake.
10:29 - Neither he nor Obama have had much in terms of specifics. Such a shame
10:32 - As a doctor, I can tell you that we already have a system where decisions are NOT made by a patient and their doctor. Insurance companies have a lot of say. To state that universal care would ruin a pure patient/doctor relationship is ridiculous
10:33 - Obama voters are not feeling the obligation that McCain voters were to support the other guy. Much lower blue scores for Jindal than red scores for Obama
10:36 - Not great. Nothing memorable from either. I don't think anyone will remember tonight on either side.
Tuesday, February 10, 2009
Things Only Government Has Motivation to Do
One of the things about free-market capitalism is that, if there's no one who has an economic incentive to do a particular thing, it's very unlikely that thing will be done. Government, by having vast sums of money (stolen at gunpoint from the people, I'll grant you) along with incentives other than profit, is uniquely situated to perform those tasks in our society which, while beneficial to society as a whole, are not economically beneficial to the performer.
An example is the FDA. Pfizer/Merck/et. al have a huge motivation to get new drugs on the market. They devote billions of dollars a year to development and marketing of new medications. There are few entities, however, who stand to profit by having new drugs not reach the market, or by ensuring that side effects are minimized. Even insurance companies will often not have an economic incentive to stop new drugs; just because a few people might die because of a new med doesn't mean that there's not money to be made by providing it to the other patients who don't have a problem with the med.
In the days before the FDA, anyone could bring any product to market. Since there was no one to oppose new products, we wound up with an era of snake oil salesmen and quack doctors. Eventually, because government had motivation to test and regulate new meds even though they would lose money doing so, we are now relatively protected from potentially harmful products.
Of course, it is imperfect protection. Due to the massive sums of money involved, along with chronic underfunding of the FDA, pharmaceutical companies are still able to ram harmful drugs through the process. Teams of lawyers, marketers, lobbyists and paid researchers line up on one side versus, usually, a single FDA scientist who is tasked with verifying thousands of pages of research on a new medication. And this single scientist is tasked with convincing FDA commissioners who know they have a lucrative drug company job waiting for them if they are perceived as being "industry-friendly" to rule against that industry. So the FDA is not without its problems, but it's better than nothing, which is what we'd get if it were left up to the market.
The economic stimulus, as discussed by President Obama last night, is another example of government stepping in when the market does not provide incentive for changes that benefit society. Because people are afraid of a continuing worsening of the economy, few are spending and investing money. Therefore, the economy continues to suffer, leading to a downward spiral of increasing fear and decreasing spending. A single, private entity isn't going to be the first to jump out to break the cycle; they'd lost all their money. In this market, if a CEO is able to keep his company afloat, he'd probably get huge bonuses, based on the bonuses Wall Street gives to people who drive their companies into the ground. So what's the motivation for this CEO to risk his company's future, even if failing to take that risk hurts the general economy?
It is up to government, therefore, to act. Only government has both the access to resources as well as the motivation to spend those resources now. Only government spending can break the cycle we're in. Giving a few hundred billion in tax cuts isn't going to do it; there's already trillions of dollars in private money that is on the sidelines in this economy, waiting for a sign to jump into the market.
One more place where government can act where no one else has an economic motive to do so is in social programs, an example of which is free condom programs. For lots of reasons (embarassment, not thinking ahead, etc.), young folk often don't use condoms. And society then has to deal with increased numbers of STDs and unintended pregnancies. Based on insurance companies' refusal to provide free condoms, it appears there is no private entity with an economic motivation to give teens free condoms. So it falls to government to do so. Let's hope voters keep giving government non-economic motivation to keep at it.
An example is the FDA. Pfizer/Merck/et. al have a huge motivation to get new drugs on the market. They devote billions of dollars a year to development and marketing of new medications. There are few entities, however, who stand to profit by having new drugs not reach the market, or by ensuring that side effects are minimized. Even insurance companies will often not have an economic incentive to stop new drugs; just because a few people might die because of a new med doesn't mean that there's not money to be made by providing it to the other patients who don't have a problem with the med.
In the days before the FDA, anyone could bring any product to market. Since there was no one to oppose new products, we wound up with an era of snake oil salesmen and quack doctors. Eventually, because government had motivation to test and regulate new meds even though they would lose money doing so, we are now relatively protected from potentially harmful products.
Of course, it is imperfect protection. Due to the massive sums of money involved, along with chronic underfunding of the FDA, pharmaceutical companies are still able to ram harmful drugs through the process. Teams of lawyers, marketers, lobbyists and paid researchers line up on one side versus, usually, a single FDA scientist who is tasked with verifying thousands of pages of research on a new medication. And this single scientist is tasked with convincing FDA commissioners who know they have a lucrative drug company job waiting for them if they are perceived as being "industry-friendly" to rule against that industry. So the FDA is not without its problems, but it's better than nothing, which is what we'd get if it were left up to the market.
The economic stimulus, as discussed by President Obama last night, is another example of government stepping in when the market does not provide incentive for changes that benefit society. Because people are afraid of a continuing worsening of the economy, few are spending and investing money. Therefore, the economy continues to suffer, leading to a downward spiral of increasing fear and decreasing spending. A single, private entity isn't going to be the first to jump out to break the cycle; they'd lost all their money. In this market, if a CEO is able to keep his company afloat, he'd probably get huge bonuses, based on the bonuses Wall Street gives to people who drive their companies into the ground. So what's the motivation for this CEO to risk his company's future, even if failing to take that risk hurts the general economy?
It is up to government, therefore, to act. Only government has both the access to resources as well as the motivation to spend those resources now. Only government spending can break the cycle we're in. Giving a few hundred billion in tax cuts isn't going to do it; there's already trillions of dollars in private money that is on the sidelines in this economy, waiting for a sign to jump into the market.
One more place where government can act where no one else has an economic motive to do so is in social programs, an example of which is free condom programs. For lots of reasons (embarassment, not thinking ahead, etc.), young folk often don't use condoms. And society then has to deal with increased numbers of STDs and unintended pregnancies. Based on insurance companies' refusal to provide free condoms, it appears there is no private entity with an economic motivation to give teens free condoms. So it falls to government to do so. Let's hope voters keep giving government non-economic motivation to keep at it.
Monday, February 2, 2009
Things Only Government Can Do
Driving in Morgantown ,WV (home of WVU and where I'm doing my pediatrics residency) when its snowing can be truly awful. Numerous hospital staff who have worked in Morgantown for decades swear to me that the snowplows don't even come out if school is cancelled that morning. And so, after a 70 mile commute, on a snowy day I spend at least an extra half-hour sitting in traffic on the 2 miles of fairly-major-but-not-Interstate roads between I-79 and the hospital.
Most of my readership probably remembers the widespread blackout in August 2003, where power was lost throughout the eastern United States.
In Kentucky, Americans are dying because of poor infrastructure. Carbon monoxide poisoning was to blame, killing people who were attempting to warm their homes that were left without electricity during record cold.
And then there's the 13 Americans who, like me and presumably you, take the risk to drive across a bridge every day lost their lives when the I-35W bridge in Minneapolis collapsed into the Mississippi River.
The American Society of Civil Engineers (i.e., people who are the experts when it comes to this sort of thing) give the existing infrastructure in the United States a "D" grade. They estimate that it would cost $2.2 trillion to get our roads, power lines and other infrastructure up to code.
As someone who loses hours to traffic, is more productive with electricity powering my workplace and my computer, and doesn't want to drown in my Honda, I really wish our leaders, knowing that they A) are tasked with creating jobs (and/or allowing private industry to create jobs) for millions of Americans, and B) have to maintain and improve the infrastructure that allows Americans to be productive and live modern lives, could figure out a way to get millions of Americans working on maintaining and improving infrastructure.
Most of my readership probably remembers the widespread blackout in August 2003, where power was lost throughout the eastern United States.
In Kentucky, Americans are dying because of poor infrastructure. Carbon monoxide poisoning was to blame, killing people who were attempting to warm their homes that were left without electricity during record cold.
And then there's the 13 Americans who, like me and presumably you, take the risk to drive across a bridge every day lost their lives when the I-35W bridge in Minneapolis collapsed into the Mississippi River.
The American Society of Civil Engineers (i.e., people who are the experts when it comes to this sort of thing) give the existing infrastructure in the United States a "D" grade. They estimate that it would cost $2.2 trillion to get our roads, power lines and other infrastructure up to code.
As someone who loses hours to traffic, is more productive with electricity powering my workplace and my computer, and doesn't want to drown in my Honda, I really wish our leaders, knowing that they A) are tasked with creating jobs (and/or allowing private industry to create jobs) for millions of Americans, and B) have to maintain and improve the infrastructure that allows Americans to be productive and live modern lives, could figure out a way to get millions of Americans working on maintaining and improving infrastructure.
Thursday, January 29, 2009
Is the Republican Party Doomed?
Rachel Maddow was up in arms yesterday on her show about the President's stimulus bill that was passed by the House. Despite efforts by the President to include elements in the bill to appeal to Republicans (tax cuts, etc.) at the expense of more spending on infrastructure, alternative energy and unemployment benefits, not one Republican voted for the bill. Not one. Amazing...
How is it possible that every single one of the 178 Republicans held together to oppose the bill? Even with Obama's popularity, eleven Democrats went against him on this one. And yet no GOPer had the gall to oppose the mighty John Boehner. I suppose this is due to circling the wagons when under attack, along with the fact that only the Republican-est of Republican districts elected Republicans this time around.
So what can be done to fight such solidarity among the GOP in opposition to Obama's attempts at bipartisanship? What can we derive from the saga of the stimulus plan regarding Obama's plan for doing so? It would appear that, as Ms. Maddow fears, that the President screwed up. He gave the Republicans part of what they wanted and yet got not one single vote in return. I have an alternative and more hopeful interpretation.
The outcome of Congressional votes is seldom in doubt. Most times, the exact vote of every single Congressman is known beforehand. Rahm Emanuel, Obama's Chief of Staff, surely knew that, despite their concessions, they wouldn't have any GOP support. And yet the Democrats decided to include the tax cuts in the bill. This is part, I think, of a plan by the Administration to crush the Republican Party once and for all.
It's important to Obama's popularity that he be seen as a new sort of politician. He can't be seen as a blithely partisan figure. He has to make these sorts of attempts to build bipartisan consensus. He still manages to have the stimulus be seen as an entirely Democratic accomplishment, but he now has the added advantage of making the Republican Party look ridiculously obstructionist and out-of-touch, refusing to give even one vote in exchange for substantial concessions by the President.
If the economy recovers by November 2010, the Republicans are doomed. Like, Whig- and Federalist-level doomed. They're already down 77 in the House, and 18 in the Senate, with way more Republican Senate seats up for re-election in 2010 than those currently held by Democrats, meaning they are more likely than not to lose even more seats. A growing economy after an all-Democrat stimulus bill means they will lose so many more seats that they will become irrelevant.
How is it possible that every single one of the 178 Republicans held together to oppose the bill? Even with Obama's popularity, eleven Democrats went against him on this one. And yet no GOPer had the gall to oppose the mighty John Boehner. I suppose this is due to circling the wagons when under attack, along with the fact that only the Republican-est of Republican districts elected Republicans this time around.
So what can be done to fight such solidarity among the GOP in opposition to Obama's attempts at bipartisanship? What can we derive from the saga of the stimulus plan regarding Obama's plan for doing so? It would appear that, as Ms. Maddow fears, that the President screwed up. He gave the Republicans part of what they wanted and yet got not one single vote in return. I have an alternative and more hopeful interpretation.
The outcome of Congressional votes is seldom in doubt. Most times, the exact vote of every single Congressman is known beforehand. Rahm Emanuel, Obama's Chief of Staff, surely knew that, despite their concessions, they wouldn't have any GOP support. And yet the Democrats decided to include the tax cuts in the bill. This is part, I think, of a plan by the Administration to crush the Republican Party once and for all.
It's important to Obama's popularity that he be seen as a new sort of politician. He can't be seen as a blithely partisan figure. He has to make these sorts of attempts to build bipartisan consensus. He still manages to have the stimulus be seen as an entirely Democratic accomplishment, but he now has the added advantage of making the Republican Party look ridiculously obstructionist and out-of-touch, refusing to give even one vote in exchange for substantial concessions by the President.
If the economy recovers by November 2010, the Republicans are doomed. Like, Whig- and Federalist-level doomed. They're already down 77 in the House, and 18 in the Senate, with way more Republican Senate seats up for re-election in 2010 than those currently held by Democrats, meaning they are more likely than not to lose even more seats. A growing economy after an all-Democrat stimulus bill means they will lose so many more seats that they will become irrelevant.
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