Tag Archives: Washington Post

Obama Cuts Deal To Reduce Social Security, Medicare, Medicaid

Hopes for any pretense of liberal change from the Obama administration collapsed yesterday, and not only because of the election in Massachusetts. While the Massachusetts voters were casting their ballots to install the upstart Republican Scott Brown to Ted Kennedy’s Senate seat, the White House was hammering out a closed-door deal to cut entitlements. Obama won the support of Democratic leaders for a plan to issue an executive order that would inevitably lead to reductions in Social Security, and especially Medicare and Medicaid.

The plan represents a capitulation to conservatives in both parties, and would leave Democratic liberals accepting unconditional surrender not only on health care, but on the most basic of all New Deal programs.  As hopes of even a tepid health care reform wane, the effect of this  plan, if accepted by Congress, will be to undermine the only single-payer health care programs this nation has ever known–Medicare for elders, and Medicaid for the poor. As an attack on entitlements, it has the potential to go beyond anything the Reagan and Bush administrations were able to achieve.

As the Washington Post explains this morning:

Under the agreement, President Obama would issue an executive order to create an 18-member panel that would be granted broad authority to propose changes in the tax code and in the massive federal entitlement programs — including Medicare, Medicaid and Social Security — that threaten to drive the nation’s debt to levels not seen since World War II.

The accord comes a week before Obama is scheduled to deliver his first State of the Union address to a nation increasingly concerned about his stewardship of the economy and the federal budget. After a year in which he advocated spending hundreds of billions of dollars on a huge economic stimulus package and a far-reaching overhaul of the health-care system, Obama has pledged to redouble his effort to rein in record budget deficits even as he has come under withering Republican attack.

The commission would deliver its recommendations after this fall’s congressional elections, postponing potentially painful decisions about the nation’s fiscal future until after Democrats face the voters. But if the commission approves a deficit-reduction plan, Congress would have to act on it quickly under the agreement, forged late Tuesday in a meeting with Vice President Biden, White House budget director Peter R. Orszag, and Democratic lawmakers led by Senate Majority Leader Harry M. Reid (Nev.), House Speaker Nancy Pelosi (D-Calif.) and House Majority Leader Steny H. Hoyer (Md.).

Senate Budget Committee Chairman Kent Conrad (D-N.D.), who has long advocated creation of an independent budget panel, called the agreement an “understanding in concept” that holds the promise of at last addressing the nation’s most wrenching budget problems.

“This goes to the question of the country’s credibility with managing its own finances. This is essential for the nation,” Conrad said.

The commission is likely to form the centerpiece of Democrats’ efforts to reduce projected budget deficits, which have soared into record territory in the aftermath of the worst recession in a generation. Government spending to bail out the troubled financial sector and to stimulate economic activity have combined with sagging tax collections to push last year’s budget deficit to a record $1.4 trillion. The budget gap is projected to be just as large this year and to hover close to $1 trillion a year for much of the next decade. 

In other words: The national treasury has been driven into deep deficits by a financial crisis caused by Wall Street greed, compounded by two wars, tax cuts for the rich, and the high prices charged by health care profiteers. And where will we turn to make up for this loss? To the poor and the old, who cling greedily to their “entitlements.”

The claim is made that we need to make these entitlements “solvent” and “sustainable” in their own right, so they don’t “run out of money”–but that’s just political flim-flam. Social Security is in fact perfectly solvent, and the fiscal problems of the Medicare and Medicaid programs stem from the excesses of profit-based health care. If cuts are made to these programs, which have saved millions of Americans out of desperate straits, it will be because there’s simply no political will to do anything else to address the deficit.

All this represents a major victory for the corporate take-over mogul Pete Peterson whose foundation has put up $1 billion to lobby the proposal. His efforts have even involved  a financial news service that pushes this rich man’s plan, and that  has wormed its way into the Washington Post.  William Greider, who has long been covering the Peterson story, writes in The Nation:

The retired mogul has created a digital news agency he dubs “The Fiscal Times” and hired eight seasoned reporters to do the work there. “An impressive group of veteran journalists,” Peterson calls them. I hope they have shaken a lot of money out of this rich geezer. Because I predict doing hack work for him will seriously soil their reputations for objectivity and independence.

With his great wealth, Peterson could have also bought a newspaper to publish his dispatches, but he did better than that. He hooked up with the Washington Post, which has agreed to “jointly produce content focusing on the budget and fiscal issues.” (This media scandal was first uncovered by economist Dean Baker.) The newspaper is thus compromising its own integrity. It’s like buying political propaganda from a Washington lobbyist, then printing it in the news columns as if it was just another news story. Shame on the Post, my old newspaper. I predict a big stink like the one that greeted the Post when its publisher decided to hold pay-for-access “salons” for corporate biggies.

The deal is based on rickety interpretation of the country’s basic laws governing taxation.  Normally, any change in taxes must be passed first by the House, with legislation wending its way through the Ways and Means Committee up to the floor. This proposed arrangement short cuts—indeed appears to bypass—this procedure. The appointed commission is to make a recommendation on the budget after the election and that recommendation then goes straight to Congress where it might go through hearings,floor debate and a vote,or as some proponents of the idea would like, just get an up or down vote. To rub salt in the wounds, it was largely crafted not by members of the House, but by vice president and former Delaware senator Joe Biden along two senators–Kent Conrad, the North Dakota Democrat, once considered heir to the Great Plains progressive tradition, and conservative Judd Gregg, from New Hampshire. The man behind the commission plan is Pete Peterson.

The National Committee to Preserve Social Security and Medicare, which has been fighting against the creation of the commission, recently sent a letter to Congress, saying in part: 

We appreciate the concerns of legislators who are looking for a means of reducing the federal deficit and slowing the growth in the debt. However, we have significant concerns about any process – including the Conrad-Gregg Commission – that would disenfranchise American voters and subject Social Security beneficiaries to harmful cuts in benefits. As supporters of Social Security, we are surprised to see the federal deficit and the federal debt cited as the reason a commission needs to be established to make cuts in Social Security. The truth is that neither the $1.4 trillion deficit nor the nearly $12 trillion debt has anything to do with Social Security benefits.   

For nearly three decades, Social Security has taken in more revenue each year than it has paid out in benefits. These excess funds have been invested in special issue U.S. government securities. Thus, Social Security has effectively been loaning its excess funds to the federal government to spend on other programs. Rather than increasing the federal deficit, Social Security’s annual surpluses have actually been covering up the true size of the deficit in the general fund.

 

Washington Post Calls for Abolition of Solitary Confinement

An editorial in Saturday’s Washington Post, called “Solitary Disgrace,” calls for an end to the widespread use of long-term lockdown in America’s prisons and jails. The Post‘s editors write:

At one time shunned in the United States, solitary confinement is becoming a tool increasingly used by corrections officials trying desperately to keep order in grossly overcrowded and sometimes chaotic prisons. These decisions are made even though solitary confinement costs roughly twice as much as keeping an inmate in the general prison population. At any given time, experts estimate that 25,000 to 100,000 prisoners are kept in some sort of “special housing unit” where they are isolated and kept apart from the general prison population. The number changes frequently as new prisoners are sent in and others sent out of solitary….

A short stint in solitary for most does not result in serious or permanent harm. But more prolonged stays of months or years — a practice not uncommon in many states — can result in devastating psychological damage, including psychosis and debilitating depression. Studies have also shown that inmates kept in solitary confinement for prolonged periods display higher levels of hostility than those in the general prison population; they tend to carry this hostility with them after they are returned to the general prison population or released back into the community.

I’ve been writing for some time about the case of the Angola 3, the Louisiana prisoners who have been held in solitary for as long as 37 years. Lawyers for Albert Woodfox, Herman Wallace, and Robert King have for years been working on a case that challenges this kind of long-term solitary confinement on the grounds that it is cruel and unusual punishment, in violation of the 8th Amendment to the Constitution. That case is expected to at last come to trial early next year, and should shed additional light on the true toll of life in lockdown.

Ironically, the issue of solitary confinement only becomes more pressing as some states gradually lose their taste for the death penalty, and offenders languish indefinitely in complete isolation, either on death row or in other lockdown units. Yet even among progressives, the practice has never received the same kind of attention or protest as the treatment of terrorism suspects abroad. The fact that this subject even made it onto the editorial pages of one of our so-called newspapers of record suggests some growing recognition that solitary confinement is a form of torture, and that we have our own Guantanamos and Abu Ghraibs to deal with here at home.

The Shape of Health Care to Come:The Federal Employees Plan

As I have written previously, the most likely upshot of the health care debate is for Congress to adopt some version of the FEHBP, the federal employee’s health benefits program. Some people are calling the FEHBP a “public option,” but that’s not what it is. In fact, it doesn’t even contain a public option. The whole reason it might be acceptable to conservatives is that it keeps the private insurance system intact, and is subject to the so-called invigorating winds of free market economics. As described by Physicians for a National HealthProgram, FEHBP “is actually a mix of private health insurance plans that carry the same problems of private plans generally: administrative waste, restrictions on health care providers, inequities and inadequate cost controls.”

In fact, the FEHBP was proposed back in the 1980s as an alternative to Teddy Kennedy’s universal health insurance campaign, by none other than the Heritage Foundation. So its credentials are spotless, or ought to be spotless in the eyes of mainstream and rightwing Republicans. Not even Dick Armey’s gang of patriots, agitating at town hall meetings, could call Heritage as a socialist institution.

The FEHBP does require private insurance plans to meet certain standards, which could represent some small improvement over the present system, provided it survives as part of the final health reform plan. But the best plans offered under FEHBP aren’t cheap, requiring steep contributions from the employee–so it also preserves the present system of unequal care depending on income.

Yesterday, in a Washington Post web discussion, a federal employee living in Maryland had this exchange with Steven Pearlstein, one of thenewspaper’s business writers. It helps in explaining how the plan might work, in a best-case scenario:

Federal employee: I have a choice among many possible insurance plans. I have chosen one of the more expensive ones (I pay a little over 30% of the premiums) and have been very pleased thus far with the range of doctors that I can access and especially the speed with which my claims are processed. I recently called to ask if a procedure had been pre-approved and was informed within just a few seconds that my plan did not require pre-approval for that procedure. It is clear that the computers at the other end are online and the people answering questions are well-trained. Last year a scheduler at a testing center nearly cried with relief when she heard what my insurance plan was.

I presume that I get this excellent service in part because if I had a bad experience, I could switch to another provider during the open plan period. Unlike a person working for a private employer with a choice of perhaps two or three plans both from the same provider, who would have to appeal to the deaf ears of the employer’s HR department, my choice is meaningful. I might have to wait out 13 months in a plan I didn’t like, but that is it. No worries about pre-existing conditions, or qualifying for coverage or anything.

So, could this model actually work for the uninsured pool of people? Could the government demand that the insurance companies offer the same plans available to federal employees to the pool of uninsured or not let them participate in the program? Could it just be negotiated that way since the potential pool is so large and the premiums will be subsidized for some? Could non-profit cooperatives have the clout to get this?

Or do I only get service this good because the Senators and the Representatives are in the same plan that I am (or at least their staff are) and the insurance companies treat us better so they don’t make the powerful people who share our plans angry?

Steven Pearlstein: The Federal Health Plan provides the model for the so-called exchanges that are at the center of the Democrats’ health reform proposal. Everyone who buys insurance through the exchange would basically have the kind of choices you do, and be able to move around from plan to plan in a way creates an ongoing competition among the plans, not only on the issue of price but quality of service and depth of network, etc. That is the kind of competition that will improve the whole system and, to a degree, help to bring down cost growth.

More on Congress’s Addiction to the Drug Lobby

The Washington Post this morning prints an lengthy article and elaborate chart showing the numbers of drug lobbyists at work on the health reform legislation. This list includes a little congress in itself of former aides and members that only lots and lots of money could buy.

The nation’s largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues, according to an analysis of lobbying disclosures and other records.

The tactic is so widespread that three of every four major health-care firms have at least one former insider on their lobbying payrolls, according to The Washington Post’s analysis. Nearly half of the insiders previously worked for the key committees and lawmakers….

The hirings are part of a record-breaking influence campaign by the health-care industry, which is spending more than $1.4 million a day on lobbying in the current fight, according to disclosure records. And even in a city where lobbying is a part of life, the scale of the effort has drawn attention. For example, the Pharmaceutical Research and Manufacturers of America (PhRMA) doubled its spending to nearly $7 million in the first quarter of 2009, followed by Pfizer, with more than $6 million.

Valuable as this information is, you have to wonder whether the paper would have published any of this without Politico’s expose of publisher Katherine Weymouth‘s audacious plan to hold a salon where, in exchange for fees running as high as $250,000, from the lobbyists, she would bring the paper’s reporters, key administration sources, and other notables to her home for a private confab on health care—like a little closed committee session, if you will, where the Post could facilitate Obama’s reform on industry’s terms. Once the plan was made public Weymouth cancelled the salon and apologized.

Throw Granny from the Train: The Washington Post Gives a Boost to Age-Based Health Care Rationing

Two pieces on the front page of the Washington Post’s Sunday “Outlook” section go a long way toward illustrating what’s wrong with the  terms of current debates around health care costs and health care for the elderly. The juxtaposition of these two commentaries, which appeared side-by-side under a photo of a sunset and the heading “The Dying of the Light,” sends an insidious message about the need for “rationing” treatment to the very old and very sick: To keep health care costs from bankrupting our society, it suggests, we may have no choice but to pull the plug on the geezers.

The Post feature is only the latest of a growing volume of commentary on so-called age-based health care rationing. Even beyond any core ethical questions, the problem with these discussions is what they too often fail to mention: the role of private profits in creating, or at least seriously exacerbating, the supposedly intractable problem of health care costs. Like everything else in the public debate over health care policy, the “dying of the light” has become subject to the lying of the right, where corporate interests trump even questions of life and death.

There’s nothing inherently objectionabale about one of the two pieces, written by doctor at a Minneapolis hospital who cares for “patients struggling through the winter of their lives.” Craig Brown writes:

Today, thanks to myriad medications and interventions that have been created to improve our health and prolong our lives, dying has become a difficult and often excruciatingly slow process.

The author questions the prevailing practice of using extreme measures to prolong the lives of the “threadworn elderly,” when “what’s waiting for them at the end of this illness is just another illness, and another struggle.” Mercy, he says, demands that we change our attitude and our approach toward death. I’ve got no argument with this, which is why I support end-of-life choice for the chronically and terminally ill.

Craig Brown is careful to say that “nothing in my medical training qualifies me to judge what kind of life is satisfying or worth living.” He also states clearly that his position “isn’t about euthanasia. It’s not about spiraling health care costs. It’s about the gift of life–and death. It is about living life and death with dignity, and letting go.”

The same is not true of Post health and science reporter David Brown (also a physician), who wrote the companion piece. He points out that health care costs are growing faster than the economy, due largely to advances in medical care. “Each year, there’s more that can be done and more that’s judged worth doing”–and it’s all terribly expensive. At the same time, life expectancies are lengthening and the population is aging. As a result, he says:

We are on a collision course between our wish to live longer, healthier lives and our capacity to pay for that wish. Whether we can somehow avoid the collision is perhaps the most important domestic issue of this century. From now on, health care costs will be up there with globalization, terrorism and climate change as a force shaping our world.

While David Brown doesn’t blame this all on old people, per se, he does point to the growth in Medicare’s costs, and warns that “unless something changes, in about 75 years, Medicare alone will cost as much as the sum of all our federal income taxes.” And while he says he has no solution to offer that will “rescue us from the Malthusian Spectre of health care spending,” the implicit solution is clear–if not from the article itself, then from its placement alongside Craig Brown’s piece on the tormented lives of the chronically ill elderly. The obvious way to slow our progress toward economic and social destruction is for old folks to stop having all those expensive interventions and just give up the ghost. And if the geezers won’t make the decision to do this voluntarily–well, then, society might have to make it for them.

In blog for the American Prospect, Dean Baker of the Center for Economic and Policy Research lays out why the underlying terms of this debate are fatally flawed. Criticizing David Brown’s Post piece for “telling readers that there is nothing we can do about health care costs,” Baker writes:

Remarkably, this lengthy column never once notes the fact that the United States pays more than twice as much per person for health care than the average of the other wealthy countries, all of whom enjoy longer life expectancies.

This is a hard to overlook piece of evidence suggesting that the United States could do a great deal to lower its health care costs. Among other things, we have a hugely wasteful insurance system (noted in the column), pay close to twice as much for prescription drugs as people in other wealthy countries, and pay our medical specialists close to twice as much as they earn in other wealthy countries.

Overpaying for drug and doctors not only directly wastes money by causing us to pay more for the same services. The huge rents created by these over-payments leads drug companies and specialists to find ways to promote excessive use of their products and services. The result is really bad and really expensive medicine.

Studies comparing health care in the United States and other industrialized countries–including those conducted by the World Health Organization, Congressional Research Service, Kaiser Family Foundation, and Commonwealth Fund–consistently find dramatically higher spending in the U.S. (both per capita and as a percentage of GDP), and poorer performance on a host of important health measures, from life expectancy to infant mortality to medical errors. All of these other countries, of course, have public single-payer health care systems, while we have medicine for profit.

I’m as public spirited as the next person, and I have a Gen-X son. So I’d like to think I’d be willing to give up some expensive, life-prolonging medical treatment if the future of humanity depended upon it. But I’m certainly not going to do it so that some pharmaceutical company executive can take another vacation in Bora-Bora, or so that an elected official can get another big campaign contribution from the insurance industry.

So here’s my advice to anyone who suggests that American geezers should do the right thing and accept age-based health care rationing: Institute a single-payer system, cut our national health care costs in half–and then get back to me.

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