June 24, 2005
Home Sweet Home
Devoted readers of this page have noted that for the past two months my girlfriend and I have been traveling from Hong Kong to Istanbul through Central Asia: China, Kazakhstan, Kyrgyzstan, Azerbaijan, Georgia and Turkey. Interest in Willard's 2008 ambitions was slight in Turfan; Massachusetts health care policy was not the talk of the town in Bishkek; and U.S. takings policy was little discussed in Istanbul, so my postings dropped off.
What? You didn't notice? Well, surely the fact that BMG's commentary has tightened to laser fineness and our signal-to-bloviation ratio has plunged in the last 60 days did not escape your attention. Welcome back to the Good Old Days.
The first thing I have to report is that U.S. citizens should feel free to hop on a jet and travel to any of these delightful countries. Fox News would have you believe that the reservations clerks at Kyrgyz Airways will take your measurements for orange jumpsuits when they book your ticket, and Tiny Donald and his cohorts at the Department of Fear urge patriotic Americans to spend their lives in homes sealed with duct tape, emerging only to work for large corporations and vote Republican. In fact, however, if you travel -- even to Muslim nations on the front lines of the WOT -- you will likely find, as we did, that you can freely identify yourself as a U.S. citizen and will be treated with the utmost of hospitality.
More, perhaps, on current goings on in these countries, from post-revolutionary Bishkek, still gutted in parts from the violence of a few months ago; to the U.S. airbase with 1,200 airmen at Kyrgyzstan's main airport; to the anti-Soros movement in Tbilisi; to the abandoned Cold War watchtowers on Turkey's eastern border, at a later date. Let me know if you are interested.
On to first impressions of our sunny summery Olde Towne after a few months in the Second and Third Worlds. First, the relative wealth of this country is stunning. In much of the world ordinary people struggle to get enough to eat every day. No one appeared to be starving in the countries we visited, but a lot of people were spending a very large amount of time and effort for a pittance -- by which I mean enough to buy carbohydrates for the next 24 hours. In Xinjiang, for example, many break rocks into gravel by hand for their daily noodles; in Georgia farmers use hand scythes to cut hay. It makes one feel a bit twisted inside, in this context, to step into a pet laundromat the first day back where the starting price for a self-service dog wash is $15. I don't fault the proprietors or the customers of this fine establishment, but I can understand how the father of four breaking rocks all day in the blazing sun for $0.75 might feel a bit resentful.
Second, the degree to which the U.S. is obsessed by race is unique. Newspaper headlines blare examinations of racial differences, racial healings, racial tensions, racial crimes, convictions, cures ... Most other countries, by circumstance, neglect, oppression, or homogeneity, avoid these discussions entirely. Their lines form around other expedients.
Third, the weight. Our country, through genetics, diet, or sloth, contains an unusual number, relative to many countries, of very large people. It is only when one travels that one realizes the degree to which the obesity epidemic has permeated our entire society. We went to many supermarkets on our trip, for example, and in not one did I spot any low-calorie, low-fat or sugar-free foods -- except for Orbit gum by Wrigley's of Chicago.
Finally, the cars. Private cars were little used in most of the places we visited, except in relatively affluent Almaty and Istanbul, and the cities on China's coast. Buses, trucks, taxis and trains were plentiful but single-driver sedans infrequent. The result? Not a single traffic jam for us from one end of Asia to the other.
Et tu, NY Times?
The fallout from yesterday's Supreme Court decision on eminent domain continues (Kelo v. City of New London). Today the NY Times editorial page weighs in, describing the Court's action as "a welcome vindication of cities' ability to act in the public interest."
In light of the scathing and surprisingly universal condemnation of the case from the left and the right, the Times is remarkably sunny about it - actually, the Times's commentary is the most positive I've seen other than the lawyer who argued the case for the city. The Times gives what the city was doing every possible benefit of the doubt, and dismisses the dissenters' worries of transferring property from less influential folks to more influential folks as "exaggerated."
Gosh, what do you think might account for the Times's attitude here? Doesn't the "liberal" NY Times usually stand up for the little guy in the face of aggressive governmental action? Here's a clue: the Times notes in its editorial that it "benefited from eminent domain in clearing the land" for its new building near the Port Authority terminal. What actually happened was a lot worse than that.
The short version is this (the Village Voice has the long version here): a couple of years back, the NY Times decided it wanted to build a big shiny new headquarters. And it wanted to built it on Eighth Avenue near the Port Authority terminal in Manhattan. Unfortunately, other people owned some of the land - Scot Cohen, for example, who owned B&J Fabrics, a family business that had been there for almost 50 years. To get the land owned by Cohen and others, the Times resorted to what is now apparently the Supreme Court approved American way: it used its political influence, and that of its developer, to work a deal with the city and state whereby New York's economic development agency would take the land and reconvey it to the developer on extremely favorable financial terms. Sound familiar? The Times got slammed by the left, the libertarians, and the right for its conduct.
Here's the hilarious part: at the time, a communications professor noted that the Times's involvement might "undermine the Times' ability to criticize similar arrangements between government and business." The Times, of course, insisted that its journalistic and editorial operations were pristine and could not possibly be influenced by what its business folks were up to: "This real estate transaction does not compromise the independence or credibility of the Times editorial voice or the integrity of the Times reporting in any way. Our business and news functions operate separately." Oopsie.
This issue is not about "liberal" or "conservative" politics. It's about big corporations with a lot of money and influence - like Pfizer in New London or the NY Times in Manhattan - deciding they want property held by people or businesses with less money and influence. Does it serve the cause of "economic development"? Sure, because the big guys will always build bigger buildings, or bigger houses, and that will always result in bigger tax payments. So the city gets more money in its coffers, the big guys get the land they want, and everybody wins - except anyone who thought that there might, somewhere, be a limit to how badly the government can treat its citizens.
IMHO, this is a hugely important decision, maybe the most important since Bush v. Gore. The Ten Commandments cases set to come down on Monday may get more attention, but really, who cares whether some stupid city council wants to post the Ten Commandments in a courthouse or not. It pisses people off (including me), but it doesn't really hurt anyone. This eminent domain business, in contrast, is about EVERYONE. Your home, or mine, could be next. So with Bush v. Gore, the Court is 0 for 2 in recent cases that truly affect the lives of everyone in the Unites States. Not too impressive.
UPDATE: The Washington Post also editorializes in favor of the Kelo decision, although in much more muted tones that the NY Times. The Post's position is that, yeah, this sucks, but there's no way to draw a line, so the Court had no choice. To which I say: what a cop-out. Anyone can decide the easy cases. We pay judges nice salaries, build them nice buildings, and give them large amounts of power so that they can decide the hard cases, bringing their years of learning and accumulated wisdom to bear on the difficult questions that come before them. So don't give me this "oh, we can't figure out how to draw the line, so let's just let the government do anything it wants" crap. The line Justice O'Connor proposes in her dissent (OK to take "blighted" property, but not OK to take property just for "economic development") seems like a reasonable start, and I'm sure there are other possibilities. If the "public use" portion of the Fifth Amendment is to have any meaning (and most people agree that it should), courts will have to draw the line, difficult task though that may be. If they shirk from that responsibility, they are simply not doing their job.
June 23, 2005
When good judges go bad
Today the Supreme Court decided, by a 5-4 vote, that your city council can decide that it would rather have a Wal-Mart occupying the land that your home and the homes of your neighbors currently occupy because Wal-Mart will generate more tax revenue. And if you don't want to sell, the city can "take" your land, and then give it to Wal-Mart to do with it what it pleases (of course, you will receive someone's version of "fair market value" for your trouble). And there's not a thing you can do about it. (The case is called Kelo v. City of New London.)
Here is the Court's description of the property at issue in the case:
Petitioner Susette Kelo has lived in the Fort Trumbull area since 1997. She has made extensive improvements to her house, which she prizes for its water view. Petitioner Wilhelmina Dery was born in her Fort Trumbull house in 1918 and has lived there her entire life. Her husband Charles (also a petitioner) has lived in the house since they married some 60 years ago.... There is no allegation that any of these properties is blighted or otherwise in poor condition; rather, they were condemned only because they happen to be located in the development area.
And yet, the Court concludes, the city's determination that the cause of "economic development" would be served by transferring this land to different private owners - namely, Pfizer Corporation - was "rational," and "economic development" is a traditional function of government, so it's OK to force these people to sell their homes.
Excuse me, but WHAT COUNTRY ARE WE LIVING IN?? Justice O'Connor's dissenting opinion is excellent, and (to me) totally convincing. Go read it - she explains why the Court's decision is wrong better than I could. Money quote:
Any property may now be taken for the benefit of another private party, but the fallout from this decision will not be random. The beneficiaries are likely to be those citizens with disproportionate influence and power in the political process, including large corporations and development firms. As for the victims, the government now has license to transfer property from those with fewer resources to those with more. The Founders cannot have intended this perverse result.
Amen. Scary stuff, but you know it's true.
Oh - the title of this post. One of the saddest things about this case is that the five-member majority consists of Justices Stevens, Souter, Ginsburg, and Breyer - traditionally the "liberal" votes - along with Justice Kennedy. Those four Justices are usually the ones we lefties expect to stand up for our side. How horrifying that not one of them could see how wrong this decision is.
UPDATE: A commenter at Daily Kos has this totally hilarious take on the decision: "Ownership Society? Nah, call it the OwnershiT society, because after this ruling, we don't own shit." Interestingly, though there's some disagreement, I'd say the majority of the comments over at Kos (most of which are presumably written by liberals) are clearly against this decision. And many of them are stunned to find themselves in agreement with the "conservative" Supreme Court Justices. Labels like "liberal" and "conservative" are not particularly useful when it comes to jurisprudence, and we'd all be better off finding a different vocabulary to talk about judges.
June 22, 2005
Who wasn't at yesterday's health care forum?
I solicited some comments from the GBIO folks who went to the Blue Cross Blue Shield Foundation's health care forum yesterday. This is from Brother Jack Rathschmidt:
Once again, the poor, the uninsured, people of color and cultures other than our own were not represented at today's gathering at JFK library. An important, informative meeting, but lacking the people who are most effected by today's meeting. I was very impressed with the quality of the research from the Urban Center folks, nevertheless, there is little input evident from the people most effected. That our Governor continues to suggest that we won't need new revenues to fund health care for all is getting very old.
The folks where I live in Jamaica Plain tell me that that are 40 to 50%
of Latinos that are uninsured. Where were they today? Who is listening
Does this post make my thumbs look big?
So... David described my post last night about Our Gov's "Insure Yourself or Else" health care plan as a "big thumbs up!". Uh... I don't know how many more commas, dependent clauses, and umms or errrs I can add to make clear my ambivalence and conditional-ness about one small aspect of his plan ... but I guess it wasn't enough for my esteemed lawyer co-blogger. (That's a joke, folks -- and David can handle it. Try him!)
And look, who could get enthusiastic about statements like this from the Governor:
''No more 'free riding,' if you will, where an individual says: 'I'm not going to pay, even though I can afford it. I'm not going to get insurance, even though I can afford it. I'm instead going to just show up and make the taxpayers pay for me,' " Romney told reporters after a healthcare speech at the John F. Kennedy Library.
I might have a finger up for that remark, but it ain't my thumb. "Out of touch" doesn't really begin to describe it, does it? You think Mitt knows what milk costs these days?
My point about Romney's mandate for individual coverage was very, very limited -- no big thumbs up or dopey grin here:
It was only that mandating coverage for individuals is indeed one way to pool risk, which is a critical part to making insurance work for everybody. (
Ed's comment in David's thread is on-target and also happens to be funny. Oops, looks like I didn't understand it correctly. Well, read it anyway.)
Of course, as worldcitizen commented, it's also a big old unfunded mandate. And as I said, if Mitt thinks he's going to get everybody insured without new funds, he's dreaming. The fact is, that money's going to come from somewhere: either from employers plus cigarette taxes (which I would prefer, as with the HA3 plan), or right out of our pockets, as Mitt would prefer. Look, I'll take whatever costs less and does the job: I'm not doctrinaire about wanting to pay an insurance company instead of the state, or vice-versa.
But people who don't have insurance (and employers who don't offer it) cost the rest of us money, through our tax dollars going to the Free Care Pool. We're already paying for these folks -- and as social investment, we don't even get good value for our money, since they don't get good preventative care, stay healthy and create the economic value they ought to. Maybe it's paternalistic to require people to be insured (by whatever mandate), but the current Free Care system exists because we've decided -- as a society -- that you don't keep someone that's had a heart attack out of the ER because they don't have insurance. That's a mandate. Well, if we're taking care of the uninsured anyway (in a half-assed and inhumane way), why not take care of them well, save ourselves some bucks long-term and create some economic value in the process?
As far as the auto insurance analogy goes: it's an example of mandated "universal" coverage. Sure, not everyone has a car (although many/most people need one), but everyone has health -- good, middling, or bad. And I think it's pretty clear that an individual's health has a significant effect, economic and otherwise, on people around him. Where we draw the line on personal vs. communal responsibility is a tough question, but I'm not really sure that Justice Holmes' bright line of personal sovereignty really applies here. By the way, through taxation, we have mandates for all kinds of things: schools, cops, highways, Social Security, corporate welfare, Gitmo, etc. etc. So I don't think it's necessarily "a significant departure from the usual role of government in our lives".
Other than that, David's points are right on regarding means-testing people ("adequate savings" for a medical emergency??) and the potential enforceability of an individual mandate. But there's going to be a mandate, either for employers or jes' folks, and whoever gets it may not like it much.
By the way, compare Ted Kennedy's comments...
US Senator Edward M. Kennedy described Romney's call for an individual mandate as ''a healthy step forward," but added that ''details of the benefits offered and the level of cost-sharing individuals will face are crucial to understanding this proposal."
I'm old fashioned -- and I long for the days when gubernatorial initiatives were accompanied by legislation and detailed policy briefs that spelled out assumptions, numbers, and details. This governor accompanies his pronouncements with zero details, making it impossible to evaluate. So the Gov. says we're spending about $947 million now for care for the uninsured, and his plan will spend -- voila -- $947 million. Believable? Who knows because the Administration keeps its numbers to itself. The Gov. embraces the fashionable notion of "transparency" in health care. A little "policy transparency" would set a good example.
My emphasis in both, of course. They seem like the same words, different tone.
Respectfully, I must dissent
Charley and I agree on a lot of things. That's why we co-founded this blog a few months back. And apropos of nothing in particular, I'm pleased to report that within the last couple of hours Blue Mass. Group welcomed its 50,000th unique visitor, according to our friends at statcounter.com. Not exactly a Daily Kos level of traffic (he gets that every couple of hours! geez!), but it's a start! Thanks so much to everyone who reads what we put up here.
Like any good Democrats, though, Charley and I disagree on occasion. Sometimes it's on little stuff. But sometimes the issues are bigger, in which case I think a separate post rather than a comment on an existing post is appropriate.
Here is what Mitt says in his Herald op-ed announcing his plan:
Everyone must either become insured or maintain adequate savings to cover their medical expenses. We cannot expect some citizens to pay for others who can afford to pay some or all of their own way. With Commonwealth Care and Safety Net Care, there would be no reason not to be insured.
So Mitt is giving everyone two choices: "become insured," or "maintain adequate savings to cover their medical expenses." I have no idea what the second choice means. Is the government going to start monitoring families' savings accounts to make sure their balance is big enough to cover some measure of medical expenses? I, for one, really hate that idea. And what will the measure of "adequate savings" be? Obviously, almost nobody can maintain savings sufficient to deal with cancer treatment, or open-heart surgery, or almost any other major medical procedure, yet those are the procedures that put real strain on the health care system. So this choice makes little sense, and I think it should be disregarded in any serious discussion of this topic.
Which leaves the first choice: everyone must "become insured." I have some practical objections to this. How will it be enforced - will police officers hand out tickets to people who cannot produce a valid health insurance card when stopped at random on the streets? What will be the penalty for disobeying this new law - jail time? a fine? harassing phone calls from some state insurance administrator? If someone who is in violation of this law has an accident and requires emergency medical care, what will happen? I'm not just trying to be clever here (well, maybe a little) - I think these are real issues with any kind of mandate like this, and they are not so easily resolved.
More importantly, though, I have some philosophical objections to requiring people to buy health insurance. To start, let's debunk this silly idea that it's just like car insurance. It is in fact very different in at least two respects. First: obviously, no one has to have a car, so car insurance isn't truly compulsory. In contrast, apparently under Romney's plan every human living in Massachusetts will have to have health insurance. Second, and perhaps more important: people are required to carry car insurance because a driver of a car can impose huge costs on another individual, either by harming the individual physically or by damaging the individual's property. It is therefore a reasonable, and I would say correct, policy choice to require all drivers to carry liability insurance so that innocent people harmed in car accidents should be guaranteed to be compensated instead of having to sue the driver (who may well have no assets anyway) - it is a variant on the Holmesian principle that "my right to swing my fist ends where the other man's nose begins." But that justification simply does not exist with health insurance, which is essentially a way of protecting people from the cost of their own health care needs, not from the claims of others that they have harmed. The difference between compulsory car insurance and compulsory health insurance is the difference between the state requiring you to ensure that your actions do not harm others and the state requiring you to ensure that you take adequate steps to protect yourself. That, to me, is a very big difference. Remember the hullaballoo about the seat belt law? Same principle, only the stakes are much bigger - it doesn't cost anything to fasten a seatbelt.
This is a very large topic that I cannot possibly cover in one post. Also, it's late and I'm getting sleepy. My basic point is this: of course, I am in favor of everyone being able to have health insurance. But the reason I feel that way is that I imagine that most people want health insurance. I have a hard time seeing why government is justified in saying to people who would prefer to spend their money on something else - e.g., better housing, or maybe sending money to their poor relatives back home - "no, you must buy health insurance, because if you don't the profile of our risk pool will not look right. And besides, it's good for you." I recognize that there's a possible moral hazard problem here. But if we really work at making health insurance affordable and available, I would think that pretty much everyone who wants it will be in, and I would further think that that will include a lot of people. I would like to see whether that would be good enough before taking what strikes me as quite a significant departure from the usual role of government in our lives.
UPDATE (6/22, 9:30 am): Today's Globe has some details of how Romney's proposal would work, as well as some interesting reactions to the mandate idea. I would note this: if the only time you force people to sign up is when they show up at the hospital needing care (as the article suggests), it's not going to work, because at that moment the patient needs care that is much more expensive than the cost of the policy. So you're doing exactly the wrong thing: throwing someone into the risk pool who is by definition a bad risk. To get this to work, you have to get people who aren't sick into the pool. Can we, and do we really want to, force those people in? That's the difficult practical and philosophical problem.
Also, today's editorial reaction is interesting. The Globe likes the individual mandate idea, adopting the flawed analogy to car insurance. The Herald likes the new insurance proposals, but says nothing about the mandate.
June 21, 2005
Into the pool, everybody!!
I never thought I'd say it ... I mean, it hurts ussss, really, but mixed in with the non-news that Our Guv is testing the muddy waters for a Presidential run, Mitt did something -- not enough, but something -- right today. He called for universal --therefore compulsory -- health insurance:
... Everyone has a responsibility to have health insurance; for those who cannot afford it, government will help, but only to the extent needed - not as an entitlement.
Not bad, insofar as it goes -- EconBlog (Jay Fitzgerald of the Herald) compares it to car insurance -- everyone who's got a car has to have it by law. And you've simply got to pool risk (i.e. include everyone, the sick and the healthy, old and young) in order to make insurance work properly.
Now, the Misanthropy Institute, er... the Hands-Off-My-Stuff Institute, er, I mean... the Am-I-My-Brother's-Keeper Institute, um, I mean ... the libertarian CATO Institute folks almost had a coronary. Hope they're covered for that:
"He said what?'' remarked an astonished Michael Cannon, director of healthcare policy at the free-market Cato Institute in Washington, D.C. "It sounds like he's running for the (liberal) wing of the Democratic Party.''
Unfortunately, Mitt seems to think he's going to do it without raising new revenues, not even from smokes. Bless his heart, but he's dreaming. John McDonough of Health Care for All has the proper response to that:
If the plan does not contain significant subsidies for low and moderate income persons, the individual mandate will be completely unworkable;
If the plan contains unaffordable cost sharing [hello Commonwealth Care™!]-- copays, deductibles, premiums -- it will also be unworkable;
An individual mandate could become a major incentive for employers now providing coverage to workers to stop doing so -- a huge cost shift from businesses to individuals and to taxpayers.
So ... we're not quite there yet. But keep in mind that the Governor is only one center of power in this discussion, and especially since he has eyes on higher office, he actually becomes less relevant to us in MA. Us? We're sticking around, and sticking it out.
Romney considering a run for President! Who'd 'a thunk it?
In news that should surprise exactly no one, Mitt Romney has publicly acknowledged that he's testing the presidential waters. He still says he's "planning on running for Governor" and will make a final decision in the fall. Translating: "It'll take me a few months to figure out whether I have any shot at the presidency, and if I don't, oh, OK, I guess I'll run for Governor again as sort of a crappy consolation prize." Nice - exactly what we need running our state.
In response, Deval Patrick fired off a statement to Blue Mass. Group (and, we suspect, to others!) noting that Romney's presidential aspirations were "no surprise," that Romney's "heart has never been in the job," and that too many of Romney's 903 days in office had been spent "traveling across the country making fun of Massachusetts to score political points," which "does nothing to help the people" of the Commonwealth. Seems about right to me.
Herald tells it like it is
Good for the Boston Herald. The opening line of a news story in today's paper, reporting the vile Westboro Baptist Church's plans to start protesting at soldiers' funerals, describes the so-called "Church" as a "radical midwestern hate group."
Exactly. And yet, perhaps because most of the bile being spewed by these disgusting people is directed at homosexuals, we haven't often seen media reports of this group using those kinds of words. More often they are called a "religious group," or a "congregation," or just a "church."
But they are a hate group. Just like the Herald said. It's too bad that it took this group's insane decision to start harassing the grieving families of dead soldiers to bring out the truth about who they really are, but better late than never. Let's hope that future media reports about these hatemongers follow the Herald's lead.
UPDATE (6/22): The Herald's editorial page also gets it.
June 20, 2005
Health care: Pollin', pollin', pollin
University of Mass. poll (6/6 to 6/12/05) for MassInsight: (a little squirrel gave them to us.)
How much responsibility do you think state government has for keeping the state's health care system financially stable?
A lot: 47%; Some: 37%; Not Much: 9%; None: 4%
One proposal to increase access to healthcare coverage for the uninsured required increasing the cigarette tax by 50 cents a pack. How strongly would you support such a proposal?
Very Strongly: 63%; Somewhat Strongly: 13%; Not Very Strongly: 5%; Not at All: 17%
Today, many companies like Stop & Shop, CVS, and Home Depot do not offer health insurance to their part time workers. When these employees become ill, they use hospital emergency rooms and the state pays the bill. How strongly would you support the state assessing a tax on companies which do not offer health insurance for those employees who use the state's Free Care Pool?
Very Strongly: 55%; Somewhat Strongly: 26%; Not Very Strongly: 7%; Not at All: 10%.
(HCFA: hope it's OK that I just stole your post in its entirety... it doesn't make much sense otherwise.)
So yeah, put it the right terms, people want the government to help out with health care. "Market-based" razzle-dazzle will only excite free-market purists and special interests -- who thankfully do not seem to comprise a majority of voters in this state. Most folks just want to see a doctor when they need to, without going bankrupt in the process. Pretty simple.
And a cigarette tax hike seems to be pretty uncontroversial: 76% support. As one GBIO-affiliated minister/wag said, "We're going to go encourage people to smoke so that we can pay for health care." Ha. Ironic ... and yet fitting.