Author: Mark Tokarski

Just a man who likes to read, argue, and occasionally be surprised.

The Baucus Medicare Proposal

I ask this question not knowing the answer, and invite speculation. I offer my own. What will be the long-term outcome of Senator Max Baucus’s proposal to allow people age 55-64 to buy into Medicare?

We hear terrible tales about how Medicare is faces monstrous unfunded liabilities – there’s something to that, but the same studies ought to be applied to the private sector as well. The simple fact is that medical advances are effective and wonderful and expensive. If we were apply the same econometric forecasts to medical needs in the private sector, which doesn’t have to deal with old people, we would still find that medical care will be sucking up more and more of GDP. Until we ration. So set aside for the fear forecasts for sake of argument about other aspects of medical care. I’m more interested in the impacts of the Baucus proposal.

Medicare has three sources of financing – a payroll tax of 2.9% on all wages in the country; monthly premiums for “Part A” (hospitals) of $96.40 from participants; and a 75% subsidy for “Part B” (doctors). (In addition, most Medicare participants pay separately for private insurance to pay for a deductible, usually 25% of what Medicare pays. This is the equivalent of the private-sector deductible and c0-pay system.)

In 2005, the total cost of the Medicare program, subsidized and unsubsdized, was $439 billion.

(I’m deliberately ignoring Medicare Part D, which is a government-sponsored industry subsidy providing a small drug benefit to Medicare recipients. It’s wildly expensive and in need of repair. Another day.)

Part of the Baucus-sponsored health care reform act in the coming legislative session would to temporarily open up Medicare to people aged 55-64. This is viewed as a temporary solution to a market deficiency – private insurers charge huge premiums for people in this age group, and these people are also likely to have preexisting conditions, meaning they can’t get insurance coverage at all.

Baucus would let them into Medicare on a “revenue neutral” basis, meaning that no part of the current subsidy would be available to them. Hence, they would be paying much more than current Medicare beneficiaries for coverage. But there would be two advantages – one, they could get coverage, and two, they could take advantage of Medicare’s built-in cost efficiencies – that is, Medicare operates with about 3% overhead, while private insurers experience 15-30%. So premiums should be considerably less than private policies – say $3,500 versus $5,000 for an individual. That’s a guess. Premiums would certainly be more than $96.40 per month.

The first impact of the Baucus plan would be similar to what Massachusetts is experiencing right now – a huge influx of sick people to whom coverage had previously been denied. This would stress the system, and cause many to cry out that it’s not working. The private sector would experience no loss or pain, however, as it is not offering coverage to these people anyway.

The second impact would be a migration of people in to Medicare. These would be people who are employed, retired and paying on their own, or retired and enjoying company-sponsored coverage as a long-term benefit. This would present a loss of revenue to the private insurers, and they would scream. They would probably try to head Baucus off at the pass, lobbying instead for premium subsidies for themselves to avoid loss of clientele. But assuming the Baucus package were to pass intact, the private insurers would suffer.

The premium advantage that people above age 55 would experience would create pressure from below as people less than age 55 would see that older people are paying lower premiums. They too would want to avail themselves of the low-overhead Medicare option. Political pressure would start to mount to expand Medicare yet further into lower age groups. Cost-conscious and financially strapped employers would want in as well.

In the end, the Baucus plan would chip away at our current hodgepodge system of profitable clients for the private sector, with non-profitable ones left out in the cold or dumped on government. Face it: We’re not going to get single-payer health care in this country even though most of us want it. The Baucus plan would be the start of a process that would eventually undermine the private sector entirely. Private insurers, as in Germany, would be left to take care of the needs of the wealthier sector, paying for private rooms and and helping them avoid waiting queues. There’d still be a niche for them, but we would no longer rely on them for basic care.

It’s going to take years, if not decades. Given the power of the medical lobby, it might not happen at all. I’m often a critic of Senator Max Baucus – he’s at best tentative and right-leaning on most issues. But I support him wholeheartedly on this. If we cannot blow up the house, at least we can chisel away at the foundation.

By the way, full disclosure: I’m 58, have a preexisting condition and am therefore uninsurable, and have to buy into the wildly expensive MCHA program.

The End of Trickle-Down?

This article from the Dismal Scientist was written in early 2008, and foreshadows a lot of what has happened since. However, Mark Zandi held no crystal ball, and did not see the tsunami that would hit us last year. He discusses tax policies and their effect on the economy. The Bush Administration was proposing a stimulus package that eventually became law and awarded rebates to most taxpayers and many Social Security recipients who did not pay taxes. It was not terribly effective.

The question posed by the article that caught my attention was about how to spend tax dollars to generate economic activity. The mantra of the right is that tax cuts are always the best policy, but that is not borne out by a study done by Moody’s Economy.com (all for sale), summarized in the following table:

Note that the rebates we received (ours is still in savings) generate a couple of pennies additional activity. “Refundable” tax rebates (given to people whose taxes are less than the rebate) generate 29 cents or so in new activity. A payroll tax holiday has the same impact – that is, since lower-income people pay the payroll tax, they are more likely to spend it if it is not assessed.

The stimuli generally proposed by right wing economists, the Bush tax cuts for the wealthy, reduced taxes on dividends and capital gains, have negative impact – that is, each generates less than half a dollar in short term activity for each dollar given. That is heresy – it says that approximately half of the economists in the country don’t know much about economics.

Most interesting: The best way to stimulate a weak economy is the Food Stamp Program. Infrastructure spending is up there too, along with extension of unemployment benefits. In other words, the best way to get us going again is to stimulate the bottom, as the flow of wealth is upward.

So what does the Obama Administration propose? It’s a $775 billion package that seems to have a bit of everything. There are payroll tax cuts, which are disproportionately paid by lower income people. He also proposes a $3,000 credit for each new hire that companies generate, but the effect of such a stimulus is debated – many feel that it merely subsidizes what is already going to happen anyway.

Then there are an assortment of business tax credits – not immediately beneficial, but maybe so in the longer term. There’s also talk of infrastructure spending for “shovel ready” projects. Surely that would have immediate impact.

There is a change in overall thrust with this new administration. Where the Bush people focused almost exclusively on the wealthy in its near religious belief that wealth trickles downward, Obama seems to understand that the process works in reverse. That is a hopeful sign.

Understanding Religious Belief

Like love, like wrath, like hope, ambition, jealousy, like every other instinctive eagerness and impulse, it adds to life an enchantment which is not rational or logically deducible from anything else. This enchantment, coming as a gift when it does come – a gift of our organism, the physiologists will tell us, a gift of God’s grace, the theologians will say – is either there or not there for us, and there are persons who can no more become possessed by it than they can fall in love with a given woman by mere word of command. Religious feeling is thus an absolute addition to the Subject’s range of life. It gives him a new sphere of power. When the outward battle is lost, and the outer world disowns him, it redeems and vivifies the interior world which otherwise would be an empty waste. (William James)

Having been raised in an extremely religious home, I came to find religious belief oppressive and boring. Praying was meaningless, worship repetitive and compulsory. Freedom – the elation of the soul, came to me when I escaped religion. It came to me in the beauty of the vast natural world and the ability to explore the thoughts of the many scholars and scientists who were also set free. That was a true joy. Absence of religion, for me, is freedom.

I’ve known a host of religious people in my life – I will briefly describe five of them, and in doing so reduce them to utter simplicity. They are far more than this, but this is what I observe. The names have been changed to protect these people, four of whom are truly innocent.

Mandy virtually exudes religious fervor from every pore. One can hardly encounter her on a sidewalk without knowing something of her deep convictions. She believes every word of the bible, and where the bible contradicts itself, she does not suffer cognitive dissonance. She claims to have been elevated to a fourth level of existence, had visions, experienced heaven and met angels. While these are surely the product of brain chemistry, one has to be a little envious. Others use physical stimulants to achieve the same result, much to their own demise.

John has had a hard life. He was a brilliant student, but long troubled. After graduating college, he was overcome by anger and self loathing, and one day bloodied his fists on a wall to the degree that he had to be institutionalized. He was given electroshock therapy for his manic depression, and emerged a broken man, but passable in society. His religious beliefs are sincere and deep – a cry for help in a world that pleases him hardly at all. It is his sanctuary, his only hope for any kind of relief from the pains of living. He attends mass daily, prays and reads the bible. Though he has a high level of comprehension, he is trapped by a brain whose limited functions have impeded his ability to communicate. He is hardly able to express a complete thought. His is a truly tragic life.

Mike is a stern taskmaster. He believes not only in the Bible, but in his own righteousness and validation through it. He knows that most of us are sinners and that he will look down on us as we are judged while he enjoys the fruits of everlasting happiness. His religious belief is validation. It makes hims strong and will eventually not only set him free, but send the rest of us to hell. He hates people. (By the way, the day of judgment is at hand.)

George is a very smart and kind man. He believes in the bible – well, Jesus anyway. He practices kindness and understanding. He is happy in his skin. He prays and meditates, but also keeps abreast of world events, reading magazines, newspapers and books. He has no desire to change people, in fact, knows that people don’t much change. Ever. He’s OK with that. He likes people as they are. He’s a lovely man.

Gidget is a buttercup, an ever-effusive font of faux-joy. Something troubles her deep down, but none around her ever get to go beyond the surface except in those dark, rare, and fleeting moments when her voice lowers and she makes an accurate observation that is not bubbly and optimistic. She believes in Jesus, and insists that any who come to her house pray to him, usually holding hands. She thinks people who are not religious are deeply depressed, and cannot fathom happiness without it. She is at once happy and in denial of reality, confused and troubled, but, as I said, an ever-effusive font of joy.

There are many others we have experienced. One cannot categorize or herd these people into one corral. To each, religion gives meaning to life otherwise not comprehensible. It becomes and extension of their personality. Where they are kind, religion is kind. Where they are dark and hateful, religion is vengeance. Where they are hopeless, they have hope, where they are simply confused, religion makes sense of it all.

I get short with people who are extremely religious, and don’t often enough give it credit for keeping us from killing one another, or, as Napoleon said, keeping the poor from killing the rich. (Religion is also validation for killing, but I want to avoid that topic.) My observations above are reflections on being on page 35 of William James’s Varieties of Religious Experience. I bought the book because I wanted to understand the religious impulse in humans. I have a long way to go.

A Cornucopia of Consumer Crap

Have you ever had the experience of wanting something, and then attaining it and being left in a gloomy state? I’m not talking about an achievement or a lover – more like buying an IPod or a new computer or Wii. As a kid, I wanted a shiny flip-calendar to put on my desk – you just turned it and the date would change automatically. I saved money, and the day I had enough, I went running to the store to buy it, and I owned it, and there it sat, and I was oh so unfulfilled.

We live in a market economy, and every niche of our lives from the space over the urinal to the back of the handle that dispenses gasoline is saturated with advertising. Conservatives talk about Adam Smith’s invisible hand, and as we run around taking care of our surface needs, we are indeed making jobs and stores, and that is all necessary.

But it is unsatisfying. Not only that, the invisible hand can hit you with its backside too. As we are all merrily running around in our SUV’s, we’re spewing CO2 into the air and ruining the habitable climate. Our garbage dumps overflow, our food system makes us fat, our TV’s make us stupid, our news networks carve out an empty holographic image and call it news. But hey – our immediate desires are fulfilled.

The essence of happiness is not the fulfillment of wants, but denial of them. Saving money creates fulfillment, as does application of our efforts towards achieving a long term goal, like building a deck (or a beautiful stone pizza oven) or painting a house or reading a difficult book and actually grasping some of its essence. Then there is the greatest satisfaction of all – facing fear. Facing down fear. Doing something scary, whether confronting a phobia or a boss or leaving an unfulfilling job or seeing a doctor about that lump or telling a friend an unpleasant truth.

In other words, the market system we have built around us is merely a distraction, and cannot possibly make us happy. And the conservatives are wrong when they tell us that satisfying our private desires creates a greater good for all of us. And they don’t seem to have a clue what “freedom” is. It’s not that I can buy a Ford or a Suburu – it’s that I can breathe clean air and walk on public lands and drink clean water. It’s when a company commits a civic wrong, like polluting our air or water, and we the public, through are democratic institutions, are strong enough to punish them, bring them in line, or put them out of business. That’s freedom: Strong societies exercising their right to control commerce and resources for the greater good.

Markets don’t give us freedom. They take it away. Markets send our jobs overseas, invade our privacy, undermine our personal spaces – when market forces are stronger than governments (“globalization”), all but a fortunate few suffer. Capital overrules democratic governance. We may gain access to alternative sneakers and have phones that take pictures, but we lose our power to govern ourselves.

In other words, markets are not the same as democracy, and democracy is far more important than free trade and free markets. Our society is corrupted now – we’ve shot the wad, spent our savings, and have little to show for it but a cornucopia of consumer crap. Perhaps as we rebuild, we can rekindle the spirit of strength through community, and reinvigorate our public selves. Maybe we can set selfish material pursuits aside, save money in bank accounts, invest in our health and education and social security systems, and teach our children that the greatest happiness comes from denial of self, rather than trying to satisfy every want.

Thus endeth the Sunday sermon.

A New Voice in Mushville

Anderson Cooper of CNN recently took a shot at Rachel Maddow, MSNBC’s liberal host, and one of the few liberals in the liberal media.

I’ll get to that, but first there’s the matter of David Gregory being elevated to host Meet the Press on NBC. The Sunday talk shows are rarely interesting to me, but I did on occasion watch Tim Russert. He had a reputation for being a hard-nosed interviewer. He was no such thing. He offered a gentle forum, as he was well-schooled in the American news business, where if you don’t treat guests with proper submissiveness, you don’t get guests.

That brings me back to Maddow briefly. She has a hard time finding Republican guests. One time she had on Nancy Pfotenhauer, a McCain campaign aid, and didn’t show proper reverence, and no McCain person appeared thereafter.

That’s why I like Maddow. She’s a different breed. Anyway, here’s what Anderson Cooper has to say:

Rachel Maddow is an incredible talent — she’s funny, and smart, obviously well researched on subjects. I’m just not interested as a viewer in listening to anchors’ opinions. It seems like there’s an awful lot of yelling, and this year yelling’s been replaced by sarcasm and snarkiness.

Allow me to translate:

I’m an American journalist, and I therefore follow the American script. I show extreme deference to American government officials and allow them to put forth their positions unchallenged. It’s not my job to challenge them. That’s not what journalists do. I therefore think that Rachel Maddow is not doing her job. She’ not being properly reverential.

Anyway, poor Rachel may be a flash in the pan. She may not last. She may go the way of Phil Donohue – a liberal with high ratings who was canned during the pre-Iraq War media/government love feast.

But Rachel (and Keith Olberman) have proved a point – there is a market for liberals on TV, and a place for them in commentary. Maddow, a Phd from Oxford is also showing us that intelligence also sells. It’s a good leaning experience for moribund boring mushy middlin’-to-right-leaning television news and opinion programming.

P.S. This was priceless. Zbignew Brzezinski called up Joe Scarborough for being “stunningly superficial”. Scarborough, who defended himself by saying he reads the New York Times and Wall Street Journal and is therefore up to speed, had never heard of the Taba Summit – a late Clinton era meeting of minds between Israelis and Palestinians that was ended by Ariel Sharon when he took office. (We came very close to having peace, but as per usual, the Israelis balked.) Scarborough is too typical of American pundits and journalists.

If Pigs Had Wings …

Adolf Godwin Hitler, in his book, Mein Kampf, defined the “big lie” as one so “colossal” that no one would believe that someone “could have the impudence to distort the truth so infamously”. It’s a propaganda technique, not terribly effective but often used. Sometimes one can spot a “big” lie by an overly specific account of something. For example, Karl Rove says that George W. Bush read 95 books in 2006, 51 in 2007, and 40 in 2008 (his total has declined – I can only assume he will slip in another 20 or so today).

It seems appropriate that it is Rove spinning this fanciful tale, as he is often referred to as “Bush’s Goebbels”. Rove is a professional liar and not a man to be trusted about anything, even the color of his eyes. He’s endured, for eight years now, the uppity criticism of Bush from the nation’s effete snobs – Bush is maligned as the C-student who is sheltered from bad news. He’s being replaced now by an intellectual, a man who thinks, writes, and above all, reads. Rove is a little testy.

There’s a reason – the critics, effete though they may be, are right. And eight years of the Bush Administration have yielded a major terrorist attack on the country, two unwinnable wars, unimaginable deficits, decrepit federal agencies unable to respond to disaster, and financial collapse. That’s only a partial list of major failures. Add an attack on the Constitution.

That’s the price of not reading.

I know Rove is lying – heck, most of us figured that out right away. But I’ll put up a little evidence. One, many have opined and offered anecdotal evidence that Bush is dyslexic. That doesn’t mean that he is not smart – only that reading is troublesome to him, so that he has to rely on other traits (such as an uncanny ability to read people, if not books) to gather data from around him and process it. Bush relies on staff to verbally summarize reports – due to trust issues, he only likes to hear one side. Hence, disaster.

Winston Churchill was dyslexic. It’s not necessarily debilitating. What undid Bush was not dyslexia, but rather isolation from competing viewpoints. But one thing it certainly means is that Bush did not read books.

Secondly, Bush has himself admitted that he does not read newspapers. As he told Brit Hume in 2003, he started his day by asking Andrew Card “what’s in the newspapers worth worrying about? I glance at the headlines just to kind of (get) a flavor of what’s moving. I rarely read the stories.”

A man who can’t bring himself to read a full newspaper account is unlikely to dive into the tomes that Rove credits him with reading – “David Halberstam’s “The Coldest Winter,” Rick Atkinson’s “Day of Battle,” Hugh Thomas’s “Spanish Civil War,” Stephen W. Sears’s “Gettysburg” and David King’s “Vienna 1814.” … U.S. Grant’s “Personal Memoirs”; Jon Meacham’s “American Lion”; James M. McPherson’s “Tried by War: Abraham Lincoln as Commander in Chief” and Jacobo Timerman’s “Prisoner Without a Name, Cell Without a Number.”

I challenge anyone reading this to cite an instance in any of Bush’s extemporaneous, unscripted comments, in which he made a historical reference. Any.

Bush might have been an adequate president if he had actually read Doris Kearns Goodwin’s “Team of Rivals”, as Rove claims he did.” He might not have surrounded himself with yes-persons. His administration is legend for being wrong with extreme clarity of vision, of the tunnel variety. Indeed, if George W. Bush could read a book, he could have spared us all a load of grief.

P.S. New Yorker writer Brendan Gill recalls roaming the Bush Kennebunkport compound one night while staying there looking for a book to read — the only title he could find was “The Fart Book.”

P.P.S. From one of Bush’s Yale classmates: it’s not the substance abuse in Bush’s past that’s disturbing, it’s the lack of substance … Georgie, as we called him, had absolutely no intellectual curiosity about anything. He wasn’t interested in ideas or in books or causes. He didn’t travel; he didn’t read the newspapers; he didn’t watch the news; he didn’t even go to the movies. How anyone got out of Yale without developing some interest in the world besides booze and sports stuns me.

Reality

Free enterprise is a term that refers, in practice, to a system of public subsidy and private profit, with massive government intervention in the economy to maintain a welfare state for the rich.
Noam Chomsky

Capitalism will never fail because Socialism will always bail it out.
Nathra Nader (Ralph’s Dad, attributed by Ralph)

We do a lot of arguing here about various abstracts – see below. Dave Budge informed us in that thread that his philosophy, libertarianism, has not failed because it has never been tried.

I wanted to deal in something less abstract, something that is not only tried, but is always practiced in the real world, and not held out as some potentially beneficial abstract theory (if only we would come to our senses).

The quotes above are dead-on. Hard to dispute what is happening right before our eyes.

Disturbing …

Top-Term-Paper-Sites.com sells term papers to kids. The advertising is sensational. I never thought denial could be practiced so openly. Here’s what they say:

Don’t Compromise

Is it high time that you should have a place where you can find term papers that will help you in real?

Never underestimate the teacher. (They have some tricks up their sleeves)

Tools like anti-plagiarism sites & softwares nail your grades and essays.

Numerous anti-plagiarism softwares are readily available online.

These online softwares come in very handy for the teachers, which makes your job really difficult.(Emphasis added.)

Guarantee # 1: A completely new research/term paper – You won’t find it anywhere.

Guarantee # 2: Professionally written term papers by American research specialists.

Guarantee # 3: Your essay will be completed on time or its FREE.

Guarantee # 4: Customer support, e-mails & requests replied within 2-4 hours.

——

Do you notice how crappy the writing is? It cries out for [sic]’s. I suspect that English is the author’s second language. Even our kids’ term papers are being outsourced!

I did my share of bad writing in my school days, but I never stole anything. No doubt some plagiarizing was going on, but I never heard anyone openly rationalizing it.