Difficult choices on Medicare spending

I wrote this for the Health Care For All Oregon (HCAO) discussion email list, which is delivered, unless you choose another option, as a daily digest. You can subscribe by sending an email (no message required) to healthcareoregon-subscribe@yahoogroups.com.  The HCAO website is at http://hcao.org.

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I found the article linked below on the Rick Ray blog on the Archimedes Movement “We Can Do Better” website. I’m wondering what you all think about it. Please reply to the list, not to me, preferably in your own words.

(If you’re getting the “fully featured” version of the daily digest, it includes a “Reply to group” link at the bottom of every post.)

I have mixed feelings. I think we need more medical effectiveness research, by people who don’t have a financial conflict of interest, with the results published on the Web so that we can avoid unnecessary, and risky, medical treatment. We also need to pay more attention to the research already done. See Overdosed America by John Abramson and Overtreated by Shannon Brownlee.

On the other hand, I’m uneasy about using this research to make rules about what treatments should be paid for by private or public insurance. I would like to know more about how that would work, a specific plan. Who will make the rules? Both private and public insurance, rightly or wrongly, already have treatment exclusions. One of the most bizarre is that Medicare part B doesn’t cover physicals.

The article says, “It’s not the profits of the drug companies or the overhead of the insurance companies that make American health care so expensive, but the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective.”

We have frequently heard that 30 cents out of every health care dollar goes to pay for insurance company profits and administration, and dealing with the insurance companies by health care providers. How can he say that’s not what makes “American health care so expensive”? Surely it’s at least a major factor. It is the reason most health care activists prefer a government-run, “single payer” system.

I do agree that we need to curtail the “financial incentives for doctors and medical institutions to recommend more procedures”. One way to do that, suggested by Brownlee, is to put doctors on salary, as is done by Kaiser and the VA.

Lynn Porter

“Obama’s Difficult Choices on Medicare Spending”
http://wecandobetter.org/node/2911

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Tabling in Eugene

The peace movement to me is not so much about vision as about providing information and simple, basic organizing.

Over three Saturdays, Hope Marston and I have been tabling opposite the Saturday Market for Eugene PeaceWorks.  We have been getting signatures on our “Cut the funding” petition, passing out literature and talking to people.  (Hope does most of the talking.)

 

So far, in a total of about six hours, we have gathered 133 petition signatures and 37 email addresses for our “Cut the funding” list.  It seems to me to be a reasonable use of our time, a way to do public outreach and bring some people into our network, which hopefully will help motivate them to take action.

 

But it requires a large tolerance for indifference.  Most people just walk by us, and probably we would get very little attention if Hope weren’t standing on the sidewalk in front of our table actively engaging people.  In a polite way, she makes herself hard to ignore.

 

Part of the problem may be the location.  The Saturday Market is a big weekly party, with a lot of visual clutter competing for attention.  We have a big sign, and Hope and I both wear “Eugene PeaceWorks” T-shirts, but I notice most eyes slide right by us.  I’ve been thinking about trying a visually quieter venue, such as the library or Kiva.

 

However, from some of the verbal responses we get, a larger problem is that most people don’t know much about the wars, and don’t care.  They don’t think it affects them.  One woman told us that as long as we’re fighting these wars they have to be funded, which has it exactly backwards: As long as they’re funded they’ll be fought.

 

My guess is that will change when we enter an economic crises, which could happen any day now, and people finally understand that the U.S. does not have limitless resources, and we cannot afford the wars.  Yesterday I read that polls show Americans are already turning against government spending and deficits.

 

If anyone in the Eugene-Springfield area wants to work with us on this EPW outreach project, please get in touch.

 

Lynn Porter

http://twitter.com/eugenepeace

“It hasn’t worked”

The claim is often made that nothing the peace movement has ever done has “worked,” because we haven’t stopped any wars.

You can’t have a logical argument on that level.  There is no way to measure the “success” or “failure” of any social movement, you can only look for evidence of what it’s effects were, and even then it’s hard to separate that from the effects of whatever else was happening.

 

Having lived through it, I believe there is sufficient evidence that the Vietnam War era peace movement had lasting effects, but there were also other causes of those effects, such as all the body bags coming home from Vietnam, which in turn was caused by the killing efficiency of our opponents.  Which also related to support they were getting from other countries, the nearby availability of sanctuaries, jungles they could use for cover, etc.  U.S. public opposition might not have developed without the draft, a draft-age baby boom, and the willingness of the news media to see largescale demonstrations as news.  (Which they mostly don’t now.)  Every historical change or event has multiple causes.  And consequences.

 

All causes taken together led to the “Vietnam War syndrome,” which kept us out of a similar quagmire for almost 30 years, until too many historically innocent people grew up and they could start the cycle over again.  Now we have a 47 year-old president who thinks the political quarrels of the 1960s are irrelevant.  He will probably find out how wrong he is.  Vietnam was just one symptom of a bipartisan American foreign policy which was always aggressively expansionist, and indeed of a similar tendency in human nature.  There have been many empires in world history.  Afghanistan has been invaded repeatedly for thousands of years.

 

I think humans have always lived on the brink of self-destruction.  It is inherent in our nature.  We’re predators.  I can only hope, for the sake of the rest of the universe, that we never make it outside of the solar system.  Meanwhile I’m looking forward to the impending bankruptcy of the U.S., to stop us from killing people.

Iraq, Afghanistan & Pakistan

Below is a letter to the editor I wrote, which was recently printed in the Register-Guard. Below that is a petition to the Oregon Congressional delegation from Eugene PeaceWorks, posted on the Oregon Progressive Network website.

If you live in Oregon, I suggest following the link provided to sign the petition. I encourage readers in other states to contact your senators and representative and tell them to vote no on all war funding. They all have websites where you can fill in a simple form and send them a message. It only takes a few minutes. I always keep it short. You can find their websites by Googling their names. If you don’t know who they are, see http://www.visi.com/juan/congress/.

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What our government is doing in Afghanistan and Pakistan is completely insane.

The war in Afghanistan never made any sense in the first place. Now we’re expanding it into Pakistan, destabilizing a country that has nuclear weapons.

Nothing seems to matter but keeping the U.S. on top. On top of what, a mountain of bones and rubble?

Since Congress and Obama are incapable of rational thought, we have to tell them that if they continue this war we will vote against them in 2010.

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Please visit  Oregon Progressive Network to sign the following petition to the Oregon Congressional delegation.

Congress will shortly be voting on a supplemental funding bill for the wars in Iraq and Afghanstan. They will also be considering a fiscal year 2010 Defense appropriations bill that will include funding for the wars.

Petition to Oregon Congressional delegation to cut war funding

Please vote against all further funding for the wars in Iraq and Afghanistan. This is the only practical way Congress can stop these wars.

Both wars are immoral and illegal, because neither qualifies as self-defense.

Iraq had not harmed the U.S. before our invasion, and was not a threat to us. Even if one believed in the presence of Iraqi WMDs, all we had to do was leave the U.N. inspectors in place to finish their work.

The 9/11 attack on the U.S. was not carried out by the Iraqi or the Afghan people. As a pretext for a U.S. invasion of Afghanistan, the Taliban was accused of “harboring” Al Qaeda. The U.S. has effectively imposed years of collective punishment on the Afghan people, who have no mechanism for collective responsibility. A tribal society living in small villages in mountain valleys, many do not see themselves as a nation, nor do they function as one.

According to one study, the U.S. may have caused the deaths of a million people in Iraq, and thousands in Afghanistan. Continuing this wanton destruction cannot be justified. Likewise, there is no justification for the deaths and wounding of thousands of American soldiers, many of them working-class people who enlisted because they had no way to make a decent living as civilians.

These wars are also ruinously expensive, driving this country ever more deeply into debt. Trying to maintain an ever-expanding American empire, the U.S. is spending its way into bankruptcy.

We ask that you take a stand to stop these wars by refusing to pay for them any longer.

Out of hiding

I recently read The Army of the Republic by Stuart Archer Cohen, a political novel that lays out one possible near future for this country. In the tradition of 1984. Worth you’re time, if you’re willing to be fully awake.

A friend tells me she is “hiding from my culture.” I wish I could do that. The problem is, if most people do that, and don’t put up any resistance, the culture gets worse. It’s a downhill slide. Just electing a biracial Democrat doesn’t change that. Nor does happy talk.

What I see in our immediate future is a return to 1982. See you at the unemployment office. Oh wait, I’m retired! So maybe I get to sit this one out. Maybe not. I’m living on government benefits. A lot of people would like to throw us overboard, on the grounds that they can’t afford us. While blowing trillions borrowed from China on evil wars and fat cat bailouts. Then they’ll use the resulting yearly federal budget deficits and skyrocketing national debt to justify cutting entitlements and postponing universal health care, probably forever. It’s a con game, supported by the mainstream news media.

Which is why I’ve mostly quit reading the Register-Guard. I don’t need to absorb any more corporate propaganda from the wire services, The New York Times and the Washington Post. I get all the news I need on the Internet, mainly from commondreams.org.

As far as action goes, I’m stuck in the middle between the organizers and the apocalyptics. I believe we need large-scale multi-issue organization, but it’s hard to get anyone behind that, at least locally. There are national groups that are trying: United for Peace and Justice (UFPJ), Peace Action, Peace Action West, etc. MoveOn, the original model for mass email activism, appears to have become a wholly owned subsidiary of the Democratic party, making it useless. Recently I read that MoveOn is not going to oppose the war in Afghanistan, to which Obama is sending another 17,000 troops. But it’s okay because he’s a Democrat. Isn’t it?

Where is The Resistance?

As an activist, I try to be somewhat pragmatic. I will work with just about any other activist in the areas where our interests overlap, which they always do to some extent. I don’t have to agree with someone on every issue, or about every strategy, to work with them. But let’s be clear: There is a lot of anger among activists, and it’s not going to go away. We cannot all just join hands and be nice. What I would like to see is the kind of organization that could seriously challenge politicians and, if necessary, put tens of thousands of people in the streets to shut things down. It has been done before, we just couldn’t sustain it.

Obama needs to deliver. At a bare minimum, we want our troops quickly out of Iraq and Afghanistan, an end to the bailouts and “stimulus” packages, universal health care, a rebuilt safety net to take care of those dropping off the bottom, a limiting of corporate power, and something serious done about global warming. If we don’t get all that before the end of Obama’s first term, expect the Left to desert him in 2012, as we bailed on Gore in 2000.

Creating war limits with protests

“Protests failed to stop the war in Iraq. However it is possible that international outrage stopped the administration from fulfilling neoconservative desires to follow up on the invasion with assaults on Syria and Iran.” — Mark Engler, How To Rule the World, The Coming Battle Over the Global Economy, 2008

I’ve read similar claims about the 1960s antiwar demonstrations, that they may have prevented Johnson and Nixon from nuking North Vietnam. It is, of course, hard to prove a case by what didn’t happen, but this idea seems credible to me, then and now.

I’m wondering if peace activists will be willing to protest against a Democratic administration, when Obama reduces the Iraq war, while leaving tens of thousands of troops there, and escalates the war in Afghanistan.

Engler’s book is excellent. He says that the American ruling class is not unified, that there are different factions with different interests. War, he writes, only serves the economic interests of a minority of American corporations, mainly those involved in weapons production and energy. For the rest war is bad for business, or simply irrelevant. Neither faction is interested in democracy, or meeting the needs of most of the world’s population. Trying to make that happen is our job.

Subprime Primer

This is seriously funny.  Click on the little icon at top right of Scribd window to blow it up so you can read it, or use link at bottom to see it on Scribd.

View this document on Scribd

No bailout

I wrote this letter to the Register-Guard:

Columnist David Brooks (R-G, 9/20) writes that cracking down on subprime loans would have been saying, “Don’t loan money to poor people.”

Yes, that’s exactly right. Don’t loan money to anyone who can’t afford to pay it back, to buy a house, a car, or anything else. Don’t give them credit cards or payday loans at exorbitant rates of interest.

You’re not doing them any favors, you’re just helping them dig themselves ever deeper into a hole they’ll never get out of. Which by the way is very profitable for the lenders — they make a lot of money off of poor people — until the crash.

And don’t turn around and sell these debts as so-called investments to other financial institutions and middle-class people who should know better. “Mortgage-backed security” is an oxymoron. A debt is not an asset.

Unregulated capitalism doesn’t work. Never has, never will, not for long.

Folks, the party is over. The longest spending binge in American history has ended. You cannot live a middle-class lifestyle on working-class wages. Read the book “Your Money or Your Life” by Joe Dominguez and Vicki Robin and learn to downsize.

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I was happy to see the bailout plan go down to defeat in the House. No socialism for the rich. My Rep. Peter DeFazio voted no after receiving 3,000 phone calls and 3,000 emails, one of them mine, against the bill. A Los Angeles Times article credits an outpouring of anger from the voters for stopping the bill. Despite what the “leaders” of both parties wanted, “The voices of angry constituents seemed to count most.”

I am not convinced that the U.S. economy will collapse if we don’t give $700 billion to the investment banks whose reckless greed got us into this mess. We cannot afford to borrow this money from Saudi Arabia and China and add it to the already huge deficit and skyrocketing national debt. Interest on the national debt is already costing us $400 billion per year.

Nor do we need to do that. The money can be raised through taxes on the rich and on stock market transactions, discouraging speculation in the process. Speculation has replaced investment. For some concrete proposals on how to do this, see “The nation’s social bargain with the rich,” by Derrick Z. Jackson in the Boston Globe.

The big financial institutions that are in trouble, and not all of them are, should be allowed to fail, not bailed out. The sooner we get them off the playing field the better.

DeFazio was quoted recently in the Register-Guard as saying that any business that is “too big to fail is too big to exist.” He advocates that we start enforcing the antitrust laws. Which were passed because this country has been here before.

I should add that rich people do have their uses. Someone wrote that they “are a good source of protein.”

ABC news today was blatantly biased in favor of the bailout bill, with almost no attention paid to its critics. Which reminds me of why I seldom watch TV news, the propaganda machine of the establishment. They said the stock market took a 7 percent dive today, the largest single-day loss in history. Yeah, so? All that money that was supposedly lost was digital money. An increase in value of a stock you own, or a house for that matter, doesn’t really exist until you cash it out. Outside of buying government bonds, investing means taking a risk. You can lose, and lose big, so don’t “invest” any money you can’t afford to lose. And always remember that the people running things are liars.

Most people only learn through pain. If investors don’t feel any pain from this, they won’t learn not to do it again.

Yes, I think we should do something. We should put money into all the safety net programs — unemployment insurance, food stamps, Medicaid, subsidized housing, etc. — that are needed to catch all the people who will fall off the bottom during this recession. Tax the rich. Re-regulate financial institutions so they won’t do this again. Start educating people that there is no tooth fairy and that they will have to live on their income.

Start a national discussion on class, inequality and the need to end America’s cheap labor policy. Rebuild our infrastructure, including health care and education, and build the new energy infrastructure needed to produce a greener country and reduce climate change, creating jobs in the process. There is no reason not to do all this except the vested interests that are making money off of the status quo, and the middle class fear of change.

Graphic below from the NY Times. Bush’s first term started in January, 2001. I presume by “Security” they mean war. Social Security and Medicare should not be counted as part of the federal budget, since they both have trust funds. Politicians do that so they can count trust fund surpluses as income, reducing the apparent size of the yearly deficit.

Click on graphic to see a larger version.

War funding votes table

I’ve compiled a table of 11 votes on war funding bills, December 2005 to June 2008, by the Oregon congressional delegation and the two presidential candidates.  You can find the table online at http://tinyurl.com/warfunding.

 

Please note that the bill and roll call vote numbers are links to the source of the information. 

 

If you live in another state, you can click on the roll call links and quickly find the votes of your representative and two senators.  

 

There are notes at the bottom for each bill, with links to further information.

 

For most of these bills there wasn’t just one vote in the House and one in the Senate, there were a whole string of votes as the bill bounced back and forth between the two houses.  The vote on the last bill was especially complex — major game playing — and I depended on an analysis from United For Peace and Justice (UFPJ) to decide which vote to count.  See note.

 

For the other bills I used my best judgment.  Someone else, with more knowledge than I have, might make a different choice.  I tried to pick the last vote in each house where there were a significant number of votes on each side.  If only a few people voted against it I figured it was probably minor.  I’m sure there is a better way, but I haven’t found it yet.  If you see any problems with this table, I would like to hear about it.  Feel free to add a Comment to this post.

 

In any case, I think our legislators should have voted “no” every time.  The wars in Iraq and Afghanistan will never stop until Congress cuts the funding.  I hope this table will help you to hold them accountable.

Getting the U.S. out of the Middle East

I wrote this in response to emails from a reader who was concerned that a rapid U.S. withdrawal from Iraq and Afghanistan, as advocated by Ralph Nader, would lead to chaos in the region, control by the Taliban, and further suffering.

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We are not preventing chaos in the Middle East, we are causing it.

I doubt that the Taliban will take over Iraq. Al-Qaeda, which is fundamentalist Muslim but not the same thing as the Taliban, has quickly worn out its welcome in Iraq by indiscriminate killing. Iraq was a secular country before we invaded and set off a civil war which has killed around a million people, a strange way to keep Iraqis from suffering.

I don’t like the Taliban, but my feelings about them are irrelevant. It is up to the people in Afghanistan and Pakistan to decide how they want to run their countries. Right now we’re supporting a loose coalition of warlords in Afghanistan, and killing a lot of noncombatants. We are not the good guys in Iraq, Afghanistan or Pakistan, we’re the bad guys.

Pakistan has nuclear weapons, so it is very dangerous for us to further destabilize it by invading along its border with Afghanistan, which Obama wants to do, and which Bush is already doing to some extent, or by trying to force the Pakistan government to fight the border tribes. We are spreading the Afghanistan war into Pakistan, just as Nixon spread the Vietnam war into Thailand and Cambodia, with genocidal results. Where does it stop, when the whole Middle East is in flames?

As I understand it, the most basic problem with Middle Eastern countries is that their populations are very young, with lots of unemployed young men, and autocratic governments which aren’t doing anything about creating enough jobs. This creates fertile ground for recruitment by fundamentalists.

There are also long-standing, well deserved resentments against the U.S. and other rich countries for supporting those autocratic governments, in order to control the oil and do business. Doing business includes selling large numbers of weapons to these governments, a great opportunity for our “defense” industry. The U.S. is one of the world’s leading arms dealers.

Our troops are not in Iraq or Afghanistan to protect the people. That’s not what they do. They kill people. That is their job, what they are paid to do. The majority of the people they kill are noncombatants who were in the wrong place at the wrong time. On a CNN panel discussion, an Iraqi said that their houses are very close together, so when we bomb one it also takes out the houses on either side. The U.S. uses air power as much as possible to keep down our troop casualties.

One of the soldiers interviewed in “The Ground Truth” talked about what happens when they take fire from an area. They just saturate the area with return fire. This suppresses the incoming fire, but it also kills or wounds everyone else in the area. This is what the soldiers are told to do by their commanders. They come back with guilty consciences and PTSD.

We invaded Iraq in order to control its oil and use its land for military bases to extend control over the rest of the Middle East, and its oil. We have the blood of over a million people on our hands. This is murder for profit, to protect our middle-class way of life, and there is no way it can be morally justified. We have to get out, as quickly as is physically possible. I won’t vote for anything less. To do so would make me morally responsible for the killing which will happen in the following years, as we drag it out.

By the way, Joe Biden, Obama’s new VP, was a prime mover in starting the Iraq war. He advocated it years before it started. This is the man Obama picked for his foreign policy “experience.” Today’s Register-Guard has an approving editorial making an unfortunate comparison with Kennedy picking LBJ because of his political experience. We know how that turned out. Experience doesn’t cure stupidity.