Band-Aid Plan To Fix Health Care Won’t Work

(Published in the Main Line Times and the Delco Times)

As the attempt to reform our health-care system crescendos, it is difficult to pinpoint exactly where the debate lost its way. Perhaps it never truly began in the right direction.

Between the fear-mongering and the screaming, it seems some of the most pressing issues – medical inflation and warped incentives – have been sidelined. And why? Perhaps because they are more complex. These issues require quite a bit of explanation and historical context, which doesn’t always fly too well in a sound-bite culture.

One of the main problems regarding our health-care industry is its lack of any organization. There was no grand design in its creation; it is a Frankenstein monster, cobbled and patched carelessly together since its birth in the wage controls of the World War II era, with little regard for consequences.

Yet, any grand design is practically doomed from the beginning, as the only two viable options – a single-payer system or a complete overhaul of incentives and the creation of a truly free market – are both met with opposition. Consequently, we receive a bill that is the worst of both worlds.

True, the House bill does work at creating a marketplace in the health insurance exchanges (an important, but underplayed, provision), but it also includes a public option. Supposedly, the public option is meant to control prices by adding a more virtuous competition into the marketplace, but when you look at the details – its limited eligibility, and the fact that prices will be set by negotiations with health care providers – it doesn’t seem as if it will control prices at all. After all, medical inflation has not left Medicare and Medicaid, two government plans, unscathed.

So, who is to blame? The Democrats or the Republicans? Both. To their credit, the Democrats have actually gotten the ball rolling on health-care reform and have put forth a bill, though their proposal remains flawed.

The Republicans, on the other hand, are too busy trying to give President Barack Obama his “Waterloo” (this can be seen in the misnomer “Obamacare,” which would be more accurately titled “Congresscare”) and preaching about fictional provisions such as nonexistent “death panels” to actually provide legitimate criticism and a legitimate alternative.

Both accept money from the big health insurance and pharmaceutical giants and allow them to actively craft the bill as well.

We, the citizens, are also to blame. We are too easily led by the talking heads to one particular conclusion. A single-payer system is not the devil, and it does not ration care any more than our current system does. Any system we adopt will require a give-and-take.

A single-payer system will cover everyone, unburden businesses that pay for employees’ health care (and thus help small businesses). It will purge the system of waste, but everyone will be required to pay through taxes and waiting lines — secondary, optional care will be a bit longer (though primary care may very well be shorter, as it is in Britain).

Remember, the government is already inextricably involved in our health-care system. A complete rebuilding of the health-care free market, hand in hand with other reforms (like tort reform), can control prices through innovative market forces and reshaped incentives. Both plans are bold and both have their strong and weak points. What we can’t afford is another plan that simply slaps a Band Aid on the issue and kicks it along to the next generation.

Michael Gaudini is a Narberth resident who attended Cardinal O’Hara High School. He is currently a student at Temple University in Philadelphia.

The State of the US Economy

We sat down with Economics Professor Moritz Ritter of Temple University to find out more about the current state of the US economy and the government’s response to the economic crisis.

What You Need to Know About the House Health Care Bill

The House of Representatives passed their version of the health care reform bill last night. But what does it all mean? The media coverage on the issue has been decidedly mixed. I’ll try to boil down for you the most important points on the House bill.

The first thing I should probably spend some time on is clarification. With all this debate over the validity of so-called “Obamacare”, many people may not realize that there are various versions of health care reforms bills floating around, and that none of them were authored by Obama (hence the irony of the name “Obamacare”).

Here are the details of the House version of the bill: (a good source of information are the NYTimes, and an NPR podcast entitled Health Care Legislation Deconstructed)

How the House Bill Expands Coverage to Uninsured Americans

  • Projected to cover 96% of legal residents under age 65.
  • Provides subsidies for individuals up to 400% of the federal poverty level $88,000 for a family of 4)
  • Expands Medicaid to 150% of federal poverty level ($16,000 for an individual; $33,000 for a family of 4)
  • No denial of coverage or higher premiums due to pre-existing conditions

How the House Bill Effects Businesses

  • Most employers will be required to provide health care for employees or pay a penalty of up to 8% of payroll.
  • Businesses up to $500,000 in payroll a year are exempt.
  • Penalties are phased in for businesses from $500,000 to $750,000
  • Small businesses are provided with tax credits to help them purchase health care

The House Bill’s Public Option

  • No state opt-out
  • Negotiated Rates — the public plan will talk to hospitals, doctors, and health care providers to negotiate a state-level payment rate

Costs of the House Bill

  • Gross Cost $1.1 trillion over ten years.
  • However, the Net Cost is $894 billion because of revenue raisers.
  • Revenue will come from surcharge on high income earners (taxes on individuals that earn above $500,000, or on couples that earn above $1 million  – projected to raise $460 billion)
  • Penalties for businesses who don’t provide health care (up to 8% of payroll)
  • Penalties for individuals who don’t buy health care (2.5% of income — but can apply for hardship waivers if can’t afford)
  • Medicaid/Medicare cuts
  • Corporate taxes/ fees

Health Insurance Exchange

  • The Exchange is essentially a marketplace where people can go to shop for health insurance. Currently, with our employer-based system, you can only really choose from the plan(s) your employer offers. Going out and buying your own insurance is expensive and messy. The Exchange creates a market of insurances options and allows you to choose which plan you want, allowing market forces to take their toll — the better plans will thrive and the uncompetitive ones will die.
  • Would begin in 2013.

Lobbyists’ Role in the Bill

  • Why was there no large-scale campaign launched against this reform by insurance industries, drug companies, and the like? Because this time around, they were brought into the fold. Yet, with lobbyists winning, the biggest loser stands to be — in many instances — the consumer. The pharmaceutical industry has lobbied for amendments, like one that would grant 12-year exclusivity to biologics, instead of 5. Read the article in TIME for more on that, but basically, it means that instead of allowing generics onto the market after a shorter waiting period (say, 5 years), it will now take 12 years for this to happen, when concerning biologics, which is rapidly growing. The downside to this is that generics help control costs by offering similar solutions for much less money. Essentially, this monopolizes the market for 12 years for each new biologic.

There was a Republican alternative to the House Bill, which included:

  • No public option
  • Individual mandate
  • State high risk pools
  • Not having language barring pre-existing conditions
  • Businesses can combine resources and buy health insurance across state lines
  • Reforms to control costs

Gay Marriage Overturned In Maine

According to the San Francisco Chronicle, Proposition 1 (overturning the legalization of gay marriage in Maine) has passed, delivering a great blow to the civil rights movement of our time.

From the article:

“Voters have a pretty good grasp about what they think marriage should be,” said Jeff Flint, the Sacramento strategist for the Yes on 1 campaign. “It’s not that they’re discriminatory or bigoted. They just draw the line at what they think marriage should be.”

It’s not discriminatory or bigoted? Perhaps it’s just me, but I can imagine those kinds of words being used to describe interracial marriage once upon a time. Of course, we wouldn’t dream of saying that of interracial marriage now, just as I think one day people won’t bat an eye at gay marriage. When that time will be, however, I do not know.

Probably when people realize it’s not the individual’s rights should supersede those of the government. And when the people who manage to ignore all things scientific (like when people mistakenly say there are ‘holes‘ in evolutionary theory) finally realize that there actually is evidence for homosexuality being biological, as opposed to the no evidence there is for it being a choice. And once people realize that it’s not their place to deny gay people the state-conferred benefits given to all married people. And once people realize that “my church is against it” is not a legitimate argument in a country where (to quote Thomas Jefferson) there is a wall of separation between church and state.

As for this whole referendum business — perhaps these issues shouldn’t always be left to the people, if the people are supporting oppression. After all, if it had been up to referendum, would the institution of slavery have ended when it did?

Election Results!

You can catch the election results for many of the PA and NJ races at 6abc. As far as the offices I discussed in previous blog posts, here’s how it stands so far:

  • PA Supreme Court — Joan Orie Melvin (R)
  • PA Superior Court — Judy Olson (R)
    Sallie Mundy (R)
  • Philadelphia District Attorney — Seth Williams (D)
  • Philadelphia Controller — Alan Butkovitz (D)
  • PA Commonwealth Court — Patricia McCullough (R)
    Kevin Brobson (R)

In non-PA news:

  • Chris Christie (R) bested Democratic incumbent Jon Corzine and potential spoiler independent conservative Chris Daggett, and is now Governor-elect of New Jersey.
  • Michael Bloomberg (I) has been re-elected to a third term as NY Mayor after persuading the City Council to amend the laws to allow him to run for a third term and then spending $90 million of his money on the campaign. I put the (I) next to his name because he is technically an Independent now — though in the past he has been a Democrat and a Republican.
  • Robert F. McDonnell (R) won the race for Virginia Governor, being the first Republican to do so in 12 years.

Endorsements for November 3 Election

After reading as much up on the candidates as I could, I’ve decided which candidates I will support in tomorrow’s election. In this blog post, I’ll list all of the candidates on the Philadelphia ballot, which ones the Philadelphia Inquirer and the Daily News are endorsing, respectively, and which ones I’ll endorse (though, as a random blogger, I doubt it’ll do much).

Each candidate’s name (in this blog) will link to his or her website.

The Committee of Seventy has a lot of good information on the candidates, including links, and also good information on the seats for which they are vying. If you want to see a broader picture of who is endorsing who (aside from the Inquirer and Daily News’ respective endorsements, check the candidates’ websites, because they’ll inevitably want to boast about who is supporting them).

Here are the candidates:

PA Supreme Court Justice (1 Seat)

District Attorney (1 Seat)

City Controller (1 Seat)

PA Superior Court (4 Seats)

Commonwealth Court Judge (2 Seats)

7 Seats are available for Court of Common Pleas Judge, and there are only 7 candidates, so I will not list them (follow the link if you want to know more)

4 Seats are available for Municipal Court Judge, and there are only 4 candidates, so I will not list them (follow the link if you want to know more)

PHILADELPHIA INQUIRER ENDORSEMENTS

  • PA Supreme Court – Joan Orie Melvin (R)
  • District Attorney — Seth Williams (D)
  • City Controller — Al Schmidt (R)
  • PA Superior Court – Judy Olson (R)
    Robert Colville (D)
    Anne Lazarus (D)
    Teresa Sarmina (D)
  • PA Commonwealth Court — Linda Judson (D)
    Kevin Brobson (R)

DAILY NEWS ENDORSEMENTS

  • District Attorney — Seth Williams (D)
  • City Controller – Alan Butkovitz (D)

MY ENDORSEMENTS

  • PA Supreme Court — Jack Panella (D)
  • District Attorney — Michael Untermeyer (R)
  • City Controller — Alan Butkovitz (D)
  • PA Superior Court — Anne Lazarus (D)
    Judy Olson (R)
    Teresa Sarmina (D)
    Marakay Rogers (L)
  • PA Commonwealth Court — Linda Judson (D)
    Kevin Brobson (R)

Follow some links, read up, get out and vote! Polling places open 7am – 8pm.

Third Parties Signaling Voter Anger?

The AP has a nice article on what is a consistent trend throughout voter history — the rise of third parties at times when voters are unhappy. The article discusses Governor’s race in NJ between Democratic Incumbent Jon Corzine, Republican candidate Chris Christie, and Independent Chris Daggett. In NY’s 23rd District, the GOP candidate (Dede Scozzafava) was forced out of the race by surging Conservative Party candidate, Doug Hoffman. Scozzafava then endorsed her former Democratic opponent, Bill Owens.

Does this mean America is headed for a new era, the end of the two party stranglehold on political power? Sadly, I’ll have to say no.

Now, I’m not saying no because I hate third parties — quite the opposite. If my young voting record is any indication (and my independent party affiliation), I advocate third parties aggressively. However, I’m a realist above all, and while I believe that a few third party candidates may make inroads here or there, this will not be a permanent phenomenon.

Historically, third parties have been strongest when there is discontent in the nation. Look at Teddy Roosevelt, who harnessed the power of the Progressive movement into his Bull-Moose party, fighting with former friend and Republican candidate William Howard Taft, paving the way for a Wilson presidency (Wilson won with only 41.8% of the popular vote).

George C. Wallace took 46 electoral votes in 1968, playing at divisions in the electorate over de-segregation (Wallace opposed de-segregation). Nixon would win that election with 301 electoral votes, but, interestingly, only little more than half of the popular vote (he got 31,710,470 votes whereas Vice President and Democratic candidate Hubert Humphrey got 30,898,055, and George Wallace got 9,906,473). An incredibly close race with a third party siphoning votes by playing to the divisive issue of the time.

Looking back to 1948, Strom Thurmond won 39 electoral votes as the segregationist, socially conservative Dixiecrat, again taking advantage of the racially divisive time period. Thurmond carried Southern states, most likely taking votes from Democratic candidate Harry S Truman (back when the South was solidly Democratic, pre-LBJ days) who still clinched a narrow victory over Thomas Dewey.

More recently, in 1992, Ross Perot gained about 19% of the popular vote, but no electoral votes. Perot’s focus on the economy, during a recession and after 12 years of Reagan-Bush, gained him a large amount of votes, even after he withdrew and then re-entered the race. However, and this is instructive as to the lot of third parties in America, Perot’s 1996 run for the Presidency was decidedly less successful. Why? Because Clinton absorbed many of the Perot voters with his economic agenda. Perot was the answer to growing discontent with both parties (the Republicans in power — Reagan and Bush — had more than tripled the national debt and the economy was in recession, and the Democrats were also saddled with a reputation of big government and larger spending), but once Clinton took office as a “New Democrat” and began the process of balancing the budget and leading the way out of recession, many voters who were discontented with the two main parties then supported Clinton. In effect, he neutralized the Perot voters, and brought them over to his side for the 1996 election.

This is the historic role of third parties in America — the answer to discontent with both the two major parties. They run, they siphon off enough votes to make the major parties recognize the growing movement in America, and then the major parties absorb their views to neutralize them and pacify the electorate. When was the last time you saw someone running on the Bull-Moose or Dixiecrat or Know-Nothing ticket? These movements don’t often survive past a few elections at the most, because their views have been taken on by one of the major parties (Perot) or their views become out of step or fall out of favor (such as the racist Dixiecrat and Know-Nothing parties). Or because people are frightened to vote third party.

Which leads us to the 2000 election. Discontent spread over various things (the Monica Lewinsky affair and Gore’s subsequent attempts to disassociate himself with Clinton, the false image of Gore perpetuated by opponents (for instance, he never said he invented the internet), and the conservative bend of the Clinton-Gore “New Democrats’” on various economic issues like deregulation and free trade), which lead to an extremely tight race in which Gore won the popular vote of the American people, but lost the election after the Supreme Court decided Bush won Florida. Ralph Nader, running as a Green Party candidate, was the answer to much of this dissatisfaction. He posed a progressive alternative to the Gore “New Democrat” and the “Reagan Conservative” Bush, and won 2.74% of the popular vote.

Viewed as the spoiler that caused Gore to lose (though Gore actually won the popular vote, as noted above), Nader would have no substantial effect in later elections. Essentially, I believe, the thought process became “a third party cannot win and can only hurt my second choice candidate, so I have to vote for one of the two major parties”. Also, the 2000 did not have the extremely large issues that dominate politics today (terrorism and the economy — the 2000 election was pre-9/11 and the economy was not in a recession). The stakes may seem higher now than they did in 2000.

Finally, as Ralph Nader has noted before (I’ll search for the link to the interview), it is extremely difficult to unify a third party, which (like any other party) boasts an intellectual diversity of members. Splintered into various segments, often on a state level instead of a national level, a party may be successful in gaining some elected seats here or there, but without a unifying force it probably won’t translate to a broader single movement that will redefine the political spectrum.

Looking at what has occurred before as a guide, these third party candidates may have scattered success as voters become disillusioned with the Obama Administration but are stilling unwilling to vote for the contemporary Republican Party (dominated as it is by its radical elements — think Limbaugh, Palin, ‘birthers’, and ‘death panelists’), but they will most likely not change the political landscape in the long-term. If the economy picks up, and things start looking better (or if the Republican Party retains its extremist views), these voters may return to the Democratic fold. If the Republican Party recreates itself into a party of intellectual conservatism and jettisons its fringe elements and evangelical base that frighten away moderate voters, then it will likely gain these independent-voters.

Tuesday Elections in Pennsylvania!

Elections Tuesday!

The Bucks County Courier Times has a voter guide you can look over here. It’s pretty expansive, so look it over if you’re in Bucks County.

If you’re not in Bucks County, but are still a PA resident, then look over the first few pages, that give an overview of the PA elections — PA Superior Court, PA Supreme Court, and PA Commonwealth Court. Here’s the breakdown of candidates for PA Supreme Court (One 10-year seat, salary of $186,450):

The Lehigh Valley Ramblings blog had this to say about Jack:

Judge Jack Panella is in a class by himself. He is the youngest person ever named to serve as County Solicitor and is the second youngest person to serve as a judge, having first been appointed in 1991. Popular and smart, Panella could have stayed there forever. But Panella, who is actually a legal scholar, bucked the odds and ran for Superior Court in 2003. Although western Pennsylvania has a lock on most appellate judgeships, Jack won.”

The conservative Bulletin published an article about Joan:

Judge Orie Melvin said her election would translate into conservative Republican values that would benefit all Pennsylvanians.

“I am a social and fiscal conservative and a reformer,” she said. “The opinions of the Supreme Court are of great public importance because they affect the lives of every Pennsylvania citizen. [Because this seat will control the majority], there will be a difference whether a Republican or Democrat justice gets elected.”

She cited endorsements from the Pennsylvania Pro-Life Federation and the National Rifle Association that go back 23 years, as well as the backing of Pennsylvanians for Effective Government and the state Chamber of Commerce, as evidence of her conservative philosophy.

The Inquirer wrote about how this Supreme Court election could be crucial. (Hint, hint, read up on the issues and go vote):

Turnout for the election may be the lowest in Pennsylvania in years.

But state Democratic leaders are just as frank as top Republicans in saying that to them, the court fight is all-important. It could influence the once-a-decade remapping of congressional and legislative districts after the 2010 U.S. Census.

Under the state constitution, each party gets two seats at the negotiating table when district boundaries are redrawn to reflect population shifts since 2000. The court likely will be called upon to appoint an arbiter to break the tie, and that’s where the election comes in.

Both parties are keenly aware that the six justices who will still be on the court next year are split 3-3 in terms of party affiliation. (The seventh justice, Jane Cutler Greenspan, was appointed to fill the seat of the late chief justice, Ralph Cappy, on condition that she not run for a full 10-year term.)

In practical partisan terms, the winner of Tuesday’s election will determine the court’s majority. And at redistricting time, the majority gets to pick the arbiter.

“The last time, it was the Republicans who controlled the state Supreme Court,” said Abe Amoros, spokesman for the Democratic State Committee. “This year, we are looking at a 4-3 majority when Jack Panella wins, which will give us some hope at redistricting.”

No one in politics is saying directly that Orie Melvin or Panella would be anything less than fair and impartial. And the candidates say, emphatically, that they won’t let partisanship influence them.

Yet Orie Melvin and Panella – now colleagues on the state Superior Court, one level below the Supreme Court – are accusing each other’s campaign of turning the remapping into an issue.

“It’s Jack Panella who puts redistricting out front in a partisan manner . . . and he continues to do so,” Orie Melvin said.

In an interview, she said Panella brought up redistricting at a Democratic State Committee meeting last winter when he was seeking party endorsement.

She said: “I am not a Republican judge; I am a judge of all the people. I have always followed the constitution – and will do so in redistricting.”

Panella, in an interview, said he worries that if Orie Melvin wins, the GOP majority on the court will give an unfair edge to Republicans in the remapping process.

“That gives me a lot of concern,” he said. “I believe we have to keep politics out of the Supreme Court.”

Because they controlled the last redistricting process a decade ago – when they had a majority on the court – Republicans were able to move district lines in ways that benefited their candidates and hurt some Democrats.

In the state’s southeastern corner, many suburban Democrats were moved into Philadelphia-based districts. This made life easier for Republicans in the suburbs, but did not affect city races that favored Democrats anyway.

Partly because of redistricting, Republicans were able to reverse the 11-10 majority that Democrats had previously held in U.S. House seats in Pennsylvania. By 2003, Republicans held 12 seats; Democrats, seven.

Redistricting is a major issue in the court race “because gerrymandering robs our citizens of the right to vote,” Panella said. “Your vote is meaningless if the district has been arranged so a political party has no chance of winning.”

In interviews on Monday, both candidates were asked how their rival’s judicial philosophy differed from their own.

Orie Melvin said that Panella’s much-larger supply of campaign funds from plaintiff lawyers evidenced that group’s belief that he is more friendly to its interests.

Panella said Orie Melvin had a record of turning away plaintiffs seeking to sue for wrongs committed by corporations and insurers.

Both candidates were rated “highly recommended” by the Pennsylvania Bar Association, which routinely evaluates the qualifications of judicial candidates.

The group called Orie Melvin “genial and fair-minded” and said “she has demonstrated sound judicial temperament.” It credited Panella with “sound judicial temperament and exceptional administrative ability,” while possessing “a rare combination of intellect, energy and skills.”

The blog Capitol Ideas also has some good info on the attack ads both campaigns have been running.

Tourism in the Greater Philadelphia Area

What brings tourists to Philadelphia? And what effect do tourists have on the region? Our team set out to answer these questions.

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