Datafork – On Free Speech

“LIVING WITHIN YOUR MEANS” is a familiar concept and easy to get behind, but does it mean that in our private lives we should never borrow in order to recover from illness,  or start a business, or to fix damages to our home? 

The new republicans, particularly the tea party type, argue for drastic cuts, without accounting for the impacts on the middle class and the poor, or the risks to our economic recovery.

“Enough is enough,” they say … we will borrow no more to advance our future, nor will we ever consider asking the wealthy to make sacrifices in order to pay for our wars, or to undo the harm from the recent financial industry meltdown.

Regarding maintaining the tax cuts to the wealthy, they argue:  It is THEIR money and we are not giving the wealthy anything they haven’t earned and deserve.

But have the wealthy truly earned their wealth independent of our infrastructure or American laborers?

Government programs can’t be trusted and are socialistic, they say … these are just ways to give our hard-earned money away to the poor, and restrict the growth of private businesses with excessive regulations.

By excessive regulations, do they mean child labor laws, or that our country is best served by not restricting a paper or power company from polluting a river?

Not stated in public by elected republicans, but evident in the right-wing talk show rhetoric: the underlying theme is that  Goverment is evil … and that  it’s agenda is give our tax dollars away to the lazy, undeserving …  

(Be aware that zealots can provide cherry-picked webcams examples of government workers behaving badly,  … but they will not mention how may stings they had to do to get ONE example (3, 6, 12, 100?) … aware that the mainstream media will never ask this common sense question, or mention that any group could be deamonized with such methods, including doctors, police, politicians, nuns,  … corporate executives)

Citizens, let’s not forget the government programs have built this nation – and continue to provide vital services to protect our health and safety, but also to protect consumers from unethical business practices (credit card abuses most recently), and to provide infrastructure essential for private-sector economic activities:

The Interstate highway system,   the Centers for Disease Control and Prevention, the National Cancer Institute,  the FDA, the Hoover Dam, the Panama Canal, public school teachers, the US Postal system, and so on.

And Medicare?

Yes, while not solvent, it controls costs better than the private insurance sector (without excluding or pricing out the sick or the elderly as the private insurance industry is free to do); further, it has administative costs equal to 2% of total program costs; Most private insurers are around 20%. Source:  http://bit.ly/erkmWY 

Why do you suppose the health insurance industry  so vigorously opposed a pubic option?  Answer: It was aware it could not compete with it on a level playing field. 

For politicians cynical about government programs, we might remind our dear elected representatives  (who have guaranteed tax-payer provided health care for life) that they are also government workers, as are our soldiers in Afghanistan and our teachers in the public school system.   

So the responsible way to address the growing deficit crisis is to make sure the government programs are chosen wisely and are operating efficiently (we are getting our money’s worth) – that they serve the intended purpose, and that the purpose still sustains and protects the public interest.

We might ask the following questions of ourselves and our leaders:

What “self-made” entrepreneur could succeed today without an electric grid, a clean water supply,  an effective transportation system, or  a literate and skilled work force?   

What patient could surive if not for the  independent review of drugs to make sure that drugs infused into our blood are safe and effective?    Should we just let the companies market foods and drugs if they safe or not .. and tobacco?

How could any of us expect to receive adequate  fire, police, and childhood education services without government programs and workers?

What citizen or business could thrive in chaos - without a strong defence provided by our service men and women?

So yes, we really must always strive to live within our means, and we will need to cut unwise and non-essential spending to head off future economic problems.  

But citizens, we need to consider also the vital role of government programs and that it’s simplistic to believe that wielding a machete in anger is wise policy for this or future generations. 

Citizens, please also consider the significance of extending the Bush tax cuts for the wealthy – which DWARFS other causes for the rising deficit as shown here in an independent CBO-data-based chart:  http://bit.ly/hapSnh  .

So we watch in astonishment while the present republican leadership promotes its Agenda of Anger without dicussion or consideration of the LARGER FACTORS driving the deficit shown above, or  the consequences of those machete cuts on our ability to build our future, which requires for example, clean air and water – and opportunity for all children to reach their full potential. 

Conspiciously absent from the tea party’s Agenda of Anger is a mention of the vital role of goverment programs in our history, or how to make the public systems work more efficiently.  

In summary:  1) To characterize all government spending as wasteful and unproductive requires that we forget our history. 2) There is no justification for extending the tax cuts to the wealthy in the present economic circumstance.  3) Even Ronald Reagan’s vision of America did not call for lowering our expectations about how Americans must live in order to spur business growth – an economic growth that increasingly leaves behind American workers.

For more on this issue, see “Wealth and an American Paradox” http://bit.ly/ec24nO 

KarlS

Greetings,

The Affordable Care Act (ACA) remains controversial, and opponents have challenged also the constitutionality of the ACA as described by legal experts in an interesting piece: 

Can Congress Make You Buy Broccoli? And Why That’s a Hard Question, NEJM | December 22, 2010 | Wendy K. Mariner, J.D., M.P.H., George J. Annas, J.D., M.P.H., and Leonard H. Glantz, J.D.  http://bit.ly/eHP1HY   

I interpreted the above piece as non-partisan because the authors gave both sides of it (as presented in courts) and didn’t say which they agreed with.

I’m progressive in temperament – I think a democratic government has a vital role in achieving a balance between commercial and public interest – to prevent unethical business practices and abuses (child labor, encouraging import of immigrant workers for slave wages, monopolistic practices that harm consumers, etc.)

From my perspective, ACA (through the government-regulated but commercial insurance exchange) is a necessary intervention to reverse a well-documented downward spiral – fewer and fewer working Americans (millions per year) able to afford health insurance and thus unable to receive timely basic care; fewer paying into the system they will be forced to use when they eventually get sick – increasing rates for all — a cost that’s passed on to those with insurance (or companies that provide it for employees).

Rosenbaum, J.D., and Gruber, Ph.D. write:

“… the uninsured consume more than $50 billion in uncompensated care, the costs of which are passed through health care institutions to insured Americans. Moreover, medical expenses not covered by insurance are one of the leading causes of bankruptcy in the United States …

NEJM, 2010, Buying Health Care, the Individual Mandate, and the Constitution: http://bit.ly/9FElMG

The constitutional challenges against ACA seem an academic attempt to find a way to leave things as they are (for those who are still able to afford healthcare). 

It should not surprise that each judge will see it differently, depending on his or her perspective on the role of government – the classic “eye of the beholder” debate.  Thus there can be no final resolution to the argument – to the Founding Father’s intent.  It will depend on the temperaments of the appointed judges – on who you ask.

The key fact for me, as cited by the State Commissioners of Insurance, is that a system where people purchase insurance only when they need it just can’t work – just as you can’t allow the purchase of house insurance when the house is already on fire.  http://bit.ly/9E5RKJ

So it comes down to this: Is mandating that all able citizens purchase health insurance good policy or bad? 

Letting the insurance industry decide on policy has already led to  a two class system – a stark and growing divide between those with access and those who gamble every day with their future … do I pay the rent and put good food on the table for my children, or pay the insurance bill?

As an aside: what might not be clear to the wealthy class in America is that even in Europe the well-to-do can purchase supplemental insurance to get even higher levels of medical services – and I’m confident that will be the case here – assuming ACA survives.

An employer-dependent insurance system also prevents people from switching careers that they may be better suited for – out of fear they will lose vital health care insurance.

… Rising costs of insurance premiums making it challenging for American businesses to compete in a global market – the ever increasing deductibles in insurance plans a familiar workaround - not understood until you have to actually pay that deductible.

To me, establishing an accessible, high-quality health care system is like providing public education – infrastructure necessary to promote the general welfare – to provide opportunity for our citizens to reach their full potential – not fall into abject poverty when the father or mom gets sick (another cost born by others indirectly).

Again, ACA is NOT a government handout, and it was originally a Republican idea: It requires that those who can afford insurance opt in, which makes sense to me – just as it makes sense to require drivers to carry auto liability insurance.

The exchange system will also require clear descriptions of the competing services – apples to apples comparisons, so consumers can compare prices readily, eventually allowing true competition to stabilize or decrease costs of health care insurance.

Will there be side effects when implementing ACA?  Without question! Every remedy, every change, has side effects and will require adjustments.

Is access to healthcare insurance THE answer to rising costs?

 Of course not.  While the present healthcare insurance system is a significant cause for rising INSURANCE rates, and to the rising medical costs per paying person – as fees are shifted to the rest of us by healthcare providers … there are many additional reasons for increased health care costs, such as relentless medical innovations that are expensive to pay for, compared to dying.

So our society will have to make hard choices going forward about what is covered in the basic plans based on comparative-effectiveness medical evidence.

We will have to fix provider abuses, fraud, the trend to over-treat and over-test (again, some of this driven by the necessity to shift costs to the insured)

We will have to start to prevent life-style illnesses that are expensive to treat and impairs our collective productivity and creativity:  obesity, smoking-related disease, diabetes etc. (Also part of ACA, but not discussed)

Will our representatives in government ever work together to solve these problems? 

How could they if  misinformation about the nature of the problem and the reform bill  continues?  (What really ticks me off, frankly, such as the irresponsible false rumor that ”government is going to kill grandma” ) .

So ACA was never honestly debated – the void filled with industry-funded commercials, misinformation and sometimes outright lies propagated by radio-talkshow “experts.”   The damage?  Any representative seen as cooperative (of killing grandma! or being in league with “communists”) – unable to win reelection.

We should not underestimate the power that radio personalities have over elected officials, who base policy on public opinion, whether that opinion is informed or not.  

Thanks to a recent Supreme Court decision, special interest groups (often undisclosed) have more power than ever to influence elections – in order to create policy favorable to their financial interests – which SOMETIMES serves the public interest and sometimes doesn’t.  

That giving free reign to business interests ALWAYS favors the public interest is an obvious myth. History is jam-packed with examples, and this is a reason that no country provides for or allows a Laissez-faire environment.

Moving forward, the public must demand honest, fact-based debates on public policy issues and for an election process that minimizes the ability of special interest groups to distort the issues or overwhelm opposing views with commercials. 

The mainstream media must do a better job of fact-checking and informing the public when a claim is not verified – and also reporting on who is funding the political commercials. 

A compounding problem here being that the mainstream News media is not necessarily a disinterested party in our public policy debates, which can influence what’s reported on and how well, affecting public opinion, which drives political behavior. 

So part of the reform I am pleading for here is the need to define what is News and what is Editorial – or to require that the News media at least declare when it is giving opinion with intent to persuade, and also disclose if has a conflict of interest in the matter. 

What’s the alternative? 

We can just let nature take its course and find out the hard way … as we discovered the need to regulate the financial industry – almost too late to stop the bleeding.

Karl