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Today’s NY Times has an article (A Health Care Plan So Simple, Even Stephen Colbert Couldn’t Simplify It by Robert H. Frank an economics professor at Cornell – New York Times, February 15, 2007; page C3) which is worth reading.

In his State of the Union address, President Bush proposed tax cuts to make health insurance more affordable to the uninsured. Apparently Stephen Colbert (of Comedy Central) had this comment on the President’s plan:

“It’s so simple. Most people who can’t afford health insurance also are too poor to owe taxes. But if you give them a deduction from the taxes they don’t owe, they can use the money they’re not getting back from what they haven’t given to buy the health care they can’t afford.”

Which does cast GW’s plan in its proper light… as a cruel joke similar to the rest of his policies.

But Professor Frank goes on to give a very well reasoned case for why a single-payer healthplan makes sense for people at all income levels and why it should save everyone money. He also outlines the underlying motivations for the forces opposing a single-payer system.

Rather than cut and paste a bunch of quotes from the article, I will post a link to the NYTimes copy of the article here.

So much for Speaker Nancy Pelosi’s 100 hour blitzkrieg to return Capitol Hill to a higher ethical standard. Not only is she weakening her message by demanding that the Pentagon fly her around in a personal 757… But it is already evident that her new rules designed to curb the influence of lobbyists is an abject failure.

According to today’s New York Times article (Congress Finds Ways of Avoiding Lobbyist Limits by David Kirkpatrick, Sunday February 11, 2007), it has taken congressmen on both sides of the aisle only a few weeks to figure out how to get around the new ethics rules. (Actually, I am sure they knew how to get around them in advance… After all it was the lawmakers who wrote the rules and they were written to have loopholes a mile wide.)

Pelosi’s new rules prohibit lobbyists from treating lawmakers to meals, trips, stadium box seats, or discounted use of private jets. However, according to the article, within the last two months, lawmakers have invited lobbyists to help pay for lavish birthday parties in a lawmaker’s honor ($1,000 per lobbyist), margaritas and martinis at Washington area restaurants ($1,000), a California wine-tasting tour, hunting and fishing trips (typically $5,000), weekend golf tournaments ($2,500 and up)… The list goes on and on…

The trick is that the lobbyists don’t pay the lawmaker directly. Instead the lobbyists pay a political fund-raising committee…which then pays for the lawmaker’s party, trip, etc. Apparently nothing in Nancy Pelosi’s new rules prohibits this… Is she a naive fool or “one of them”?

The New York Times article has the following table:

Join Your Favorite Lawmaker For… (for a “small” contribution)
Democratic Senatorial Campaign Committee	Weekend at the Harbor House resort on Nantucket	$25,000
Senator Max Baucus (Dem. Montana)	Skiing or snowmobiling in February or golfing or fly-fishing in the summer	$5,000
Senator Tom Carper (Dem. Delaware)	Skiing weekend at the Ritz-Carleton Bachelor Gulch in Colorado	$5,000
Senator Bill Nelson (Dem. Florida)	Super Bowl Party in Miami	$5,000
Rep. Stephanie Tubbs Jones (Dem. Ohio)	“Manicures and Muffins” at Capitol Nails in Washington	$2,500
Senator Mel Martinez (Rep. Florida)	Presidents’ Day Weekend at Disneyland	$5,000
Rep. Eric Cantor (Rep. Virginia)	Coffee at Starbucks (four mornings this Spring)	$2,500
Rep. Ron Manzullo (Rep. Illinois)	Valentine’s Day Reception at Landini Brothers in Alexandria, VA	$1,500
Rep. Mary Bono (Rep. California)	Concert by The Who	$2,500 for two
Rep. Vito Fossella (Rep. New York)	Performance of “Mary Poppins” on Broadway	$2,500 for two
Rep. Kay Granger (Rep. Texas)	“Grangertinis” birthday party at a Washington Steakhouse	$1,000

I really like the sound of the “Manicures and Muffins”, myself. For $2,500, I am sure those are really good muffins.

There are a lot of differences between Iraq and Vietnam but it’s probably worth looking back on Vietnam as we consider what course to take in Iraq.

Should we “cut and run” or should we keep sending soldiers and marines over there to secure “peace with honor.”

When our political and military leadership have no clear plan or objective, does it make any sense, and is it morally defensible, to keep on wasting the lives of our rank and file military.

The Bush administration says that if we simply withdraw that it will be disastrous; that Iraq will be a haven for terrorists. Yet I don’t think anyone outside of the White House believes that sending another 20,000 troops to Baghdad for a couple of months is going magically stabilize Iraq. If we’d followed General Shinseki’s advice in 2003 and sent in 300,000 troops and had a less corrupt and incompetent reconstruction effort things might have turned out better. But we didn’t and it’s three years later and it’s really too late now.

Let’s get the troops out before any more are wasted. It’s worth remembering that we lost in Vietnam… The bad guys ended up in control of both North and South Vietnam. And what harm has come of it? It’s thirty years down the road from the fall of South Vietnam and we are now trading partners with Vietnam.

There is no doubt that the Middle East is very different from South East Asia and the mindset and cultural and religious issues are enormously different. It is ironic, about 2 million Vietnamese and over 50,000 Americans died during the war there and yet an American traveler today is probably safer in Hanoi today than he would be anywhere else in the world. That isn’t going to be true in the Middle East; not now, not in thirty years, and probably not ever. Muslim fundamentalism, the Arab/Israeli conflict, Iran’s nuclear ambitions are not going to away and we will have to figure out political and military responses to them all.

But the invasion of Iraq was ill-conceived from the beginning and hopelessly bungled in its execution. It’s time to get our guys out of there and leave the Kurds, Sunnis, and Shiites to sort it out among themselves. We won’t be able to just walk away and forget about it… But we need to back off and find another approach, wait two years until GW and his gang of fools are gone and have a more intelligent and less corrupt President try to sort this out.

Update 31JAN09: Well, we now have a more intelligent, less corrupt President. And a combination of the troop surge and the new policy of reaching out to the Sunni militants has resulted in a much more stable Iraq. Both thanks to General Petraeus and getting rid of Rumsfeld. Now we can, one hopes, get out of Iraq and attend to our unfinished business in Afghanistan and Pakistan.

The US healthcare system is a disaster. If you total up all the healthcare costs (government tax dollars, private insurance premiums, etc.), US healthcare costs about twice as much per person as the healthcare in any European country, Canada, or Japan. And yet we have 40 million or so uninsured and on virtually every measure of health, the US ranks close to last of all the developed countries.

So the whole system needs to be changed. But we have all sorts of powerful, enormously wealthy institutions (insurance companies, drug companies, medical diagnostic labs, medical equipment suppliers, etc.) who are making vast amounts of money under the current system. They will resist any changes that they think will threaten the gravy train. And they and their lobbyists have had Congress in their pockets for decades.

There is a growing consensus among the public that the current system is not serving anyone well, not even those of us who have healthcare coverage. So the question is what sort of system to we move to.

To me it seems obvious that we should be moving to a single-payer system that is managed by the government and that guarantees that every citizen gets the same access to care. That’s what almost every other developed country in the world has and, while their systems certainly have problems, the statistics show that their plans are both less expensive and produce better results than what we have.

The opponents of single-payer systems are quick to point out, for example, that Canadians must wait months for routine medical appointments but when US seniors are struggling to find affordable prescription drugs where do the turn… They buy the drugs from Canada. And who is trying to stop them? The US Food and Drug Administration under the influence of the pharmaceutical industry lobbyists. And why are these drugs (most manufactured in the US) cheaper in Canada? Because the Canadian healthplan used their leverage as the sole provider of prescription coverage in Canada to negotiate better prices.

When the Republican Congress created Medicare Plan D they specifically forbade Medicare from negotiating drug prices. So now the Medicare Plan D prices are significantly higher than, for example, the prices charged the Veterans Administration. Why? Because the Veterans Administration is allowed to negotiate drug prices.

So why do I say that there is going to be a battle between “Universal Coverage” and “single-payer”? Because Universal Coverage is a nice sounding name for a Rube-Goldberg mess by which private insurers will be subsidized using tax dollars to provide 2nd-class-citizen coverage for the less affluent members of US society.

We currently have two single-payer plans in this country (Medicare and the Veterans Administration) that appear to work rather well. My understanding is that they are actually more efficient in their administrative costs than private insurers. We should be studying them and the single-payer health plans in place in other countries to try and come up with a single-payer plan that is better than all of them.

The Boston Globe has an article (February 3, 2007 by Rick Klein) entitled Romney distances self from Mass. health plan. Just as GW slunk off to Washington leaving various disasters in Texas, Mitt is doing the same.

As pointed out in the Globe article:

The plan for statewide, near-universal health coverage was the centerpiece of Romney’s administration, and it has become a key part of his presidential resume.

As Democratic legislator Richard Moore pointed out in the article:

“That’s why he left [office] in a hurry,” said Moore, the chairman of the Senate Health Care Financing Committee. “He’s setting himself up so he can go either way. If it’s a success, he’ll take all the credit in the world. If it’s a failure, he’ll blame everybody else.”

Moore said Romney can’t hide the fact that he worked closely with Democrats to craft the law, and his administration was responsible for implementing its early stages. “If it doesn’t work, it’s going to be a shared responsibility,” he said.

One of the ironies of this state-mandated plan is that it will either lead to businesses dropping coverage of their employees… Or the coverage standards (deductibles, services included, etc.) are going to be reduced until you truly have a 2nd-Class-Citizen coverage plan.

According to previous Globe articles, under the current plan, about 200,000 people who are currently insured by their employers are going to be told that their coverage is insufficient and that they are going to be penalized. But are their employers going to pay to have their coverage improved??? All the employers have to do to bail out completely on insuring their employees is pay the state $200 per year per employee… Much less than they are currently paying for their employees current coverage.

To avoid that, the State will almost certainly reduce the coverage requirements (which is what the insurance industry desperately wants) and, yes, you will have true 2nd-Class-Citizen coverage… That isn’t worth the money and that you are required to buy by the State.