Krugman on Bush’s Latest Health Plan: Gold-Plated Indifference

Paul Krugman has similar objections to Bush’s latest health plan as I expressed earlier:

Going without health insurance isn’t like deciding to rent an apartment instead of buying a house. It’s a terrifying experience, which most people endure only if they have no alternative. The uninsured don’t need an “incentive” to buy insurance; they need something that makes getting insurance possible.

Most people without health insurance have low incomes, and just can’t afford the premiums. And making premiums tax-deductible is almost worthless to workers whose income puts them in a low tax bracket.

Of those uninsured who aren’t low-income, many can’t get coverage because of pre-existing conditions — everything from diabetes to a long-ago case of jock itch. Again, tax deductions won’t solve their problem.

The only people the Bush plan might move out of the ranks of the uninsured are the people we’re least concerned about — affluent, healthy Americans who choose voluntarily not to be insured. At most, the Bush plan might induce some of those people to buy insurance, while in the process — whaddya know — giving many other high-income individuals yet another tax break.

While proposing this high-end tax break, Mr. Bush is also proposing a tax increase — not on the wealthy, but on workers who, he thinks, have too much health insurance. The tax code, he said, “unwisely encourages workers to choose overly expensive, gold-plated plans. The result is that insurance premiums rise, and many Americans cannot afford the coverage they need.”

Again, wow. No economic analysis I’m aware of says that when Peter chooses a good health plan, he raises Paul’s premiums. And look at the condescension. Will all those who think they have “gold plated” health coverage please raise their hands?

According to press reports, the actual plan is to penalize workers with relatively generous insurance coverage. Just to be clear, we’re not talking about the wealthy; we’re talking about ordinary workers who have managed to negotiate better-than-average health plans.

What’s driving all this is the theory, popular in conservative circles but utterly at odds with the evidence, that the big problem with U.S. health care is that people have too much insurance — that there would be large cost savings if people were forced to pay more of their medical expenses out of pocket.

The administration also believes, for some reason, that people should be pushed out of employment-based health insurance — admittedly a deeply flawed system — into the individual insurance market, which is a disaster on all fronts. Insurance companies try to avoid selling policies to people who are likely to use them, so a large fraction of premiums in the individual market goes not to paying medical bills but to bureaucracies dedicated to weeding out “high risk” applicants — and keeping them uninsured.

Hagel Explains Role of Congress to Dick Cheney

Last week Chuck Hagel explained the realities of the war to Joe Lieberman. Today he responded to Dick Cheney’s stock attack on Face the Nation (hat tip to Think Progress):

SCHEIFFER: Let me ask you this, Senator. Vice President Cheney says this sort of thing undercuts the troops. What’s your response?

HAGEL: Let me tell you this. I served in Vietnam in 1968. Others did too. Jim Webb, John McCain. John Kerry. Other members in the House. In 1968 when I was there with my brother, worst year, deaths, I would have welcomed the Congress of the United States to pay a little attention as to what was going on. I would have welcomed that. That is complete nonsense to say we’re undercutting the support of the troops. What are we about? We’re Article 1 of the Constitution. We are co-equal branch of government. Are we not to participate? Are we not to say anything? Are we not to register our sense of where we’re going in this country on foreign policy? Bottom line is this: our young men and women and their families, these young men and women who are asked to fight and die deserve a policy worthy of those sacrifices. I don’t think we have one now.


Conservatives and Their Enemies at Home

Last week I wrote about Dinesh D’Souza’s book The Enemy at Home  showing the similarities between fundamentalist Christianity on the right and Muslim fundamentalism. Alan Wolfe writes on this in today’s New York Times. After showing D’Souza’s soft spot for bin Laden, he discusses D’Souza’s lists of enemies at home:

The “domestic insurgents” who, in D’Souza’s view, constitute the cultural left want “America to be a shining beacon of global depravity, a kind of Gomorrah on a Hill.” “I intend to name the enemy at home,” D’Souza proclaims, and so he does. Twenty recent members of Congress, including Hillary Rodham Clinton and Ted Kennedy, are on one of his lists, and 17 intellectuals (one dead, one British) are on another, with similar numbers of Hollywood figures, activists, foreign policy experts, cultural leaders and organizations. Some of those he identifies — Noam Chomsky, Ramsey Clark, Ward Churchill — might not be surprised to find themselves here. Others — the sociologist Paul Starr, the historian Sean Wilentz, the clergyman Jim Wallis, the philosopher Martha Nussbaum — are less obvious candidates for inclusion. (One person, Thomas Frank, is mentioned on two different lists.) All these people might charge D’Souza with “McCarthyism” for supposedly exposing them, but he accepts the challenge. McCarthy, after all, was “largely right.”

Lest one think that D’Souza exaggerates the danger the cultural left presents to America, he has an ace in the hole to back him up: Osama bin Laden himself. Bin Laden, it seems, has taken pains to identify his natural allies within the United States and regularly engages in “signaling” them through videotapes in “an effort to establish a broader political alliance.” In particular, his fall 2004 tape, generally believed to have helped George W. Bush defeat John F. Kerry, contained a secret message to the cultural left that D’Souza, and D’Souza alone, has decoded. “Whichever state does not encroach upon our security thereby ensures its own,” bin Laden declared. Anyone who thinks bin Laden used the term “state” to mean “country” — common usage in Europe and the Middle East — is wrong. He was actually telling residents of New York and Massachusetts that if they voted for the Democrats, he would refrain from killing them. D’Souza writes like a lover spurned; despite all his efforts to reach out to bin Laden, the man insists on joining forces with the Satanists.

D’Souza has fallen on hard times lately. Political correctness and affirmative action — the issues he has addressed in inflammatory ways in the past — no longer inspire the same passion. “The Enemy at Home” is clearly designed to restore his reputation as the man who will say anything to call attention to his views; charging prominent senators and presidential candidates with treason can do that. (One can dismiss D’Souza’s claim that “I am not accusing anyone of treason or even of anti-Americanism” as either self-delusional or dishonest; my guess is the former.) Yet despite all his heated rhetoric, D’Souza’s book is unlikely to make much of a dent. It relies on a distinction between traditional and radical Islam that even he does not take seriously; there are no theological differences between the two camps, he suggests at one point, and even the “few” political differences between them are disappearing. It is filled with factual errors (Milton Himmelfarb, not Irving Kristol, compared the voting behavior of Jews to that of Puerto Ricans; Diana Eck is not a historian, but Thomas Frank, wrongly identified as a political scientist, is). In a line D’Souza will surely wish he had never written, he brags of the “remarkable progress” in Iraq “since Hussein’s removal from power.” Some of the people he elevates to the status of major enemies of the United States — Kristine Holmgren, Robert Jensen, Glenda Gilmore — are (no offense intended) anything but household names.

Wolfe ends saying, ” I look forward to the reaction from decent conservatives and Republicans who will, if they have any sense of honor, distance themselves, quickly and cleanly” from these views. This is not likely to happen from the group which embraces Ann Coulter, Rush Limbaugh, and Dick Cheney when they express similar disdain for anyone who doesn’t share their extremist views.


A woman, a black, and a hispanic entered the presidential race. . .

Image:Jimmy Smits.jpg

In a year where the front runners are a woman and a black, and other characteristics of each are far more important to their chances, Bill Ricardson’s hispanic background will likely have little impact upon his chances. There is far more talk about Obama’s charisma by supporters and lack of experience by opponents than of his race, and Hillary has so much baggage that her sex hardly matters. Matt Santos became the first hispanic President on The West Wing, but it will be hard for Bill Richardson to accomplish the same in the real world. While Bill Richardson has far more experience than Santos, and, more significantly, more than the major contenders in the race, this won’t benefit him anywhere near as much as the charisma of Jimmy Smits would. If a candidates’s resume was the deciding factor, neither Obama or Edwards would be in the top tier.Despite his experience in Congress, as Energy Secretary, as an ambassador, and Governor, Richardson is given little chance to raise the money needed to compete with the top tier candidates. This is unfortunate as, unless John Kerry or Al Gore get into the race, few of the candidates will start the job with as much first hand knowledge of our problems should they be elected.

At this stage I know little about Richardson beyond his impressive biography and do not know if I would ultimately support him. While experience is of value, I will ultimately choose more on the positions each candidate takes and look at the details of how they have faced similar problems in the past. Unfortunately the media prefers to cover the horse race, leaving little time for discussion of issues or the candiates they don’t feel have a chance (unless they create excitement as Al Sharpton did),often causing their predictions to come about. Candidates are also often reluctant to provide specifics out of fear of alienating potential supporters. Although the media might ignore him, Ricardson appears to be one candidate worth watching.

Bush Again Offers Inadequate Health Care Plan

The New York Times reports on George Bush’s latest health care proposal which is to be announced in the State of the Union Address:

The basic concept is that employer-provided health insurance, now treated as a fringe benefit exempt from taxation, would no longer be entirely tax-free. Workers could be taxed if their coverage exceeded limits set by the government. But the government would also offer a new tax deduction for people buying health insurance on their own…

White House officials say the health tax plan would neither increase spending nor reduce tax revenues. Supporters say it would expand coverage to some of the 47 million uninsured. But critics say it would, in effect, tax people with insurance to provide coverage to those without it…

In his radio address on Saturday, Mr. Bush described his proposal as a way to “treat health insurance more like home ownership,” giving people tax deductions for their health insurance in much the same way as they get tax deductions for home mortgage interest. He said the current system “unwisely encourages workers to choose overly expensive, gold-plated plans,” driving up the overall cost of coverage and care.

I’ve seen plenty of people who are under-insured, but I certainly have not had any patients with these “gold-plated plans.” Some people actually have their health care covered without high co-pays and deductibles, and some even get additional benfits such as dental care, but I hardly think that these are the cause of inadequate access to care.

At least Bush does have one good idea included when he provides tax breaks to those paying for their own plans, but this should not be at the cost of those who currently are insured.  Nor should this be considered a complete solution as there are many people, especially those who are not young and healthy, who will have problems finding affordable care even with these tax breaks.