Policy 08/01/2009

• Health Care Spending Disparities Stir a Fight – NYTimes.com

  tags: Policy

  • Published: June 8, 2009

    WASHINGTON — President Obama recently summoned aides to the Oval Office to discuss a magazine article investigating why the border town of McAllen, Tex., was the country’s most expensive place for health care. The article became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.

  • “He came into the meeting with that article having affected his thinking dramatically,” said Senator Ron Wyden, Democrat of Oregon. “He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we’ve got to fix.’ ”

• Health industry is generous to Blue Dogs – Washington Post- msnbc.com

  tags: Policy

  • A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money — about 25 percent — from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.

    Most of the major corporations and trade groups in those sectors are regular contributors to the Blue Dog PAC. They include drugmakers such as Pfizer and Novartis; insurers such as WellPoint and Northwestern Mutual Life; and industry organizations such as America’s Health Insurance Plans. The American Medical Association also has been one of the top contributors to individual Blue Dog members over the past 20 years.

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Economics 08/01/2009

• How Medical Breakthroughs Happen: A Response to Megan McArdle | The New Ledger

  tags: Economics

  • To understand how research is divided overall, consider it as three tranches: basic, translational, and clinical. Basic is research at the molecular level to understand how things work; translational research takes basic findings and tries to find applications for those findings in a clinical setting; and clinical research takes the translational findings and produces procedures, drugs, and equipment for use by and on patients.
  • Pharma operates under a great deal of pressure these days, and not just from the political side — everyone wants to avoid being left holding the next Vioxx. But as a matter of focus, their only area of interest is that last category: clinical research. What’s more, they’re only really interested in clinical research into areas that hold the promise of recouping the cost of their investment, and more. They are a business, and they perform as one.
  • The truth, as anyone knowledgeable within the system will tell you, is that private companies just don’t do basic research. They do productization research, and only for well-known medical conditions that have a lot of commercial value to solve. The government funds nearly everything else, whether it’s done by government scientists or by academic scientists whose work is funded overwhelmingly by government grants.

• Some U.S. bank pay unmoored from performance: Cuomo | Reuters

  tags: Economics

  • Cuomo said his office studied historical financial filings and found that at many banks compensation increased in the 2003-2006 bull market years, but stayed at those levels as the mortgage crisis and recession hit.

    “Thus, when the banks did well, their employees were paid well. When the banks did poorly, their employees were paid well. And when the banks did very poorly, they were bailed out by taxpayers and their employees were still paid well.

    “Bonuses and overall compensation did not vary significantly as profits diminished.”

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Policy 07/31/2009

• Ezra Klein – Obama Speaks About Speaking

  tags: Policy

  • This quote from LBJ: “…it is so clear indeed that we marvel not simply at the passage of this bill, but what we marvel at is that it took so many years to pass it.”

    I trust that we will pass some kind of reform this year. And this will be the start of more to come. It all takes time.

    And btw I love Calvin Jones’s point about health care being tied to a job – what a damper on an efficient labor market this has been.

  • and getting back to the point of Ezra’s post – I fully expect Obama to figure out how to communicate all this to the nation, clearly, cleanly, and in a time of subverted and corrupt media communications.

    First, I’m in awe of his desire to do it, and second, this is one of the greatest tests so far of the reach of his abilities.

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Policy 07/29/2009

• Ezra Klein – For, And Against, Reappointing Ben Bernanke

  tags: Policy

  • I agree with RobbL about the (de)merits of the situation. It was a disgrace and even in this disgraceful age there should be at least some token punishment (justice would be too much to hope for).

    And I’ve argued that the Fed should be reformed along the lines that William Greider is advocating currently:
    http://voices.washingtonpost.com/ezra-klein/2009/07/the_problems_with_the_federal.html

    However, as I’ve also said before, Obama obviously has never wanted to mess with the finance system, at least not at this stage of his game. He was ambushed by the meltdown, a red-hot coal tossed from the outgoing regime. He has other things to do, and he’s content for now just to restore the status quo.

    Maybe in the future we get to reform all this. I’m sure Obama would back it if the country would show the muscle for it. We’ll have to do the heavy lifting.

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Policy 07/25/2009

• Lexington: The Obama cult | The Economist

  Obama became President six months ago, in the middle of a worldwide financial meltdown brought about by the laissez-faire “policies” so admired by “The Economist”. In those six months, a good measure of confidence and viability has been restored to the economic system, and reforms are being introduced to prevent another similar debacle (until the Republicans can sell the next Hoover-Nixon-Reagan-Bush, and rape the system yet again). Obama has begun to unravel Guantanamo, and ended the use of torture. He has nominated a Supreme Court Justice who will win confirmation easily, and reverse the trend toward appointing flat-earthers too stupid to memorize an Oath of Office less complex than a nursery rhyme despite having three years to master it. He has pushed the debate on universal health care and energy policy farther in 180 days than all of the Presidents before him did in the history of the country. He has begun the withdrawl from Iraq, and changed course (for better or worse)in Afghanistan. He has restored the belief of the world at large that America can lead, and can behave rationally, without divorcing her selfish interests from their world context. Not bad, given the all-out attempt of the ultraconservative Rump that is now the Republican Party to sabotage him at every turn.

  Very few Obama supporters saw him as a Messiah; most saw him as a welcome change from a befuddled fool and his incompetent lock-step cronies, and a return to the progressive narrative of world and American history that was so rudely and disastrously interrupted by the Bush Administration. Given the financial straits he inherited (unlike the peace and prosperity that Bush was handed), it’s remarkable that he has kept so many balls in the air so successfully.

  The demagoguery of the American right (Limbaugh, O’Reilly, Faux News, etc.) is what got America and the world into the mess they’re in. It’s sad to see “The Economist”, which has had a tradition of at least maintaining its intellectual integrity while trying to explain why failed 19t

  tags: Policy

• Ezra Klein – Obama Returns to Campaign Footing

  tags: Policy

  • The reason I visited the Cleveland Clinic is because along with the Mayo Clinic, they have been able to drive down costs more than any other health care system out there, while maintaining some of the highest quality.

    Now, when I asked how did you go about doing it, well, they started this thing — when was it started, Cleveland Clinic? 1921. And they — what they’ve done is — for example, doctors who are part of the Cleveland Clinic get paid a salary instead of being paid fee-for-service. So that makes it easier for them to make some of these changes, because people don’t feel like maybe they’re losing some money out of pocket; they just know that they’re getting a salary.

    Now, that’s not maybe the thing that every doctor is going to want to do. But there are other ways that we can take that same approach where they start thinking in terms of what’s needed for the patient, and making sure that they’re getting reimbursed for what’s good for the patient, and they don’t then have to worry about what’s the government saying, or what’s the insurance company saying;

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Economics 07/24/2009

• Ezra Klein – The Problems With the Federal Reserve — and Its Alternatives

  tags: Economics

  • JonathanTE I recommend Greider’s book, Secrets of the Temple. I just re-read it this year, and it’s plain to see that nothng has changed since his initial explanation in the Eighties of how the Fed works.

    This business of slow versus fast, Congress versus some agency or commission, non-expert versus expert, is a bit of a straw man.

    It’s commonly posited that the Fed CAUSED the Great Depression by not loosening the money supply.

    Congress only has fiscal policy, because monetary policy is given to the Fed. Money creation is a part of how our economy works, and from old history the banks remain a party to this creation, which gives them lovely free profits.

    The point is that it’s government money, a sovereign thing. We the people through our representative government could actually share in this largesse of the system, rather than the banks, who actually do nothing for it other than expand credit – except when we really need it of course.

    The Fed over the decades has caused immense suffering and hardship. The governors have shown in analysis after analysis that they really haven’t known what happens in the economy – they operate by incremental trial and error. The trials generally err in favor of the banks, and the erors are weighted against us.

    They consistently sacrifice the productive economy to bolster the banking industry – their mandated and acculturated constituency.

    So when Greider is saying reform the Fed he’s talking about switching the constituency of the money-creation power back to the productive economy of us, the people.

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Policy 07/23/2009

• Obama Talks Health Care With Fred Hiatt – washingtonpost.com

  tags: Policy

  • I’ve been in office six months. I think sometimes people forget the fact that I think at this point in Ronald Reagan or Bill Clinton’s presidency, their major initiative hadn’t even gotten off the ground yet. I mean, in some ways we’re our own worst enemy because we’ve gotten so many things done in these first six months, a lot of them dealing with extraordinary circumstances, that the sense is somehow that we have been putting off things that are also important to us. I just can’t do everything at once.

  • So I think that the perception that we haven’t been worried about this is partly subject to circumstances. You had — we had to come out with a stimulus early. That was not what I would have preferred to do. I then had an omnibus because the previous administration and Congress had not been able to sort through their problems. And I will confess that there were aspects of that that I did not like, but I had to make a decision — at a time when I wasn’t clear whether or not the economy was going to get even worse and we potentially were going to have to take even more extraordinary action — about the consequences of being embroiled in an enormous budget fight about last year’s business.

    We then had, by law, we had to introduce our budget, and then we had the supplemental, all at a time when government revenues are tanking.

    And so I understand why a deficit hawk would be nervous. I’m nervous about this. And if you talk to my senior advisors, they’ll tell you I’m on them every day about how are we going to make sure that we’re positioning ourselves to take care of this long term.

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Economics 07/23/2009

• Dismantling the Temple

  tags: Economics

  • The Fed was
    never independent in any real sense. Its power depended on taking care
    of its one true constituency in banking and finance.

    A reconstituted central bank might keep the famous name and
    presidentially appointed governors, confirmed by Congress, but it would
    forfeit the mystique and submit to the usual standards of transparency
    and public scrutiny. The institution would be directed to concentrate on
    the Fed’s one great purpose–making monetary policy and controlling
    credit expansion to produce balanced economic growth and stable money.
    Most regulatory functions would be located elsewhere, in a new
    enforcement agency that would oversee regulated commercial banks as well
    as the “shadow banking” of hedge funds, private equity firms and others.

    The Fed would thus be relieved of its conflicted objectives. Bank
    examiners would be free of the insider pressures that inevitably emanate
    from the Fed’s cozy relations with major banks. All of the
    private-public ambiguities concocted in 1913 would be swept away,
    including bank ownership of the twelve Federal Reserve banks, which
    could be reorganized as branch offices with a focus on regional
    economies.

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Policy 07/19/2009

• Winning the Good War – Peter Bergen

  tags: Policy

  • Afghanistan will not be Obama’s Vietnam, nor will it be his Iraq. Rather, the renewed and better resourced American effort in Afghanistan will, in time, produce a relatively stable and prosperous Central Asian state.

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Economics 07/19/2009

• Op-Ed Columnist – The Joy of Sachs – NYTimes.com

  tags: Economics

  • First, it tells us that Goldman is very good at what it does. Unfortunately, what it does is bad for America.

    Second, it shows that Wall Street’s bad habits — above all, the system of compensation that helped cause the financial crisis — have not gone away.

    Third, it shows that by rescuing the financial system without reforming it, Washington has done nothing to protect us from a new crisis, and, in fact, has made another crisis more likely.

  • Goldman’s role in the financialization of America was similar to that of other players, except for one thing: Goldman didn’t believe its own hype. Other banks invested heavily in the same toxic waste they were selling to the public at large. Goldman, famously, made a lot of money selling securities backed by subprime mortgages — then made a lot more money by selling mortgage-backed securities short, just before their value crashed. All of this was perfectly legal, but the net effect was that Goldman made profits by playing the rest of us for suckers.

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Policy 07/18/2009

• Ezra Klein – Anger.

  tags: Policy

  • nope – anger no good. We’ve seen too much of this shouting, and interrupting people. It just doesn’t belong in the public debate.

    Never mind the guy may be right on, angry people just throw their credibility to the winds. So we lose a potential commentator, and have to keep looking for rational debate.

    For example: what could be more challenging than Simon Johnson’s early “banana-republic” claims, and yet it would be hard to find more dignified and plausible discourse.

    Let the commentary be dignified and follow some rules of order and reason. We’re the ones who get angry, not the presenters.

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Policy 07/12/2009

• Palin leads the right into a reality TV vortex – Times Online

  tags: Policy

  • The reality of Sarah Palin is that politics is a means to her higher goal:
    celebrity.

  • And this helps explain the broader problem with American conservatism right
    now. It is less a movement than an industry. From Fox News to talk radio to
    conservative publishing houses, it has created an alternate and lucrative
    media reality that is worth a fortune to those able to exploit it. Alas,
    these alternative media thrive on paranoia, hatred of liberal elites and
    growing extremist rhetoric made worse by a hermetically sealed echo chamber
    of true believers. Anyone criticised by the left or even by the
    establishment right is a martyr in this world. In America, martyrdom sells.
    And Palin is a product worth lots of money.

    She wants some of it; and she has no actual interest in governing America
    (even though she’d love the title of president). She referred to giving up
    her “title” as governor, not her “office”. In this, she is the ultimate
    Republican of this degenerate moment: all culture war, no policy; all
    identity politics, no engagement with practical answers to difficult public
    problems; and all hysterical opposition to Barack Obama, no actual
    alternatives offered.

    Since even epic scandals heighten celebrity rather than diminish it, Palin’s
    future is secure. Her party’s? Getting bleaker by the day.

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Policy 07/11/2009

• A Few Thoughts on Stimulus

  tags: Policy

  • it may appear foolish, but if the talk now is over whether to have a second one or not – and not about, for example, let’s hang the Obama adminstration – then politically, expectations have been managed well.

    I’m on Obama’s side, just to make it clear. And as always I’m fascinated to see how well he’s runing things. He incremented our expectations from the beginning, suspecting he would have to increment the solutions.

    And the problems weren’t even his to begin with. He inherited nonsense that simply stands in his way, and he’s dealing with them using as little political capital as necessary to save the country from its dirty past while he focuses on its future.

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Economics 07/11/2009

• Ezra Klein – The Stars And Stripes Model

  tags: Economics

  • I note that UNsubsidized media (e.g FOX) doesn’t pursue truth either. Kind of shoots down the free part of free enterprise.

    The fact is that recipients of public monies can be held to standards, including the standard of transparency. And objective reporting can be measured and created by standards – the standards of logic and verifiability have long existed.

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Policy 07/02/2009

• Lincoln more than FDR « Las Vegas Review-Journal :: Blogs

  tags: Policy

  • Lincoln was the quintessential patient man. He refused all impulses to push change. Lincoln allowed opinions to swirl around him, unaffected, letting the societal shifts he knew the country had to have come slowly, to evolve. Over time, his patience was the greatest virtue the country had. The nation changed forever, but not because Lincoln forced it. The people went where Lincoln stood, not where he pushed.
  • The MSM is not reporting that Americans want the change they voted for in November. The latest CBS/NYT poll showed that Americans want an expansion of Medicare 4 to 1, a fact that is not reflected in the Senate’s wrestling over the issue. The poll should shock politicians at how far left Americans have gone. It should convince the MSM to ignore if not outright challenge conservative politicians and pundits that their positions are out of touch.
  • Obama is between them. Much like Lincoln wanted to compromise with Democrats over states’ rights and slavery, Obama wants to compromise with Republicans and Wall Street. Like FDR, he often goes over their heads to the people. Unlike FDR, Obama is not forcing his opponents to cave. Perhaps he is saving this option in case the people fail to pressure their senators to get with their program, or maybe Obama will stay with his Lincolnesque traits and ultimately fail to reform the institutions that need change.

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