Byron Dorgan Tells His Flood-Ravaged State That A Repowered America Is ‘Not Going To Happen’
Byron Dorgan Tells His Flood-Ravaged State That A Repowered America Is ‘Not Going To Happen’
Even though his state is still rebuilding from unprecedented floods, Sen. Byron Dorgan (D-ND) is committed to coal and wary of fighting climate change. Dorgan told the North Dakota Senate that he was concerned that the market created by capping global warming pollution could be open to manipulation:
I’m not very interested with having a bunch of folks with a bunch of money get their mitts on trading credits, and have our future and our destiny tied to their interests. I feel very strongly there’s something going on with our climate. We need to be attentive to it, we need to deal with it, but as we do, we have to be smart.
It’s legitimate to have a concern about the regulatory structure of a carbon market, about one-tenth the size of the fossil-fuel commodity markets, and Sen. Dorgan has the expertise to design the legislation. But he seems to be letting a policy detail obscure the real issue — that global warming pollution is completely unregulated, allowing corporate polluters to make astronomical profits while destroying the atmosphere.
This carbon loophole has allowed pollution giants like Exxon Mobil, Koch Industries, Peabody Coal, and Massey Energy to ravage the planet, sicken our children, and rake in obscene profits for decades. Now, as North Dakota reels from its third extreme flood in as many years, scientists are warning that the climate crisis is outstripping their projections.
Yet Dorgan seems to be confusing political “reality” with actual reality, when he summarily dismissed Vice President Al Gore’s “Repower America” call that “the nation should rely solely on renewable fuels by 2020″:
Not going to happen. Not even close. We need to continue to use our most abundant resource, but to be able to do that, we have to be able to unlock the technology … to decarbonize coal, and we’re going to do that.
Again, Dorgan is missing the forest for the trees. Dorgan is strikingly pessimistic that America can free itself of fossil fuel dependence, even though the sun, wind, and human ingenuity are much more “abundant” resources than coal. Yet he willing to guarantee the success of experimental carbon capture and sequestration technology for coal-fired power plants Of course, a $300 million loan to a North Dakota coal plant for CCS development may help it along. If Dorgan truly wants CCS to happen, he should recognize that the most important thing the government can do is to create a market for clean energy by passing strong cap-and-trade legislation as soon as possible. Unfortunately, his voting record reveals he puts GOP filibusters of clean energy legislation above the security and health of the United States.
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Flu Farms: Decreasing Factory Farming Could Help Avert the Next Swine Flu Epidemic
Flu Farms: Decreasing Factory Farming Could Help Avert the Next Swine Flu Epidemic
Our guest blogger is Aysha Akhtar MD, MPH, a fellow for the Oxford Center for Animal Ethics and a neurologist and public health specialist at the Food and Drug Administration.
In order to better avert the threat of swine flu epidemics like the one currently spreading around the globe, public health efforts must address the conditions that allow pigs to become breeding grounds for infectious disease. As the number of confirmed cases of swine flu around the globe increases, we grow closer and closer to having a pandemic on our hands. Surprisingly, however, there is very little discussion about how swine flu got started in the first place.
The primary reservoir for influenza viruses is aquatic birds, but humans are not readily directly infected by the strains from those animals. Pigs, however, are highly susceptible to both avian and human influenza A viruses. In pigs, viruses swap genes, and new influenza strains emerge with the potential to infect humans. The current swine influenza A, called H1N1, is a triple hybrid avian/pig/human virus, “definitely” of swine origin.
More focus needs to be placed on preventing pathogens from getting into the human population in the first place, and that means starting at the farm. The source of the current epidemic has not yet been identified, but the first confirmed case of swine flu occurred in La Gloria, Mexico, a town surrounded by industrial pig farms, partly owned by Smithfields Foods. Even if these particular farms are not confirmed as the primary source, based on research into the previous outbreaks of swine flu, it makes sense to consider factory farms as very likely potential sites for the development of these pathogens.
In recent years the influenza virus has undergone an “evolutionary surge,” with new variants emerging rapidly. According to the World Health Organization, we are seeing more new infectious diseases and epidemics than ever before, and they are appearing at an alarming rate. Increased human travel is certainly a factor, but perhaps the most significant variable is the change in animal agricultural practices that have occurred in the last few decades:
– By 2020, world meat production is expected to double.
– In the U.S. alone, approximately 1 million land animals are slaughtered for food every hour.
– The percentage of operations in North America with 5,000 or more animals expanded from 18 percent in 1993 to 53 percent in 2002.
As a result of the rise in animal product demand, traditional farming practices have been mostly replaced in developed countries by immense intensive animal operations, and developing countries are rapidly catching up. More »
Banking Lobby Successfully Defeats Mortgage Cram-Down Provision
Banking Lobby Successfully Defeats Mortgage Cram-Down Provision
Today, a proposal to change bankruptcy law and allow bankruptcy judges to cram-down mortgage payments for troubled homeowners failed in the Senate by a vote of 45-51. The provision, which was introduced as an amendment by Sen. Dick Durbin (D-IL), required 60 votes to pass. In recent weeks, support for the measure evaporated in the face of furious lobbying by the banking and mortgage industries. Prior to the vote, Durbin — who this week said that bankers “are still the most powerful lobby on Capitol Hill” — took to the floor to decry the banking industry’s influence in the cram-down debate:
At some point the senators in this chamber will decide the bankers shouldn’t write the agenda for the United States Senate. At some point the people in this chamber will decide the people we represent are not the folks working in the big banks, but the folks struggling to make a living and struggling to keep a decent home.
Watch it:
The American News Project noted that the Mortgage Bankers Association was “in a celebratory mood” at its annual meeting this week, because “a massive lobbying campaign” against cram-down appeared to be working.
Economists: ‘Most Disappointing Feature’ Of Bank Plan Is Lack Of Financial System ‘Reorganization’
Economists: ‘Most Disappointing Feature’ Of Bank Plan Is Lack Of Financial System ‘Reorganization’
Courtesy of Hendrik Hertzberg, we have two Nobel prize winning economists — Joseph Stiglitz and Robert Solow — saying that the “most disappointing” aspect of the Obama administration’s economic plan is that it seems to imply a return to Wall Street’s pre-crisis status quo:
They see the lack of a thoroughgoing “reorganization of the financial system” as the “most disappointing” feature of the new dispensation…Stiglitz said he has the impression that while the Administration’s policymakers are familiar with the approach he and Solow advocate and have discussed it among themselves, it hasn’t been given the kind of in-depth consideration that has been extended to the solutions preferred by the big banks. “When push comes to shove,” Solow said, “politics wins over economics every time. It’s the unanswerable objection: ‘You can’t get it through Congress.’ ”
This ties back to Matthew Yglesias’ concern that “Obama is unduly optimistic about the idea that we can keep the financial industry basically as is, but regulate it ‘better.’” “The pre-crash state of regulation had a lot to do with the political clout and prestige of the institutions in question. If you keep the same institutions in place, I worry that they’ll swiftly recapture the regulators,” he wrote.
This is a very legitimate concern, and one the administration has done little to address. Obama said last night that he expects “to sign legislation by the end of this year that sets new rules of the road for Wall Street.” But more than new rules are needed. There has to be a fundamental change in the nature of institutions, so that they don’t become too big to fail. As FDIC Chairman Sheila Bair said this week:
Investors and creditors have lacked strong incentives to perform due diligence because of the perception that these institutions are so large and complex that the government would have to bail them out. And they were absolutely right…This is unacceptable, and simply reinforces the notion of “too big to fail”…a 25-year old idea that ought to be tossed into the dustbin.
The big banks still have a lot of sway on Capitol Hill, and as MIT professor Simon Johnson said “I think [the administration has] been too deferential to big finance…I think they should be more willing to take them on.” Of course, it would be nice if this weren’t a unilateral fight, but one that the administration and both parties in Congress joined, in the interests of sustainable economic growth. The president can use his bully pulpit to outline a new direction, but it will take a concerted effort across the board to ensure that Wall Street doesn’t gamble the economy into oblivion again.
How Health Care Reform Would Help Contain The Swine Flu
How Health Care Reform Would Help Contain The Swine Flu
Under the ‘what should I do if I get sick‘ section of the CDC’s ‘Swine Flu and You’ page, the agency writes that “if you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms…you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.”
But for the millions of Americans who can’t afford to purchase health insurance, a visit to a “health care provider” is an expensive proposition. We know that the 45.7 million Americans without insurance are less likely to visit a doctor and receive needed care, but the the economic crisis, the erosion of employer-based benefits and the skyrocketing costs of health insurance are now causing an increasing number of insured Americans to avoid their “health care provider.” According to the latest Kaiser Poll, 60 percent of Americans say that “they or a member of their household have delayed or skipped health care in the past year” and many are “substituting home remedies or over the counter drugs for doctors visits.”
Unsustainable health care prices are already threatening the nation’s economic prosperity, but in the midst of a possible flu epidemic, the consequences of a large number of Americans forgoing care because it’s too costly become all the more frighting.
This isn’t to say that health care reform will end epidemics. Providing everyone with affordable access to basic medical benefits can only contain health emergencies, but it’s now difficult to argue that extending coverage to all Americans is a wasteful entitlement, or that the insured have little to gain from bringing everyone into the system.
More broadly, the epidemic serves a reminder that the health care system is in many ways a public function. Free markets work very well for ordinary consumption goods, but Tamiflu is not an ordinary consumption good. It’s important to be able to direct the health care delivery system’s resources toward public purposes and not have the resources allocated purely by market demand.
Rice: Al Qaeda A Greater Threat Than Nazi Germany
Rice: Al Qaeda A Greater Threat Than Nazi Germany
Responding to a question from a Stanford University student who noted that, even in moments of actual existential peril like World War II, the United States never resorted to techniques like waterboarding, former Secretary of State Condoleezza Rice made a pretty startling claim about the relative threat posed by Al Qaeda:
Q: Even in World War II facing Nazi Germany, probably the greatest threat that America has ever faced –
RICE: Uh, with all due respect, Nazi Germany never attacked the homeland of the United States.
Q: No, but they bombed our allies –
RICE: No, just a second, just a second. Three-thousand Americans died in the Twin Towers and the Pentagon.
Q: 500,000 died in World War II –
RICE: Fighting a war in Europe.
Q: — and yet we did not torture the prisoners of war.
RICE: We didn’t torture anybody here either.
Watch it (segment begins at 3:28):
What’s interesting here is that the “threat” that Rice is talking about has nothing to do with the actual threat posed to the United States by a few hundred committed jihadists, but rather with the threat that she and others in the administration “felt” in the days and months after 9/11:
RICE: I’ll tell you something, unless you were there in a position of responsibility after September 11, you cannot possibly imagine the dilemmas that you faced in trying to protect Americans. And I know a lot of people are second guessing now, but let me tell you what the second guessing that would really have hurt me: If the second guessing were about 3,000 more Americans dying because we didn’t do everything we could to protect them.
If you were there in a position of authority and watched Americans jump out of 80 story buildings because these murderous tyrants went after innocent people, then you were determined to do anything you could — that was legal — to prevent that from happening again.
It’s hard not to read this as an admission by our former Secretary of State that terrorism works — or at least it worked on her, to the extent that it induced her to embrace interrogation methods that previous American administrations prosecuted as crimes.
No one should pretend that these aren’t tough questions, or forget the trauma we all felt after 9/11, but being a nation of laws means we can’t just jettison those laws through fancy lawyering when the going gets tough and we get freaked out.
I would also remind Dr. Rice that it is a fact that quite a few more than 3,000 more Americans have died as a result of the Bush administration’s anti-terrorism policies, and a good portion of those as a direct result of the detention and interrogation methods that she continues to defend as necessary to protect Americans.
In fact, the German Kriegsmarine sank approximately 600 US and Allied merchant vessels in and around US territorial waters between January and June 1942. These attacks came shortly after Nazi Germany declared war on the United States. Approximately 1500 American sailors were killed in these attacks. I suspect that an attack on an American ship in US territorial waters would be interpreted by just about anyone as an attack on the homeland of the United States.
The WonkLine: April 30, 2009
The WonkLine: April 30, 2009
Welcome to The WonkLine, a daily 10 a.m. roundup of the latest news about health care, the economy, national security and climate policy. This is what we’re reading. Tell us what you found in the comments section below, and subscribe to the RSS feed. Also, you can now follow The Wonk Room on Twitter.
Economy
“Talks between the Treasury Department and lenders aimed at keeping Chrysler LLC out of bankruptcy broke down Wednesday, making it all but certain the car maker will file for Chapter 11 protection Thursday,” the Wall Street Journal reports.
Sen. Max Baucus (D-MT) “plans to introduce legislation in the coming weeks to give U.S. tax collectors more tools to police offshore tax evasion.” Tax evasion using offshore accounts “is said to cost the U.S. government $100 billion a year.”
Private student loan lenders that claim President Obama’s loan reforms will be a tax on the middle class are wrong, and their argument is “a sign of how far this conversation has gotten from students’ experiences and what policies are most likely to benefit them.”
National Security
British troops have officially ended their combat role in Iraq. “Since the 2003 invasion, 179 British service personnel have been killed there. In the southern city of Basra, the British military held a ceremony to honor those who died during the war.”
“At least 32 people were killed and 54 others injured in two days of fighting as rival political groups exchanged gunfire in Pakistan’s commercial capital of Karachi.”
Responding to North Korea’s threat to conduct another nuclear test, China said such a test was “hypothetical,” and it could not say how it would affect relations. “We hope that all sides will pay attention to the big picture and appropriately resolve the relevant problems,” Chinese Foreign Ministry spokeswoman Jiang Yu said.
Health Care
Sixteen Democratic senators wrote a letter “expressing their support for a public insurance plan, urging key Senate committee chairmen not to abandon the option as they negotiate a health care overhaul bill.”
On Wednesday, Sens. Max Baucus (D-MT) and Chuck Grassley (R-IA) “unveiled a set of detailed recommendations intended to slow the growth of Medicare, hold doctors and hospitals more accountable, and improve the care of patients with chronic illnesses.” “After a six-hour meeting to discuss the proposals with members of both parties, Mr. Grassley said, “I did not find a lot of dissension.” Read more about the proposals here.
Tommy Thompson on why the Congressional Budget Office won’t capture all of the savings from health care reform.
Climate
E&E News notes that “as House Democrats work behind closed doors to shore up support on a major energy and climate bill, agriculture groups are pleading for major changes to make it more palatable in farm states.”
“Roughly 60 percent of Americans live in areas where air pollution has reached unhealthy levels that can make people sick,” says the 2009 State of the Air report released today by the American Lung Association.
CQ reports that “opponents of federal limits on greenhouse gases are launching ad campaigns in the districts of moderate Democrats negotiating a bill in the House Energy and Commerce Committee. The radio ads, sponsored by the American Energy Alliance, are running in the districts of nine committee Democrats and one Republican.”
Hiatt Stands By His Man, Accuses Critics Of George Will Of ‘Trying To Shut Him Down’
Hiatt Stands By His Man, Accuses Critics Of George Will Of ‘Trying To Shut Him Down’
Fred Hiatt, the opinion page editor of the Washington Post, is sticking to his guns in defense of George Will’s egregiously mendacious global warming columns. In an online chat today, Hiatt repeated his claim that Will’s lies were just “inferences,” and lashed out at Will’s critics:
Boston: This doesn’t relate to Obama but would you care to address the whole George Will global warming column controversy? Is there any concern that lax standards for accuracy hurts the prestige of The Post opinion page more generally?
Fred Hiatt: Happy to, because we don’t have lax standards for accuracy. He addressed the factual challenges to his column in detail in a later column. In general we do careful fact checking. What people have mostly objected to is not that his data are wrong but that he draws wrong inferences. I would think folks would be eager to engage in the debate, given how sure they are of their case, rather than trying to shut him down.
When faced with an opportunity to restore the Washington Post’s besmirched reputation, Hiatt instead slung mud. The reality is that Hiatt does have “lax standards for accuracy,” and Will’s errors were both errors of fact and of “inference.” Will, of course, did not address “the factual challenges to his column in detail in a later column” — he added new errors. It’s bizarre that Hiatt is worried for Will’s ability to reach an audience — the man is one of the most widely syndicated columnists in one of the most prominent newspapers in the land, with a weekly appearance on national television. From the beginning, critics have been calling on the Washington Post to run a correction — something that, to this day, Hiatt refuses to do.
(HT: Media Matters)
Conrad Hits GOP’s Small Business Claim: Under Your Definition, Dick Cheney Is A Small Business Owner
Conrad Hits GOP’s Small Business Claim: Under Your Definition, Dick Cheney Is A Small Business Owner
One of the right wing’s favorite pieces of misinformation regarding President Obama’s budget is that the tax increases he plans to enact on the top two income tax brackets will destroy small businesses. The New York Times’ Caucus blog noted that Sen. Kent Conrad (D-ND) “moved aggressively on Wednesday to counter Republican complaints” in a very original manner:
To prove the Democrats’ point – that only a minute portion of actual small business owners would face a tax increase under the budget plan – Mr. Conrad displayed a poster on the Senate floor featuring a large photograph of former Vice President Dick Cheney. Mr. Cheney, who has been vocally critical of the Obama administration, would qualify as a small business owner under the Republicans’ definition, Mr. Conrad said, even though only about $180,000 of Mr. Cheney’s more than $3 million in income in 2007 came from small business interests.
Conrad then “let loose a final dagger“: “I would say, that’s a tortured definition,” he said.
In reality, only 1.9 percent of taxpayers with small business income file in the top two income brackets, and many of those individuals don’t have employees or earn their income through passive investments. The Center on Budget and Policy Priorities has pointed out that “the $84 of income President Bush received in 2001 from a passive investment in an oil and gas company made him a ’small-business owner’.”
High School Math And Reading Scores Have Been Stagnant Since The 1970’s
High School Math And Reading Scores Have Been Stagnant Since The 1970’s
Today, the National Assessment of Educational Progress released its 2008 Nation’s Report Card, which provides a look at long term trends in the educational achievement of American students.
The report reveals some pretty depressing information. For instance, while both 9 and 13 year-olds made modest gains in math and reading, high school students have been stuck in neutral since the 1970’s (which is when the first assessments were made):
Reading (1971-2008):
Math (1973-2008):
These results eerily mirror America’s college graduation and retention rates, which have also both been stagnant for two decades.
All of this ties back to America’s falling rate of educational attainment, which for young people has slipped to tenth in the world. America’s overall ranking in terms of education has been inflated for some time by the success of previous generations, but in recent decades we’ve been in a holding pattern, while other countries have surged ahead. As Bruce Fuller, an education professor at the University of California, Berkeley, pointed out, “we’re lifting the basic skills of young kids,” but “not lifting 21st-century skills for the new economy.”
One good step towards fixing all of this could be the Fast Track to College Act, which was introduced last month by Rep. Dale Kildee (D-MI) and Sen. Herb Kohl (D-WI). The bill is aimed at streamlining the transition between high school and college, encouraging partnerships between high schools and college, and “exposing [students] to the rigors of college-level work” at an earlier age. The government should also make investments at all levels of the education system to encourage human capital growth and ensure that stagnation doesn’t turn into outright decline.
Baucus And Grassley Preview What Bipartisan Health Reform Will Look Like
Baucus And Grassley Preview What Bipartisan Health Reform Will Look Like
The Senate Finance Committee is meeting behind closed doors today to consider a series of health care delivery reforms that could potentially improve health care quality and lower costs. Yesterday, Sens. Max Baucus (D-MT) and Chuck Grassley (R-IA) released ‘Description of Policy Options: Transforming the Health Care Delivery System – Proposals to Improve Patient Care and Reduce Health Care Costs,’ a compilation of recommendations for how to reform the way Medicare and Medicaid reimburse providers:
– Paying for health outcomes: Currently, the system pays hospitals and providers for reporting data on quality, the Senate Finance Committee (SFC) is proposing to pay for actual improved outcomes. That means paying hospitals that meet certain quality performance standards and lowering preventable hospital readmission by reducing payments to hospitals with high preventable readmission rations.
– Encouraging care coordination through payment reform: SFC is proposing developing payment innovations that encourage independent health care providers to work cooperatively for the benefit of the patient. They would bundle hospital stays with post-acute care services, allow groups of providers who voluntarily meet quality thresholds to share in the cost-savings they achieve for the Medicare program, and pay for a health care professional to help patients transition out of the hospital.
– Expanding electronic health records: Electronic health records lower medical errors, improve care quality and reduce health care spending, but many providers are reluctant to invest in a system with limited national standardization and slow financial return. Nationally, less than 25 percent of hospitals, and less than 20 percent of doctor’s offices, employ health information technology systems (HIT). The stimulus provided $19 billion to encourage providers to implement electronic health records and SFC is looking to expedite health care’s push into the 21st century by “exploring the possibility of expanding eligibility” for electronic health records by offering incentive payments not just to doctors but also to nurse practitioners, physician assistants and other providers.
– Improving comparative effectiveness research: The stimulus bill already includes $1.1 billion for research that compares the effectiveness of different treatments and procedures. SFC would establish “a private, non-profit corporation that would generate and synthesize evidence on what works in health care.” The institute would remain independent and diverse “so that no stakeholder interest dominates” and would “establish a national agenda for research priorities.” To ensure patient safety, Medicare “could be allowed to use the findings only in circumstances where the process by which it uses the information is transparent, relies on all available evidence, considers the potential effects on subpopulations of beneficiaries, and allows for public comment on any draft proposals that use the information.”
– Dealing with the shortage of primary care providers: Some studies have shown that “the trajectory of the supply of primary care physicians for adult patients is now falling behind the growth of the adult population” and HHS estimates that “by 2020 there will be a shortage of 66,000 primary care doctors nationwide.” Lower primary care salaries discourage medical students from practicing primary care and residency slots for primacy are physicians have decreased in recent years. SFC is proposing redistributing unused residency slots to encourage training in primary care and general surgery and establishing bonuses payments “for general surgeons practicing in newly defined rural general surgeon scarcity areas.” Primary care providers could also receive 10 percent bonus payments.
– Linking Medicare Advantage payments to quality: Currently, the federal government subsidizes private insurers to provide Medicare beneficiaries with some extra benefits and care in rural areas. But numerous studies have demonstrated that rather than using the extra federal dollars to provide better quality care (and coordinated care), insurers are pocketing the extra dough. SFC is promising to tie “some portion of payment” “to performance and quality measures,” modify payment to encourage plans to provide care more efficiently and play plans a bonus for chronic care management.
Individually these reforms seem small. For instance, the document places some restraints on the use of data obtains from comparative effectiveness research (for instance, considering effects on ’subpopulations’ may very well prevent CMS from making serious reimbursement decisions) and does not call for the elimination of Medicare Advantage overpayments. But collectively, these reforms start the slow process of re-orienting the system from one that encourages providers to over-prescribe treatments, to one that rewards quality care and outcomes.
Bayh And Landrieu Side With Banking Lobby, Against Homeowners
Bayh And Landrieu Side With Banking Lobby, Against Homeowners
Yesterday, Sens. Evan Bayh (D-IN) and Mary Landrieu (D-LA) both voiced their opposition to the cram-down bill that may come up for a vote in the Senate this week.
With their respective decisions, Bayh and Landrieu are siding with a slew of special interests — including bailed out banks, goaded by Republicans into not compromising — and standing in the way of economic recovery. As Politico reported, “the primary reason for the banks’ success is simple: money. The industry spent $56 million lobbying Congress last year alone. That can buy a lot of advocates who can win face time with lawmakers to plead the industry’s case.” And that case seems to be taking root.
“My concern about this is that in our appropriate zeal to help the four or five percent of Americans who might be faced with bankruptcy, we don’t unduly raise the costs of homeownership on the 95 percent who never will,” said Bayh, who supported the legislation last year. Implying that cram-down will raise mortgage rates for all homeowners is the Mortgage Bankers Association’s favorite talking point, but it’s simply not true. Incidentally, Indiana has the 13th highest foreclosure rate in the country.
Landrieu, meanwhile, said that “I think we gotta be careful about adopting processes and procedures that would really hurt our community banks.” This is a more legitimate concern, as community banks tend to be closer to their borrowers than giant mega-banks, muck around less with securitization, and retain more servicing fee rights. But as long as banks are working with homeowners to make loan modifications, cram-downs shouldn’t be too much of an issue.
In any case, the need for the cram-down bill hasn’t diminished. According to RealtyTrac, “nationwide, nearly 804,000 homes received at least one foreclosure-related notice from January through March.” And as Harvard Law professor and bankruptcy expert Elizabeth Warren said this week, cram-downs are necessary because the administration’s housing plan “will not help much in hard-hit housing markets where home prices have fallen 30 to 50 percent below their mortgage principal”:
So-called “cramdown” changes to bankruptcy laws or other legal devices were needed to cut mortgage debt to underlying home values. “It would be the one way to deal with principal that exceeds the value of the loan,” she said. “Without that, we risk a foreclosure mitigation plan that is helpful in the areas of modest need, but not helpful where the problems are acute.”
So in the end, why should the banks and their lobbyists be allowed to hold the plan up?
And the banks -- hard to believe in a time when we're facing a banking crisis that many of the banks created -- are still the most powerful lobby on Capitol Hill. And they frankly own the place.
Friedman: America Successfully Used Iraqis As Bait
Friedman: America Successfully Used Iraqis As Bait
One of Tom Friedman’s favorite column-writing techniques is to feature an Egyptian cab driver/Lebanese hotel clerk/Emirati businessman whose pithy comment conveniently underscores the point Friedman wants to make.
Interestingly, none of these characters appear in Friedman’s column today, in which he exhumes the “flypaper” argument for the Iraq war:
I believe that the most important reason there has not been another 9/11, besides the improved security and intelligence, is that Al Qaeda is primarily focused on defeating America in the heart of the Arab-Muslim world — particularly in Iraq. Al Qaeda knows that if it can destroy the U.S. effort (still a long shot) to build a decent, modernizing society in Iraq, it will undermine every U.S. ally in the region.
You’ll remember that after the WMD and “Saddam-Al Qaeda relationship” arguments for the war disintegrated, the “fighting them over there so we don’t have to fight them over here” argument — which Richard Clarke mockingly termed the “puppy dog” theory of counterterrorism — became popular for a time. President Bush infamously taunted the insurgents to “bring ‘em on” — which they did. They brought it on so much that, six years later, Iraq accounts for more than half of all suicide terrorist attacks in the world since 1981, according to a study (pdf) by Assaf Moghadam of Harvard’s Belfer Center.
Who have been, and continue to be, the targets of these attacks? Mostly Iraqi civilians — tens of thousands of whom have been killed, with many more maimed and permanently disfigured and disabled. This, then, is what Tom Friedman — in antiseptic language designed to leave elite consciences undisturbed — would like to portray as successful American policy: Using the Iraqi people as bait to attract jihadists from around the region and distract them from attacking the American homeland.
But let’s say we grant this argument, intellectually dubious and morally repugnant as it is. Add it to the numerous other costs of the Iraq war, and what did it all earn us? A “long shot” chance at building a stable Iraq — one dominated by Shia factions with close ties to Iran, and viewed with deep suspicion by America’s allies in the region.
It’s not hard to understand why none of Friedman’s usual local interlocutors make an appearance in the column. I doubt he could ever find an actual Iraqi who would second such an argument, any more than you might expect to find an Israeli who would praise the strategic brilliance of Arab propagandists in directing jihadist rage toward Israel.
Obama Speaks Out On The Challenges Of Comparative Effectiveness Research
Obama Speaks Out On The Challenges Of Comparative Effectiveness Research
In an interview with The New York Times Magazine, President Obama suggests that comparative effectiveness research — that is, research that compares clinical outcomes of alternative therapies used to manage the same condition — leaves doctors, patients, and the government with some difficult choices:
So when Peter Orszag and I talk about the importance of using comparative-effectiveness studies as a way of reining in costs, that’s not an attempt to micromanage the doctor-patient relationship. It is an attempt to say to patients, you know what, we’ve looked at some objective studies out here, people who know about this stuff, concluding that the blue pill, which costs half as much as the red pill, is just as effective, and you might want to go ahead and get the blue one. And if a provider is pushing the red one on you, then you should at least ask some important questions. [...]
Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting….So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here. [...]
It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
Obama highlights the anxiety surrounding comparative effectiveness research. We spend too much money on ineffective treatments, but designing a policy that lowers the use of unnecessary/unproven procedures and preserves access to experimental treatments or other unproven procedures is tricky; it’s a source of political concern and contention. Providing doctors with independent analysis about which drugs work and which don’t could save money and countless lives. But that’s the easy part. Almost everyone agrees that telling doctors that that drug X causes more harm than good would encourage providers to switch course and benefit the patient.
What’s more difficult is netting savings from unnecessary medical procedures and discouraging the system from over-treating patients. As the President points out, “the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here” and it’s unclear that putting these patients through surgery during the last weeks or months of their lives is best for the patient. America’s medical culture and current payment structure dictates that you have to do everything in your power to extend a person’s life — by hours, days, or weeks — but the patient is rarely consulted. As Dr. Robert Martensen, author of “A Life Worth Living: A Doctor’s Reflections on Illness in a High-Tech Era” and the director of the museum and the office of history at the NIH, recently explained on NPR’s Fresh Air:
What’s different in American hospitals is that advanced technologies, aggressive interventions, keep getting applied to patients and literally applied right up until the body can no longer respond….Nobody stands back and says this patient is dying. Nobody says it to the family. Nobody says it to the patient if the patient is responsive. Things just keep getting done.
And the result is that, I think, we who are doing these treatments are causing great suffering. So there are structural problems in the system, and the result is that the patient who doesn’t want any more aggressive treatment, who just wants comfort care, can feel very frustrated.
This isn’t to say that the government should dictate a certain course of treatment. That should be left to the patient and her/his doctor (a conversation about different treatment options and choices can only improve patient satisfaction). But what the government can do is provide doctors with unbiased information about which treatments work and provide incentives for providers to focus on care quality and not care quantity (i.e. payment reform)
Today a doctor can spend hours talking to a patient like Obama’s grandmother about end-of-life decisions, discussing what matters to them, relevant medical history etc.. but in New York, Medicaid only pays $18 for that service. If however, a doctor is to recommend a complicated procedure, it would be well compensated.
A model that encourages providers to over-prescribe treatments of dubious quality and necessity is unsustainable and a cause of medical inflation. If we’re really serious about lowering health care costs, then the first step is comparative effectiveness research. But to really generate savings, “we will need legislation to provide incentives on penalties for following or not following where that information leads.” That isn’t health care rationing. It’s just smart medicine and good economic policy.
China’s Changing Climate Provides New Energy In Negotiations
China’s Changing Climate Provides New Energy In Negotiations
Our guest bloggers are Andrew Light and Nina Hachigian, Senior Fellows at the Center for American Progress.
Su Wei, China’s chief climate change negotiator.
This week the Obama administration convened a meeting of 17 of the world’s major economies in a forum on global warming outside of the ongoing U.N. climate change process. Though the history of this Major Economies Forum is somewhat tainted, it may well provide a useful opportunity to engage China on global warming, on its way to surpass the United States as the world’s number one carbon emitter. Recent statements by top Chinese officials evince a new openness to adopting targets to reduce the rate of growth in carbon emissions:
Su Wei, a leading figure in China’s climate change negotiating team, said that officials were considering introducing a national target that would limit emissions relative to economic growth in the country’s next five-year plan from 2011.
While that is a small step, it’s a significant one. China and the five other major emitters among developing nations — India, Indonesia, Brazil, South Africa, and Mexico — were not required to accept mandatory carbon emissions caps under the Kyoto Protocol, as they did not put the greenhouse gases in the atmosphere that are causing current increases in global temperatures. The United States alone is responsible for nearly 30 percent of all cumulative global warming pollution. Nonetheless, this exception for developing countries was a key part of the unanimous Senate objection to U.S. ratification of the treaty. The China exception remains at the core of congressional objections to an international agreement on climate change.
Enticing direct negotiation with the major emitting developing nations — especially China — is critical to getting a global climate change agreement inside or outside of the UNFCCC process. There are many indications that China is ready to talk — and even more that China is already taking action.
China is ahead of the United States in terms of its own green stimulus package. It’s a much bemoaned talking point in these discussions that China has far surpassed U.S. capacity in solar cell production since 2005. Chinese leaders are “investing $12.6 million every hour to green their economy.” China is spending twice as much as we are in the American Recovery and Reinvestment Act on green jobs and a green recovery despite the relatively larger size of the U.S. economy.
As China’s political climate changes, its physical climate is getting hotter as well. In January 2008, the United Nations Convention to Combat Desertification was held in Beijing, a megacity that is already severely swept by dust storms from western and northern regions every year. Shrinking glaciers are starting to cause serious water problems and more intensive damage in the country’s mountainous regions — problems that will soon stress the country’s capacity for short-term mitigation. Just as in the United States, the consequences of climate change are increasingly felt immediately and understood through direct observation rather than being confined to climate modeling.
Joint technological capacity building may be the best road to a new global energy future and help to stimulate the set of climate change agreements which will move us there. Xie Zhenhua, Vice Chairman of the National Development Reform Commission, reiterated that China’s commitment to accepting nationally appropriate reduction goals depends on receiving technology assistance. In Todd Stern’s testimony earlier this month he made it clear that the first priority for the United States in these meetings will be to push along the conversation on technology transfer as a key component of acceptance of emissions caps by the developing major emitters. Such proposals should be discussed now and followed up at the next Major Economies Forum this July in La Maddalena, Italy following the G-8 meeting.
The official Chinese position on climate change remains — you broke it, you fix it. But a creative nudge on the U.S.’s part and a subtle shift in Beijing’s position could open up some real movement in the diplomatic lead up to global climate-change negotiations in Copenhagen.
Read the extended version of this post, “Rise of the Green Dragon?,” at the Center for American Progress.
The WonkLine: April 29, 2009
The WonkLine: April 29, 2009
Welcome to The WonkLine, a daily 10 a.m. roundup of the latest news about health care, the economy, national security and climate policy. This is what we’re reading. Tell us what you found in the comments section below, and subscribe to the RSS feed. Also, you can now follow The Wonk Room on Twitter.
National Security
U.S. forces hope to cut off the Taliban’s main source of finance, Afghanistan’s opium crop, “by pouring thousands of troops into the three provinces that bankroll much of the group’s operations.”
Rival Palestinian factions Fatah and Hamas will attempt a fifth round of reconciliation talks. “Egypt, which has been mediating the negotiations, set May 15 as the new deadline for reaching an agreement,” the New York Times reports.
Times Online reports that “North Korea has threatened to carry out a second nuclear test unless the United National Security Council apologizes for criticism of its rocket launch earlier this month.”
Economy
“At least six of the 19 largest U.S. banks require additional capital, according to preliminary results of government stress tests.” Barry Rithholz writes that “all this goes to show is that receivership was the correct approach to this in the first place.”
The Supreme Court heard arguments in Cuomo v. the Clearing House Association yesterday, a case that may decide “which part of the government should serve as the nation’s watchdog for national banks.”
Financial Times reports that “the volume of commercial mortgages at risk of default has quintupled since the beginning of 2008” as its been “increasingly difficult for shops and businesses to keep up with their payments.”
Health Care
By a vote of 65 to 31, “the Senate confirmed the nomination of Kathleen Sebelius as secretary of health and human services on Tuesday, allowing President Obama to fill the last vacancy in his cabinet with a seasoned politician who will take charge of the fight against swine flu.” Sebelius was also sworn in yesterday.
Did you know that insurance companies “are the only sector of the health care industry lacking a code of conduct?”
Powerful business groups “sent a letter to House Ways and Means Committee Chair Charles Rangel (D-N.Y.) expressing ‘grave reservations’ about creating a public insurance option.” Meanwhile, the leaders of four House caucuses called on Democratic leaders and President Obama “to ensure that a public health insurance plan is part of comprehensive health care reform legislation this year.”
Climate
A new report details how toxic pollution released by companies like DuPont, Archers Daniel Midland, and Exxon Mobil “disproportionately contaminates the air in neighborhoods where people of color and low-income families live.”
After Sen. Kit Bond (R-MO) said green jobs are too expensive, the St. Louis Post-Dispatch responded: “Creating jobs by making our homes, buildings, cars and products as environmentally friendly and sustainable as possible is something Missourians should welcome.”
The U.S. Chamber of Commerce, which has opposed limits on global warming pollution for decades, released a report “projecting ’significant’ economic consequences if President Obama’s proposal to cap greenhouse gases is implemented.”
Republicans Falsely Complain That Democrats Aren’t Consulting Them On Health Care
Republicans Falsely Complain That Democrats Aren’t Consulting Them On Health Care
Republicans are still complaining that the reconciliation instructions in the budget will allow the Democrats to pass health care reform without debate. Today, during an appearance on MSNBC’s Morning Joe, Rep. Paul Ryan (R-WI) dramatically proclaimed that “what’s taking place here is one party rule, moving this thing faster than lighting speed…there is some talk in the Senate, but not in the House at all”:
Bipartisanship means you have collaboration, meaning you sit down, you come together, you write bills, you collaborate, you compromise, you negotiate and then you move together to pass things. That’s not what’s taking place… What’s taking place here is one party rule, moving this thing faster than lightning speed…there is some talking currently in the Senate, but not in the House at all. We’ve asked our Ways and Means Committee Chairman Charley Rangel, let’s sit down and start talking health care reform and find where we have common ground…haven’t had a meeting yet.
Watch it:
Democrats’ decision to use reconciliation after October 15th does not prevent the parties from working cooperatively on health care legislation. As the Washington Post explains, reconciliation “merely provide a ‘fallback provision’ in case Congress fails to pass legislation by the end of the August recess.” In fact, not only will Republicans have ample opportunity to negotiate with Democrats, but Congress has already hosted numerous hearings on health care reform.
In the House, for instance, the committees with jursidiction over health have held at least 12 public hearings; the House Ways and Means Committee, of which Ryan is a member, held 6:
4-22-2009: Health Reform in the 21st Century: Insurance Market Reforms
4-01-2009: Health Reform in the 21st Century: Reforming the Health Care Delivery System
3-17-2009: Hearing on MedPAC’s Annual March Report to the Congress on Medicare Payment Policy
3-11-2009: Health Reform in the 21st Century: Expanding Coverage, Improving Quality and Controlling Costs
3-04-2009: Hearing on the President’s Fiscal Year 2010 Budget Overview with OMB Director Peter R. Orszag
House Energy And Commerce (Subcommittee On Health):
3-24-2009: Making Health Care Work For American Families: Improving Access To Care
3-17-2009: Making Health Care Work For American Families: Ensuring Affordable Coverage
3-11-2009: How Do You Fix Our Ailing Food Safety System?
3-10-2009: Making Health Care Work For American Families: Designing A High Performing Healthcare System
House Committee On Education And Labor:
4-23-2009: Ways to Reduce the Cost of Health Insurance for Employers, Employees and their Families
3-10-2009: Strengthening Employer-Based Health Care
Last week, House Majority Leader Steny Hoyer (D-MD) “told reporters on Capitol Hill that he intends to meet with Rep. Roy Blunt (R-MO), chairman of the House Republican Health Care Caucus…to continue a discussion on comparative-effectiveness research and a public health-plan option—among other measures—that have proven to be sticking points between the two parties.” Ryan is a member of Blunt’s group, but he and his fellow Republicans are more interested in railing against so-called government-run health insurance than offering viable policy solutions to the health care crisis (check out their solution page).
DOJ’s Hinnen: ‘A Lawless Response To Terrorism’ Undermines Our Nat’l Security
DOJ’s Hinnen: ‘A Lawless Response To Terrorism’ Undermines Our Nat’l Security
Earlier today, I attended a presentation at the Washington Institute for Near East Policy by Todd Hinnen, Deputy Assistant Attorney General for Law and Policy in the Department of Justice’s National Security Division. The division was created in 2006 by the USA Patriot Reauthorization and Improvement Act, merging the core national security functions of the DOJ, as recommended in March 2005 by the Iraq Intelligence Commission.
Hinnen described his team at the DOJ as doing the “30,000 foot level strategic thinking, policy development and legal analysis” for the Department’s national security work. Hinnen stated his belief that the development of an appropriate and enduring legal framework was “essential to effectively combating terrorism for reasons that are both principled and pragmatic.”
It is essential on grounds of principle because the law has defined this nation, a nation of laws, since its founding…It would be a Pyrrhic victory if, in our struggle the preserve this country against the threat of international terrorism we sacrificed so central a part of what this country stands for and why it has been a model for the rest of the world.
It is essential on grounds of pragmatism because a lawless response to terrorism — one for instance that includes torture, black site prisons, and indefinite detention without due process — undermines our moral credibility and standing abroad, weakens the coalitions with foreign governments that we need to effectively combat terrorism, and provides terrorist recruiters with some of their most effective material.
It’s good to hear government officials expressing this kind of understanding of what it is that really makes America exceptional — and what really makes us safe.
Progress Toward Equal Pay In The Last 45 Years: 19 Cents
Progress Toward Equal Pay In The Last 45 Years: 19 Cents
On Equal Pay Day 2009 — the day on which the average woman’s pay will catch up to a man’s total earnings from the previous year — Change.Org’s Jen Nedeau points us to this stat:
[I]n the United States, women are paid only 78¢ on average for every dollar paid to men. The National Women’s Law Center reports how when President Kennedy signed the Equal Pay Act into law, it made it illegal for employers to pay unequal wages to men and women who perform equal work….At the time of the Equal Pay Act’s passage in 1963, women were paid merely 59 cents to every dollar earned by men. Hmm – so in 45 years, women’s wages compared to men’s have only increased by 19 cents?
Plus, “over the last six years, the wage gap has closed only 2 cents.” That’s slow progress, to be sure.
The Wonk Room has noted before that the difference between the median wages of all full-time working men and women over a 40 year period amounts to about $434,000, on average. Women’s pay is actually less than men’s in every one of the 20 industries and 25 occupation groups surveyed by the US Census Bureau in 2007.
And as Rep. Carolyn Maloney (D-NY) pointed out, “the impact of the wage gap is particularly painful in our current economic downturn as families struggle to make ends meet in the face of stagnant wages and job losses”:
Women make up more than 46 percent of the workforce and, as the number of working women continues to grow, so does the number of families reliant solely on the salaries of women. Since the recession began in December 2007, 3.7 million men have lost their jobs; creating even more families dependant on the smaller pay checks women earn.
The Congress has passed — and President Obama has signed into law — the Lilly Ledbetter Fair Pay Act, which is a good step toward full pay equality. But as CAP’s Jessica Arrons, Heather Boushey and Lauren Smith wrote, more can be done, including passing the Paycheck Fairness Act. The act prohibits retaliation against employees who actively seek knowledge regarding the pay rates of their coworkers, closes “loopholes that employers have exploited to avoid paying fines and provides funding for programs that will train women to negotiate their wages.”
Global Threats Require A Global Response
Global Threats Require A Global Response
Our guest blogger is Nina Hachigian, Senior Fellow at the Center for American Progress Action Fund.
In his column this morning, David Brooks claims that the response to swine flu “suggests that a decentralized approach is best,” relying on nations and localities to deal with the threat. He rejects the idea of building “centralized global institutions that are strong enough to respond to transnational threats,” an idea he attributes to G. John Ikenberry, of Princeton.
Dan Drezner, quoting an email exchange with Ikenberry himself, makes the point that jumped to my mind, (as I was muttering “no, no, no!” at the breakfast table) which is that the two are not mutually exclusive. Both a local response and international coordination are necessary to fight a global threat.
Why do you need those international architectures, like, in this case, the World Health Organization (WHO)? There are many reasons, but to name a few:
1. To track the spread of the flu globally, and see how it is mutating as it goes, you need flu samples from around the world. Some countries, for political reasons, would not offer them freely to the US. Only a politically neutral body like the World Health Organization can collect those (and sometimes, not even it can).
2. The WHO helps create and foster the very networks among scientists and government officials around the world that Brooks cites as useful.
3. Some countries don’t have the capacity to mount what Brooks calls a “bottom-up, highly aggressive response.” Some organization needs to help create that capacity and call attention to its absence as a weak link in the global chain. If every country had a CDC like ours, there would be less reason to worry. But they don’t. Not even close.
Global threats need a global response. Nations are the ultimate actors, but international organizations can go a long way toward making the global response more effective.
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