Wednesday, September 19, 2012

Z-Files: Separation

Stuart Zechman's Z-Files: Separation

(Listen to Separation.)

I'm Stuart Zechman, and, as a movement liberal, I'm totally for religious liberty.

Yep, as a firm supporter of the Bill of Rights, I think that the first sentence of the First Amendment, which reads:

"Congress shall make no law respecting an establishment of religion"
represents an inherently American value: the government has no place whatsoever instituting anybody's church's dogma into public policy...anywhere.

The next beautiful sentence in the First Amendment, which reads:

"or prohibiting the free exercise thereof"
, means exactly that: the state can't tell you if, when or how to worship whom. That is entirely your business as an individual, not mine and not the government's.

What you believe in your heart of hearts depends solely on what your conscience dictates, and nobody else's. That's freedom. That's liberalism. That's America.

So then I read this latest statement from the White House on the implementation of their Rube Goldberg health care law, the "PPACA," and it says:

"Today, President Obama announced that his Administration will implement a policy that accommodates religious liberty while protecting the health of women."
and I read that Nancy Keenan, head of NARAL, the Washington-based "National Abortion Rights Action League" put out the statement:
"the announcement makes it clear that President Obama is firmly committed to protecting women's health."
, and I thought to myself "Great! That must mean that the PPACA will be amended to say that abortion is now covered by Medicaid, which is the health insurer used by about 49 million low-income Americans, amongst whom a disproportionate share are low-income women, since the PPACA provides the majority of its 'Universal Coverage' by expanding Medicaid, and that the state-based private insurance exchanges in which the law forces individuals to participate will now be regulated to mandate abortion coverage."

You know, what else could it mean?

Religious liberty, making no law that establishes anybody's religious doctrine as the basis for public policy, surely that's what he discussion is about, right?

I mean, it's not like the President and Nancy Keenan could possibly mean that religious liberty somehow involves the government writing laws and regulations on the basis of the theology of a particular church?

Even if that church is a huge, world-wide institution, it would be a violation of everybody else's religious liberty to enforce the laws with special exceptions for them. That's crazy.

It's funny, the little church that I attend, the Middle Church on Second Avenue in New York, where I live, well, those folks believe that Jesus wasn't only giving out bread to eat, they note that he was healing the sick, too. So why shouldn't the law follow that example? Why do some churches get to say what's in the health care laws and regulations, while other churches --like mine-- don't? Isn't that the whole point behind "no law respecting an establishment of religion"? Why does some people's religion seem to matter more to the government than mine...or yours?

It seems to me as if the term "religious liberty" is being turned on its head to mean that some people's church doctrines are to be respected to the point where the President gets up at a podium and says "the government will accommodate you immediately," and some people's aren't. And, not to paint with too broad of a brush here, but it always seems to be a certain kind of church that gets the special treatment, that gets special rights, usually the ones that are the political enemies of movement liberals like me in their spare time, or have a great deal of institutional power and wealth.

That's not accommodating religious liberty, that's accommodating something else.

Maybe we movement liberals ought to be a bit more clear about just how much we support the Bill of Rights, and real religious liberty in particular.

Maybe we ought to start demanding that our government be concerned about the health of everybody, even the women on Medicaid that Washington lobbyists like Nancy Keenan don't seem too concerned about, and start respecting the religious liberty of everybody, by not granting special favors in the law to the churches with the most money to pay for public relations campaigns in an election year.

Maybe, when we talk about "the free exercise" of our religious liberties, we ought to be asking "Whose? Yours? Or everybody's?" for a change we can all believe in.

I'm Stuart Zechman, and this has been the Z-Files.

Saturday, September 08, 2012

Third Way

Z-Files Episode 14, 04/17/2012                    

"Third Way"

I'm Stuart Zechman, and I'd like to do a little experiment with you folks listening, if you wouldn't mind helping me out.

So I'm going read you a representative quote from a politician, and I want you to try to guess whether that politician is liberal or conservative, OK?
Here goes, quote number 1:
""...God’s still up there. The arrogance of people to think that we, human beings, would be able to change what He is doing in the climate is to me outrageous.""
Is the politician who said that liberal or conservative?

OK, here's quote number 2:
""I favor the death penalty for abortionists and other people who take life""
Again, liberal or conservative?

What about this one, Quote number 3:
"The truth is that abortion drugs are not about women’s health but are really a seemingly innocuous means of advancing a radical agenda."
And now for quote number 4. I wanted three quotes, but the fourth one is just too...perfect to leave out, so here goes, quote number 4:
""the gay community has infiltrated the very centers of power. They are the greatest threat, that agenda is the greatest threat to our freedom we face today.""
OK, I could go on like this all day.
But, by now, you're all probably saying impatiently "Hey Stuart, that was beyond easy. They're all conservative!"

And you would be correct!
Of course these are all right-wing politicians, all Republicans.

The first right-wing quote was from bible-based science denier, the Senator from Big Oil --I mean, Oklahoma, James Inhofe.

The second, that managed to combine aggressive death penalty advocacy with an abortion is premeditated murder message, that's from conservative Senator Tom Coburn.

The third right-wing quote, about the radical agenda behind access to contraception, was Congresswoman Virginia Fox, who will be the first to tell you that conservatism is an equal opportunity philosophy...apart from the "equality of opportunity" part of that statement.

And extra-bonus fourth right-wing quote, the one about the gays being the greatest threat...well, that was a trick question, it's Coburn again. 

So, the point of this exercise is this: these politicians --no matter how corrupt, no matter how stupid, no matter how cowardly and vote-seeking they are-- are all giving voice to the conservative movement. They're right-wing.  Informed people couldn't possibly confuse them with non-right-wing politicians.

But there's a related point I'd like to demonstrate, and that requires us to do another quick "guess the ideology" game, so here goes:

Quote number 1:
“Repealing ‘Don’t Ask, Don’t Tell’ will affirm the Senate’s commitment to the civil rights of all Americans and also make our military even stronger.”
Liberal or conservative?

OK, quote number 2, I have to mention this is from a 1995 speech entitled "Women's Rights Are Human Rights":
"As long as discrimination and inequities remain so commonplace around the world - as long as girls and women are valued less, fed less, fed last, overworked, underpaid, not schooled and subjected to violence in and out of their homes - the potential of the human family to create a peaceful, prosperous world will not be realized."
So, liberal or conservative?

Alright, I'm running out of time, so the last quote is actually a double quote from two different speeches:
""A woman's ability to decide how many children to have and when, without interference from the government, is one of the most fundamental rights we possess. It is not just an issue of choice, but equality and opportunity for all women.""

""I am pro-choice. I believe in Roe v. Wade...""
Is the politician who said those things conservative, in your mind?
I think that virtually anybody who heard that second set of quotes would say that the speakers were not right-wing, that those were not expressions of conservatism.

So let me tell you who said what:

Quote number 1, from the guy who successfully led the fight to repeal Don't Ask Don't Tell in 2010, that was Joe Lieberman.

Quote number 2, from "Women's Rights Are Human Rights" was from Hillary Clinton.

And quote number 3, about the basic, fundamental right to our own persons, and the declaration "I am pro-choice"?

Well, that was from Barack Obama, the President who just appointed two Supreme Court justices who are, like him, public proponents of the Constitutional right of Americans to choose.

I think these quotes and the record demonstrate that these politicians are not conservative.

They will never get gigs writing for National Review. They will never be given campaign money from Concerned Women for America. Their names, if ever mentioned at a CPAC convention, will mostly likely be greeted with calls for summary execution as fifth column traitors.

In almost every corner of America, if one were to publicly claim that Lieberman, Clinton and Obama are actually right-wing conservatives, one could expect to be met with derisive laughter, and for good reason.

But are they liberal?

Well, they're Democrats, that's true, but not all Democrats are liberals.

What Joe Lieberman, Hillary Clinton and Barack Obama have in common is that they're "New Democrats," meaning they were all members of something called the "New Democrat Coalition," which is a Congressional caucus of ideologically like-minded Democrats, kind of like the "Progressive Caucus," who are the left-most wing of the Party, or Blue Dogs who actually are a bloc of conservative Democrats.

Here's a description:
"New Democrats...are an ideologically centrist faction within the Democratic Party...identified with centrist social/cultural/pluralist positions and neoliberal fiscal values.[1][2] ...represented by organizations such as the Democratic Leadership Council (DLC), the New Democrat Network, and the Senate and House New Democrat Coalitions."
Let me read to you what the New Democrats say about themselves:
  "As Congress works to tackle the challenges facing our nation, the New Dems, through our seven policy task forces, have put forward a commonsense agenda...These initiatives are about moving the U.S. forward in the 21st century.

The Coalition’s seven task forces are: Critical Infrastructure and Manufacturing; Education; Energy; Financial Services; Health Care; Innovation, Competitiveness and Tax Reform; and Trade.
Well, well, well. Health care. Financial Services. Taxes and trade.

And what were the Obama Administration's and Democratic Congress's "historic achievements" during the past four years, again?

Heritage Foundation-Third Way compromise health care "reform." Financial "regulation" that leaves "Too Big To Fail" bigger and with more fail than ever. The lame duck Bush-Obama tax cut deal and estate tax repeal. And more NAFTA-style free trade agreements as far as the eye can see.

What inevitably passed into law these past four years was the New Democrats' agenda. Just as inevitably, what wasn't the New Democrats' agenda was universally characterized as "politically impossible," and never put on the table.

And, just as surely as we can recognize the first set of quotes as conservative, and the second set of quotes as not-conservative, we movement liberals can recognize that the New Democrats' agenda is not liberal.

So there must be something else, other than liberal or conservative, that describes that ideological framework, a "Third Way," if you will, between right and left. An ideological center, a committee-packing voting bloc of bipartisan-fetishizing, Tom Friedman-idolizing, anti-right and anti-left Democrats who always seem weirdly, ideologically desperate to compromise, especially in the name of destroying entitlements, or keeping America at constant war, even when that means they lose elections.

I think that people who are truly interested in saving our country from this not-New Deal we've been handed ought to play "guess the ideology" a bit more often, and consider that, in addition to many Democratic politicians being corrupt or stupid or cowardly, maybe there's an agenda other than left or right that, like many important things that go on, the purveyors of conventional political wisdom would prefer to ignore. Maybe, when other explanations fail to adequately describe how politicians who get a 100% NARAL rating or who repeal DADT can still not be liberal, we should at least begin to try --in an organized way-- to help liberal Democratic voters understand that there's left, right and Third Way center represented in the capital, and that, for the vast majority of Americans, two out of three are bad.

I'm Stuart Zechman, and this has been the Z-Files.

Tuesday, September 04, 2012

Z-Files Episode 9, 03/13/2012


I'm Stuart Zechman, and I've been hearing the phrase "false equivalence" being used lately in ways I've never heard before.

You remember what "false equivalence" is, right?

It's when someone points out what appears to be a similarity between two things that are, in reality, not equivalent at all.

I'm pretty darn familiar with the expression, because, especially during the 2000s, the national press corps would put their centrist biases on display by manufacturing false equivalences all the time.

Remember that?

The centrist media would routinely couch its reporting in language like:

"...the extreme rhetoric from both liberals and conservatives in the debate over the Iraq invasion became even more heated than usual this week, as Ann Coulter's new book 'Treason: Liberal Treachery from the Cold War to the War on Terrorism' topped the New York Times best-seller list..."

and we'd say, whoah-whoah, hold on a minute there...we movement liberals are saying that, in addition to it being weirdly immoral to invade a country for basically no reason, and then spend the next decade occupying hostile foreign lands, it's a stupendously bad idea in policy terms, because it makes America less safe to bankrupt ourselves whilst inspiring more and more people around the world to dedicate themselves to blowing us up than would otherwise. Like, say, if we weren't pointlessly blowing up people who are just trying to go about their lives in their homes day after day, year after year.

The movement conservatives, on the other hand, were saying that, by definition, liberals are traitors. During wartime. Also, Joe McCarthy was right, and McCarthyism was a good thing...because liberals really are traitors who would love to sell out their country during a time of war, because we don't like America or Americans. Ann Coulter would say things on television and in print like “Liberals have a preternatural gift for always striking a position on the side of treason,” and “Everyone says liberals love America, too. No, they don’t.” That was June of 2003, by the way. It was just a few months into the Iraq war, and just a year and a half after 9/11, and that's what movement conservatives were saying about their fellow Americans, that we were trying to betray our country just because of who we are.

Now, anybody can see that these two sets of arguments aren't the same. They're just not equivalent. That would be false equivalence.

And so it became a pretty widely accepted critique of the centrist media on the left, for good reason.

But I've noticed something:  "false equivalence" now means something else entirely.

When I've said that prime time MSNBC sounds sometimes like the same partisan, propaganda channel devoted to the political empowerment of a single Party we liberal Democrats used to mock, I'm now told that I'm engaging in "false equivalence."

And when I've said that Eric Holder's declaration based on a secret legal memo that when it comes to the government assassinating American citizens, "due process" doesn't necessarily mean "judicial process," sounds like John Yoo at a "24" DVD drinking party, I'm now told that I'm engaging in "false equivalence."

It now means "When Democrats do the same thing that Republicans do, pointing out those facts is engaging in false equivalence, because, although it may appear to be similar policy regimes, Democrats are basically good, and have people's interests at heart, while Republicans are nasty, evil racists and misogynists who motivated purely by hatred of liberals like us."


According to this view, Democrats in power can't possibly be like Republicans, even when they do identical things, because, by definition, liberals are good, and, by definition, conservatives are bad.

But when Paul Krugman accurately writes that Mitt Romney's "signature achievement was a health reform identical in all important respects to the national reform signed into law by President Obama four years later," it just can't be "false equivalence" to call the Affordable Care Act "Romney-Care," even if that makes some Democrats mad to hear it described that way.

You know, we liberal Democrats like to say that we're "the reality-based community."  If that term is to continue to have any meaning at all, and not become the tragic joke of the 2012 election cycle, we movement liberals should probably spend less time yelling about false equivalence between Democrats and Republicans, and more time pointing out the actual equivalence between some Democratic and Republican matter which party happens to be in charge at the time.

I'm Stuart Zechman, and this has been the Z-Files.

Monday, September 03, 2012

Z-Files: "Extremists"

Z-Files, 02/28/2012 "Extremists"
I'm Stuart Zechman, and I've heard something that really disturbs me.

I've heard that the Republican Party is now populated with wild extremists, right-wing lunatics who are completely divorced from reality, and so, like never before in American history, the GOP is now totally unreasonable and insane, and, if they get into power in Washington,  the will enact the most dreadful, terrible, awful policy...ever.

Have you been hearing this, lately, too?

See, I thought that the Republican Party has always advocated the worst kind of policies and agenda.

Since, like, as far back as the 1990s, I remember Republicans being in favor of all kinds of anti-Bill of Rights, pro-endless war, anti-New Deal and pro-big corporate monopoly proposals, and performing all of these crazy political hostage-taking maneuvers to try to get that horrifying agenda through the government.

I vaguely --really vaguely-- remember way back when that Christian fundamentalist and televangelist fraud Pat Robertson actually ran for President as a Republican, I think that was in the 1980s, actually.

I remember, in the late 90s, when Congressman Dan Burton, a Republican from Indiana, was so freaking nuts that he actually staged a supposed "re-enactment" of how Hillary Clinton murdered a White House staffer named Vince Foster, by shooting a pumpkin in his back yard, and telling reporters to imagine that this was Foster's head. I remember when he said things like "If I could prove 10 percent of what I believe happened, he'd [Clinton] be gone. This guy's a scumbag. That's why I'm after him."

Just to give you some idea of what I'm talking about, Dan Burton, I swear to you, once proclaimed in a 1995 House hearing on the War on Some Drugs, that

"the US military "should place an aircraft carrier off the coast of Bolivia and crop dust the coca fields." It was later pointed out to him that a) Bolivia is landlocked and has no coast (Burton was chairman of the Western Hemisphere Subcommittee); b) the Bolivian coca fields (in the yungas and Amazon lowlands) are beyond the reach of any carrier-borne crop-duster, being separated from the nearest coastline (the Pacific coast of Peru and Chile) by the 20,000+ feet high peaks of the Andes; and c) F-18s cannot crop-dust."

I'm telling you, this is well-documented. The Republicans from the 1990s were like this.  If you listened to talk radio, like I did, or had enough time on your hands to watch the Christian conservative religious broadcasters, like I did, you were more than likely to hear Hillary Clinton referred to as a secret lesbian murderess. I'm not kidding.  They literally told people that Clinton was Satan.  These guys made today's "War on Religious Freedom" hucksters look like college Democrats. It makes Romney's references to Obama as a "European-style socialist" look like an endorsement.

And then they were so suicide-bomber insane, that they actually impeached a sitting president over a blow-job. Bob Livingston, the Speaker of the House to be actually resigned when he was caught having an affair, so that they could more easily go after Clinton, they were that kamikazi. (His successor was a straight-shooter from Louisiana named David Vitter.) I'm not making this up.  You think that the debt-ceiling debate was Republicans at their craziest? I'm telling you, back in the 1990s they stopped the whole government, held a trial in which the now Very Serious Lindsey Graham got up on the House floor to carefully consider the nature of semen stains. This was the Republican Party of the 1990s...totally f-ing crazy.

And in the policy realm, it was unbelievable...their policy agenda, the policy proposals that came out of conservative think tanks like Heritage Foundation and American Enterprise Institute, was even worse for America than all the phony investigations, and fake scandals and even the blow-job impeachment.

These guys, these Republicans, actually proposed things like turning Medicare into a "premium support" system kind of like the Medicare Part D prescription drug coverage we got that exploded drug prices when the crazy GOP controlled all three branches of government, and proposed --get this-- creating this vast, privatized health insurance scheme where, state-by-state, the private health insurance monopolies would sell people junk insurance who were forced by law to buy their crappy coverage. It would all be means-tested and funded through HHS, so the federal government would end up actually paying insurance companies to say in business, and only the deserving poor would get any help.  And this regime would somehow make health care "affordable care." Yeah, I know. Crazy, isn't it?

Or, talk about nuts, they proposed repealing the New Deal laws that stopped savings banks from becoming investment banks and even financial insurance companies. They basically said that the government needed to get out of the way of the giant banks gambling with all of our money, and should essentially let these geniuses create whatever debt they felt like making and selling, and then insuring themselves against default.

Now that's insane.

You really can't get more out of touch with reality than this, folks.

And they were just as crazy in the 2000s, too. You had best-seller books, like Ann Coulter's "Liberal Treachery from the Cold War to the War on Terrorism" or Michelle Malkin's "In Defense of Internment: The Case for Racial Profiling in World War II and the War on Terror."

I mean, how do you reason with people like this, people who want to, say, institute a massive program to infiltrate Muslim mosques with law enforcement agents, and put grade schools for African-American Muslim kids under constant state surveillance?

Remember when they said that the President had the power to do virtually anything to "keep us safe," and we just had to basically trust that he wasn't going to abuse that virtually unlimited power?

What kind of lunatics believe that this sort of due-process-less regime is somehow compatible with small-d democratic government? It's obviously the path to oligarchy and tyranny, right?

It's like we might all have to pack up and move to Canada, if extremists like that ever got into power.

So, when I was reading the New York Times the other day --you know, they're so much more reality-based than Fox News, despite the whole Judy Miller/Iraq war thing-- anyway, and I saw Paul Krugman say that the party of American conservatism is divorced from reality, quote:
" How did American conservatism end up so detached from, indeed at odds with, facts and rationality? For it was not always thus. After all, that health reform Mr. Romney wants us to forget followed a blueprint originally laid out at the Heritage Foundation!

The truth, of course, is that he was not a “severely conservative” governor. His signature achievement was a health reform identical in all important respects to the national reform signed into law by President Obama four years later. And in a rational political world, his campaign would be centered on that achievement."

 And I thought:  wait a second...Krugman is openly declaring that Heritage Foundation health care policy, the policy that flowed from those same insane, pumpkin-shooting Republicans in the 1990s, is an "achievement."

The argument in elite, big-D Democratic circles seems to be that the scary Republicans are scarier than ever before, so scary, with their Tea Party and their conservative media, that they make the Republicans of the late 1990s look reasonable.

So reasonable, in fact, that conservative Republican policies from the late 1990s, policies that are completely at odds with the philosophy of the New Deal, a functioning government, a federal state that doesn't spy on anybody it feels like, and a free and fair market for everybody, policies that reject everything that movement liberals stand for are now considered to be "achievements" when enacted into law by today's centrist Democrats.

Now, if you think about it, that is, itself, quite detached from, indeed at odds with, facts and rationality. And, it was not always thus.

But it does seem to be the argument that national Democrats are using to win over people like Dr. Krugman.

How could it be that the passage of policy identical in all important respects to conservative think-tank Heritage Foundation's, policy we movement liberals would have recognized in 1998 as an obviously, deeply unpopular non-solution, the product of bankrupt ideological premises regarding the superiority of "markets", certain to bring tragic consequences to the people of our country, and discredit to the party which promoted it, how could this be ever be rationally called an "achievement?"

It can't be. Not unless one jumps through extraordinary intellectual hoops to rationalize voting for a Democratic politician whose own "signature achievement" is Mitt Romney's health care policy.

And that's what this line is about, folks. We movement liberals are being told from on high that the reason why centrist Democrats' failures are actually because the Republicans of today are super-scary.

And that's just not true. The movement conservatives are just as frighteningly wrong today as when Ann Coulter became a millionaire writing a book entitled "Godless" about liberals, and when Ramesh Ponnuru wrote "The Party of Death" about Democrats a few years ago.
Quote-unquote "market-oriented" policies from the 1990s and 2000s are just as bad for America today as they were back when the majority of Democrats actually opposed them, instead of arm-twisting "progressive caucus" members into shilling for them.

So when you hear this line, that Republicans of today are like Congressional Ahmadinejads because they won't vote for Newt Gingrich's old agenda when it's proposed by Democrats, just remember:  it's pretty likely that you're going to read Dem-leaning pundits in the Washington Post consider how reasonable Newt Gingrich's old agenda actually is, compared to the new Newt Gingrich's agenda.

And then ask yourself:  is the political price that you're being asked to pay to protect yourself from these terrifying new Tea Party-style Republicans that you now have to vote for old, Dan Burton-style Republicans' agenda, and...

...what did FDR say about "fear itself"?

I'm Stuart Zechman, and this has been the Z-Files.

Saturday, May 19, 2012

Pow Wow's comment, one year on

Pow Wow's comment, one year on

BDBlue mentioned in comments to this post at The Sideshow an excellent comment from last year to a post by Glenn Greenwald called "The Patriot Act and bipartisanship". That comment by Pow Wow is difficult to find thanks to the permalink at Salon being screwed up, so I thought I'd post it here to make a direct link for it.

[Two countries divided note: For reasons I have never been given an explanation for, the parliamentary term "tabled", in the United States, means the opposite of what it means everywhere else.]

pow wow
Tuesday, May 24, 2011 01:50 AM +0100

Resistance is NOT (yet) futile, thanks to Rand Paul

Let me see if I can coherently explain - even for Senate-myth-saturated audiences (which are remarkably, if unconsciously, resistant to criticism of "bipartisan" Party dogma) - how and why Rand Paul came to singlehandedly hold the power, if he so chooses, to delay S. 1038 into the weekend, without "filibustering," ahead of the Senate's planned week-long Memorial Day recess next week. [I've linked to a lengthier general explanation.]

Before I do that, though, read what Rand Paul himself said on CNN Friday night (May 20th), for a rare insider's view of what the Senate is today, courtesy of both Parties:

Senator Rand Paul: "We go week after week in the Senate and do nothing. I feel like sometimes I should return my check because I go up, they do no votes and no debate. Look at this horrendous debt crisis - we don't debate that either.

Anderson Cooper: "Really, you feel like that? You feel like you're not doing anything there?"

Paul: "Yes. I feel... Absolutely. We go up week to week and there's no debate in Congress. No debate in the Senate. We sit idly by. Some weeks we vote on two-three non-controversial judges and we go back home. It, really..."

Cooper: "Why is that?"

Paul: "I'm trying to get a vote on Libya. They say they don't have time. I was told, when I wanted to bring up my resolution on Libya - which I did force them to, but I had to kinda capture the floor..."

Cooper: "It got tabled like 90-10..."

Paul: "Yeah, and they weren't too happy with me because I used some parliamentary procedures to gain access to the floor, and they came running down to the floor. They were apoplectic that I had taken over the floor, and the thing is is that we should be having these debates on the floor - they don't want to have any debate. I'm asking right now to vote on Libya - I have a resolution saying we're in violation of the War Powers Act. It's hard for me to get the floor unless I somehow sneak on the floor when no one's looking to try to get a vote. Why would we not want to debate great Constitutional questions? When I ran for office, that's what I thought - there will be great and momentous debates on the floor. We don't have any because they prevent the debates from ever even beginning."

Cooper: "Senator Rand Paul, appreciate your coming on. Thank you."

Paul: "Thank you."


"They" in this case being the Party (= fundraising) organizations and their leadership, which operate almost entirely off the public record and out of public view. Their objective at all times: avoid unpredictable democratic floor action, and the accountability of public debate.

To meet that objective the Parties basically gave the Senate the 'boiling frog' treatment. Slowly, over years - imperceptibly enough to have escaped journalistic notice of a sudden, shocking dismantling of the Senate - a fake quorum call (which doesn't call the quorum, but does suspend all floor business until lifted by unanimous consent, or by the Majority Leader) that was once a rare interruption to floor proceedings instead itself became the essence of Senate floor proceedings.

In other words, what was once informally used as a procedural pause on occasion, when floor debate needed to be suspended so Senators could briefly confer with each other off the record, now instead predominates in the Senate, hour after hour, day after day, week after week, with only an occasional speech or business action interrupting the non-quorum-call "quorum call's" idling away of Senate time. [See Paul's description above.]

Note, first, that this pernicious Fake Quorum Call (FQCall) is controlled by the Majority Leader (he can lift it at any time), and its existence is not formalized under any Senate rule.

Note, next, that in the absence of the FQCall, the Presiding Officer of the Senate is obligated under Senate rules to put the pending question to a simple-majority vote of the Senate, unless someone seeks the floor to debate (or requests an actual quorum call, to verify that there is a Constitutional quorum of Senators present).

By putting those facts together, I hope it's clear that, absent the FQCall, under default Senate rules and procedure, if no business or debate (or a real, live quorum call) is ongoing, nothing can stop a simple-majority vote on the pending business from being put to the Senate by the Presiding Officer while the Senate's in session.

And, thus, if the Senate this week was operating under default order and procedure, Rand Paul would have had to conduct an actual, extended-debate filibuster to singlehandedly "temporarily block" action on S. 1038.

So what's happened to change the situation, from that ordinary, default Senate order, to something else?

In addition to the usual (unchallenged) abuse of the FQCall, 18 Democratic Senators, including Harry Reid, voluntarily filed a cloture motion last Thursday to try (as is their wont) to impose a different, supermajority set of (Rule 22) procedures on the Senate - to replace the default, simple-majority public debating rules (held in abeyance by the FQCall) despite no unanimous consent agreement to do so.

Thus, Rule 22 cloture rules replaced default Senate rules when Thursday's cloture motion passed Monday, and they empower Senators to simply "object" to further action until Rule 22 says the Senate may proceed.

Significantly, Rule 22 mandates 30 hours of debate on the pending question after passage of a cloture motion. Unanimous consent is required to waive those 30 hours of debate, and we know that someone - presumably Rand Paul, but possibly someone else (we don't know because the FQCall creates a Senate that operates in backroom secrecy) - already "objected" Monday to waiving the 30 post-cloture hours of debate on the motion to proceed to S. 1038. Because the motion to proceed itself has not yet received a vote, and S. 1038 is thus not yet officially before the Senate.

Thursday, January 19, 2012

PPACA: The Third Way To Lowering Health Care Prices?

PPACA: The Third Way To Lowering Health Care Prices?

Stuart Zechman

[I asked Stuart to post something here that explained one of the big reasons medical costs are so high in the United States that is unrelated to the forces we usually discuss. He felt that this comment he posted in late 2010 at Swampland helped unpack it. - Avedon]

Kate Pickert:

You write:

"The commission report also calls for a much stronger Independent Payment Advisory Board, the newly created commission charged with slowing the growth in Medicare spending."

What exactly is this "Independent Payment Advisory Board?"

How exactly will it "slow the growth" of Medicare's medical insurance payments?

There are two ways of achieving a slower-growing Medicare that come to mind, of course.

One is to cut spending by reducing the amount of things for which Medicare pays, like, for example, setting a limit on how many MRI's, pain-alleviating pills or doctors' visits someone may have before they have to pay more for these things in some way themselves --which, at current prices, they will simply be unable to pay.

The other is to change the way that the "Resource-based Relative Value Scale" (the price schedule for the hospital visits, laboratory tests, etc for which Medicare pays) determines pricing for health care.

Since not only Medicare, but all HMOs use this price menu to determine how much they pay for all health care spending

(from the Wikipedia entry)

Resource-Based Relative Value Scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is currently used by Medicare in the United States and by nearly all Health maintenance organizations (HMOs).

RBRVS assigns procedures performed by a physician or other medical provider a relative value which is adjusted by geographic region (so a procedure performed in Manhattan is worth more than a procedure performed in El Paso). This value is then multiplied by a fixed conversion factor, which changes annually, to determine the amount of payment.

RBRVS determines prices based on three separate factors: physician work (52%), practice expense (44%), and malpractice expense (4%).[1][2]

, adjusting the prices on the menu to grow more slowly or to be less expensive altogether would not only have the effect of reducing Medicare's burden, it would lower the price of health care for Americans in the private market as well.

In theory, the pricing of health care by Medicare, and therefore the entire private health insurance industry, should be a matter of transparent, public record. In theory, the manner in which prices were decided would be available to all kinds of public scrutiny, including yours, Kate Pickert.

Unfortunately, that's not the case currently:
The RBRVS system has been criticized on a number of grounds:

# The regulatory committee (RUC) is largely privately run, an example of regulatory capture.[3]

# The regulatory committee (RUC) is secretive, with the meetings being closed to the public and uninvited observers.[3][4]

# The data are effectively copyrighted by the AMA, but its use is required by statute.

Although the RBRVS system is mandated by the Centers for Medicare and Medicaid Services (CMS) and the data for it appears in the Federal Register, the American Medical Association (AMA) maintains that their copyright of the CPT allows them to charge a license fee to anyone who wishes to associate RVU values with CPT codes. The AMA receives approximately $70 million annually from these fees, making them reluctant to allow the free distribution of tools and data that might help physicians calculate their fees accurately and fairly.

Will the Independent Payment Advisory Board address these obviously corrupting flaws in the secretive, closed, copyrighted, regulatory capture-prone process used to decide how much Americans pay every year in health care prices, Kate Pickert?

And what about this other obvious flaw in the current, secret pricing scheme?

Paying based on effort rather than effect skews incentives, leading to overuse of complicated procedures without consideration for outcomes.[3] Contrast with evidence-based medicine (EBM), which is based on outcomes.

According to this critique, RBRVS misaligns incentives: because the medical value to the patient of a service is not included in how much is paid for the service, there is no financial incentive to help the patient, nor to minimize costs. Rather, payment is partly based on difficulty of the service (the "physician work" component), and thus a profit-maximizing physician is incentivized to provide maximally complicated services, with no consideration for effectiveness.

One effect attributed to RBRVS is a lack of primary care physicians (PCPs) at the expense of specialists – because specialist services require more effort and specialized training, they are paid more highly, incentivizing physicians to specialize, leading to a lack of PCPs.

Will the Independent Payment Advisory Board attempt to slow the growth in Medicare spending by changing the way that prices are calculated, so that a hospital can't charge the tax payer, say, $140 for a Tylenol pill, just because they're a hospital, and not a convenience store?

Or, Kate Pickert, will the Independent Payment Advisory Board simply declare some devices, laboratory tests, drugs and procedures "less effective" using some similarly secretive and complex pricing scale set by unknown insiders, and therefore shove the burden for paying for them back on ordinary people?

Is that latter method how this Board intends to lower health care prices, by making it so that (in theory, at least) eventually providers stop lobbying the government to keep their prices high, and begin to lower their prices themselves, after average people prove year after year that they simply cannot pay --and suffer their individual fates?

I am, of course, perfectly aware that you've included mentions of the Independent Payment Advisory Board in prior reports, Kate Pickert, such as this one in September of this year:

...the [minority Republican] motion [to the 9/11 responder's bill] would have rolled back a few key provisions in the Affordable Care Act, particularly those that are highly unpopular or easy to caricature. The motion would have, for example, repealed the Independent Payment Advisory Board, a 15-member independent panel created by the ACA and charged with figuring out ways to cut Medicare payment rates to keep them from increasing so quickly. (Political attack version: “Mr. Congressman voted to ration Medicare.”)

, but you haven't (as far as I am aware) reported exactly how the Board says (or if it's willing to say) how it will reduce payments.

So, Kate Pickert, is the cost-cutting method likely to be of the first way, in which people increasingly pay more for care at current price growth rates, until the exorbitant health care prices paid by Americans come down "by themselves"?

Or will it be of the second, in which the current Resource-Based Relative Value Scale method of a private group deciding how much we will pay for health care is brought out of the shadows, and we, the people who are paying the highest prices in the world, can see for ourselves that things are fair, well and good with our money?

Can you tell us exactly, or in more key detail how the PPACA's new Independent Payment Advisory Board will reduce health care prices for Americans, Kate Pickert?