Deflating the Massachusetts Healthcare Bill

When it was announced that a form of universal health coverage was coming to Massachusetts, quite a few people on our side of the aisle were excited by the news. After all, isn't universal coverage something progressives have been striving for for the better part of the last century? There were a few notable dissenters, however. John Sweeney of the AFL-CIO was perhaps the loudest, and while I think his criticism may have been a bit harsh, I agree with his general read of the situation.

This legislation leaves middle-income families dangling without a safety net, jeopardizes families who currently have employer-sponsored health care, and gives employers a free ride.

The bill protects workers with the lowest incomes, but punishes middle-income families. A typical family in which the husband and wife each earn a little more than $30,000 and who have two children would be forced to purchase health care, but would not be qualified for any help even if their employer does not offer any coverage or they can't afford their share of the premium. With the average employer-sponsored insurance premium costing more than $4,000 a year for single workers and close to $11,000 a year for working families, Massachusetts' new requirement will bankrupt many middle-class families.

Yesterday at The American Prospect, Robert Kuttner waded into the debate as well. He exhibits some mixed emotions, seeming to come down on the side of of those who would say this is not a great bill, but is perhaps the best we're going to get at the moment, even if it is based on "three dubious assumptions" made by Governor Mitt Romney. They are "that basic health insurance could be had for $2,400 a year,""that 'market reforms' could liberate hundreds of millions of wasted dollars to redirect to coverage," and "that health insurance is like auto insurance; government should just make everyone buy it." Economic writer that he is, Kuttner sums up the facts about the bill quite well.

Given these limitations, the bill that finally emerged is a small miracle. It cobbles together several pots of money -- Medicaid, the existing uncompensated-cost pool, projected savings from "market reform" and from sick people being treated by doctors rather than in emergency rooms. It adds $125 million a year in new state spending, and another $50-100 million from proceeds of a $295 per worker charge and other assessments to be paid by employers who fail to provide insurance and whose workers disproportionately tap the free care pool. Romney delicately calls this new tax a "fee." It is pitifully low, compared to the several thousand dollars per worker that insurance costs. It is far too feeble an incentive to induce any non-insuring employer to provide decent coverage, but it was all the business lobbyists and Romney would deign to accept.

The key criticism there is the same one made by the folks PLAN. The $295 fee per uninsured employee is an absurdly small stick with which to disincent employers from refusing to provide coverage to workers. When the pay for CEOs is averaging somewhere in the neighborhood of four hundred times that of workers, it's ridiculous that the corporate penalty for not insuring their workforce should be over three times less than the penalty imposed on the workers.

The need for universal health coverage is rapidly becoming an unavoidable fact of American life. There are a variety of ways this can be achieved and, to be sure, the Massachusetts plan is one of them. But as John Sweeney points out, it's straight out of "the Newt Gingrich playbook for health care reform." It's largely a 'market-based' approach to a problem that the market has consistently proven incapable of dealing with effectively. Worst of all, while it may not be so bad for those living in poverty or those whose employers wouldn't dream of taking away their health benefits, the hardest hit are the middle class. At the median income level, the bill for quality health insurance represents a huge chunk of the family budget.

The progressive alternative to this is some form of increased public involvement in healthcare, whether it's in the form of a single-payer system or a hybridized system of public subsidies and private add-on coverage. Point being, the Republicans are warming up their healthcare fixes, from the Massachusetts plan to Health Savings Accounts, and I'm not hearing enough from Democrats about alternative proposals. This is one debate we cannot afford to lose.

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Preliminary Thoughts On ABC's 2008 'Invisible Primary Ratings'

When I first saw these rankings of the 2008 contenders, I thought maybe ABC should just have titled the report "Netroots: You Are Irrelevant." But perhaps that's unfair. After all, they do include as part of their rankings a "Netroots" score, even if it isn't weighted very heavily. And in all honesty, this isn't a completely terrible ranking, even if it is quite early for rankings. They're broken down by a number of criteria -- the aforementioned "Netroots,""Polling / Name ID,""Money Potential,""New Hampshire," and so on. They point to the fact that their ranking of the 2004 contenders at this same point in 2002 found the number one and two spots going to John Kerry and John Edwards, respectively. Not bad, but I'm still not convinced. After all, in mid-2002, Kerry and Edwards had been knocked down by Gore and Gephardt, and Gray Davis came in at number nine. A lot can happen in two years.

On the GOP side, the top five, in order, are John McCain, George Allen, Mitt Romney, Rudy Giuliani, and Mike Huckabee. For the Democrats, it's Hillary Clinton, John Edwards, Mark Warner, John Kerry, and Tom Vilsack. Though they do offer some explanation of their methodology, it seems there's a lot of boilerplate conventional wisdom in here. Is Vilsack really in the top five for the Democrats? Does he really outrank Bill Richardson and Wes Clark? Personally, I doubt it. And among the Republicans, I can't buy Rudy Giuliani at number four. Now, maybe that works. But in two years, with his social life the talk of the GOP primary circuit, not so much.

So those are my issues with the overall rankings. What do I think of their more specific charts? Honestly, I don't feel well-equipped enough to dissect every list here. "Polling / Name ID?" That's a matter of hard numbers, hard to argue, unless you're going to talk about their relevance this early in the game. "Fire in the Belly?" Well... okay. Here's how they describe the category:

Fire in the Belly: How badly does the candidate want it? How hard is he/she willing to work? Will he/she do "what it takes" to win, including shedding or at least temporarily freeing himself/herself from other responsibilities and distractions? Are they ready to ask strangers for $4,200 contributions and sleep in bad hotels away from the family night after night?

On our side, the winner in this category is Mark Warner, with Hillary Clinton, John Edwards, and Bill Richardson tying for second place. What, no John Kerry? This strikes me as too nebulous a characteristic to rank accurately, but in terms of gut instinct, I'd say again, it's not terrible. I do disagree with putting Russ Feingold in the middle of a four-way tie with Tom Vilsack, Evan Bayh, and Wes Clark for seventh place, however. If "fire in the belly" is defined by willingness to twist one's self like a pretzel to placate every constituency, Feingold is certainly not the winner. But if it's defined by willingness to put one's self out in public as a strong advocate for his or her beliefs, then Feingold is massively underestimated here. Point being, once again, I think this is too vague to be considered serious criteria.

And finally -- for the purposes of this post, anyway -- the "Netroots" ranking. ABC figures that Russ Feingold is in solid first place in the Democratic blogosphere, with Wes Clark in second. Obviously, they've been paying attention to the straw polls. However, they put Kerry in third here, and I'm going to have to disagree. Kerry's certainly been courting the netroots vigorously, but does that really earn him the number three spot? I still sense a lot of skepticism of Kerry after 2004, here and at other sites. And Kerry also tied Mark Warner in third, which I don't agree with. By all means, Warner has earned the spot by both reaching out to the netroots and taking advantage of people like Jerome and Nate. But other than his e-mail list and posting diaries, Kerry hasn't come close to matching that effort.

At the end of the day, rankings like this serve to define the conventional wisdom as much as codify it. Of course, the media's already defined Hillary Clinton and John McCain as the front-runners, so ABC isn't really doing them any favors here. However, I can't help but feeling there's a not-so-subtle message in here directed at candidates like Russ Feingold and Chuck Hagel, that they really shouldn't bother, and neither should their supporters. But I don't really like taking my marching orders from the vaunted "Gang of 500," and I'm fairly certain I'm not alone in that.

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Romney Misses The Point On Adoption

Up in Massachusetts, there's an interesting debate going on about adoption and discrimination. At issue is whether or not religious groups involved in adoption services should be allowed to discriminate against same-sex couples who want to adopt. Catholic Charities of Boston has announced they will no longer provide adoption services rather than comply with state anti-discrimination laws that prohibit them from rejecting gay and lesbian couples interested in adopting. In response, Governor Mitt Romney, a 2008 contender, wants to exempt religious organizations from such laws. He's tried to play both sides of the issue, saying that even though he believes there is a "legitimate interest" on the part of gay couples in adoption, subjecting Catholic Charities to the law represents a "threat to religious freedom."

I take serious, serious issue with Romney's characterization of adoption. He views it not as a service of necessity to children who need solid families, but as a service of convenience to would-be parents. While he acknowledges that same-sex couples are likely to view his position as discriminatory, he points out that there are non-religious "agencies that can meet the needs of those gay couples." In this case, I understand what Romney's trying to say, but he clearly just does not get the issue. Sure, there are other adoption agencies besides Catholic Charities that gay couples can turn to.

The problem, however, is that this move threatens to shrink the pool of good parents available to children who desperately need them. Oddly enough, it seems the forty two members of the board of Catholic Charities agree with my assessment, voting unanimously in December to continue placing children with same-sex couples for adoption. When it was announced a few weeks ago that the organization was going to halt the practice anyway, seven prominent board members quit.

In covering the story of the board member resignations, The Boston Globe examined the thirteen cases of adoption by gay couples handled by Catholic Charities of Boston over a two-decade period. All of the children "were considered hard to place, either because they were older or because they had special needs." And that is the point here. In 2003, there were roughly 120,000 children in public foster care waiting to be adopted in the United States. Romney apparently doesn't get that this isn't about meeting the desires of couples, gay or straight. It's about meeting the needs of children who need strong families, gay or straight.

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Outlawing Choice No Longer Exists In The Abstract

As you've undoubtedly already heard, Governor Mike Rounds has signed into law a bill banning abortion in the state of South Dakota. While there is an exception in the bill if the life of the mother is at risk, there are no exceptions for cases of rape, incest, or situations where the health of the mother is compromised. The South Dakota ban is likely to be followed shortly by a similar ban in Mississippi, which does allow exceptions for cases of rape and incest. Right now, each state only has one abortion clinic.

Now, neither of these bills is really going to outlaw abortion in either state. Yet. Rounds openly admits that the South Dakota ban will be bogged down in the courts for years to come. Both (again, as you've undoubtedly already heard) are designed to challenge the precedent of Roe v Wade in the Supreme Court, where their backers expect to find a receptive audience with John Roberts and Samuel Alito. This is the moment that every pro-choice voter who has ever voted for a Republican never thought would come. They voted for Republican tax cuts, confident that the social agenda was just some sort of ruse to win over the Falwell crowd. For example, in September of 2004, polling indicated that in the crucial state of Ohio, support for Bush among self-identified pro-choice voters was much higher than support for Kerry among self-identified pro-life voters. This is a critical point. Throughout the pro-choice electorate, there has long been this assumption that the woman's right to choose is not seriously threatened. It has always been an incredibly stupid and undisciplined thing to assume. Elected Republicans haven't been pandering to the Falwell crowd. They are the Falwell crowd.

And this fight isn't over. It doesn't end with Bush naming Roberts and Alito to the Supreme Court. If not Bush, the next President will name a replacement to John Paul Stevens, whose death Republicans are gleefully hoping for because it will likely push the court decisively one way or the other (or at least more than it has already been pushed). A quick review of Republicans likely to run for their party's nomination in 2008 shows that ignoring choice at the ballot box is no longer an option. John McCain, George Allen, and Mitt Romney have all promised that, like Rounds, they would sign the South Dakota ban, as has darkhorse candidate Mike Huckabee.

Advocates for choice have been warning voters about this for years. Obviously, after a while, those warnings sounded alarmist and unrealistic to some. Unfortunately, they were neither. So here we are. This issue no longer exists in the abstract.

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Is Rove Grooming Romney?

Political Wire links to an article from the CBS affiliate in Boston about the the White House courting Massachusetts Governor and likely 2008 GOP candidate Mitt Romney to oversee the federal recovery effort on the Gulf Coast.

As the White House gears up for the massive job of rebuilding hurricane-stricken areas, there's been talk of bringing in someone like Governor Mitt Romney to oversee the project. And CBS4 News has learned there may be more to that than just talk.
. . .
"It's an honor to have some people suggest that I should be a possible candidate to lead a reconstruction effort in New Orleans, but I'm happy being governor," Romney told CBS4 Political Analyst Jon Keller.

For a guy who claims disinterest in the job, Governor Romney seems to have given it a lot of thought.

"You begin by finding out what's really going on. Do a complete audit of the infrastructure, not just a financial audit but an audit of the people, of the capital in place, of the infrastructure, what has to be done, what the options are," Romney said.

And two top Republican sources tell CBS4 News that GOP officials have made tentative inquiries about Romney's availability to help guide the recovery.

With Karl Rove leading up the administration's Katrina 'efforts', the logical inference to make here is that Rove is trying to put Romney into a position of national prominence to help him in 2008. As we all well know from Mike Allen's piece in Time and a variety of other sources, that the Bush administration's first priority is politics, with actual governance coming in a distant second.

Though Romney is the Governor of Massachusetts, he couldn't be any less moderate. His tenure in that job has exposed him as a hardcore partisan, not a consensus builder. Just this past May, Romney vetoed a pro-embryonic stem cell research bill. And then in July, he vetoed an emergency contraception bill, parroting the extremist claim that it's a form of abortion (which it is not). Both vetoes were overridden easily by the Massachusetts Legislature, but Romney wanted to make a big show of proving his rightist credentials.

Leave it to the Bush administration to fill yet another position with a political ally. This is not a job to give out for resume padding. This is something that needs to be handled on a bipartistan --if not completely nonpartisan -- basis. For me, this is just one more piece of evidence that the administration is far more concerned about politics than people.


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