Excise Tax Harms Health Care Policy

I argue against the excise tax for the following reasons:

a. The tax penalizes the middle class by cutting health care. 

b. The tax does not increase wages, and, now, there is evidence against the argument that it does. These arguments favoring the tax relied upon correlation rather than causation.

c. The tax assumes health care consumers are rational based on right wing ideological assumptions. These assumptions are often paraded around as fact, and, indeed, this can be seen with regard to how often issues of correlation on wages are quickly assumed to be causation for the purposes of buying into the right wing ideological frames. I do not assume intend here. I merely assume that one has bought intentional or not into right wing assumptions.

d. As a corollary, the argument assumes we will "bend the cost curve" is also false. This depends on assuming monopolies will stop being monopolies and that consumers will not under or overestimate their need for health care services. 

e. Finally, the tax is regressive rather than progressive. Thus, the ideological reason for the tax is flawed.

This is an extremely long post, and for that, I apologize, but often in these debates people attempt to reduce complicated debates to talking points. I want to delve into why I have a problem with the assumptions, and that means really covering all angles of the discussion with supporting evidence.

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Why Regulations of Health Insurance is Insufficient (UPDATED-2nd))

Making the rounds to justify this crap-tastic bill are arguments regarding the importance of regulatory controls over insurance companies as a good enough reason to push the bill forward. Indeed, people point to Massachusetts and countries like Switzerland as their basis for why regulations can achieve the same thing as what market forces can obtain through the public option in conjunction with regulation.  I want to take on the regulatory reform arguments head on in this diary. One of the reasons I have become frustrated is that I know the ploys  behind the regulatory situation and how this allows for the image of reform, but in actually application you are merely changing the form of how bad faith actors perform their bad faith acts rather than preventing them from acting in bad faith.

There are several reasons the argument rings hollow to me: 1) The proposed reforms are wholly inadequate with regard to the task they being asked to perform due to loopholes; 2) The regulations are no where near the place they need to be to produce the price controls that you might find in Switzerland, and indeed, our most liberal example of this approach- MA- still has no price control involved; 3) Regulatory reform at the federal level has been wholly inadequate for decades with regard to addressing the abuses of bad faith actors; and finally 4) States like MA and countries like the Switzerland have a culture that allow for regulations to matter whereas DC does not (or "The Republicans will one day be in control so they will muck it up" argument).

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Will Senate Health Insurance Bill Save Lives? Probably Not

One of the memes now circulating is the Senate bill will save lives. I have to go out soon, but I wanted to quickly say that this meme is probably wrong due to the specific details of the bill. We are making  a trillion dollar gamble at this point on junk insurance to address a lack of insurance. We are moving from a system of no insurance to one of inadequate insurance. The results on behavior of consumers when it comes to health care services will, therefore, probably remain the same.

The legislation itself is watered down on the regulatory front, and will be watered down further. Moreover, the bill now encourages junk insurance that will cover only 60 percent of cost, will have life time caps and statutory language that one can drive a truck through regarding requirement to provide services. In other words, the same bad faith behavior is still a part of the new system. This is part of the way that the bill makes the status quo worse.

Nate Silver's has made much of the subsidies, but his argument ignores that the bill actually does not possess a COLA, and the incentive for premium increases remains. The premiums are projected to go up from an average of 12k a year to 23k. Add to this the reality that premium increases are occurring at 4.4 times the increase of wages, and you begin to form a basic picture of the problems ahead that will lead to more deaths rather than less.

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10 Signs That 2009 Is Not 1994

I have noticed that Democrats, especially the leadership and its apologists, are stuck in the 1990s. Paraphrasing what one commentator said of White House Chief of Staff Rahm, he's "an old general fighting old battles." I think that will be the party's epitaph if it does not heed the wake up call. We are no longer fighting the rise of Reaganism. We are at Reaganism's, or neoliberalism's, end.

I should point out that in writing this I am not claiming that the GOP has better ideas or will easily capitalize on progressive ideas coming into popularity. What I can say is that Democrats will remain static if they do not heed the call. Now, this outcome, a party that is perpetually not quite strong enough to pass progressive policies, may be a feature rather than a bug, but let's pretend for this diary that they really do want to pass progressive policy. Let's also assume that the real issue is that they are living in 1994 rather than 2009.

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A Wolf Among Sheep: Why Timothy Geithner Must Go

Previously, I voiced  my concern about Timonthy Geithner's role as one of the chief stewards of our economy.

Certainly, his neoliberal bent, solutions to the banking crisis and his push for "too big to fail" into policy were disturbing, but some part of me believed he was simply an ideologue. A misguided, incompetent one, but just an ideologue.

Now, comes news that he was one of the principles "responsible for overpayments that put billions of extra tax dollars in the coffers of major Wall Street firms, most notably Goldman Sachs."

http://www.huffingtonpost.com/2009/11/16 /aig-bailout-government-ov_n_359919.html

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Understanding Gay Rights Anger: On Low Hanging Fruit

There is this perception amongst those who wish to act favor the Democratic Party leader that the gay rights debate is solely about wealthy white gay men who are impatient or want to assimilate. This stereotypes ignores the reality.

First, let me start by pointing out what this is really about. This is about a checklist of things that the Democrats said they were going to do once in office, and many of which, have not been done. Many of them are fairly easy to do, but are, nevertheless, not being done.

This issue is not simply, therefore, about marriage equality or Don't Ask, Don't Tell. Although, to me, all is the same on the front of these issues because they are all at base about animus toward gay people.

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Grain of Salt: Reid to Include Anti-abortion Provision?

Take this with a grain of salt, but Politico is reporting that Reid may include the Stupak anti-abortion provision in the Senate version of the bill:

"Senator Reid opposes abortion except in the cases of rape, incest or when the life of the mother is at risk. Passing comprehensive health reform and improving access to health care will likely go a long way towards reducing the rate of unintended pregnancies and the resulting abortions.

I expect that any bill that Senator Reid brings to the floor will ensure that no federal funds are used for abortion and that the conscience rights of providers and health care facilities like Catholic Hospitals are protected."

http://www.politico.com/livepulse/1109/R eid_will_likely_include_antiabortion_pro vision.html

It is from Politico. Therefore, I am not sure how much this should be considered true.

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Toward American Economic Realism-- Assessing Risks

Polling data indicates that Americans are more positive than Europeans about economic outcomes. The question is whether this positive attitude represents economic realism, or, to put it another way, the ability to accurately assess risk? Does the American attitude reflect a gap between reality and belief that harms our ability to assess what policies politicians should be enacting? On the flip side, are politicians enacting policies that properly assess economic risks to the American middle class?  I argue here that our attitude does not reflect a proper assessment of risk, and that this harms our ability to properly set for the right policies.

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Quality of Life versus GDP in America

Economic indicators are funny things. If you measure the right thing, they can tell you that even in bad times for most Americans that things are going well. In my previous diary, I discussed the great risk shift from multinational corporations to the average American citizen. Now, I would like to take the discussion in a different direction by looking at why we do not notice this great risk shift. One of the reasons we do notice the shift is the use of GDP as the primary indicator for the state of our economy. Indeed, right now, the GDP has begun to grow for the first time in a year. It stands up 3.5 percent.

The problem, however, in the number is several folds. One it does not address job creation, kind of jobs created or wage stagnation/deflation. Two, it does not address what is being left out of the equation, which is the subject matter of this diary. Thus, the GDP is as interesting for what it leaves out as what it  puts into the equation. However, we rarely have that discussion in America. For these reasons, I advocate that we look at the Quality of Life Index to see where our country really is for the bulk of Americans in our economy.

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The Great Risk Shift: Understanding American Capitalism

The bailout of the banking industry was the result of decades of Reagan policy making carried out by both Democratic and Republican neoliberals that shifted risk from corporations to the American public.  It is only the tip of iceberg. This shifting of risk is the flip side of the coin to wage stagnation and deflation that acts to increase the debt and loses of the American people.

To understand, why this is the case requires an understanding of what risk is.  This is not an easy task.  However, to have a working definition, let's just say that risk is the chance in any given transaction for one to be a winner or a loser. It is the concept of working the odds. What are the  odds that you will obtain a job that will cover your debt from college?  What are the odds that you will have enough money to pay for health care premiums and save money? What are odds of bank failure if they are too big to fail?

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