The President’s weekly message this week has generated more attention than a lot of the others, because it features him taking his hardest edge yet against the health insurance industry – the kind of message that progressives have wanted him to deliver for some time now.
This is the unsustainable path we’re on, and it’s the path the insurers want to keep us on. In fact, the insurance industry is rolling out the big guns and breaking open their massive war chest – to marshal their forces for one last fight to save the status quo. They’re filling the airwaves with deceptive and dishonest ads. They’re flooding Capitol Hill with lobbyists and campaign contributions. And they’re funding studies designed to mislead the American people.
Of course, like clockwork, we’ve seen folks on cable television who know better, waving these industry-funded studies in the air. We’ve seen industry insiders – and their apologists – citing these studies as proof of claims that just aren’t true. They’ll claim that premiums will go up under reform; but they know that the non-partisan Congressional Budget Office found that reforms will lower premiums in a new insurance exchange while offering consumer protections that will limit out-of-pocket costs and prevent discrimination based on pre-existing conditions. They’ll claim that you’ll have to pay more out of pocket; but they know that this is based on a study that willfully ignores whole sections of the bill, including tax credits and cost savings that will greatly benefit middle class families. Even the authors of one of these studies have now admitted publicly that the insurance companies actually asked them to do an incomplete job.
It’s smoke and mirrors. It’s bogus. And it’s all too familiar.
Later on in the address, the President mentions the insurance industry’s anti-trust exemption, once again raising the possibility that it would be repealed in this round of reform.
And they’re earning these profits and bonuses while enjoying a privileged exception from our anti-trust laws, a matter that Congress is rightfully reviewing.
The House Judiciary Committee will actually tackle this issue in the coming week, by marking up the “Health Insurance Industry Antitrust Enforcement Act of 2009,” a bill that would repeal the exemption, on Wednesday. John Conyers, the chair of the Committee, said, “These abuses are plainly illegal in other industries, and it does not make sense, when Congress is working so hard to bring meaningful reform to the market in health insurance, that health insurers should continue to be exempted from federal antitrust oversight.” And Nancy Pelosi expressed support for the measure at her press conference on Thursday. I’d say the chances of repeal being inserted into the final health care bill have gone up to at least 50/50.
The White House has been nudging in the direction of painting the insurance industry as a villain in this debate for several weeks now. But this is a full frontal assault, clearly in reaction to the flawed industry reports and attack ads designed to scare seniors that we’ve seen this week.
Of course, if the niceties have ended and the deals faded, then the President could actually make insurers REALLY uncomfortable through actions and not words, by supporting competition for them through a public option and demanding its inclusion in any bill.
Front and center in the debate over the Afghan War these days are General Stanley “Stan” McChrystal, Afghan war commander, whose “classified, pre-decisional” and devastating report — almost eight years and at least $220 billion later, the war is a complete disaster — was conveniently, not to say suspiciously, leaked to Bob Woodward of the Washington Post by we-know-not-who at a particularly embarrassing moment for Barack Obama; Admiral Michael “Mike” Mullen, chairman of the Joint Chiefs of Staff, who has been increasingly vocal about a “deteriorating” war and the need for more American boots on the ground; and the president himself, who blitzed every TV show in sight last Sunday and Monday for his health reform program, but spent significant time expressing doubts about sending more American troops to Afghanistan. (”I’m not interested in just being in Afghanistan for the sake of being in Afghanistan… or sending a message that America is here for the duration.”)
On the other hand, here’s someone you haven’t seen front and center for a while: General David Petraeus. He was, of course, George W. Bush’s pick to lead the president’s last-ditch effort in Iraq. He was the poster boy for Bush’s military policies in his last two years. He was the highly praised architect and symbol of “the surge.” He appeared repeatedly, his chest a mass of medals and ribbons, for heavily publicized, widely televised congressional testimony, complete with charts and graphs, that was meant, at least in part, for the American public. He was the man who, to use an image from that period which has recently resurfaced, managed to synchronize the American and Baghdad “clocks,” pacifying for a time both the home and war fronts. Continue reading →
The Pentagon expects to receive General McChrystal’s troop request by the end of the week (remember, you heard it here first). If we accept Defense Department spokesman Geoff Morrell’s remarks during today’s press briefing, Defense Secretary Gates will pocket the document until the Obama Administration completes its strategic review. But, Morrell is clearly working to prevent the document from becoming a “moment of truth” for the secretary and the president, and I would be very surprised if a strategy assessment took place without a cost/benefit analysis. After all, a discussion on strategy not constrained by resource considerations would produce strategies as useful as a retirement plan that included “win the lottery” as a necessary step.
Looking for evaluative tools for the upcoming troop request, I flipped through my copy of The 33 Strategies of Warby Robert Greene and came across this passage:
…Rommel once made a distinction between a gamble and a risk. Both cases involve an action with only a chance of success, a chance that is heightened by acting with boldness. The difference is that with a risk, if you lose, you can recover: your reputation will suffer no long-term damage, your resources will not be depleted, and you can return to your original position with acceptable losses. With a gamble, on the other hand, defeat can lead to a slew of problems that are likely to spiral out of control. …[I]f you encounter difficulties in a gamble, it becomes harder to pull out–you realize that the stakes are too high; you cannot afford to lose. So you try harder to rescue the situation, often making it worse and sinking deeper in to the hole that you cannot get out of. People are drawn into gambles by their emotions…Taking risks is essential; gambling is foolhardy.
…
The worst way to end…a war…is slowly and painfully…Before entering any action, you must calculate in precise terms your exit strategy…If the answers…seem to vague and full of speculation, if success seems all too alluring and failure somewhat dangerous, you are more than likely taking a gamble. Your emotions are leading you into a situation that could end up a quagmire.
Before that happens, catch yourself. And if you do find you have made this mistake, you have only two rational solutions: either end the conflict as quickly as you can, with a strong, violent blow aimed to win, accepting the costs and knowing they are better than a slow and painful death, or cut your losses and quit without delay. Never let pride or concern for your reputation pull you farther into the morass; both will suffer far greater blows by your persistence. Short-term defeat is better than long-term disaster.
Greene writes these words interpreting the Soviet experience in Afghanistan. They apply equally well to the situation in which the United States finds itself in the same country. Continue reading →
The video I linked earlier with Hollywood celebrities coming out to defend those poor insurance companies has gone viral, with hundreds of thousands of views today. What’s a little less-known is that prominent Republicans are basically engaging in a note-for-note remake of that video, leaping to the defense of that industry which has turned in record profits, raising premiums even during the Great Recession and saving money by denying Americans care.
Here’s the story so far: yesterday the Department of Health and Human Services launched an investigation into Humana for sending its elderly customers a mailer warning that they would lose benefits under the new health insurance reform plan. Interestingly, Max Baucus, yes that Max Baucus, registered the complaint that triggered the investigation. The whole thing concerns Medicare Advantage payments:
Humana is one of the largest private carriers serving seniors under a program called Medicare Advantage. About one-fourth of the elderly and disabled people covered under Medicare participate in the Advantage program, which offers a choice of private plans that usually deliver added benefits.
Humana has about 1.4 million Medicare Advantage enrollees, and the program accounts for about half the company’s revenue, Noland said.
Government experts say the private plans are being paid too much — about 14 percent more than it costs to care for seniors in traditional Medicare. The Baucus plan — and other proposals — would reduce payments to the plans, and the health insurance industry is fighting back.
The Humana mailer focused squarely on the Medicare Advantage program.
Actually the Medicare Advantage plans cost the government about 14% more and deliver less than traditional Medicare, according to the Government Accountability Office. We are subsidizing private industry billions of dollars so they can perform the exact same task as Medicare, and with lower quality.
The mailer that Humana sent to beneficiaries, designed to look like official communication with customers and not naked lobbying documents, wasn’t all; a website which generated automatic emails to members of Congress, claiming to be from customers (despite the fact that anyone could generate an email), is also being probed. And of course, this is not the only example of insurance companies filling their customers’ heads with misinformation and turning them into citizen lobbyists.
A spokesman for America’s Health Insurance Plans, the industry’s main lobbying group, issued a statement Tuesday criticizing what he described as the government’s “gag order.”
“Seniors have a right to know how the current reform proposals will affect the coverage they currently like and rely on,” AHIP spokesman Robert Zirkelbach said.
Sen. Mitch McConnell of Kentucky, the Senate’s Republican leader, denounced the HHS order as an attempt to squelch free speech.
“We cannot allow government officials to target individuals or companies because they do not like what they have to say,” McConnell said.
“Is this what we believe as a Senate — that this body should debate a trillion-dollar health care bill that affects every American while using the powerful arm of government to shut down speech?” McConnell said.
McConnell noted that Humana, an insurer at the center of the controversy, is based in his home state. The company has been a large contributor to McConnell, donating $112,452 over his career, according to Eric Schultz, communications director for the Democratic Senatorial Campaign Committee. (emphasis mine)
Shocking that Mitch McConnell would leap to the defense, Will Ferrell-style, of a health insurer based in his state which has feathered his nest to the tune of six figures, no?
There is a difference between free speech issues and what Humana and others are doing, namely violating federal law. Medicare Advantage providers are contracted employees of the federal government, and under the terms of Medicare Advantage, providers have strict limits on what they can communicate to beneficiaries. This lobbying effort would appear to violate those guidelines, and those customers receiving this letter could be excused for believing it to be an official document warning of loss of benefits if they failed to take action.
In short, Medicare Advantage is a wasteful corporate welfare program providing no benefit to individual subscribers and actually worse quality of care to seniors, at a cost of around $150 billion over 10 years to the taxpayer. The government has no imperative to keep such a scheme going, and they certainly shouldn’t be paying providers to send misleading letters to their customers so they can keep the gravy train going.
But the real amusement here is watching Republicans like Mitch McConnell read from the Will Ferrell script and crying to “leave health insurance CEOs alone,” as if they don’t get enough help from the taxpayers to fund their lavish lifestyles.
General McChrystal’s “new strategy” has been leaked to press in what looks to me like a continued effort to box in the President on troop increases. Here’s the core of the document:
The New Strategy: Focus on the Population
…To accomplish the mission and defeat the insurgency we also require a properly resourced strategy built on four main pillars:
Improve effectiveness through greater partnering with ANSF. We will increase the size and accelerate the growth of the ANSF, with a radically improved partnership at every level, to improve effectiveness and prepare them to take the lead in security operations.
Prioritize responsive and accountable governance. We must assist in improving governance at all levels through both formal and traditional mechanisms.
Gain the initiative. Our first imperative, in a series of operational stages, is to gain the initiative and reverse the insurgency’s momentum.
Focus resources. We will prioritize available resources to those critical areas where vulnerable populations are most threatened.
The first two pillars seem to have been written while someone was smoking hashish. Let’s take them one at a time.
The Henry J. Kaiser Family Foundation released a simple document that could transform the entire health care debate in the United States. Absolutely no other set of statistics so cleanly identify the nature of our broken system.
This week we put out our annual benchmark survey of employer health coverage and costs. Two numbers jumped off the pages.
The first number was the average cost of a family health insurance policy in 2009: $13,375. To put that number in context, if you are an employer, you can hire an employee at the minimum wage for about $15,000 per year. If you are a consumer, you can rent an average two-bedroom apartment nationwide for $11,136 per year (though it is quite a bit more here in Menlo Park, California where our Foundation is based). You can also buy a new Chevy Aveo for $12,000, and it gets 35 miles per gallon on the highway.
The other result that jumped off the page was the stark contrast between increases in health insurance premiums and overall inflation in the general economy. Premiums went up 5% and prices overall fell 0.7% (mainly driven by a big drop-off in energy prices) [...] over the last ten years premiums have increased by 131%, while wages have grown 38% and inflation has grown 28%. Consider this: If people (and businesses) are as concerned as they are now about rising health care costs in a period when they are actually moderating, how much more concerned will they be when rates of increase return to historic averages?
Let’s do some very simple arithmetic. Start with a fairly conservative assumption: If we assume that premium increases over the next ten years will average what they did over the last five (about 6.1% per year), the average premium for a family policy in 2019 will be $24,180. That’s a big number. On the other hand, if we assume increases revert to the average of the last ten years—an average annual increase of about 8.7% and a very plausible scenario—premiums in 2019 will average a whopping $30,803, a very scary number.
And here’s the chart:
Very few families will be able to afford a $30,000 insurance policy. Even less companies will find a market for it. So their only choice will be to cut back on what the coverage offers, either with less benefits or lower amounts of coverage. More businesses will have to drop their coverage and throw their employees on to the individual market, driving costs up higher, as individuals aren’t bargaining collectively with insurers for lower prices.
Simply put, the private insurance market would cease to exist within 10 years, maybe a little more, on the current trajectory.
Those who think “failure is not an option” is just a slogan should really take a look at the Kaiser Foundation numbers. What they show is nothing but a nightmare.
In fact, a new report from the Kaiser Family Foundation was released today showing that family premiums rose more than 130 percent over the last 10 years — three times faster than wages. They now average over $13,000 a year, the highest amount on record, which is why when you go in to negotiate, you can’t even think about negotiating for a salary — a wage increase because the whole negotiation is about trying to keep the benefits you already have. (Applause.)
That’s not just the fault of the employer, it’s the fault of a broken health care system that’s sucking up all the money. When are we going to stop it? (Applause.) When are we going to say enough is enough? How many more workers have to lose their coverage? How many more families have to go into the red for a sick loved one? (Applause.) How much longer are we going to have to wait? It can’t wait. (Applause.)
AUDIENCE: We can’t wait! We can’t wait! We can’t wait!
It’s not an idle threat to tell everyone that they will not have health insurance in ten years without reform. Heck, that’s why the insurance industry, while fighting anything that drains their profits, ostensibly supports reform. If the insurance market goes down the gutter, so do they. The opportunity exists for us to remake our health care system to remove the excess, the money that never goes toward care, the bloated salaries. Otherwise, even with a reformed system we could end up with the same people running the same system right into the ground.
When the people of an occupied country want foreign troops out while the people of the occupying country want their troops to come home, and the troops remain, something is wrong. Both the American people and the Afghan people want a troop decrease in Afghanistan. Yet the President is reviewing a strategic assessment prepared by General Stanley McChrystal widely portrayed as a prelude to a request for an escalation. Should the president approve such a request, he’d be saying, in effect, that to protect democracy in America and to build it in Afghanistan, we must trample it.
During his speech to the Veterans of Foreign Wars earlier this week, President Obama validated the basic frame of the Bush Administration. Obama said that the war in Afghanistan “is not a war of choice. This is a war of necessity.” This statement accepts a frame designed to bludgeon the progressive movement to death: the War on Terror frame. Incidentally, it’s also really, really bad theology.
In 2006, George Lakoff and Evan Frisch wrote an article critiquing the War on Terror frame that should be required reading for progressives. In it, the authors argue that the war metaphor is a dagger aimed at the heart of the progressive movement in the U.S., chosen primarily to influence domestic audiences to acquiesce to radical right-wing policies:
The war metaphor was chosen for political reasons. First and foremost, it was chosen for the domestic political reasons. The war metaphor defined war as the only way to defend the nation. From within the war metaphor, being against war as a response was to be unpatriotic, to be against defending the nation. The war metaphor put progressives on the defensive. Once the war metaphor took hold, any refusal to grant the president full authority to conduct the war would open progressives in Congress to the charge of being unpatriotic, unwilling to defend America, defeatist. And once the military went into battle, the war metaphor created a new reality that reinforced the metaphor.
Once adopted, the war metaphor allowed the president to assume war powers, which made him politically immune from serious criticism and gave him extraordinary domestic power to carry the agenda of the radical right: Power to shift money and resources away from social needs and to the military and related industries. Power to override environmental safeguards on the grounds of military need. Power to set up a domestic surveillance system to spy on our citizens and to intimidate political enemies. Power over political discussion, since war trumps all other topics. In short, power to reshape America to the vision of the radical right — with no end date.
According to Lakoff and Frisch, Choosing and accepting the war metaphor also led to policy decisions that undermined American security and prosperity, playing right into al-Qaida’s hands.
What was the moral of 9/11?
To Osama bin Laden, the moral was simple: American power can be used against America itself. This moral has defined the post 9/11 world: the more America uses military force in the Middle East, the more damage is done to America and Americans. The more Americans kill and terrorize Muslims, the more we recruit Muslims to become terrorists and fight against us.
That this was the “moral” of 9/11 has been borne out again and again in reports showing that U.S. policy choices in the Middle East are creating more terrorism, not less, including but not limited to Afghanistan.
The domestic and foreign policy repercussions of the War on Terror frame led me to pound out this little outburst earlier this year:
I must admit, I am exhausted by repeated attempts to pound this into the head of liberals, but here we go again: The War on Terror is a metaphor designed to bludgeon the progressive movement to death. Write that in stone. Tattoo it somewhere on your body where it will hurt. The phrase “War on Terror” blunts dissent, it undermines progressive values at home, and it plays directly into the hands of al-Qaida’s propaganda. People who perpetuate the War on Terror metaphor are, knowingly or not, undermining progress, justice, and peace.
To his credit, the President seems to recognize the dangers of the War on Terror frame. He is usually very careful about avoiding the phrase “war on terror” in his speeches. This rejection, however, is superficial. As the President’s speech to the VFW shows, he retains the basic outlines of the war on terror frame:
the 9/11 attacks were acts of war, rather than spectacular criminal attacks;
al-Qaida members are the new Nazis/Soviets rather than “religiously motivated Mafia,” as Bacevich put it in testimony before Congress;
the proper response to the 9/11 attacks, as acts of war, was not juridical but military.
All of these elements are either explicit or implicit in the President’s rhetoric. It’s not enough to throw out the explicit phrase “War on Terror” if you retain the basic War on Terror construct in your worldview.
The President’s juxtaposition of the phrases “war of choice” and “war of necessity” also displays some very bad theology and a lack of maturity. If you accept the distinction made by the President, the United States is not responsible for any of the mayhem loose in Afghanistan. The war in Afghanistan happened to us, or was elicited from us in a process over which we had no control. We didn’t choose because we couldn’t. We had no choice. Thus our violence has a different moral quality to it than that of the 9/11 hijackers and is required to impose order and safety on a violent world.
In short, the Myth of Redemptive Violence is the story of the victory of order over chaos by means of violence.…Life is combat. Any form of order is preferable to chaos, according to this myth. Ours is neither a perfect nor perfectible world; it is theatre of perpetual conflict in which the prize goes to the strong. Peace through war, security through strength: these are the core convictions that arise from this ancient historical religion, and they form the solid bedrock on which the Domination System is founded in every society.
This, Wink writes in Engaging the Powers, is the religion of the national security state. It’s running free in the President’s rhetoric. It’s extraordinarily dangerous–the myth of redemptive violence, once accepted, reshapes any religion into a religion of self-justification and domination. By retaining it in his rhetoric, the President is, consciously or not, activating a pervasive and destructive theological frame caustic to justice and peace.
The President is factually and theologically incorrect. We had a deliberative process in the United States after the attacks that ended with a Congressional resolution. In other words, we chose. And, because we chose, responsibility for our violence and its consequences rests squarely with us.
We had a choice. We have a choice. We should choose to reject the basic assumptions of Bush’s discredited war frame and reverse the war policies that emerged from it. We should start with Afghanistan.
Writing on the phenomenon of escalation, journalist Norman Solomon begins a recent piece this way: “The president has set a limit on the number of U.S. troops in Afghanistan. For now. That’s how escalation works. Ceilings become floors. Gradually.” Then he adds: “[N]o amount of spin can change the fact that the U.S. military situation in Afghanistan continues to deteriorate. It would be astonishing if plans for add-on deployments weren’t already far along at the Pentagon.”
Well, be astonished no longer. Right now, unsurprisingly enough, it’s not looking good in that country. Roadside bomb (IED) attacks are spiking (with an “all-time high” of 465 in May alone), and American and NATO deaths have jumped by 40% since 2008, 75% since 2007. And so, despite a major Obama administration expansion of the war and a significant commitment of new troops and money, fast on the heels of Solomon’s piece came the first trial balloon — the first leaks in a Washington Post piece from those unnamed, if ubiquitous, “senior military officials” — for what may be the next round of escalation.
When I directed Iraq for Sale, it became appallingly evident that private contractors like CACI and Titan played a critical role in the torture and abuse of detainees at Abu Ghraib prison. Much like Blackwater, KBR, and others, these war profiteers were never held accountable for their unconscionable crimes. Instead, they were rewarded with hundreds of millions in new contracts. The Obama administration has already taken some laudable steps to prevent another Abu Ghraib: ordering the CIA to end enhanced interrogation techniques and follow a more lawful code of conduct; and ordering the Justice Department to investigate the use of torture. However, the President’s recent objection to a provision in the 2010 defense funding bill that would make interrogation an “inherently governmental function” is a huge step backwards.
This provision, backed by Senate Armed Services Committee Chairman Carl Levin (D-Mich.), states “the interrogation of enemy prisoners of war, civilian internees, retained persons, other detainees, terrorists, and criminals when captured, transferred, confined, or detained during or in the aftermath of hostilities is an inherently governmental function and cannot be transferred to contractor personnel.” In other words, our government would no longer be able to hand off interrogation duties (and the lavish contracts that come with them) to mercenary firms out to profit from the wars in Iraq and Afghanistan. What’s more, if interrogators are caught violating the law and abusing detainees, our government would have the power to hold those interrogators accountable.
According to The Washington Post, both the White House and the Pentagon have a litany of excuses for opposing this provision. They don’t want US forces to be “limited” in conducting lawful interrogations, but the whole point of the provision is to set limitations and create transparency for interrogation practices. And either the US military should be training new interrogators themselves, as a senior Senate aide has suggested, or, lacking enough soldiers to accomplish this goal, perhaps our government should seek diplomatic alternatives to military escalation in Afghanistan.
Last month, Jeremy Scahill reported that the use of “private security contractors” has shot up 23 percent in Iraq and 29 percent in Afghanistan during the second quarter of 2009. Scahill estimated that there are over 242,000 contractors working on these two wars, and that contractors comprise a whopping 50 percent of our total forces in the region.
Our morals mean nothing if we do not act on them. Our tax dollars are funding this abuse and we must not be complacent. Call your senators today 202-224-3121 and tell them contractors have no place in interrogations, and you expect them to support Senator Levin’s government-only interrogation provision. Once you have done that, call the White House 202-456-1414 and leave a message for President Obama, urging him to stand with you to end prisoner abuse.
