Morning Fog

Does The Public Option Have Health Insurance?

It's not a big surprise that the Senate has rejected efforts to include a public option in its version of health care reform.  The deliberative pace of this deliberative body is legendary, and trying new ideas isn't really their cup of tea.  Yet as some analysts remind us (in this case, Gail Russell Chaddock of the Christian Science Monitor), the vote was closer than expected, and it's too early to write the obit.  What the public option really needs, it seems, is a good health insurance plan to keep it alive while the House and Senate conference on whether to pull the plug on it.

Actually, rather than pull the plug, we'd better freeze it and wait for advances in cryogenics to make it live again in a decade or so, because one thing seems increasingly evident to me:  If we don't put the public option - or a public role - in the mix now, we will have to do so in future. 

T.R. Reid's study of health care systems around the world, The Healing of America (see right margin), still one of the most revealing things I've read on the health care issue, makes amply clear that even for health care systems far more inclusive, inexpensive, and effective than ours (that's effectively all of them) there is no successful system that leaves health care pricing strictly to the private sector.  That's true even in the German and Swiss systems, which rely on private insurance companies but which regulate the prices of most basic and essential medical services.  (The private companies make most of their profits by selling ancillary policies covering optional procedures.)

The major cost difference between health care in the U.S. and in other countries (even though ours covers fewer of us and drops us when we need it) is profit.  Other factors contribute (costs of drug research and testing, malpractice insurance, unnecessary tests, etc.) of course, but not enough to account for the extra 6-7% of GDP we pay compared to France, Germany, or Japan.  What Reid's book proves is that we stand little chance of controlling the growth of costs without government involvement, either as an insurance/care provider, or as a regulator of costs.  Granted, the Senate (and Congress in general) has never excelled in tasks requiring far-sightedness; but if there's no sense of urgency at the moment, there will come a time, perhaps when our health expenditures reach 25%, or 30%, of our total spending, that we'll be forced to address the issue of cost.  

Incrementalism sometimes is the only way to get things done, but it carries a cost.  If we wait, the price of fixing things later will be far more than if we do it now, and the resources expended in the interim will have been wasted.

Full Moon Crazy 5: Roman Polanski

The last of five vignettes on events that demonstrate the weirdness a full moon can bring on...  

And finally, the strange case of Roman (or Roamin', as the case may be) Polanski.  Weird guy, yes.  Pled guilty to rape of a minor, yes.  Put one over on the authorities and took French leave, yes.  I suppose legal authorities in California are within their rights to try to bring him to justice, yet the question "why now" does arise.  I believe the real reason is that he made fools of them.  The parallel to Bush 1, Sadam Hussein, and Bush 2 is clear. 

I don't mean to defend Polanski; it may indeed be just and proper to pursue extradition and prosecution of Polanski now.  Those involved, however, should also see the other side of the coin:   The effect of our using extradition treaties to pursue cases that are viewed abroad as extreme will be to weaken extradition treaties.  Countries already unwilling to extradite to the U.S. because we have the death penalty will be less willing to honor agreements, or to negotiate new ones. 

Full Moon Crazy 4: Full Orchestral Dress

The fourth of five vignettes about events unrelated except for their seeming lack of reason moves from the cataclysmic to the frivolous: 

Be it noted that the National Symphony Orchestra debuted its season by allowing the women musicians to wear all colors of garb.  Men were still limited to black tie or nothing (none, apparently, chose nothing).  I guess if we want to go non-traditional, this is a start, but it's always puzzled me why the traditional orchestra has uniform garb (black tie) for its gents, but lets the ladies appear in anything black that strikes their fancy, rather than standardizing.  It's motley looking.  The one or two orchestras that standardize their women's dress look far more professional.  If adding colors is needed to make classical music seem less stuffy, shouldn't the guys get an equal chance to amaze? 

Full Moon Crazy 3: Iran's Nukes

Today seems to have been a full moon day in terms of current events.  "Luna"-tic events occurred.  Here is the third of five vignettes.   

The world is a-flutter because Iran not only turned out to have nuclear facilities it had denied having, but yesterday test-fired some missiles.  Should we be surprised that other countries seek the security (and indeed the prestige) of going nuclear, especially when it rattles their mortal enemies and brings such international attention?    I'm certainly in favor of nuclear nonproliferation generally because, after all, this is an area where a slight miscalculation could blow away a significant portion of mankind.  The more such weapons, and the more different governments that have them, obviously, the greater the risk of some mistake (Second Amendment buffs please take note).  Ultimately the answer to the nuclear arms race lies in diplomacy that seeks to reduce overall levels, including our own.  That's the policy of this administration and previous ones.

On the other hand, to be fair, it's not lost on North Korea or Iran that we seem to get more nervous about their nuclear programs than we do about our friends'.   We fear Ahmadinejad is a dangerous nut case, but we should recognize there were people around the world who figured George W. Bush for a dangerous nut case too.  It's just that Bush was our nut case. 

Full Moon Crazy 2: Environmental Impact of Roadbuilding

Every now and then you get one of those days when everybody driving around you is doing something really dumb.  Usually I say to my wife, or she to me, "It must have been a full moon last night."  And surprisingly often, it actually was.

Today seems to have been a full moon day in terms of current events.  This is the second of five miniposts on the theme. 

Officials of Maryland's Montgomery County propose to require extensive environmental impact studies for road projects.  These folks must have been smoking road tar themselves!  This is the kind of unthinking "green" claptrap that gives environmentalism a bad name.  If such a plan were enacted, county residents might want to consider acquiring a horse, since it ought to pretty well put a stop to road-building.  Surely everyone understands that roads bring pollution of the air, dust, and other bad things.  Yet for centuries, people have voted with their feet to go where the roads are.  When we choose to live in an urban area, we accept the downsides of pollution, crowding, traffic, higher crime.  These factors may all be ameliorated, but they won't be eliminated.  Want clear air? Live in the country.

Full Moon Crazy 1: The Obama Assassination Poll

Every now and then you get one of those days when everybody driving around you is doing something really dumb - left turn from the right lane (on a four lane road?), stopping dead without warning, doing 35 on the interstate, or the like.  Usually I say to my wife, or she to me, "It must have been a full moon last night."  And surprisingly often, it actually was.

Today seems to have been a full moon day in terms of current events.  I'm posting five vignettes.  Here's Number One.  

Somebody posted a poll on Facebook asking opinions on whether Obama should be assassinated.  How cute.  What kind of sicko puts out this stuff?  Something I read very recently mentioned that this kind of behavior is encouraged by the anonymity of the internet; if they had to identify themselves, the creators of this sort of "content" would not be prepared to attract the scorn of their friends (if they had any).  I remember Jane Jacobs, in her seminal book The Death and Life of Great American Cities, making a similar point: children will be more apt to behave (and also safer) in city neighborhoods where people are active in the streets - people who may know them, or who may correct their behavior.

Virginia Politics: The Value of Junk Mail

I'm pretty good at recognizing junk mail, and usually throw it out unopened.  Receiving an envelope with no return address but "absentee processing center," and marked "Commonwealth of Virginia Absentee Ballot Application Enclosed," I knew I was getting junk mail.  But it was the red-lettered legend, "Do Not Tamper: Official Document" that made me decide to open it to see who was sending me this junk, so I could report this probably illegal implication that this mailing came from a government entity.

Gee, it was just my old friend "Bob."  As in Robert "Bob" McDonnell, candidate for Governor of Virginia.  Yes, the envelope did contain an application for an absentee ballot (that I had not requested), but it contained a campaign epistle with the same tired old lies his party has pushed for the past year and more: according to "Bob," the federal government is "attempting a government takeover of health care, while pushing massive tax increases...."  Also, as a writer, I was amused by the grammatical errors of the letter -- McDonnell is receiving lots of Republican Party bucks for this off-cycle election; he has money to hire a coiffeur to give him the bland blow-dry look of the slick professional pol, but can't find a writer who knows "its" from "it's."

Back in June I suggested that our upcoming gubernatorial race in Virginia would be an interesting faceoff between a Republican (McDonnell) who's striving to present himself as a moderate, and a Democrat (Deeds) who has espoused some very un-liberal ideas.  This blurring of lines is reflected in the recent refusal of popular moderate ex-Governor Wilder's refusal last week to formally endorse either candidate.

Over the intervening months since the candidates were named, however, McDonnell has run into trouble trying to sell himself as a "moderate."  Though claiming to be pro-business, his public campaign materials have focused more on his military background (wave the flag) and on his belief in strong families (ever the original thinker, he figured out how to father five kids).  He has sought, not too successfully, to play down extreme anti-women and anti-gay views he argued for in his thesis at a local religious university only twenty years ago.

So, junk mail has a certain value, but maybe not the one envisioned by this candidate.  Too often, choice in elections is between the lesser of two evils (last year's Presidential election was one of the first exceptions in many a year).  Is it possible I'll receive an equally dumb bulk mailing from McDonnell's opponent Creigh Deeds? Yes.  Would I reconsider? Yes, perhaps, because I seek to be open-minded. I'm the moderate pragmatist McDonnell claims to be but isn't.  But the odds are...that this straw broke the camel's back.  McDonnell has shown he's more a goober than gubernatorial.

Postscript:  Yesterday I wrote in support of an idea McDonnell is pushing to privatize the wasteful state-owned "Alcoholic Beverage Control" stores in Virginia.  I'm happy to see the Washington Post editorial staff today agrees with me: It's a valid idea, but NOT because it would generate much savings. (It won't.)

When The Answer Is To Privatize

Virginia is one of those states that allows hard liquor to be sold only in state-run stores.  The buildings are state-owned (or leased), the staff are state employees, the prices are high and the selection is poor.  For years, I have wondered why we didn't put the liquor business in private hands.  The state could still get its tax revenue, but it would save a bundle on the costs of owning or leasing property and buildings, as well as the employee salaries and benefits.  All gain, no pain.  I can't see a downside.

Now, finally, Robert McDonnell, the Republican candidate for Governor, proposes to do exactly that.  He also points out another benefit, i.e. that privately owned stores would pay property and other taxes into local communities, as government stores of course do not. (McDonnell is on much weaker ground when he claims that this will produce savings that will contribute significantly to the state's crying need for road improvements.  It's only a drop in the bucket.)  Nevertheless, the idea is worth considering on its own merits.  Here's a case where there doesn't seem to be any benefit to citizens by having government involved, so the candidate proposes to get the government completely out, which is key to saving money.  I wish him well in implementing it if he's elected. 

Defense Expenditures

At the UN and in other international meetings, Obama has been playing up the idea that other governments must shoulder their share of the costs of meeting the threats to global security.  Some of those foreign governments -- and I speak here only of our allies in the NATO/EU framework -- seem a little skeptical about the message.  Not all of them agree with our past assessment of the terrorist threat represented by Iraq, for example; and others might argue that their efforts on other global issues such as climate change have exceeded ours.  On the broad global scale, Obama seeks to change all that with new U.S. approaches and that's a good thing, if he succeeds.

The most important element of this renewed emphasis on "sharing," which has been deemphasized (I suspect consciously) by the Administration, is the extent to which our defense expenditures are proportionately greater than most of our Allies'.  We can look at absolutes, like the raw defense budgets of individual countries, or at relative costs as a percentage of national GDPs (the U.S. spends more than 4% of its GDP on "defense" while major allies spend far less: France, 2.6, UK, 2.4, Germany, 1.5), or even at the global distribution of military outlays (of all the money spent around the world for military purposes, the U.S. spends 42%; the next highest is China, at less than 6%).  

Of course, statistics gathered around the world, from budgets often only partially transparent, and sometimes from different years, can never be an exact measure of comparability.  Yet even allowing for statistical aberration, it's rather clear that since World War II:

• U.S. defense expenditures have typically been considerably higher than our Allies', or our potential enemies' ; and
• those expenditures have constituted at least 50%, and sometimes more than 60%, of our discretionary spending.

That latter point explains why the U.S. increasingly lags behind its equally developed peer countries in such areas as health care, education, hunger, and other domestic programs. We have to choose between guns and butter (shall I say guns and olive oil these days?); usually, we have favored the guns, assuming we can have the butter later.

Some would argue that maintaining our military superiority by a factor of ten over other nations is essential to our national security.  While it's a point that should be debated, it's rather questionable that we need to fund such an immense gap.  Ultimately, whether or not we can continue to afford the current levels of military expenditures now, it seems evident to me that we can't keep doing so for ever.  The longer we do so, the more pinched we'll be between our military "entitlements" and our domestic ones; and the more deterioration we will see in quality-of-life programs, including infrastructure. 

The gap could be reduced by choosing our wars a little more carefully (see the right margin for Richard Haass's book War of Necessity, War of Choice); it can also be reduced by encouraging those who share our basic security interests to pony up a more commensurate share.  That, I hope, is something the Administration perceives and is working toward. 

The Tinker(er)'s Damn(ation)

A foreword: A century ago, tinkers weren't yet uncommon; they were itinerant repairers and tinners of kitchen pots and other household items.  Nowadays, the word "tinker" is more often used as a verb, meaning ineffective or inexpert fiddling with something in an effort to fix it, and one who tinkers in that way has become a tinkerer.  Coincidentally, from the same earlier era as tinkers also comes the old adage, "Don't fix it if it ain't broke."

Unfortunately, some people can't seem to resist meddling with things that are perfectly good as they are.  Those people seem to be especially good at getting elected to Congress. 

In the Washington DC area, for example, we have become accustomed to a whole range of such elected officials who consider it their god-given right to fiddle with anything and everything in local government (whether or not they are on the committee that reigns over the District of Columbia and prevents its citizens from getting the right to be represented in Congress).  They have variously tinkered with DC gun laws; messed around with taxi regulation; proposed that Roosevelt Island (a park maintained in its natural state to honor Theodore Roosevelt and the preservation movement) be sold and converted to shops and condos; renamed the area's most central airport and then forced local jurisdictions to pay to change signage in the subway system.  If Chicago used to be the "city that works," it's no wonder DC is the city that doesn't, with these clowns constantly sticking their noses in.

As summer gave way officially to fall today, morning darkness now lingers until nearly 7:00 AM, so it's the season also to remember Congressman Ed Markey of Massachusetts, the tinkerer of time, who inexpertly mended our time zones so that we can get up and go to work in the dark most of the year.

Not to be outdone, the current crop of U.S. Representatives has discovered that the new hybrid cars are very quiet when they're operating electrically, so they want to add noise.   In fairness, I note that some car manufacturers also seem interested in making their quiet cars audible, though I suspect a lot of the impetus for that comes from the interest in Congress and from the concern about being sued. 

They're just trying to fix what ain't broke.  Let's hark back to the 1980's (I think) when somebody did a study and found that people would notice a car's brake lights much more easily when a third light was mounted in the middle of the back window.  From there, it was an easy step for the tinkerers to "improve" things by requiring every car to have that third brake light.  But here's the problem:  If I go out in public wearing a fluorescent green hat, it's very likely people will notice me more readily than they will you, with your plain ol' bare head; yet if everybody wears a fluorescent green hat, I just blend into the crowd. Of course test subjects noticed those new third lights, they were something out of the ordinary.  Now that every car has them, three lights are no better than two.  What have we gained, besides an unnecessary increase in the car's cost?

Those who favor making quiet technology noisy argue that pedestrians may not hear approaching cars, a theory borne out somewhat by a yet-unpublished study that finds when electric vehicles back up they're 50% more likely to be involved in an accident with a pedestrian.  On the other hand, there are relatively few of these electric vehicles so far, so the statistic is very likely not meaningful.  Of course, we have the blind to consider, but really, a blind person who relies solely on sound to detect cars in a parking lot has a fool for a navigator -- there's too much ambient noise to depend on that, and other technology could surely be developed (how about a signal emitted by these cars, inaudible to most, but picked up by an earpiece designed for the blind?). 

I applaud those manufacturers who say they do not intend to add artificial sound to their cars.  God forbid that we would have to put up with every car in a parking lot toodling along making that annoying, high-pitched beeping noise that trucks now have.  That would definitely be making a sow's ear out of a silk purse. 

Once we come to think of a car as a silent machine, we will adapt very well (we're humans, that's what we do) without the aid of Congressional meddle-men.  And we'll be happier for having reduced, rather than increased, the level of noise pollution in our everyday lives.