From a New York Times report on plans to use light-touch US military assistance to help the de jure Somali government assert control over Mogadishu:
Whenever Somalia has hit a turning point in the past, the United States has been there, sometimes openly, sometimes not.
In 1992, shortly after the central government imploded, Marines stormed ashore to help feed starving Somalis. In early 2006, when an Islamist alliance was poised to sweep the country, the C.I.A.teamed up with warlords to stop them, and when that backfired, the American military covertly supported an Ethiopian invasion.
I think a better way of putting it would be to say that over the past 18 years the United States has sporadically intervened in Somalia and the interventions have rarely produced the desired results. I’m skeptical this time will be any different.
But the assertion that too few employees pay enough toward their plans to realize the full cost of their medical activities is true for fewer and fewer Americans. It’s not as if employers are completely footing the bill as insurance premiums continue to rise astronomically; more and more employers are asking employees to chip in higher amounts. And higher numbers of employees can only afford plans with deductibles or co-insurance for every procedure but annual physicals, so people are paying something for each visit, more so than they were in the ’90s. It also ignores the fact that health-care consumers in many European countries pay little to nothing per doctor visit, and overall their medical costs are much lower than in the U.S.
I’m a believer in the promise ofprogressive cost-sharing to reduce medical expenditures on needless health care services. But as Potts implies, this is hardly the only path to cost control. But in the United States we go to extremely lengths to talk around the fact that the main way jurisdictions around the world control health care costs is by regulating prices.
In the US, we do a little of this. Medicare doesn’t pay doctors and hospitals as much as private insurance does. Because Medicare is such a big client-base, most providers deem it worthwhile to treat Medicare patients anyway. But some doctors are able to have a nice business while eschewing Medicare clients. If we adopted a Universal Medicare system (or a robust public option) we’d drive costs way down primarily because we’d be paying less to health care providers. This would have the effect of driving most private insurance companies out of business, but they’re hardly the only interest group who’d squeal at the possibility. Alternatively in Europe both the systems that rely on private insurers (e.g., Netherlands) and those that rely on a government insurer engage in systematic price controls to contain costs.
In Singapore, where they have probably the lowest health care costs, they do both. The country is often invoked as an example of successful cost-sharing, which it is, but it’s also a place where “actively regulating the supply and prices of healthcare services in the country” plays an important role.
You can argue that there are downsides to adopting this approach and there’s an argument to be made that most of the world is free-riding on innovation driven by the ultra-profitable US market, but the fact of the matter is that this model—controlling costs by making the price lower—is in place almost everywhere, even as the insurance model varies dramatically from place to place.
Barack Obama’s health insurance reform plan involves an individual mandate. So does the plan that Mitt Romney signed as Governor of Massachusetts. At the time Romney signed the plan, he was a moderate Republican and CommonwealthCare was considered a sober-minded centrist plan. Now Romney is a conservative, and conservatives have decided that ObamaCare is a socialist plot, so he’s had to make up a lot of reasons that their extremely similar plans are actually totally different. Part of the conservative assault, though, is hard for Romney to wriggle away from—the right’s claim that the individual mandate is unconstitutional. Obama’s got one, and Romney’s got one. So does Romney agree with the right that RomneyCare is unconstitutional, or will he defend Obama from this charge?
By Climate Guest Blogger on Mar 6, 2010 at 1:30 pm
Former chair says IPCC must acknowledge mistakes and “consider shorter reports focused on the key issues,” but “In many cases, the IPCC is very conservative in its statements, e.g., the projections of sea level rise.”
All major emitters of carbon dioxide and other greenhouse gases need to rapidly and cost-effectively transition to a low-carbon economy, in both the production and use of energy and the management of forests and agricultural lands. In order to ensure food, water, and human security, and to protect the world’s biodiversity, the goal should be to limit the global average temperature rise to 2 degrees C (3.6 degrees F) above pre-industrial levels…. Without concerted action now, the world will be faced with temperature increases far in excess of 2 degrees C, with unthinkable impacts.
Dr. Robert Watson was chair of the Intergovernmental Panel on Climate Change from 1997 to 2002. He was opposed by fossil fuel companies like ExxonMobil and the Bush administration waged a successful campaign to have him replaced with Rajendra Pachauri. Now Watson is Strategic Director for the Tyndall Center at the University of East Anglia and Chief Scientific Advisor for the UK Department for Environment, Food and Rural Affairs. Yale’s Environment 360 online magazine has a piece by him they have given me permission to repost.
The research I’ve seen indicates that one of the biggest impediments to making people want to do more to help resolve problems associated with extreme poverty in the third world is a sense of futility. People believe that Africa is just hopelessly mired in poverty, and any effort to help would prove futile. So I think it’s important to highlight the considerable evidence that this isn’t the case.
Measures of real consumption based upon the ownership of durable goods, the quality of housing, the health and mortality of children, the education of youth and the allocation of female time in the household indicate that sub-Saharan living standards have, for the past two decades, been growing in excess of 3 percent per annum, i.e. more than three times the rate indicated in international data sets.
And I think it’s worth taking a relatively holistic view of what “being helpful to Africa” entails. Trade policy and foreign aid policy and debt issues are the obvious chestnuts. But there’s also a lot that could be done around migration and intellectual property issues. And there are broad structural concerns. Catastrophic climate change will fall much more heavily on poor countries with weak institutions. And Africa has benefitted enormously from the decline of superpower rivalry—you know longer have the US and USSR arming and financing rival gangs of vicious killers—and would suffer enormously if US-China animosity really broke out.
While many of Thiessen’s opinions are appalling from a moral perspective (he justifies torture and abuse through the religious writings of St. Thomas Aquinas), the book is comprised of errors, omissions, and a whopping dose of fear-mongering. I’ll concentrate here on his worst misstatements and why his conclusions ultimately make us less safe.
But, you know, Thiessen has a lot of experience as a second-tier speechwriter so maybe he should take his word for it.
Anyways, I’ll just observe that this review, like a lot of the best political commentary published by various arms of the Kaplan Test Prep octopus, is dedicated to rebutting views that various arms of the Kaplan Test Prep octopus have seen fit to publish. If Foreign Policy hadn’t run an absurd piece by Thiessen, and the Washington Post hadn’t hired Thiessen as a columnist, I’m not sure we’d care enough about Thiessen to want to see his reviews rebutted. When the Post publishes George Will lying about climate science, and then does an editorial weeks later about correct climate science, that’s on net a negative for understanding—creating the impression of controversy. The world would be a better place if these guys just stuck to SAT tips.
At the behest of Robert Byrd, some time ago Social Security was made exempt from the budget reconciliation process. Both the effect and the intent of that measure was to make it more difficult to reduce Social Security benefits. Now John McCain is proposing to do the same for Medicare.
As narrow hardball politics, this makes sense as it’s designed to make it more difficult to pass the Obama administration’s health care initiative. At the same time, the actual impact of this would be much, much broader. The idea behind the Social Security exemption, whether you like it or not, was precisely to make it hard to cut the growth in Social Security benefits. Do conservatives really want to do this to Medicare? The evidence says otherwise. McCain himself has voted for reconciliation-implemented Medicare cuts on four different occasions. Paul Ryan’s GOP budget roadmap would phase Medicare out entirely.
And while there’s lots of disagreement about Medicare in American politics, nobody can seriously deny that these projections are unsustainable:
So McCain’s rule would, yes, have the impact of blocking the health care bill. But the cost would be to make it essentially impossible to ever resolve a looming budget catastrophe.
By Climate Guest Blogger on Mar 6, 2010 at 9:23 am
The United States created the solar cell industry and literally launched it into space 50 years ago. Solar PV is going to be one of the largest job-creating industries of the century, projected to grow “from a $20 billion industry in 2007 to $74 billion by 2017″ (see “Invented here, sold there”).
On Fox News last week, Sen. Judd Gregg (R-AZ) declared that using reconciliation “to pass the most significant piece of public policy” of his lifetime would be “a railroading of the system”:
GREGG: We’re talking now about changing the entire way that health care is delivered in this country. We’re talking about taking the federal government and growing it from 20 percent of the economy to 25, 26 percent of the economy. We’re talking about changing the way that you and your doctor interact and you and your hospital — and your hospital treats you. These are huge public policy issues which really are way outside the reconciliation concept because they need debate. They need discussion. And they need to be subject to amendments on the floor of the Senate in order to do them correctly, or at least to have a proper airing of them and a fair treatment of them.
GREGG: But that’s what the game plan here is. Is to pass that bill, the big bill, and what they’re doing is they’re using this other bill, reconciliation, to basically buy off votes in the House from the more liberal members of the House who want to make this bill even bigger and more intrusive. And when they get those votes and they pass the big bill, that will go down to the president and it will be signed. And this side bill, which is called the reconciliation bill, will really become almost irrelevant. I mean, as a very practical matter, there isn’t really going to be a lot of people who really care whether it passes or not because they will have already gotten their massive bill through and it will be law.
Later in the interview, Gregg further contradicted his previous claims that reconciliation would be used as “an entire rewrite of the health care system of America.” “Even if they did something else, it would be at the margins. I mean it’s not going to dramatically impact what is this huge bill that will then be law,” said Gregg. Listen here: