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Health

Hospitals In Minnesota Blame Health Care Reform For Pending Nurses Strike

1012MNA_march2Up to 12,000 union nurses will go on strike tomorrow morning in Minnesota, after failing to reach a contract agreement with 14 Twin Cities hospitals. The two sides are at odds over wages, benefits, and patient-to-staff ratios, with the nurses proposing “some of the strictest staffing rules in the country.” But the hospitals “call the plan a nonstarter, saying it would add hundreds of millions of dollars in unnecessary costs” during a period of economic recession and uncertainty following the passage of health care reform.

In an email from Park Nicollet Health Services CEO David Abelson, obtained by the Wonk Room, the hospitals argue that the end of the fee-for-service system and the reduction in government payments for uncompensated care, have presented the industry with “very harsh realities”:

The changes in health care present very harsh realities. The current fee-for-service business model of health care is faltering and will become a thing of the past. A new business model has not yet emerged. The future of health care is uncertain as state and federal government drastically reduce health care reimbursements in a time of dramatically escalating need. The percentage of our business from government programs on which we lose money is increasing. And we still don’t know the long term costs and implications of the parts of federal health care reform that won’t take effect until years from now.

The economic recession and the shrinking of safety net programs — particularly given Gov. Tim Pawlenty’s cuts in health care services — have certainly placed greater financial strain on Minnesota hospitals, but Abelson’s claim that health care reform will present hospitals with “very harsh realities” is an exaggeration. Throughout the reform debate, hospitals and their lobbyists argued that the influx of insured patients could yield a return of $16 billion dollars and supported the final law since it “delays most of the industry’s cost givebacks until the second half the agreement’s 10-year year period — well after the hospitals have enjoyed some of the benefits of the new money they’re expecting from expanded insurance coverage.” Health reform also protects hospitals from cuts under the Independent Payment Advisory Board through 2019, guaranteeing a stream of profit that’s far stronger than hospitals can hope for under the current system.

Several hospital systems can also serve as “a new business model” for facilities transitioning away from the fee-for-service system. As CAP’s Ellen-Marie Whelan and Lesley Russell argue in this paper, “there are many ways to decrease the cost of health care while ensuring quality care and there are many examples of this underway in the United States right now.”

For instance, Geisinger Health System is a physician driven system that has led the nation in delivery and payment reform. In the latest issue of Health Affairs, Geisinger president and CEO Glenn Steele estimates that its advanced medical home model for the care of chronically ill Medicare patient has “bent the cost curve and lowered projected spending by up to 7 percent.” That system, along with other prominent examples like the Cleveland Clinic, has successfully adopted many of the new law’s delivery reforms without sacrificing profits. As Steele observes, “We don’t know if the Geisinger experience is scalable or generalizable through U.S. health care, but we do think that the way our country pays for and delivers health care nationally will need to move to something that looks a little bit more like Geisinger in a relatively short period of time.”

Climate Progress

Public support for action on global warming has grown since January

The Yale Project on Climate Change just released a poll that found growing support for measures to reduce global warming pollution.   It interviewed 1,024 people from May 14 to June 1, and compared the results to a similar poll it conducted in January 2010.  CAP’s Daniel J. Weiss and intern Ariel Powell have the story.

There was more support or more intense support in the June survey for the following actions.

Read more

Economy

Hatch: Wealthy Money Managers Need Their Tax Loophole, ‘I Don’t Think Anybody Can Fight That Analysis’

This week, the Senate is debating its version of the tax extenders bill that the House passed before the Memorial Day recess. The bill extends unemployment benefits through November (as well as some popular tax credits) and is partially offset by the closing of a few tax loopholes.

One of these loopholes has to do with carried interest, or the money that investors pay to money managers to manage hedge funds or private equity firms. Currently, such income is taxed at the lower capital gains rate, even though it is received in return for a service like any other salary or hourly wage. The Senate has, for a week now, been watering down the tax change (suggesting subjecting only 50 or 60 percent of carried interest to the higher tax rate), in an attempt to drum up conservative votes.

But Sen. Orrin Hatch (R-UT) today took to the Senate floor to proclaim that he would vote against the extenders package — and thus prevent millions of Americans from claiming unemployment benefits — because of the tax change, and dared the world to fight his analysis:

Why, then, am I planning to vote against this bill?It is for the same reason that much of the business community is opposed to this legislation. The tax increases added to this bill will damage the economy and job creation and outweigh the benefits of extending the expired tax provisions [...]

For several years now we have heard it stated with outrage that hedge fund managers get by paying a lower tax rate on their billion dollar compensation packages than their secretaries pay on their relatively meager salaries…The simple fact is that if we increase the tax rates and change the nature of income for these partnerships, the economic hurdle rates will rise and fewer deals will get done. And if fewer deals get done, less economic activity will be generated and fewer jobs will be created. I don’t think anybody can fight that analysis.

Watch it:

Of course, plenty of people have already fought that analysis, pointing out that investors will not be affected by the change, only the wealthy managers they employ to oversee their investments.

But since Hatch is so concerned about venture capitalists shutting down their shops if the change comes to pass, I’ll turn it over to Fred Wilson, who is a venture capitalist, and wrote that “changing the taxation of the managers will not reduce the amount of capital going to productive areas”:

The sources of the capital; wealthy families, endowments, pension funds, and the like, will still put the capital in the places where they will get the highest after tax return. And these sources of capital, if they are tax payers, will still get capital gains treatment on their investments in hedge funds, buyouts, and venture capital. And the fund managers will still have to compete with each other to get access to that capital and their incentives will still be to produce the highest returns they can produce, regardless of whether they are paying capital gains or ordinary income on their fees.

As David Weidner pointed out (in the Wall Street Journal, of all places), “Wall Street’s private equity industry is going Tea Party on a new tax making its way across Capitol Hill. But don’t be fooled, this isn’t a populist movement, unless your brand of populism includes a dozen vacation homes.” Zaid Jilani also noted that opponents of the increase are making all sorts of outlandish claims about it, including that it will harm cancer patients. But taxing carried interest for what it is — income — is simply about fairness and fixing a bizarre inequity in the tax code that has no reason for existing.

Economy

BP, Halliburton, And Transocean Skip Mississippi Hearings On The Oil Disaster

Late last month, Mississippi state House Speaker Billy McCoy (D) and Lt. Gov. Phil Bryant (R) created a select committee to investigate the Gulf Coast oil spill. “[T]he people of Mississippi deserve to know how this happened and what the future may hold for this most valuable part of our state,” said McCoy. A key part of the select committees’ mission would be to hold hearings with top officials from companies responsible for the spill.

However, yesterday, BP wrote a letter saying it wouldn’t be showing up for the three-day hearings this week. ThinkProgress obtained the letter to McCoy, addressed from Margaret D. Laney, BP’s Mississippi Coordinator for Public and Government Affairs. From the letter:

I regret that we are unable to accommodate your invitation to participate Wednesday or Thursday in the hearing of the Mississippi House of Representatives Select Committee on the Gulf Coast Disaster.

We at BP take very seriously the desire of the Select Committee to gather information on the circumstances on the Mississippi coast relative to the oil spill. We are committed to meeting regularly with stakeholders along the Gulf Coast and to providing briefings for government officials on a regular basis, and we will continue to remain engaged in this way. When we meet with the Committee, it will be important for us to have appropriate BP representatives who are implementing the strategic response plan for Mississippi and working in the Mississippi Gulf Coast area. Unfortunately, the appropriate individuals are not available this week. We would be pleased to work with the Select Committee to identify a day in the near future for another meeting of the Committee — either in Jackson or on the Coast where the Committee also can visit incident response operations.

A BP spokesperson told the AP that the “many of the company’s executives” would be in Washington, DC. According to the Biloxi Sun Herald, both Transocean and Halliburton were also no shows.

McCoy was suspicious of the corporations’ refusal to testify, stating, “Considering the many officials BP has on standby in the Gulf Coast region, it is simply incomprehensible that the company could not send at least one to these hearings to give our citizens, lawmakers and business leaders their viewpoint on this oil spill disaster. We are not holding these hearings to conduct a witch hunt.” “Every one of BP’s public pronouncements has been as produced and careful as the Tiger Woods’ apology,” Rep. Brandon Jones (D) added. “What we want is for them to answer the hard questions and give us a sense of what is going on. By not showing up, it just leaves all that to our imagination and it breeds frustration.”

The last hearings BP, Halliburton, and Transocean officials attended didn’t go so well because they were all trying to pass blame for the spill and received widespread condemnation. The Washington Post noted that at last month’s Capitol Hill hearings, senior executives were “pointed fingers” at each other the whole time.

Climate Progress

Murkowski ‘dirty air’ proposal would increase oil dependence, cost consumers at gas pump

The U.S. Senate is poised to vote Thursday on the Murkowski Resolution (see “Clean air Lisa vs. dirty air Lisa“).  EPA chief Jackson says passage would “increase our dependence on oil … by billions of barrels.”  Environment America has a new state-by-state analysis, confirming that conclusion, which I repost below:

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Security

An Immigration Platform That Meg Whitman May Live to Regret

meg-frontpage-300x230Following Meg Whitman’s (R-CA) victory last night in the Republican primary race for California governor, it’s worth reviewing her shift to the right on immigration before she gets the chance to move back to the center as she will likely have to if she wants to win the general election. Rep. Kevin McCarthy (R-CA), who is cited as one of Whitman’s earliest supporters, has stated “You can’t get there in the general without 30 percent of Hispanics.” Whitman seems confident that she can win over Latinos by hosting mariachi events and talking about “jobs and education,” but she may be surprised. Immigration isn’t necessarily the most important issue for Latinos, but anti-immigrant rhetoric is often enough to drive Latinos away from a candidate in droves.

Whitman once said that she supported comprehensive immigration reform. She always maintained that she opposes outright amnesty “100%,” but used to reportedly favor a “program in which people would go to the end of the line, pay a fine and do things that would allow for a path to legalization.” However, as her race against immigration hardliner Steve Poizner (R-CA) tightened, Whitman went out of her way to clarify that what she really “meant” was that she supports reform that “secures the border first and includes a temporary guest worker program” and not an earned path to legalization for undocumented immigrants. Meanwhile, 77% of Latino voters support a legalization plan.

It also doesn’t help that Whitman’s proposals don’t even make economic sense. Government data shows that the border “is safer now than it’s ever been.” The top four biggest American cities with the lowest rates of violent crime also happen to be in border states: San Diego, Phoenix, El Paso and Austin. This is especially true for California. The Los Angeles Times recently wrote that “the California frontier is quieter than it has been in years.” Not only is Whitman okay with the idea of pouring more money into securing a border that is already safe, she’s apparently opposed to generating $16 billion annually from putting California’s 1.8 million undocumented Latino immigrants on a path to legalization. Other studies have shown that temporary worker programs, in the absence of legalization, are associated with more costs than benefits.

The Latino Politics blog points out that Latinos have a saying: “Dime con quién andas y te diré quién eres,” which means “Tell me who you walk with, and I will tell you who you are.” Last month, Whitman released an ad featuring former Gov. Pete Wilson (R-CA) who affirmed that Whitman will be “as tough as nails” on immigration. Wilson’s endorsement might’ve scored some points with right-wingers, but it also meant a lot to California Latinos who remember him backing Proposition 187 — an Arizona type law that was ultimately deemed unconstitutional. The law never really went into effect, but Republicans are still hurting from it. In a report released by the Center for American Progress, Gebe Martinez writes “after 1994, California Democrats won every presidential, U.S. Senate, and gubernatorial election until 2003″ — largely thanks to a Latino electorate that was deeply offended by Wilson and his Party. Allan Hoffenblum, a longtime Los Angeles-based GOP strategist is worried about the potential fallout from Whitman’s primary campaign. “This is bringing back all the fears that the Republican Party is a white man’s party,” Hoffenblum told Politico. “It’s depressing.” In the video, Whitman also proclaims, “Illegal immigrants are just that, illegal.”

In the general election, Whitman faces a much different race against Democratic opponent Jerry Brown. “Yes, protect our border. Yes, enforce the law,” Brown has said. “[But] I’m not going to scapegoat immigrants and public servants and poor people.” However, he may want to bring up the immigration issue early and often by reminding Latino voters of Whitman’s desperate move to the right and providing a welcoming immigration platform for them to flock to.

Politics

Hot mic catches Fiorina dissing Hannity: ‘Very bad choice’ to go on his show.

While waiting to be interviewed by Sacramento ABC affiliate KXTV this morning, GOP Senate candidate Carly Fiorina was caught by a hot mic taking a dig at Fox News host Sean Hannity. Fiorina criticized her friend Meg Whitman, the GOP gubernatorial candidate in California, for agreeing to go on Sean Hannity’s show the day after the primary elections:

I find it really surprising that on the first day of the general Meg Whitman is going on Sean Hannity. Did you hear that? I think it’s bizarre. I mean, she’s never been on Sean Hannity. I think it’s a very bad choice actually. You know how he is. … But why, after saying no to all these people, would you go on Sean Hannity? That’s not the one you would do. … Sean Hannity is not an easy interview, you know?

Watch it:

Fiorina is presumably observing that Whitman’s efforts to appeal to the general California electorate are going to be complicated by her appearance on the right-wing Fox News show. We can’t wait for Fiorina to explain how her dig at Hannity is simply a misinterpretation by the liberal media, and what she was actually trying to say is that Hannity is one of the best “journalists” on TV today.

Update

Ben Smith deems Fiorina’s comment to be “great for Hannity’s cred.”

Climate Progress

Admin Allows BP 90 Days To Process ’48-Hour’ Claims

Today, the Obama administration announced initial steps to improve oversight of BP’s processing of claims of economic damage caused by the foreign oil giant’s Deepwater Horizon catastrophe. After weeks of growing complaints and a huge backlog of unpaid claims, National Incident Commander Thad Allen met with BP officials and wrote a letter to BP CEO Tony Hayward demanding “access to the BP claims database with personally identifiable information removed.” On Sunday, Hayward lavishly praised his own company’s performance in a BBC interview, saying BP had paid “every claim” by instituting a claims process that takes only “48 hours”:

We’ve taken a claims process that has taken 45 days traditionally in the United States and shortened it to 48 hours. It takes 12 seconds when you phone the BP claims line to be put into the process, be given a number. If you turn up at the claims office, within 48 hours you’re given a cheque.

Watch it:

Hayward’s fantastical 48-hour deadline is not being enforced by the government, however. Instead, unpaid claimants must wait 90 days before the federal government has promised to take action:

Any claim that is denied by BP or not settled within 90 days of submission to BP may be presented to the Coast Guard for relief from the Oil Spill Liability Trust Fund through the National Pollution Funds Center (NPFC).

The administration should make BP stand behind its CEO’s words, and mandate Hayward’s purported 48-hour turnaround for processing claims. Better yet, the administration could take the Center for American Progress’s suggestion to take over the claims process from this environmental criminal. For fishermen, hotel owners, and other Gulf Coast businesses, a ninety-day wait would be an economic death sentence.

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