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Health

Why Government Health-Insurance Caps Are Not Enough To Control Health Spending

By Igor Volsky on Jun 28, 2010 at 8:45 pm

Over at BNet, Ken Terry argues that while capping insurance rates may help reduce the number of outrageous rate increases and keep issuers from making those rather embarrassing mathematical errors, policy makers will have to address increasing costs on the provider side to really get spending under control:

Insurance companies do raise rates by ridiculous amounts; their executives earn too much; and the national companies, in particular, are hugely profitable. But it’s also true that, especially in Massachusetts, some hospitals and physician groups have held up insurers and employers for ridiculous payment increases. And there is no doubt that as the economy worsens and fewer people can afford insurance, more healthy people are dropping out of the insurance pool, driving up rates for those who remain covered.

Clearly, we need a new deal in healthcare. Just capping insurance rates won’t do it.

None of this takes away from the importance of ensuring that health premiums are reasonable or pressing for some kind of federal rate review authority, but since premiums are closely tied to the underlying cost of services, we’re going to have to get a hold of spending on the provider side.

Democrats and advocacy groups like HCAN do a commendable job in publicizing the access of some large insurers and a lot of that same energy could also be extended to pressing providers or lobbying for the relevant cost control measures. Stronger rate review provisions will help control costs over the short term and vilifying insurers can reap some political dividends, but we’re gonna have to look very closely at things like reimbursing for outcomes if we’re going to bring costs down over the long haul.

Politics

Citing SB-1070, Latinos withdraw applications for top University of Arizona position.

By Guest Blogger on Jun 28, 2010 at 8:00 pm

dream-act-rallyWith criticism of its harsh immigration law mounting, Arizona continues to feel the negative effects of the fallout. While Arizona businesses have borne the brunt of the impact, the state’s educational system has also faced the law’s consequences. Within a month of the law’s passage, the parents of 70 students pulled them out of a Phoenix school district, where the population is 75 percent Hispanic. In April, prospective and current students already started to withdraw from the University of Arizona. More recently, however, SB-1070 has made it increasingly difficult for the university to find a replacement for a top position available since mid-April:

The University of Arizona’s senior vice president, Joel Valdez, officially retires this week. Planning VP Bob Smith is taking over in the interim.

Provost Meredith Hay is leading a national search committee for Valdez’s replacement. She commented on the search during a strategic planning meeting last month. According to meeting minutes: “The committee is having difficulty attracting a diverse pool of candidates. The Hispanic candidates have all withdrawn, citing SB 1070 as an issue of sufficient concern regarding bringing their families to Arizona.”

– Nina Bhattacharya

Justice

Kagan Hearing Day One: The Battle To Define ‘Judicial Activism’

By Ian Millhiser on Jun 28, 2010 at 7:20 pm

Kagan 1If someone does a word cloud of today’s opening statements in the Kagan hearing, the word “activism” will dominate the screen.  And this is nothing new.  Conservative senators figured out a long time ago that if they label anyone to the left of Samuel Alito a “judicial activist” then their more progressive colleagues will put their tail between their legs and cower.

Today, however, this tactic backfired.

Sure, Republicans brought their typical bluster to the hearing.  Sen. Jeff Sessions (R-AL) warned that Kagan may try to “change” the law’s meaning after she becomes a judge.  Sen. Jon Kyl (R-AZ) suggested that Kagan would “abandon impartiality and instead engage in results-oriented judging.”  These warnings, however, were largely empty.  Sessions, Kyl and their co-ideologues brought little in the way of evidence that Kagan wouldn’t follow the law.  In many cases, their attacks boiled down to nothing more than insinuations that there must be something wrong with General Kagan because she once heaped praise on her former boss, Justice Thurgood Marshall.

These attacks on Justice Marshall sparked what was easily the most eloquent moment of the hearing, Sen. Dick Durbin (D-IL) reminding Senate Republicans exactly who they were going after:

On at least three or four occasions I have been disappointed by my Republican colleagues warning us that you just might follow in the tradition of Justice Thurgood Marshall. . . . Let me say for the record, America is a better nation because of the tenacity, integrity and values of Thurgood Marshall. Some may dismiss Justice Marshall’s pioneering work on civil rights as an example of “empathy”—that somehow as a black man that had been a victim of discrimination, his feelings became part of his passionate life’s work—and I say “thank God.” The results which Justice Marshall dedicated his life to broke down barriers of racial discrimination that had haunted America for generations. . . . And I might also add that his most famous case, Brown v. Board of Education—if that is an activist mind at work, we should be grateful as a nation that he argued before the Supreme Court, based on discrimination in this society and changed America for the better.

Beyond this stirring rejection of conservative smears on Justice Marshall, the Committee’s progressives came armed with actual examples of right-wing judicial activism.  Progressives like Sens. Durbin, Chuck Schumer (D-NY), Amy Klobuchar (D-MN) and Al Franken (D-MN) each focused on cases where the Roberts Court placed a conservative agenda ahead of the law.  Citizens United and Ledbetter were both villians in today’s hearing, as were lesser known cases such as Gross v. FBL Financial Services, which stripped many older workers of their ability to challenge age discrimination, and Stoneridge v. Scientific-Atlanta, which left many investors powerless against securities fraud.

At the conclusion of today’s session, Kagan herself finally got a chance to speak.  Although her brief statement was heavy on biography and statements of gratitude, it also included an important indicator of what kind of justice she will be.  Yesterday, Sessions demanded that Kagan embrace “tentherism,” a radical theory of the Constitution which requires the Supreme Court to strike down health reform and other laws that conservatives don’t like.  Kagan’s statement firmly rejected this demand:

What I most took away from [my government service] was simple admiration for the democratic process. That process is often messy and frustrating, but the people of this country have great wisdom, and their representatives work hard to protect their interests. The Supreme Court, of course, has the responsibility of ensuring that our government never oversteps its proper bounds or violates the rights of individuals. But the Court must also recognize the limits on itself and respect the choices made by the American people.

Tomorrow, the senators get to grill Kagan, and the real drama begins.  In the meantime, however, Kagan and her allies appear to have finally found their voice on judicial issues.  They have learned to embrace democracy and decry the very real activism of the right.  Sessions and his ilk did not come off very well by comparison.

Economy

Sen. Carper Derails Tax Haven Crackdown By Proposing That Shell Companies Count As Real People

By Pat Garofalo on Jun 28, 2010 at 6:20 pm

Last year, Sens. Carl Levin (D-MI), Claire McCaskill (D-MO) and Chuck Grassley (R-IA) proposed legislation requiring states to collect information on those individuals forming corporations within their borders, in an effort to crack down tax avoidance and money laundering through fake companies. Currently, someone creating a corporation is required to give “less information to the State of incorporation than is needed to obtain a bank account or driver’s license and typically does not name a single beneficial owner.”

The Levin-McCaskill-Grassley bill was supposed to be marked up last week, but was derailed by Sen. Tom Carper (D-DE), who, according to Citizens for Tax Justice (CTJ), proposed changing the legislation to “allow the beneficial owner on record to be a shell company, rather than requiring it to be an actual human being.” This, for obvious reasons, would ruin the whole thing, if the point of the legislation is to prevent phantom companies from engaging in illegal activity. As CTJ explained:

Shell companies — as they are called because they don’t do any real business — are used for all kinds of illegal purposes, including laundering money from illegal activities and financing terrorists. They are also used extensively for tax evasion…Sen. Carper is obviously concerned about his state’s ability to maintain its status as the incorporation capital. But that can hardly take priority over addressing criminal activities and threats to national security. Let’s hope his colleagues on HSGAC are less myopic than he is.

The Tax Justice Network has actually named Delaware the world’s number one tax haven, ranking it ahead of familiar locales for hiding income like Switzerland and the Cayman Islands. As Levin has pointed out, the federal government uncovered “an individual who set up over 2,000 Delaware shell companies, opened bank accounts for those companies, and then moved $1.4 billion dollars through those bank accounts, all without revealing who was behind these transactions.”

In a different case, Immigration and Customs Enforcement “discovered a web of over 800 companies formed in all 50 states, all controlled by the same Panamanian entities.” The original company had been incorporated in, you guessed it, Delaware, and an investigation into the company’s suspicious wire transfers “hit a dead end when ICE was unable to discover who the beneficial owners of the corporations actually were.”

Obviously, privacy concerns shouldn’t be discounted here, but requiring that a company have one, real, actual person prove their existence before incorporation doesn’t seem like too much to ask. As the Government Accountability Office has found, as long as privacy concerns are balanced, “having more information would make using U.S. shell companies for illicit activities harder and give investigators more information to use in pursuing the actual owners.”

Climate Progress

Harry Reid calls the bluff of Climate Peacocks

By Climate Guest Blogger on Jun 28, 2010 at 6:17 pm

Climate peacocks like to preen and call attention to themselves with flashy moves — but they are not sincerely interested in taking the difficult but necessary steps toward reducing carbon pollution.  Wonk Room’s Brad Johnson has the story of this rara avis, which should be an endangered species, but, sadly, isn’t.

Read more

Politics

Montana GOP seeks to ‘keep homosexual acts illegal.’

By Igor Volsky on Jun 28, 2010 at 6:15 pm

MontanaGOPAndy Towle is reporting that like the Texas GOP, the Montana Republican Party has adopted a platform that would criminalize “homosexual acts”:

Homosexual Acts

We support the clear will of the people of Montana expressed by legislation to keep homosexual acts illegal.

Ironically, the platform uses some form of the word “constitutional” at least 10 times and even argues that constitutionality should be decided by the states. But the Montana Supreme Court struck down the State’s sodomy law in 1997 and ruled that it violated the constitutional right to privacy. In 2003, the U.S. Supreme Court found in Lawrence v. Texas that Texas’ “Homosexual Conduct” law — a measure outlawing oral and anal sex — unconstitutional. The Court ruled that the Texas statute “making it a crime for two persons of the same sex to engage in certain intimate sexual conduct violates the Due Process Clause.” “The liberty protected by the Constitution allows homosexual persons the right to choose to enter upon relationships in the confines of their homes and their own private lives and still retain their dignity as free persons,” the Court ruled in a 6-3 ruling.

Health

Federal Government Prepares To Implement First Real Benefits From Health Reform

By Igor Volsky on Jun 28, 2010 at 5:30 pm

The federal government will unveil the first real benefits from the health care reform law this week, as states begin enrolling sicker individuals into health insurance policies and the federal government rolls out a new web portal designed to help Americans compare and purchase insurance products.

In at least 20 states, uninsured individuals with pre-existing conditions who have been without coverage for six months will be able to enroll in the new pools starting Thursday, but coverage will not begin until sometime in August. Under the new regulations, high-risk insurance pools will not be able to impose preexisting condition exclusions, will have to keep their premiums at “standard rates” (or no higher than the average person of that age would pay for insurance in the private market), limit on out-of-pocket medical costs to $5,950 a year for an individual, and maintain an actuarial value of at least 65%. Issuers will also be prohibited from varying premiums on the basis of age by a factor greater than 4 to 1.

According to Politico’s The Pulse, NASCHIP, a trade organization of high risk pools, is negotiating between the states and the federal government, pressing HHS for a “fair contract in terms of protecting states so that when they enter into this agreement, they’re not exposing themselves in terms of financial or legal liabilities,” and clarifying that states do not have “a financial commitment to run the pool if HHS funds run out.” The health care law gives states $5 billion establish the pools as an interim measure to provide coverage for Americans with pre-existing conditions until the exchanges become operational in 2014. Thirty states have announced that they will be administrating their own pools, but only 20 have submitted proposals to do so. The federal government will administer pools “through a private nonprofit entity” in the 19 states that have decided against implementing the measure.

On Thursday, HHS is also scheduled to unveil it’s new insurance portal, HealthCare.gov. The new website that will allow individuals and small businesses to comparison shop between different coverage options, “including private insurance plans, high risk pools, CHIP and Medicaid.” Initially the site will only list the different insurance plans, but will eventually expand to include information about pricing and quality measures.

Yglesias

Steven Aftergood vs Wikileaks

By Matthew Yglesias on Jun 28, 2010 at 5:29 pm

Steven Aftergood, a veteran crusader against excessive government secrecy at the Federation of American Scientists, has unleashed a merciless critique of Wikileaks and its methods whose ferocity has really left me taken aback.

I think Aftergood makes a number of solid critiques of Wikileaks, most notably the point that there’s little value in invading the privacy of private associations and that indeed such activities do more to undermine liberal ideals than to promote them. It’s also definitely true that Wikileaks’ methods are quite different from journalistic methods, and also that there are some downsides to that approach. On the other hand, there are also some upsides.

All in all, I’m left with a sense of massive disproportion between the individual points Aftergood makes and his overall scornful attitude. It’s often the case that when you have organizations working in a similar space with similar goals that they disagree—at times strongly—about the best way to proceed. To my way of thinking, the most reasonable thing to conclude is that it’s a good thing that not everyone is doing the same thing. The world needs a diversity of approaches, not excommunications over relatively minor differences.

Politics

Defense Department unveils $50,000 portrait of Donald Rumsfeld.

By Amanda Terkel on Jun 28, 2010 at 5:20 pm

On Friday, Donald Rumsfeld was back at the Pentagon for the unveiling of his official portrait in a ceremony hosted by Defense Secretary Robert Gates. The painting “shows Rumsfeld at his stand-up desk with a picture of first-responders and soldiers unfurling the flag over the still-burning Pentagon on Sept. 12, 2001.” It will hang in the Pentagon along with his other portrait, commemorating when he served as defense secretary from 1975 to 1977. As the Washington Post reported in 2008, this new portrait of Rumsfeld cost nearly $50,000:

The price of original portraiture ranges widely. In a sampling, The Washington Post examined summaries of 30 portrait contracts, most awarded with no competitive bidding, and found costs ranging from $7,500 to nearly $50,000. Officials say costs sometimes run higher.

At the upper end of the scale, the Defense Department awaits the expected February completion of a $46,790 portrait of controversial former secretary Donald H. Rumsfeld. It will grace a Pentagon hallway lined with portraits of his predecessors, as well as one from Rumsfeld’s first stint as defense secretary from 1975 to 1977, officials said.

ThinkProgress contacted Rumsfeld spokesperson Keith Urbahn, who noted that the former secretary paid for the cost of the portrait himself. One of the “treats” at Friday’s event was sugar cookies shaped like snowflakes.

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