Some Context

As we think about the potential costs if various reform plans; from the Washington Post's not terrible 8 Questions about Health care Reform.

Legalized Bribery?

Or something else? From FAIR:

As powerful lawmakers debate healthcare legislation of enormous potential impact, corporate media have largely failed to explore the problem of health and insurance industries attempting to influence many of these legislators with a flood of campaign contributions.

Despite Deep Throat’s urging journalists to “follow the money,” there’s a longstanding media taboo against discussing the role of campaign contributions in healthcare initiatives (Extra!, 1–2/04). This reluctance is particularly striking this year, when health industry spending on lobbying efforts and political contributions is unprecedented.

In what the Washington Post (7/6/09) referred to as “a record-breaking influence campaign by the healthcare industry,” $1.4 million is spent on lobbying every day. According to the Center for Responsive Politics, lobbying expenditures for all health and insurance sectors total $263 million so far this year, while those sectors have directly donated more than $23 million to federal lawmakers.

Some of the greatest beneficiaries of these donations also happen to be pivotal arbiters in the shaping of healthcare legislation. Yet corporate media have rarely raised the issue of these lawmakers’ potential conflicts of interest.

. . . . . .

Baucus has received nearly $3.4 million in campaign contributions from health and insurance industries since 2003—more than any other member of Congress. These donations represent about 23 percent of Baucus’ total fundraising (including from his PAC) during that time. This includes “$853,000 from pharmaceutical and health products, $851,000 from health professionals, $467,000 from hospitals and nursing homes, $466,000 from health service and HMO interests, and $784,000 from insurance” (Montana Standard, 6/14/09). Baucus also ranks fourth all-time in financial contributions from pharmaceutical companies (Capital Eye, 6/25/09). A Nexis search for “Max Baucus” among the seven outlets in the survey found mentions in over 100 healthcare-related stories from June 1–September 1, 2009, but Baucus’ financial ties to the healthcare industry came up only six times (Washington Post, 7/6/09, 7/21/09, 7/25/09; New York Times, 6/24/09, 8/19/09; ABC World News, 8/14/09).

Only two of these reports noted that Baucus continued to collect campaign donations from health and insurance industries even as he chaired the Finance Committee’s work on a healthcare reform bill. The July 21 Washington Post noted: “Top health executives and lobbyists continued to flock to the senator’s often extravagant fundraising events in recent months.” Aides to Baucus told the Post that he had refused donations from healthcare PACs after June 1. “But the policy does not apply to lobbyists or corporate executives, who continued to make donations.” The New York Times (6/24/09) reported that Baucus’ fundraising after June 1 also included “industry interests” like “drug companies and insurers.”

More often, though, news accounts portrayed Baucus’ industry-friendly approach to the healthcare issue—including his dismissal of a single-payer approach and his opposition to a public option—as a reflection of his “more cautious approach” (New York Times, 6/16/09), his “long history of collaborating with Republicans” (New York Times, 7/23/09) or his “pursuit of a centrist compromise” (New York Times, 6/8/09). Or he was portrayed as simply bowing to political reality (Washington Post, 8/7/09). . . . .

Read the rest here.

For the Lazy

Comparing Health Reform bills: here, here, here, and here. UPDATE: See also this. And, again, there's always the CBPP and Ezra. UPDATE II: CBO estimates, HR 3962, Baucus bill, Kennedy/HELP bill. See also, more generally, the CBO here. UPDATE III: To clarify, reports are that there will be a CBO estimate of the unified/merged Senate bill soon, but likely too late for it to be of any use for our discussion.

ADDING: Ezra Klein makes the case that a poor bill is better than no bill -- camel's nose/thin end of the wedge and all that, mostly.

Aaron Burr's Lost Hamilton Rap is Found, Finally

New Study

Familiar findings.

Estimating the Risk of Food Stamp Use and Impoverishment During Childhood

Mark R. Rank, PhD; Thomas A. Hirschl, PhD

Arch Pediatr Adolesc Med. 2009;163(11):994-999.

ABSTRACT

Objective To estimate the lifetime risk that an American child will reside in a household receiving food stamps and, as a result, will encounter poverty and a heightened exposure to food insecurity.

Design Thirty years of longitudinal data from the Panel Study of Income Dynamics survey data set.

Setting Nationally representative sample of the US population.

Participants Approximately 90 000 childhood years of information are pooled together to create a series of life tables that span the ages of 1 to 20 years.

Main Outcome Measure Self-reporting measure of whether survey households received the Food Stamp Program during the prior year.

Results Between the ages of 1 to 20 years, nearly half (49.2%) of all American children will, at some point, reside in a household that receives food stamps. Households in need of the program use it for relatively short periods but are also likely to return to the program at several points during the childhood years. Race, parental education, and head of household's marital status exert a strong influence on the proportion of children residing in a food stamp household.

Conclusions American children are at a high risk of encountering a spell during which their families are in poverty and food insecure as indicated through their use of food stamps. Such events have the potential to seriously jeopardize a child's overall health.

UPDATE: Nice new succinct precis on the Food Stamp (now SNAP) program from CBPP.

The Opt-Out

A Panoply of Policy Papers

Well, actually, they're books reviews (but I seemed to need the alliteration today -- dreary out). All are from the most recent NYRB, and all are worth your attention (the first two, especially). The subjects:

• Criminal Justice
• Education
• Climate Change

And then, as a reward, read this lovely essay on Dorothea Lange.

Some Health Care Links

For useful background as we approach the finish line??

FRONTLINE: Sick Around the World (a TV documentary highlighting the comparison between the US and other nations' approached to health care)

NRP: Interview with T.R. Reid, "Looking Overseas for the Healing of America"

Washington Post, T.R. Reid, "5 Myths About Health Care Around the World"

For ongoing analysis as bills move through Congress, see Ezra Klein, Kaiser Health News and CBPP.

Finally, The Commonwealth Fund compares the two current bills (click on "Interactive Features" for a nifty comparison tool. Yes, I said nifty. Sue me.)

Energy Information Resources

Public Agenda provides a list.

Ezra Sums Up

On Healthcare:

Among the many implicit precepts directing health-care reform are the following:

(1) The employer-based system doesn't work, either to assure coverage or control cost.

(2) The employer-based system must be preserved.

(3) A strong public option would offer consumers lower premiums and attract a lot of customers.

(4) A strong public option cannot be included because private insurers cannot effectively compete with it.

(5) Among the worst economic distortions of the system is the fact that employers choose insurance for their employees, and thus employees don't really understand the cost of coverage.

(6) The exchange cannot initially be open to employees, and may never be opened to employees, because they might leave employer-based insurance in order to shop for their own policies more aggressively.

You can go on in this vein, of course. It's a bit of a problem.

Do You Miss the Society for Inoculating the Poor Gratis?

Andrew Wehrman in the Boston Globe:

Watching the current debate in Washington, it’s tempting to think of health care reform as something radical and new - an issue that could force a profound shift in national identity. But America has been through this already. More than 200 years prior to this year’s push for a new national health policy, Americans were already becoming incensed about how they paid for health care, and who got access to it.

Health care in Colonial America looked nothing like what we’d consider medicine today, but the debates it triggered were similar. The danger of smallpox and the high cost of its prevention led to divisive questions about who should pay, whether everyone deserved equal access, and if responsibility lay at the feet of the individual, the state, or the nation. Epidemics forced the early republic to wrestle with the question of the federal government’s proper role in regulating the nation’s health.

Colonial leaders and ordinary people alike possessed a similar sense that a proper solution to these issues would determine the brightness and shape of America’s future. At times conflicts over public health threatened the social and political fabric of communities. Did these rowdy Colonials, with the aid of the Founding Fathers, solve these dilemmas? Hardly. But their observations, questions, and compromises offer a useful lesson for what we can expect as we find ourselves again with health care in the forefront of the national conversation.

The rest here.

Broadway to Washington Square

From the NYT:

Ms. White never mentioned to the others who slept in the park that she had been nominated for a Tony award when she performed, alongside Glenn Close, in “Barnum,” in 1980; nor did she ask about their pasts. Severely depressed, she was too proud to reach out to social services, and kept the extent of her problems from friends. “Most of them are barely getting by in their tiny apartments as it is,” she said. “People in New York, they need their patterns. You can’t interrupt them.”

To avoid the police, Ms. White usually alternated sleeping for an hour with walking for an hour, which is what she was doing when she ran into Officer David Taylor on Grove Street at 4 a.m. one day last fall. Officer Taylor had come to know Ms. White when he was patrolling the West Village. He admired her energy, and, off-duty, came to see her perform. He had never seen her looking like she did on Grove Street. “She is usually someone who lifts your energy if you’re feeling down,” he said. “That night she looked soulless. I was concerned for her — scared.”

Read the rest.

For Our Discussion Today

"Some Will Have to Die"

Changing the Subject

"From Welfare to Poverty to a Living Income," by Peter Edelman. h/t Poverty Law Blog

Shrewd Politics Meets Sound Policy?

". . . .Pelosi wants to back the so-called fiscally responsible Blue Dogs into a corner by giving them a bill that the CBO scores well and includes a robust public option as well as bills with a trigger or a weak public option that score worse, so that to reject it, they would have to actually accept a larger price tag. . . ."

"NO! Why Would You Leave it There?! There is a Terrible Place to Leave It!"

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
CNN Leaves It There
www.thedailyshow.com
Daily Show Full Episodes Political Humor Ron Paul Interview

Faces of Poverty

Poor in NYC

A summary of new data:

The Bronx remained the country’s poorest urban county; the income gap in Manhattan was still higher than in any other county; and the poverty rate in Connecticut rose faster than in any other state.

And the relatively positive part of the local economic picture was tempered by the fact that the latest census figures from the rolling American Community Survey captured only the start of the recession.

In New York City, the poverty rate in 2008 was 18.2 percent — the lowest this decade — compared with 18.5 percent in 2007. Median household income was unchanged, at $51,116, but median family income rose to $56,552 from $54,846.

Those figures masked vast disparities, though, based on race, ethnicity and geography.

In the Bronx, the median household income was $35,033, and nearly 28 percent of the borough’s residents — and 47 percent of its households headed by women with children — were living in poverty.

Citywide, the poverty rate for racial and ethnic groups stayed relatively unchanged in 2008 compared with the previous year: 11 percent for non-Hispanic whites, 17 percent for Asians, 21 percent for blacks and 26 percent for Hispanics.

The proportion of people receiving food stamps increased in New York State by about a percentage point, to 10.6 percent.

Not Left or Right

But inside vs. outside?

UPDATE: Nate Silver sort of weighs in. UPDATE II: James Poulos responds to Nate.