31 January 2007
And here is another installment of when smart institutions do stupid things. From the Washington Monthly comes the sordid tale of how the Bush White House got the American Psychological Association to abet torture of prisoners.
At around six-foot-eight and clad in combat fatigues, Kevin Kiley, the army surgeon general, cut an imposing figure. It was August 2006, and Kiley was in New Orleans to address the governing council of the American Psychological Association (APA) on the subject of psychology in the war on terror. For over a year, the organization had been under fire from human-rights groups and many of its own members, because psychologists had been tied to coercive interrogations and abuse at Guantanamo Bay and other places. Now, many APA members wanted the organization to draw up a firm policy—one that mandated adherence to international standards barring abuse—to prevent psychologists from participating in such practices again.
It was Kiley's job to convince them not to bail out on interrogations. It's an open question how much psychologists have contributed to the art of interrogation in the war on terror, but the APA provides a seal of legitimacy that the government values. If it joined the American Medical Association (AMA) and the American Psychiatric Association by barring their members from joining the Guantanamo interrogations, it would further stigmatize the military's practices. So, armed with PowerPoint slides, Kiley argued for keeping psychologists on the offensive against "sworn enemies" of the country. "Psychology is an important weapons system," he explained. For the APA to draw up an explicit definition of abuse would be counterproductive. After all, "is four hours of sleep deprivation? How loud does a scream have to be? How many angels can dance on the head of a pin?"
Kiley had the blessing of the organization's leadership. Despite the controversial nature of the topic in question, APA leaders had originally invited no other speakers to counterbalance Kiley with an opposing view. When this fact was reported by Salon, the group hastily issued a last-minute invitation to Steven Reisner, a New York psychoanalyst who had circulated an online petition protesting APA's involvement in interrogations. Reisner was visiting his parents in Florida when the call from APA came, and he arrived in New Orleans in an ill-fitting off-the-rack suit and without a formal speech.
Reisner made his pitch nonetheless. ("The Hippocratic oath says 'do no harm.' It does not say 'measure harm and see if it is the correct amount,'" he reminded the crowd.) But, having had almost no time to prepare, he was no match for Kiley's slick presentation and call-to-arms rhetoric. Ultimately, APA's governing council passed a blandly worded resolution that, most critically, left the definition of the phrase "cruel, inhumane, and degrading treatment" up to current government interpretations.
Yet again, the official bamboozlement of the ostensibly smart audience happens thanks in no small measure to a set of PowerPoint slides. Why does no one listen to Edward Tufte and his clarion call to consign PowerPoint, at least as popularly used, to the remainder bin of history? It is easier, I suspect, even for those who ought to know better, to obey than to dissent.
Pro Bono Nostrum
Back in August 2004, I wondered whether notedly Republican attorney Benjamin L. Ginsberg knew what he was doing when he mused about doing his legal work for the Swift Boat Veterans for Truth pro bono.
Mr. Ginsberg said that he had yet to work out payment details with the group and that he might consider doing the work pro bono.
Well, even before the election was over, the idea that Patton Boggs LLP was doing the work pro bono seemed to evaporate. And the payment details must have gotten themselves worked out, because there were soon to be a lot of them. Indeed, through the end of 2006, the Swift Boat Veterans and POWs for Truth spent over $500,000 in legal and consulting fees to Ginsberg's firm.
- 1 October 2004: $9,659
- 10 November 2004: $31,153
- 23 December 2004: $25,626
- 23 February 2005: $1,971
- 18 April 2005: $1,037
- 9 May 2005: $12,325
- 10 June 2005: $20,476
- 2 July 2005: $11,741
- 23 August 2005: $11,274
- 4 January 2006: $17,367
- 8 February 2006: $65,484
- 22 March 2006: $30,844
- 5 April 2006: $74,431
- 7 May 2006: $44,202
- 18 July 2006: $17,378
- 20 July 2006: $68,376
- 16 October 2006: $21,709
- 30 November 2006: $46,485
I ought to point out that a lot of the expenditures in 2005 and 2006 were related to the Swift Boaters fighting allegations of coordinated campaign activities in 2004. But I would think that supporting the right of a 527 organization to do its own thing ought to have been a good use for all of that pro bono energy.
Don't worry; it's not the end of the world or anything. Just ignore what the pink business paper from England says and just do whatever the Wall Street Journal editorial board says to. Remember that burning more coal means a better, stronger America.
The Bush administration has routinely suppressed or distorted communication of climate change science to the public, a climate specialist at Nasa's Goddard Institute said on Tuesday.
The accusation, before the chief oversight committee in the House of Representatives, was reinforced by claims by Democratic lawmakers that the White House was withholding documents proving that Philip Cooney, a former Bush administration official who now works as a lobbyist for ExxonMobil, regularly edited climate reports for political reasons....
In one instance of political interference described by Drew Shindell, the Nasa specialist, a press release he drafted in 2004 about future warming in Antarctica was "repeatedly delayed, altered and watered down" by Nasa headquarters. After being told to soften the title of the proposed press release, officials altered the title of the document from "Cool Antarctica may warm rapidly this century" to "Scientists predict Antarctica climate changes".
30 January 2007
Taking Care of Business
Now that Maria Bartiromo is the subject of widespread gossip about he relationship with former Citigroup executive Todd Thomson, what are her and her layers up to?
Trademarking the phrase "Money Honey," of course. (See trademark applications 77083967, 77093972, 77083986, 77093987, 77083992, 77083997, 77084001, and 77084008, at the trademark search for the United States Patent and Trademark Office.
Prerecorded video tapes, audio tapes, compact discs, CD-ROMs, DVDs, and floppy discs featuring entertainment and educational programming for children; computer and video game software, downloadable computer and video game software, computer and video game cartridges, computer and video game programs, educational computer software for children, decorative magnets, calculators, computer game discs, electronic game software for handheld electronic devices, adding machines, coin counting or sorting machines and mouse pads
Children's educational and activity books, storybooks and workbooks, coloring books, comic books, diaries, calendars, bookmarks, posters, trading cards, book covers, decalcomania, stickers; stationery, memo pads, greeting cards, notebooks, notepads, ring binders, folders, pen and pencil cases, rulers, pencils, pens, pencil sharpeners, markers, rubber stamps, children's paper placemats, lunch bags, gift wrapping paper, crayons, decorations for pencils, extensions and attachments for pencils, erasers, desktop organizers, coin albums, coupon books, and flash cards
Backpacks, book bags, school bags, school backpacks, tote bags, handbags, shoulder bags, travel bags, purses, coin purses, duffel bags, waist packs, and wallets
Beverage glasses, plates, bowls, cups, mugs, meal trays, nonmetal coin banks, nonmetal piggy banks, wastepaper baskets, lunch boxes, lunch pails, thermal insulated lunch containers, thermal insulated beverage containers, beverage squeeze bottles sold empty, paper cups, paper plates, plastic cups, plastic plates, cookie jars, handheld portable dispensers for candy, canister sets, thermal insulated tote bags and containers for food or beverages, and non-metal decorative boxes
T-shirts, jackets, hats, baseball caps, headbands, and visors
Games and toys, namely stuffed animals, hand-held unit for playing electronic games, electronic educational game machines for children, dolls, doll accessories, toy action figures and accessories therefore, collectible toy figures, toy building blocks, toy banks, toy mobiles, board games, card games, jigsaw puzzles, manipulative puzzles, toy cube puzzles, children's multiple activity toys and tables, children's multiple activity toys sold as a unit with printed books, electronic learning toys, hand held unit for playing electronic games, play money, talking toys, toy banks, and toy cash registers
Providing online chat rooms and electronic bulletin boards for the transmission of messages among users in the fields of children's education and entertainment
Entertainment services, namely, an ongoing children's television series; motion picture films; theatrical programs; fan club services; online entertainment services, namely information, interactive games, and quizzes based on a children's television series; website featuring information, interactive games, and quizzes based on a children's television series
Do you think that perhaps Maria Bartiromo is somehow expecting to have a whole lot of free time on her hands? If so, expect the onslaught of the wrapping paper, PEZ dispensers, and children's chat rooms of CNBC-pimped capitalism!
28 January 2007
You do not need to have a friend who works at Public Library of Science (as I do), or to have had a link to there on your weblog (as I have, since practically its inception) to realize that Some people are feeling very threatened.
Now, Nature has learned, a group of big scientific publishers has hired [public relations] pit bull [Eric Dezenhall] to take on the free-information movement, which campaigns for scientific results to be made freely available. Some traditional journals, which depend on subscription charges, say that open-access journals and public databases of scientific papers such as the National Institutes of Health's (NIH's) PubMed Central, threaten their livelihoods.
From e-mails passed to Nature, it seems Dezenhall spoke to employees from Elsevier, Wiley and the American Chemical Society at a meeting arranged last July by the Association of American Publishers (AAP). A follow-up message in which Dezenhall suggests a strategy for the publishers provides some insight into the approach they are considering taking.
The consultant advised them to focus on simple messages, such as "Public access equals government censorship". He hinted that the publishers should attempt to equate traditional publishing models with peer review, and "paint a picture of what the world would look like without peer-reviewed articles".
Dezenhall also recommended joining forces with groups that may be ideologically opposed to government-mandated projects such as PubMed Central, including organizations that have angered scientists. One suggestion was the Competitive Enterprise Institute, a conservative think-tank based in Washington DC, which has used oil-industry money to promote sceptical views on climate change. Dezenhall estimated his fee for the campaign at $300,000–500,000.
Indeed, the notion that anyone might have found a way to do something that does not include making someone a big profit is very distressing to those accustomed to those profits. (In this case, the scientific publishers are very, very used to forcing libraries to pay exorbitant subscription fees for their publications. And PubMed Central and the Public Library of Science have shown that there are much cheaper ways of publishing top-flight journals.)
What the Zell Is He Thinking?
Talking Points Memo points out that Joe Lieberman is hinting that he might vote Christian Reconstructionist in 2008.
The two milestones left before he speaks at the 2008 Republican National Convention? Being declared "George Bush's Favorite Democrat," and writing a book slamming his party.
24 January 2007
Not So True Believers
Atrios asks a pertinent question, but not of the right people:
Wonder what kind of health plan Brit Hume has? Or the people at Cato?
...regarding Cato, I've been informed they have plans with high deductibles and HSAs. True believers, apparently. Good for them.
I think that the real question is what kind of health plan George Bush and Dick Cheney have.
George and Laura Bush did not have high deductible plans and HSAs until 2005—only his 2005 tax return has the associated adjustment to income, unlike their 2004 tax return. Dick and Lynne Cheney, on the other hand, through 2005 did not have HSAs through 2005. I would think that if George Bush was a true believer, then by the time of his August 2004 paean for "consumer-driven" health care, he and Cheney would certainly have been on board.
(This reminds me: for all of the disparagement that Republicans have made about public financing of primary and general elections, why do Dick and Lynne Cheney keep allocating $6 of their income tax toward the election fund?)
22 January 2007
Could It Be?
Could it be true that the Boston Globe op-ed page finally has some standards? We won't be seeing faux feminist-libertarian-moderate Cathy Young's byline regularly anymore. (By faux feminist, I mean someone who regularly champions "fathers' rights." By faux libertariam, I mean someone yet to really decry a war that has cost over a trillion dollars. And by faux moderate, I mean someone expert in the art of setting straw men to one's right and left to show how wonderfully sensible their own rightist views are.)
All imputed praise on the Globe's editorial staff requires tempering, of course, if Young left on her own volition.
19 January 2007
The Welch Way
There was a time, not so long ago, when Business Week was a really useful magazine. Not quite as useful as the pink newspaper of business, the Financial Times, but useful enough.
Not so long ago, it did not have a weekly wine column. Not so long ago, it had a great reporter, Aaron Bernstein, who was smart and incisive about labor and business. And, not so long ago, it was a thorn in Jack Welch's overly padded wallet.
Today, though, Jack and Suzy Welch have a column at the back of the magazine. But, thanks to some aggressive promotion by the Business Week circulation department—72 cents an issue cannot possibly make McGraw-Hill any money—it will be worth it to fact-check the Welches every week.
Yes, we will read the Welches' column so you won't have to.
In the current issue, we have a question about hiring, I mean firing, from Chile.
How fast should you move when you sense you've made a hiring mistake? — M— F—, Santiago, Chile
In a word, very. So fast, in fact, that if you're moving at the right speed in taking care of a hiring mistake, it will probably feel too fast. That's O.K. In every case, a rapid intervention is better for the organization, your own career, and even the person you're letting go.
Look, hiring great people is brutally hard. New managers are lucky to get it right half the time. And even executives with decades of experience will tell you that they make the right calls 75% of the time at best.
The problem is, the stakes are so high. Never has it been so important to field a team with the best players. Every smart idea matters. Every ounce of passion makes a difference. You cannot have a black hole in your organization where a star should be.
So that's the first reason you need to face up to hiring mistakes quickly. Sure, maybe one individual's poor performance won't sink the company. But when your "mistakes" aren't doing their jobs, it invariably puts a strain on the whole team and makes work harder for everyone else. So resentment toward the underperformers—and toward you for hiring them—builds up.
The Welches go on to recommend being candid and fair, both in terms of process and remuneration, with the unfortunate underling. And they also recommend being more careful with hiring in the first place. While this is hardly the stuff of post-capitalist syndicalism, it is decent enough, especially coming from a business magazine.
Alas, it makes no sense to the committed Jack and Suzy acolyte. Here is a particularly similar question, only more particular, from only a few months ago.
Forgetting politics, how long would you continue to employ Defense Secretary Donald Rumsfeld? He appears to have done a poor job planning and executing the war, and he has evidently lost the respect of the people who work for him. How do you look at this from a management perspective? — J— M—, Las Vegas
You can't forget politics in this case because Cabinet appointments are all about politics. In fact, you can't really evaluate this situation from a strict management perspective, although it's perfectly natural for a businessperson to want to do that. Government is not business, especially when it comes to dealing with performance issues.
To understand what we mean, consider the recent spate of high-profile corporate departures. Bill Ford basically fired himself as CEO, stepping down from the family company he had run for five years. After more than two decades of close collaboration, Sumner Redstone asked Tom Freston, CEO of Viacom to move on. And in an opposite scenario, Dave Calhoun, a vice-chairman at GE, was lured to the private-equity world with an offer to run the privately held Dutch company VNU Group.
All three of these departures caused reactions from surprise to disappointment—Freston's was particularly unexpected —but otherwise occurred without incident. The transitions were swift and smooth. Ford, who will stay involved as chairman, announced his resignation as CEO at the same time he named his successor, Boeing executive Alan Mulally. Freston was immediately replaced by a longtime Redstone adviser, Philippe Dauman, and within days was given a splashy send-off. Calhoun's job was filled instantly by another strong GE executive, John Rice.
Now imagine what would happen if President Bush accepted the resignation letter Rumsfeld says he has tendered several times. Forget swift and smooth. All partisan hell would break loose, culminating in the confirmation hearings for Bush's nominee. Without a doubt, Bush would nominate someone closely aligned with his mission. So those hearings would surely last months, with both Republicans and Democrats using them as a big fat media opportunity to conduct a kangaroo trial of not just U.S. policy in Afghanistan and Iraq but also the entire Bush Presidency. Who would run the war during this political slugfest? Everyone—and no one. What a dangerous mess.
Business can be political, of course, but in a company setting, letting people go doesn't present the same kind of peril or complexity. Indeed, as the departures mentioned above show, top managers can leave with a minimum of upheaval, especially when successors are put in place immediately. That keeps the machine running and shouts out the all-important message that no individual is indispensable or bigger than the organization. In the best-case scenario, jobs should be filled within eight hours.
Almost nothing in government happens in eight hours. So forget looking at the Rumsfeld situation from a management perspective. It can only be seen through a political filter.
George Bush announced Donald Rumsfeld's resignation on 7 November 2006. The resignation took effect when a replacement was confirmed (so the "who would run the war" question was moot not only because the generals run the war, but also because Rumsfeld was still around. On 6 December, 29 days later, the Senate confirmed Robert Gates by a 95-2 margin. Now that's predictive inaccuracy of Falstaffian proportions.
The bigger problem with the Welches' reply to the question on Rumsfeld is that running the federal government ought to be considered a more important thing than running any one business. The "peril or complexity" of letting cabinet members go has a flip side, the peril of having the wrong people in the job in the first place.
In addition, while the examples that the Welches give about recent turnover in executive suites underscore the fact that top managers leave companies all the time, they ignore an interesting parallel. Top managers in the government leave all the time as well. Many presidents leave after only 4 years in office; the most successful have only 8 years to do their jobs. A huge number of cabinet officials over the past two centuries have left before their presidents have finished their terms. Just like most businesses, the federal government has both the institutional capacity and the institutional history to handle change.
18 January 2007
Ad Execs Think We're Idiots, Part XCVIII
What was Nissan thinking? It must have sounded cool to have a heavy metal song behind a commercial for its Titan pickup truck. But perhaps this particular Black Sabbath song does not inspire confidence that the truck will always, shall we say, do the right thing.
Now the time is here
For iron man to spread fear
Vengeance from the grave
Kills the people he once saved
Nobody wants him
They just turn their heads
Nobody helps him
Now he has his revenge
Heavy boots of lead
Fills his victims full of dread
Running as fast as they can
Iron man lives again!
Yes, that is exactly the image that the manufacturer wants associated with their product—treat it badly and it will come back to kill you.
of the Huffington Post points out what my inaction kept me from doing. In the debate about global warming and climate change, what is the easiest way to make a right-wing argument look sensible? Set up straw-man arguments one either side, and, voilá
, you are a "moderate."
In the Boston Globe, Cathy Young—a contributing editor at Reason magazine, funded by the libertarian Reason Foundation— ... [writes] a state-of-the-art piece of agit-prop. She says global warming skeptics are always getting yelled at, so why is no one yelling at the dirty hippies, for whom "environmentalism has become a matter of not just ideology but quasi-religious zealotry"?
This is a classic of the genre, lifted straight from template. Note carefully what's happening: The denialists have been discredited. Now, the right wing is eager to cast the debate as having two equivalent sides, "alarmists and deniers." That way they use the marginalization of denialists to marginalize advocates. It's really a clever piece of judo, one the right's become incredibly adept at using.
It relies, of course, on everyone accepting that there are "two sides." That way, having given up the ghost of denialism, the right can now turn to advocating weak, industry-friendly policies and calling them the "sensible middle."
It's bullshit. Once more for the cheap seats: there is no equivalence between denialists and global warming activists. None. Their motives are not the same. They do not have equal credibility or deserve equal respect. They are not "two sides" of anything. There are people within the reality-based community who disagree with one another over the proper way to communicate about climate change and the proper way to respond to it. But those internal disagreements are microscopic compared to the disagreement between denialists and reality.
It should come as no surprise to anyone who reads the Globe op-ed page that for faux-libertarian posturing, disingenuous arguments, and a healthy dose of corrections, Cathy Young's regular column is a great place to start. Take a recent column by Young in the Globe. She loved the Euston manifesto because it took a moderate position on American foreign policy. "Moderate" here means "strongly condemn[ing] human rights abuses toward detained terror suspects in United States custody, but just as strongly reject[ing] the mentality that views the United States as the chief perpetrator of human rights abuses in the world today."
Of course, being "moderate" means claiming that Martin Peretz is a "liberal" and that the Progressive Policy Institute, an arm of the conservative Democratic Leadership Council, is "liberal" as well. It is not bad to have a libertarian writing for a major metropolitan newspaper. But can the Boston Globe not find a better one?
16 January 2007
Anti-War Before It Was Cool
Kevin Drum asks why anti-war liberals were against the Iraq war ahead of time. Frankly, there were a lot of reasons, but they all had to do with the glaring disconnection between the supposed need for war and the actual need for war.
In September 2002, thirty-three prominent international relations scholars paid for an advertisement on the op-ed page of the New York Times. Let us revisit their reasons for not invading Iraq.
[M]ilitary force should be used only when it advances U.S. national interests. War with Iraq does not meet this standard.
- Saddam Hussein is a murderous despot, but no one has provided credible evidence that Iraq is cooperating with al Qaeda.
- Even if Saddam Hussein acquired nuclear weapons, he could not use them without suffering massive U.S. or Israeli retaliation.
- The first Bush administration did not try to conquer Iraq in 1991 because it understood that doing so could spread instability in the Middle East, threatening U.S. interests. This remains a valid concern today.
- The United States would win a war against Iraq, but Iraq has military options—chemical and biological weapons, urban combat—that might impose significant costs on the invading forces and neighboring states.
- Even if we win easily, we have no plausible exit strategy. Iraq is a deeply divided society that the United States would have to occupy and police for many years to create a viable state.
- Al Qaeda poses a greater threat to the U.S. than does Iraq. War with Iraq will jeopardize the campaign against al Qaeda by diverting resources and attention from that campaign and by increasing anti-Americanism around the globe.
The United States should maintain vigilant containment of IraqÂ?using its own assets and the resources of the United Nations—and be prepared to invade Iraq if it threatens to attack America or its allies. That is not the case today. We should concentrate instead on defeating al Qaeda.
Except for the cautionary statement about Iraq's military options—Iraq's chemical and biological capability was nil and its capacity for coordinated urban combat was minimal—these cautions were really quite prescient. Saddam Hussein had no alliance with al Qaeda. Iraq had no nuclear weapons, and was not close to obtaining them. Invading Iraq has indeed adding to instability in the Middle East.
The scholars saved the best observations for last. The United States has absolutely no exit strategy and Iraq is mired in a civil war that shows no sign of ending. And, indeed, concentrating on Iraq allowed al-Qaeda to regain its strength in Afghanistan and build bridges, where none previously existed, to militias in Iraq.
After they proved to be quite prescient about the war, one might expect that these scholars might be in high demand by the Sunday talk shows, by newspaper op-ed pages, or even by bloggers. No, the "liberal hawks," the ones who bought into war fever in the first place, are the ones who still garner the attention.
02 January 2007
More Bad News, and Perhaps More Good News
The Massachusetts legislature indeed reconsidered the vote to allow the amendment banning same-sex marriage to proceed, but on the second vote, 62 voted aye and 136 nay, so the amendment, which needed 50 votes to proceed, goes to a similar convention sometime in the next two years. That is the first piece of bad news.
The second piece of bad news was the way that Senate President Robert Travaglini handled the joint session. Not only did he introduce the measure for a vote without any debate, but he managed to avoid a vote on a health care amendment that was also on the calendar. When the Supreme Judicial Court ruled last week that the legislature must vote on the proposed amendments before it, legislators, who had already acted to kill both amendments through postponement, faced a dilemma. Should they let the amendments die by defying the court order, or should they vote on the amendments anyway, perhaps leaving the decisions to the voters?
Travaglini essentially squirmed out of the dilemma by obeying the court order on the issue that was the favorite of the right wing, gay marriage, but flouting the court order on the issue that the left wing had been very quiet about, universal health care. His maneuver represented political chicanery at its worst.
There is still some good news here. The first piece of good news is that several of the 62 aye votes in favor of the amendment come from legislators who are in, literally, their final hours in office, so anti-amendment forces will grow in the next session. (When the roll call is available, I can be more specific.)
The second piece of good news is a conditional one. If the Green-Rainbow Party ever needed an easy issue to campaign on, same-sex marriage is it. In the 2006 elections, this supposedly grassroots party managed to contest exactly one out of 200 seats in the legislature. A truly grassroots party would contest those 62 seats, whether the incumbents be Democratic or Republican, and it would especially contest Travaglini's seat—Travaglini who took neither the courageous action nor the law-fearing action.
I suspect, though, that the party will yet again have almost no activity in the legislative elections. In 2006, for example, the party's committees spent much time helping to kill the ballot question that would allow fusion voting, and very little time getting anyone to run for legislative office. When your state website trumpets the campaings of six candidates, and one is running for Selectman in Belchewrtown, then something is very, very wrong with your party. Greens and Rainbows, the legislature just handed you an issue for the next 22 months. Are you going to do something with it?
Good News and Bad News
The bad news first: Massachusetts voters are one step closer to facing a 2008 ballot question to overturn the landmark decision allowing same-sex couples to marry in Massachusetts. I am still waiting to see any evidence that the decision hurt any heterosexual marriage.
The good news: out of 189 members voting, fewer than one-third voted not to kill the amendment.
The amendment would need to be approved by 50 member of the current Legislature and 50 members of the new Legislature before going to voters on the 2008 ballot. On Tuesday, 61 lawmakers backed moving the measure forward, compared to 132 opposed.
Until today, I thought that the only two chances to keep the current marriage setup were either to avoid a vote of the legislature (thus killing the amendment by default), or to rely on the voters in 2008. The first option became less palatable when the Massachusetts State Juducial Court ruled that the legislature must vote, although the court admitted that it lacked a mechanism for enforcement. And the second option is still viable, especially after none of the current supporters of same-sex marriage in the legislature lost a re-election campaign in 2006. Despite what the theocrats among us wish for, the actual populace has supported the same-sex marriage ruling.
But now it seems possible that the amendment may not garner even 50 votes in the next session. (Or, perhaps, later today if a motion to reconsider passes.) That would truly be good news.
What's The Matter With Kansas?
I always hoped that Thomas Frank would be proven pessimistic in his assertion that liberal elites were driving away the rural working class.
If the recent troubles of the Right in Kansas last, then perhaps nothing at all is the matter with Kansas—at least nothing that a revival of the Non-Partisan League would not alleviate a bit.
01 January 2007
I fully expect that the forthcoming State of the Union speech will have more claptrap about "consumer-driven" health care and Health Savings Accounts (HSAs), just like the speech from 2006.
Encouraging consumers to buy the best health care for the buck sounds wise, except for all the problems with health care in America.
First, preventive medicine is not free. The annual checkup, or the twice yearly trip to the dentist are not solely for keeping one's doctor and dentist in new shoes; they also serve to prevent more serious (and more costly) problems down the road. One beneficial thing about good insurance plans is that they encourage preventive care, typically by making it free or almost free. HSAs typically do the opposite.
Second, the idea that consumers have any hope of adequately comparing health care prices is a ludicrous one. When consumers need health care the most—in emergencies—they hardly have the ability in any sense of the term to compare the relative cost and efficacy of each health care choice. Even if they did, it is either almost impossible or literally impossible to understand how much each health care provider or pharmacy charges for the range of services that a consumer might conceivably need.
Third, the idea that consumers will use less health care if they have to pay out of pocket for it more assumes that going to the doctor or dentist or pharmacy is something that consumers do in excess because insurance lets them. Surely, for some consumers this is the case. Some people really do treat trips to the doctor's office like ordering french fries at McDonald's—why not Supersize the order for just a quarter more? But how many people are really eager to overspend on health care? Do the free marketeers really think that most Americans suffer from cases of Munchausen Syndrome that a little free-market tough love would solve?
Yet another problem with HSAs is a basic one. There are two ways for HSAs to save a consumer money. The first case, which proponents do not like to discuss much, involves rich consumers who have maxed out their retirement savings. Putting money into an HSA allows them to defer taxation on an extra few thousand dollars per year. They fully expect to use up their deductibles. The second case, which proponents like to discuss an awful lot, is one in which consumers buy a high-deductible policy but manage to spend less than the deductible each year on health care. Yes, this will happen quite often. But one trip to the hospital will generally mean that the HSA is cleaned out.
The elder red diaper baby at K Marx the Spot had a very minor surgical procedure done this summer, one that surgeons have performed for decades, one without the latest in high-tech gadgetry, except for the MRI needed to confirm the problem. The cost of just the hospital stay would have wiped out the family's deductible for the plan that a fellow named Chad was touting to my colleagues at my old job. The cost of the MRI and the surgeon's fees were surely thousands of dollars more.
Yes, American health care is an expensive mess. But waving the magical wand of the free market over it will not make the situation any better.
And there is one final, overarching problem with HSAs, as with much of America's health insurance. It is based on the notion that profit-maximizing companies will somehow have their customers' best interests at heart. United Health Care did not even have the interests of its shareholders at heart when it issued $1.5 billion of options to its chief executive officer. A big reason why other industrialized countirs have better and cheaper health care than the United States is that private insurers have a much smaller role in health care everywhere else.