Krugman Shouts Out Nick Beaudrot, Former JRE Supporter

Today my friend TomP, who writes a lot of diaries at the Daily Kos and Docudharma, e-mailed a few folks to inform us that our fellow JRE supporter and blogger, Nick Beaudrot, had a shout out from Nobel Prize winner, economist, and NYT columnist Paul Krugman on his blog today.

Here is the flow diagram by Nick that Krugman thinks simplifies what the current plan for health insurance reform should do:


Source: Donkeylicious

This makes perfect sense to me as it did to Paul Krugman.

Nick and I were bloggers together for the JRE campaign in 2007 until JRE suspended the campaign in late Jan 2008. I sent Nick a SMS to congratulate him on this shout-out.

I wonder if Krugman knew that Nick was a JRE supporter, especially as Krugman always thought JRE's health care proposals were the most progressive amongst the major candidates. I didn't ask Nick if he was personally acquainted with Krugman. Figured that was not my business.

Now, if Obama would only sell the diagram to Blue Dogs and the hijackers on the Senate Finance Committee. Max Baucus, are you listening?

Why a Revamped Public Plan for National Health Care is Important

The Congress continues to struggle with PAC donations from insurance, pharmaceutical and the American Hospital Association --or whether or not to they tell them that our system is broken. Which do you think is winning?

Meantime, Progressive Tokyo penned at Docudharma a diary about how National Insurance works in Japan. My understanding is that it is similar in other parts of Asia, and I'm pretty certain it is the same for Germany and the Netherlands.

Every month a certain percentage is deducted from my pay check which includes both my National Health Care and my National Pension. This amount is matched by my employer. While I don`t wish to discuss my finances in detail, I can tell you every month they deduct roughly 40,000 yen (around $385 dollars) by comparison my wife who is a stay at home mom pays roughly 7000 yen (around $65) for her coverage. All children under 15 are covered for free. Once you are in the National Health Care system you are given a National Health card.

With this card you can go to ANY doctor, hospital, or clinic.

Now when you do need care you go to the provider of your choice and give them your card. After seeing the doctor and getting your treatment and/or prescription drugs you will have to pay a small co-pay. This is 30% of service cost 70% of which is paid by your National Health insurance.

Progressive Tokyo gave an illustration of what he considered affordable care:

Two days before Christmas 2 years ago I had developed a extremely sore throat and was worried so I decided to go to my local hospital in Chofu. When I arrived I had a severe fever and I could barely swallow. I walked into the hospital and was seen by a bi-lingual physician almost immediately (maybe a 5 minute wait after showing my National Health Care Card) who examined my throat, asked when it had began and took my temperature. He decided that a throat culture was necessary and it was sent to the lab.In the meantime he prescribed a painkiller and antibiotic and asked me to come back in 2 days. While the painkiller certainly helped my throat pain, it seemed that the antibiotic was having no effect. When I went back to the hospital they informed me that I had a severe case of Strep throat and I needed a much stronger antibiotic, which was prescribed immediately.

After 1 and 1/2 weeks of antibiotics I was healthy and able to enjoy the New Years celebration (unfortunately no alcohol)!

The total cost of this treatment including prescribed drugs and lab work?

Roughly 7000 yen ($65.00)

I would have said about a year ago, my treatment would have cost the same, except recently, my insurance now requires a deductible for prescriptions. Thus, I'm not clear that this more affordable than I have now, but here's the difference: he can go anytime to any doctor anywhere. I cannot do that. If it is after 8pm, I am charged $250 for an emergency room visit, or if it was more severe than a sore throat, I'm likely to still be shipped off to the emergency room. I haven't asked Progressive Tokyo if that was also the case and he seems to be offline at the moment.

I also like it that alternative medicine is covered under Progressive Tokyo's plan.

And don't forget the $385 monthly premium includes towards a pension plan. So roughly, he is paying for a pension and health care for that amount. This is a lot less than I pay for a pension and health insurance.

I did ask if PT (at the Daily Kos version of his diary) was unemployed, what would it cost, and he said $60-70 per month. That's the safety net involved, and one that many of us believe we need, but the problem then is that those who are homeless and no job, what happens to them? That's where Canada and Britain are superior.

Congress, it doesn't make sense for more insurance companies to regulate the care we get. What is more important to improve their inefficiencies and make care not just affordable but also based on performance. From the Center of American Progress (where Elizabeth Edwards is a senior fellow), here are the problems to be addressed:

How to modernize the health system to eliminate and reduce costs

Many of the problems in the U.S. health care system come from the antiquated way in which we deliver care. Most of what is done in medicine was developed in the past few decades, yet it is delivered in doctors’ offices that haven’t changed in decades and with payment systems designed 50 years ago. The result is flawed care: Many patients fail to receive adequate care, receive too much care, or receive care in the wrong way.

There are a number of areas where care is poor, ultimately leading to worse health and (often) higher costs, such as:

* Oversupply of well-reimbursed services. Most providers are still paid according to the number of services they perform rather than the quality of that care, which incentivizes doing too much.
* Failure of chronic care management. Primary and secondary prevention are not provided as routinely as they ought to be, or in settings that work for patients.
* Lack of performance data. Little is known about which treatments are best for particular patients and which providers are best at doing them.
* Insufficient competition in insurance. The insurance market for individuals and small firms often revolves around selecting healthy patients to insure rather than providing valuable care to the sick.
* Ineffective health system design. The wrong people often provide services (e.g., primary care doctors doing what nurses do better) or services are provided in the wrong way (e.g., surgery performed at hospitals with a very low volume of patients).
* Needless administrative complexity. Medical offices and insurance companies often have to hire extra administrative personnel to handle the complex paperwork that comes from dealing with multiple insurance companies and the uninsured.
* Inappropriate end of life care. Patient wishes about death are often overridden or unknown at the end of life.

I have to agree with these reforms as I believe my mother's care was not very good in the last two or three years of her life, and while I'm about to sound like a freeper, I was very disappointed in how the doctors handled her COPD care, and at the end, she died from it, with a bill of $187K. There were many hours no doctor saw her. She was given drugs that didn't help all of that much. In mid-March this year, she suffered a stroke and a heart attack within 24 hours, and it's because of neglect, to a certain extent. That's outrageous, and I think the hospital just racked up the charges towards the government (she was on Medicare), with poor assessment, and they had put a breathing apparatus on her when she succinctly did not want her life extended. I guess they wanted to keep her alive long enough for the family to get there, but when I got there, she was already in a semi-coma. I'd like to believe she heard me say good-bye, but I will never know, to be truthful. I also think I was misled that she was going to be better. My sister sensed that she would not, but what was she supposed to believe either?

So I think that the public plan needs to also exert leadership with quality care--to make these other private insurers compete successfully.

My mother probably should have been sent to hospice if there was not much they could do to save her. But no, hospice care was only covered 50%. Again, another freakin' insurance issue. Why wouldn't anyone be allowed to die with dignity and with comfort instead trying all kinds of ICU that wasn't necessary anymore? Again the difference between US and European care, in this instance.

Our President has said he would like to see a public option, but yet, after convening all of these special interest groups, it's not gotten anywhere how to hammer out a better plan. Paul Krugman had a few words to say about that yesterday:

But just three days later the hospital association insisted that it had not, in fact, promised what the president said it had promised — that it had made no commitment to the administration’s goal of reducing the rate at which health care costs are rising by 1.5 percentage points a year. And the head of the insurance lobby said that the idea was merely to “ramp up” savings, whatever that means.

Meanwhile, the insurance industry is busily lobbying Congress to block one crucial element of health care reform, the public option — that is, offering Americans the right to buy insurance directly from the government as well as from private insurance companies. And at least some insurers are gearing up for a major smear campaign.

On Monday, just a week after the White House photo-op, The Washington Post reported that Blue Cross Blue Shield of North Carolina was preparing to run a series of ads attacking the public option. The planning for this ad campaign must have begun quite some time ago.

Guess who said the same thing on September 17, 2007:



Looks like the same situation as Krugman described the ads from BCBSNC yesterday:

It’s a scary image that might make some sense if private health insurance — which these days comes primarily via HMOs — offered all of us free choice of doctors, with no wait for medical procedures. But my health plan isn’t like that. Is yours?

“We can do a lot better than a government-run health care system,” says a voice-over in one of the ads. To which the obvious response is, if that’s true, why don’t you? Why deny Americans the chance to reject government insurance if it’s really that bad?

For none of the reform proposals currently on the table would force people into a government-run insurance plan. At most they would offer Americans the choice of buying into such a plan.

And the goal of the insurers is to deny Americans that choice. They fear that many people would prefer a government plan to dealing with private insurance companies that, in the real world as opposed to the world of their ads, are more bureaucratic than any government agency, routinely deny clients their choice of doctor, and often refuse to pay for care.

And indeed, when I looked at Senate Finance plan, it tipped-toed around a public plan.

JRE once said that "joining them" instead of beating the system would not bring universal health care. And yep, I think we are still going to get screwed, with Obama saying that compromise was necessary, meaning not having it mandated and that if millions still get left out, we are still making "progress."

As Krugman said, it's up to our President to convince us otherwise. The special interests have already called his bluff.

Hey Paul Krugman (a song)

This song by the Rock Cookie Bottom speaks for me. Hey Paul Krugman, we need you in the WH. And we also need Joe Stiglitz, Jamie Galbraith, and Atrios.

Stupid Idea

Inviting the Wealthy to Invest in the Bailout?

Washington Post

I have to agree with Atrios on this one. Why would anyone invite wealthy folks who messed up the system to expect them to clean up the mess when the government hands over the money with few questions asked.

I wonder why no one in the Treasury Department nor the Fed listens to Paul Krugman?

No, they didn’t, and no, it isn’t.

Paul Krugman nails it on the Recovery Package.

No arguments from me.

An Essay on Krugman's The Conscience of a Liberal by Montana Maven

BW readers, I have a great treat for you. Montana Maven (whose blog is on my blogroll) wrote an exquisite essay that would rival anything one would read in the NYT Books section. It incorporates a theme about getting the gentry out of the government and restoring it back to the people, using Paul Krugman's new book, The Conscience of Liberal as a theme. The essay was originally diaried on the Daily Kos earlier today. It was so well received that I e-mailed Montana Maven to obtain permission to reproduce it here, and she responded very enthusiastically a "Yes".

Readers will see how this ties to JRE's message. Oh, in case you didn't know, Krugman has complemented JRE quite a few times this year, particularly about his universal health care plan. Additionally, Montana Maven said that on her radio show yesterday out of Des Moines, quite a few Ron Paul supporters called in. They think the system is rigged against us, but of course they prefer less government in general.

So, here is her essay, with the proper title below. Enjoy. Special thanks to Montana Maven for allowing Benny's World to reprint this excellent piece. Do drop by her blog and listen to her podcasts of her radio show. She has the most interesting guests to interview. And if you like her work, drop her a note with some change.

Krugman Asks Us to Fight for a New New Deal and Not Betray Progressivism

by Montana Maven

That’s what is behind Krugman and his recent columns. Democracy has been shoved aside, but he sees our chance out of this radical inequality we find ourselves in. But is must be done NOW. It is urgent that we elect the person most capable of taking on FDR’s mantle and fighting like heck for universal heath care. It’s not as radical as some lefties would like. It still is working within the capitalist system. But it will lead us from the brink. His book "The Conscience of a Liberal" is an ode to the New Deal and he makes a strong case for a New New Deal.

"Your Future Still Lies Ahead of You" declared Thomas Dewey in his campaign against Harry Truman. And so it goes in every election. Barfy populist statements. Meaningless platitudes escape from the lips of grown men and the occasional woman. They mostly used to come from the Republican side to mask the real agenda. I call it Smiley Face Fascism delivered by affable politicians.

In 1948, Dewey masked his assault on the New Deal with generalizations like the one quoted. But just as Senator Howard Taft had attacked the labor reforms of the New Deal with the Taft Hartley Act, Dewey’s agenda was to reverse the programs of the New Deal like social security and worker’s rights. He was appealing to Americans to return to the oligarchic system in place prior to Roosevelt.

Well the people wanted none of it and elected Truman. After Dewey's defeat, for the most part, the Republicans gave up trying to undo The New Deal. Their ideas were literally bankrupt. In 1954, Eisenhower, in a letter to his brother Edgar, said that "a tiny splinter group...H.L. Hunt...a few other Texas oil millionaires, and an occasional politician or business man from other areas" wanted to eliminate labor laws and farms programs." "Their numbers are negligible and they are stupid".

But 30 years later, the "tiny splinter group" came back with a vengeance and "The Great Compression" that resulted from Roosevelt’s policies to counter "The Great Depression" took a backward turn that continues today. The modern conservatives built a movement, media outlets, organizations, around the ideas of economist Milton Friedman and sociologist, Irving Kristol. When the next crisis hit, their ideas would be ready. Naomi Klein whole book "The Shock Doctrine: The Rise of Disaster Capitalism" is about how these folks would exploit crisis after crisis swooping in with their radical fundamental free market ideas.

Krugman’s new book is not as shocking or as filled with personal interviews as Naomi Klein’s, but it is a very smart, succinct, and smart companion piece to it. It's also a personal story and a personal journey of Krugman's that I understand being the same age and growing up in the 1950's and the 1960's. Klein was trained as an economist but she has found her gift in journalism. Her book is filled with brilliant reportage; of personal accounts of the tragedies inflicted by the Milton Friedman "greed is good" school. Like Klein, Krugman’s writing in his economic column morphed from an attack on George W. Bush and his administration to the conservative movement as a whole. He couldn’t help it. He became a gadfly who has changed in the way he looks at the "why" of where we are today. Why are we in another Gilded Age when it looked like we were heading towards greater equality not less? The Friedman (Miltie and Tommie) mantra has been globalization, globalization, globalization.

But Krugman, as he examined the period from Gilded to Gilded, sees two arcs; one in economics and one in politics and they parallel each other. The greatest inequality of incomes in the Gilded Age was mirrored by extreme partisanship. In the 1950’s, post war America, there was the greatest income equality and the greatest bi-partisanship. His book is an examination of the "why?" of these arcs. It is an ode to The New Deal and its reforms.

To his credit, Krugman said that he believed the story that:

"technological changes and globalization caused America’s income distribution to become increasingly unequal, with an elite minority pulling away from the rest of the population. The Republican Party chose to cater to the interests of that rising elite... And so a gap opened between the parties, with the Republicans becoming the part of the winners...the Democrats represented those left behind."

But in his research he became more and more convinced that the arrow pointed in the other direction; not from economic inequality causing a growing political rift, but a radical political shift caused the economic inequality. This idea is heresy to traditional economists who believe that the invisible hand of the market mattered most in how income is distributed.

And more and more economists are starting to take another look at the shenanigans of the political right and neo-liberal crookedness disguised as theory. Krugman posits:

"Forces of technological change and globalization...affect everyone. If the rise in inequality has political roots, the United States should stand out; if it’s mainly due to impersonal market forces, trends in inequality should have been similar across the advanced world. And the fact is that the increase in U.S. inequality has no counterpart anywhere else in the advanced world.

Political change seems to be at the heart of the story. How did that political change happen?"

Krugman unearths the same culprit as Klein does; the modern radical conservative movement, but by going back an examining The New Deal, he puts our salvation clearly in a New New Deal that puts first and foremost as it’s number one agenda, universal health care "something every other advanced country already has." And in order to make his case he examines our politics from the Gilded Age of the 1890’s to the Gilded Age of the last 30 years. In the telling of the tale, he hopes that we will not repeat the mistakes of the past, but embrace the great radical reforms that Roosevelt instituted that led to our finest hours.

And here's where the "Bourbon Democrats" come in. From the civil war to Woodrow Wilson, the Democrats were primarily led by pro-business Northerners and reactionary Southerners. They differed in being pro free trade and anti-tariff and they decried corruption. The Republican Party was clearly the party of the rich and no longer the party of free labor. So who got left out? Labor and farmers. Hence the rise of the Populists. But their chosen leader, William Jennings Bryan, could never create a coalition of labor and farm; of urban and rural workers. He also got hung up with silver and gold standards and being awfully preachy. And one of his worst mistakes was to pick a Northern pro-business running mate instead of the great Southern populist Tom Watson. So once again, the choice wasn't clear. When one side is mushy, the voters usually go for the strong clear "commander guy".

Today we have a version of the "Bourbon Democrats". Some call them the "Gentry Democrats". A great article in the Baltimore Sun "Worker's Aren't on the Agenda of Today's Gentry Liberals" is a great read.
http://www.baltimoresun.com/...

The ascent of gentry liberalism remains largely unchallenged, in part because of the abject failure of the Republicans to address middle-class aspirations in a serious way and in part because of the absence of a strong pro-middle-class voice among Democratic presidential contenders, with the exception of former Sen. John Edwards. As a result, Democrats are unlikely to stop, let alone reverse, the current economic trend that dispenses major benefits to gentry-favored sectors such as private equity firms, dot-com giants and entertainment media.

Over the last half-century, liberals have moved from strong support for basic middle-class concerns - epitomized by the New Deal and the GI Bill - to policies that reflect the concerns and prejudices of ever-more-elite interests. As a result, neither party speaks for broad middle-class concerns.

The nation deserves better than that.

Yes, our future still lies ahead of us if we put away hollow pseudo progressivism that worships power and loves the world of corporate jets and perks. We must put away those childish things and go for the substantial. And that lies in embracing labor once again and putting its needs first. By putting money into the hands of the poorest workers, everybody gains in income except the top 1 %. Bummer. But that’s what happened from the 1930’s to the 1970’s. Good strong labor unions (fraternity) and fair progressive taxes (equality). That gave everybody freedom (liberty) and restored the American dream.

In 1936, Franklin Delano Roosevelt did not pussy foot around with barfy populist statements. He "let the malefactors of great wealth have it with both barrels", says Krugman:

We had to struggle with the old enemies of peace, business and financial monopoly, speculation, reckless banking, class antagonism, sectionalism, war profiteering.

They had begun to consider the Government of the United States as a mere appendage to their own affairs. We know now that Government by organized money is just as dangerous as Government by organized mob.

Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me⎯and I welcome their hatred.

You cannot sleep with these forces. You cannot cajole them. The only way we will get back to more political bi-partisanship is to fix inequality of income and inequality of health care and inequality of opportunity and restore democracy. Not the other way around. You cannot rise above or transcend the fierce bickering. You must fight the causes of it. There is no Staples EASY button to right these wrong that involve race, poverty, class and the rift between town and country. The progressive/liberal/labor movement has been growing getting stronger. The old Jesse Jackson Rainbow Coalition is being reborn with the new resurgence o the unions and our Latino and Latina allies. It is a new coalition that has strength and power and not just intellectual exercises.

Naomi Klein said that when a crisis hits, Milton Friedman says that government will turn to the "ideas lying around." In the 1990’s there was no visible progressive movement. Bill Clinton did not come in to office on a wave of a movement. He got lucky. Then he wasn’t sure what to do, so he winged it.

This accounted for part of the reason why health care reform didn’t happen. Krugman says that there were many reasons why Hillary and Bill’s health care plan didn’t work:

"but a key weakness was that it wasn’t an attempt to give substance to the goals of a broad movement⎯it was a personal venture, developed in isolation and without a supporting coalition. And after the Republican victory in 1994, Bill Clinton was reduced to making marginal policy changes. He ran the government well, but he didn’t advance a larger agenda, and he didn’t build a movement. This could happen again, but if it does, progressives will rightly feel betrayed."

Well, we have a movement, thank goodness. We don’t have time to wait for somebody to begin to build one. Besides a movement is really never built by following a person. That’s a cult. To return to traditional liberalism will take a radical turn. (And John McLaughlin, of all people, noted several months ago that is what the country needed right now.)

It will take courage. It will take being a partisan; a defender of liberty, equality, and fraternity. Just like the Free French Partisans, we must fight entrenched greed not collaborate with them. By becoming fiercely partisan, fighting for equality and justice, we can finally regain such a thing as bi-partisanship aka working through our differences towards the common good. John Edwards said in a town hall meeting in Iowa on December 12, "We have an epic battle ahead of us."

Krugman in his final chapter defines liberals and progressives:

"To be a liberal is in a sense to be a conservative. It means, to a large extent, wanting us to go back to being a middle class society. To be progressive, however, clearly implies wanting to move forward...Advancing the traditional goals of liberalism requires new policies."

The Democratic Primary has seen a great many ideas surface while on the other side they are trying to see who can expand Gitmo and who can up the ante on our next war. But still there will be "fierce opposition" to the reforms the people want. So Krugman leaves us with this admonition:

"For now being an active liberal means being a progressive, and being a progressive means being partisan. But the end goal isn’t one-party rule. It’s the reestablishment of a truly vital, competitive, democracy. Because in the end, democracy is what being a liberal is all about. "

But we need a clear choice. Aristocrats and democrats, Jefferson said, are the divide in a nation. It is time for liberals in the name of liberty, equality and fraternity to take back the Republic from the gentry Democrats and the Radical Republicans.