We have come to the first major battle over health care reform: will there be a strong and viable public plan for health care as part of the reform components?  The Washington Post has editorialized that this is a test for bipartisanship by which they mean that the Democrats should give in to the Republicans and that there should not be a a public plan, much less a strong public plan.

Sure there is a partisan divide over health care.  It goes back a long way.  Conservative Republicans have hated Medicare and Medicaid since its inception.  They have tried to destroy both programs repeatedly, and have come fairly close on a couple of occasions.  They agreed to the Part D (prescription drugs) addition in large part because they thought they were getting a chance to destroy Medicare with the now almost forgotten rule that when general funding exceeded 45 percent of Medicare Part A that would have to be reported and that would initiate a mandatory process of voting on Medicare changes.

Conservative Republicans lined up squarely with the private insurance companies to defeat health care reform led by the Clintons.  It is hardly surprising that they have lined up to defeat reform under the Obama administration.  The health care situation has gotten worse while Conservative  Republicans have held off reform, but the Republicans have scored big in political terms.  The private insurers, the drug companies, the device makers, and many more who have become very wealthy because people in the United States are paying far more than they should for health care, have been sending in big contributions to Republicans in a steady stream.

Sure a public plan in health care reform is a partisan issue.  Instead of focusing on what is good for the health of people in the United States, Republicans have chosen for ideological purposes and political self-interest to fight against reform that helps the people who need access to care, helps the economy/stock holders/employers/workers who are hurt by unnecesary high health care costs, and hurts taxpayers who have to pay too much for publicly funded health care.  The Democrats are divided over the best way to structure reforms but they are on the side of cost efficiency, access, quality, transparency, and accountability.  A lot of the division among Democrats is about what is affordable from a federal budget point of view, what is pragmatically achievable in the current political climate, regional differences over current health care practices and costs, etc.
Let’s be clear about the ideologically driven, politically focused, posture of the Conservative Republicans.  They support socialized medicine, with the federal government both paying for and directly providing the medical services for the military and for veterans.  It was okay for the Veterans Administration to negotiate for lower health care costs from the drug companies, but not Medicare because such negotiations by Medicare to lower costs would work.  But when it comes to civilians, anything “public” is ideologically blasted as “socialized medicine.”

Let’s further be clear about the fundamental politics of Medicare and Medicaid.  The United States got these core programs done in the 1960s because there were big Democrat majorities AND because the private insurance companies didn’t want to serve the Medicare and Medicaid populations.  Private health insurance, primarily at that time Blue Cross and Blue Shield and the early employer based coverage forced by unions, were aimed at workers, and finally, after reforms, at workers and their families.  Since the 1960s, the functioning of Medicare and Medicaid has been improved and, under the Obama Administration, significant steps nuts and bolts improvements are underway.

The public plans that the Republicans oppose are being opposed because they would be far more cost efficient than private plans.  Whenever you hear the Republicans say, “Public plans would have an unfair advantage if they were allowed to compete with private plans,” what you should hear is, “Private plans drive up the cost of health care and cost people, one way or another, a whole lot of money that is not going into health care services.”  If you don’t believe me, think about this.  Every time you are pulling your hair out about getting private insurance plans to pay what they are contractually obligated to pay for health care, remember that on the other end of the phone a lot of workers are being paid a lot of money.   The private insurance companies will tell you that this is their way of driving down costs.  But common sense will tell you that the right way to cost efficiency is not denying payment for care, most of it needed, but cutting the costs of delivering care.

Many of you may be shocked to know that it is Medicare, rather than private insurance companies, which has wrestled with the complex issues of what should be paid for different services.  Huge amounts of research and repeated adjustments to payment formulas has continued to improve the Medicare formula.  If there was more transparency about the costs of providing health care services, the Medicare formula could work better and be more fairly applied.  The work done on Medicare cost efficiency is the primary standard for other public and private efforts to move toward more efficient and more fair payment structures.  The primary point is that congressional and administrative oversight gives us a mechanism for addressing cost issues on their merits.

A public plan in the context of the current health care reform battle would be different from Medicare in that Medicare serves all comers in large sectors of the U.S. population, expensive populations in terms of need for health care.  Medicare also has the advantage of being partly forward funded, though such forward funding needs to be increased through an increased Medicare tax.  Just about everyone can look forward to getting Medicare when they get old enough to qualify.  Taxes are paid while people are working to get benefits when they are no longer working.

A public plan option in current health care reform would compete with private plans primarily on the basis of cost-efficiency.  The public plan would also have the great advantages of being clear and stable in comparison to private plans that are constantly shifting around.  They would be more consistent from state-to-state.  Providers would be able to make their delivery plans concerning public plans with more confidence.  There would be far more transparency and accountability.

Health care reform with a strong public plan could become a bipartisan issue.  After all, in the original passage of Medicare and  Medicaid some Moderate Republicans voted in support and some Conservative Democrats voted against.  Particularly in the Senate, getting a few votes from he diminished number of Moderate Republicans could prove crucial.  For the rest, the answer is “Seize the day.”  The Clintons never tried to have a public political battle over health care reform.  I’m hoping Obama will be willing to have the fight.  It is a fight Democrats can win, even if the private insurance companies and there allies spend tens, even hundreds of millions of dollars in opposition.  An election would be a good place to give the people of the United States a say in their health care future.  When the Democrats pick up a net of 3 Senate seats in 2010 the fight for heath care reform would be over.
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One line of my forebears almost perished when they believed the lies of Robber Baron James P. Hill that they, and others, would have houses waiting for them when they got off his train in Minnesota in late Fall.  They survived a Minnesota winter by digging trenches in the ground and huddling together in their blankets.  Neighbors helped them by sharing some of their corn.

That lesson, passed down the generations, reminds me that capitalists and heroes are not the same thing, no matter how much they spend on public relations.   At the turn of the 20th Century the United States government broke the power of the Robber Barons with a sequence of legislation including the Interstate Commerce Act and the Fair Labor Standards Act.  We need similar spine and vision as we head into a round of 21st Century legislation to reshape our financial system.

My great, great grandparents paid a terrible tuition but took the lesson and passed it on.  We have paid an incredible tuition in the current financial crisis that is counted in the trillions of dollars.  Following is the core lesson I think we should learn.

The  big news these days is that the big bankers are mounting a big fight to protect their executive pay.  They are paying back their loans from the U.S. Government as fast as they can so that can go back to their old ways of doing business.  I misjudged the importance of the executive pay issue.  The press helped me in my misjudgement.  I read the story line as: “Big bankers are greedy.”  My response was, “They are not worth that much and I bet a lot of people could do their jobs very well for a small sliver of their pay and benefits.”  I still think this is true, but it is a formidable misdirection.  If that is all we learn from this, we lose.  We lose big time: to be counted in the next trillions of dollars.

The first big lesson is this: big bankers apply the logic of robber baron capitalism in their personal self-interests rather than in the interests of the companies they manage, the people who give them their money to manage, or in the interests of the United States, or the people of the United States, or the economy in general, or any other abstraction you care to mention.  Assume greed and keep on looking for the more fundamental tragedy.

What is a house worth?  The traditional answer was that it was worth the cost of building plus the value of the land.  The market answer is whatever a buyer is willing to pay.  The housing bubble grew out of the disconnect between these two answers and the disconnect was created by the big bankers.  Let’s be generous and assume that the actions of the big bankers were some plunder and a lot of blunder.  (See Dean Baker’s most recent book.)  Even so, it was the motive to plunder that led them into the blunder part.

This is how it worked.  (Deregulation made a lot of this story line possible and good new regulation could stop it.)  Many people and companies that originated mortgages turned around and quickly sold them to big bundler companies and banks, including Fannie Mae.  The income of the initiating individual brokers and the mortgage originating businesses, including some banks, was based on how many mortgages they could sell on the secondary market.  Some mortgage originators started making and then selling mortgages that broke the old pattern of a 10 percent down payment and a 30 year fixed rate mortgage to people who could demonstrate they had the financial capacity to make the payments.   They offered 100 percent mortgages with no down payments.  They offered adjustable rate mortgages with initial teaser rates.  The gave mortgages to people who didn’t have to prove their financial capacity to make the mortgage payments.

Why did the big mortgage bundlers buy these lousy mortgages?  Were they crazy?  Here comes a two-part answer.  First the appraised value of the houses showed that the houses were worth the mortgage price.  The bundlers thought they had equity: if the loan goes bad just resell the house.  But the appraisers, like the mortgage initiators, were just looking out for their personal (and company) financial interests.  If they didn’t supply inflated appraisals then the mortgage initiators would use other appraisers.  That’s the first step in the distortion from base value to market value.  The second part of the answer is that the bundlers, the big bankers, didn’t care because they in turn were passing the risk onto others as if they were trustworthy investments.  Every pass through they made, like the mortgage originators, brought big fees and they had figured out how to escape the risk.  These fees were big enough to pay the gigantic executive pay bonuses to the big bankers and a whole lot of their minions.  Some of those minions probably figured out some of the deceptions but it was not in their financial interest to point this out.

The deceptions of the big bundlers is called “securitization.”  I know, your eyes just started to glaze over and you thought about ordering in Chinese.  Stay with me and you get the really big lesson.  The bundlers bundled scads of these lousy mortagages into financial instruments that were a lot like traditional bonds.  Investors like TIAA-CREF that just cut back my pension bought these bonds because they thought they were secure.  They thought they were secure because Moody’s and other bond appraisers said they were secure and gave them AAA ratings.  (In some cases they got lower rating and the bundlers simply offered higher bond interest rates.)  The bond appraisers, like the house appraisers, are paid by the big bankers and it was in their interest to provide high ratings and rake in their share of the big fees.  That is step two in the deformation from base rate to market rate for the value of the houses.

So why didn’t the investors do their due diligence and figure out they were buying lousy bonds based on lousy mortgages?  That’s their job, right?  They are smart, right?  Well, first of all they were likely to believe the bond appraisers.  Second they were likely to assume that their was equity in the houses.  And third, they often bought insurance from AIG just in case they were wrong.  Because of deregulation, AIG was able to sell a lot of insurance with little capacity to back it up.  Did the top officials of AIG care?  Not much.  When AIG went bust the top officials, more of the big bankers dressed up as insurance officials, just walked away with the huge personal fortunes they had gotten from fees.  The big bankers also had already made their fortunes but many of them got to stick around or join the Obama Administration because it is believed they are needed to manage the financial recovery.
Before the bubble burst there were very few economists who saw it coming, almost no regulators who were concerned, and a press that was reporting all the public relations from Alan Greenspan and the mortgage and banking industries that everything was fine.  “Don’t worry,” they said.  The few who made the distress call, even bet their personal fortunes on the collapse of the bubble, were unheard because almost everyone was functionally deaf.  This monumental disaster was masked for years by the fact that the market value of houses was spiraling up at previously unheard of rates, unheard of because it used to be that housing prices were closely related to based prices rather than crazy market prices.  But make no mistake, this was wilfull deafness.  Everyone was making personal fortunes off the bubble except the end investors, the taxpayers, the unemployed workers, and all of us who were out of this loop entirely.  To be fair to Alan Greenspan, he said he didn’t see it coming.  “Just a mistake (blunder)” he said.  Maybe it’s true.  He had ego but not plunder motives.

The new round of regulation has to start with more transparency and has to eliminate or take care regulatory control some of the weirder and incomprehensible financial instruments.   Those reforms are in the air these days and merely have to run over the big bankers who are opposing them.  Road kill seems like an appealing metaphor to me for those who have done so much damage to us.  However, I’d settle merely for shunning them into forced retirements and their retreat to a life of luxury spending their ill-gotten fortunes.  What this story lines really points out is that we have to break the reward structure that makes economic sense out of screwing nearly everyone.  I think it is called putting everyone on salary and letting the benefit of any fees pass through to stockholders.  What a radical idea that is.  Imagine, top corporate leadership being dependent for salary increases because they are building up the value of their companies for stockholders.  So that stockholders can see the advantage of longer-term company profitability, let’s require companies to publish their five-year running averages of return on investment and create incentives for increasing such a running average.  And let’s take a little heat out of the stock markets and bond markets by a modest, but meaningful, additional tax on short turn capital gains.

And to show what a kind and gentle commentator I am, let’s not call the big bankers, the big bundlers, robber barons.  They don’t have the scope and vision of James P. Hill.  Let just call them pirates who steal whenever they see an opportunity float by.

Imagine!  A new justice on the Supreme Court who would be a champion for the constitutional rights of individuals who actually need to have those rights protected.  Consider the implications of the impact of the life history and contextual assumptions of white male judges who grew up thinking that their culture was THE culture of the United States and thus need no explanation or defense.  Why does the press write these stories as if everyone else needs explanations to show they are okay.

Consider the fire-fighters in Connecticut who just assume that their typical advantages in testing needs no explanation or defense.  Recognizing such an unfair advantage doesn’t make one an anti-racist it makes one a defender of fair play for all.  Guess what.  Fair play sometimes requires giving up unfair, and sometimes unrecognized, advantages in competing for jobs, college admissions, etc.

I don’t know the details of the tests those fire-fighters took, but I do know that tests are commonly unfair based on such factors as race or ethnicity, on language, on gender, on age.  The first big research breakthrough on bias in tests came on standardized intelligence tests.  That research is thirty years old, even older, and it has been refined over and over by follow-up research.  It is a big time concern in the construction of the big tests.  There is a lot of complex detail in such research but their are two basic concepts that will let anybody get the hang of it.  Vocabulary matters.  “Get the hang of it” communicates just fine for people like me.  It probably is not fair language for most testing because it is a colloquialism.  Colloquialism is a fancy word that probably isn’t fair either because it is outside the vocabulary of a lot people.  I had to guess at the spelling and I haven’t used the word in a sentence for decades.

The other key consideration is practice.  A standard intelligence test using children’s blocks showed an advantage in intelligence for boys.  But when somebody thought about the fact that boys commonly play with blocks more than girls, they had girls play with blocks for awhile and then the supposed innate intelligence advantage of boys disappeared.

It is challenging and expensive work to create reasonably fair tests.  No matter how well the initial construction of a test is thought out, you have to do a good bit of pre-testing on comparable samples of individuals divided by various criteria to become confident your test is fair.  Very few tests are worth that kind of investment.  But some are.  When I joined the Army in 1958, the intelligence test I took was just a 50 word vocabulary test, and the hardest word was “textile.”  I bet the testing is more sophisticated now.

It would be hard and expensive to estimate the fairness of the test given to the fire-fighters based on research.  But, if the test routinely gives advantage to one group and not to another that is prima facie evidence that it is unfair.  And if you don’t now what prima facie means that just underscores my point.  It is just this kind of reasoning that has led many colleges to put less weight on standardized tests, even those which have been “scrubbed” for racial fairness.  Sonia Sotomayor, as a careful legal scholar with an interest in racial and ethnic unfairness, probably knows the testing bias research better than I do.  That makes her the kind of judge that would make an excellent jurist on the Supreme Court.

I’m reading a disturbing story in the May 2009 Harper’s Magazine called “Jesus Killed Mohammed.”   It made me sufficiently angry that I had trouble going to sleep.  Angry for two reasons actually: anger at some stupid soldiers who painted “Jesus Killed Mohammed” on their Bradley Fighting Vehicle and drove around inciting violent responses and killing the violent responders, and then anger at the author, Jeff Sharlet, for failing to distinguish between “fundamentalists,” “evangelicals,” and the “radical religious right.”

The main theme of the story is about ugly Christian proseletyzing in the armed services and the emergence of a minority culture in the armed servicees, particularly the Air Force, that favors theocracy over democracy.  Sharlet shows that all the bad behavior of the Radical Christian Right is showing up in the armed forces as it has in other parts of our society.  It is particularly ugly and dangerous in the armed forces because we give these guys, and it is apparently a guy thing, powerful weapons to kill people they don’t like and to do great damage to the fundamental process of counter-insurgency that is the primary strategy of the United States for countering terrorism in Iraq and Afghanistan. Instead of “Kill a Commie for Christ” we now have, in effect, “Kill a Muslim for Christ.”  If you think that is an overstatement consider this, the Air Force Academy held a required assembly for students in which evangelical proselytizers said “Kill Islam.”

That event netly summarizes the two major things wrong with the Radical Christian Right: a basic hostility to the Great Commandment and to the “Golden Rule,” and a fundamental disrespect for the Constitution of the United States.  The Great Commandment reads, “You shall love the Lord your God with all your heart, soul, and mind, and your neighbor as yourself.”  It is a strong Christian affirmation of the Golden Rule to do unto others as you would have them do unto you, a guidance shared by many others.

George W. Bush added to his many sins when he took the guidance of people who framed Middle East policy as a culture war, and which the radical religious right reads as a religious war.  Joining the military to defend the United States is fundamentally different than joining the military to “fight for Christ.”  From a true gospel perspective that respects the Great Commandment, these Radical Christian Right soldiers have been tricked by the “Devil” into fighting against the Christ, the living presence of God among us that we can discern by looking to the teaching and behavior of Jesus.  I call on my friends and family who understand themselves to be fundamentalists or evangelicals, and who revere the Great Commandment, to call out and isolate the Radical Christian Right and thus minimize their destructive impact on Christianity and the United States.

A Christian Radical Right student at the Air Force Academy argued that his position was not unconstitutional because the separation between church and state is not in the Constituion.  Sharlet, in a footnote, said the student was technically correct because the Establishment Clause is in the First Amendment.  Both the student and Mr Sharlet should know that to amend is to include.  The First Amendment is one of the most precious and most litigated parts of the Constitution.  What the evangelists did at the Air Force Academy assembly was done to me in 1953 in a required assembly of ElIzabeth Cobb Junior High students in Tallahassee, Florida.  I make this point to show that constitutional disrespect is not new or unusual for the Radical Christian Right.  I was upset and my father was outraged in 1953.  Now it is 2009 and my turn, once again, to be outraged.

Unfortunately, as Sharlet shows, outrage can often lead to blindness.  I’ve had micro strokes that have left me permanent blindness spots in my right eye.  Fortunately my left eye responded by becoming my dominant eye and I get along pretty well, but with a constant reminder that I can be blind at points too.  My “left eye” reminds me that fundamentalists have sometimes been the strongest defenders of the Establsihment Clause because they experienced what is like to be subject to religious discrimination.  Roman Catholics and Jews have also known how destructive religious discrimination in the United States can be.  Sadly, the Southern Baptist Convention, and a variety of fundamentalists and evangelicals, have forgotten their own roots and instead switched over to “religious freedom for us” and “reliigious oppression for you.”  This boils down to, “We are right and you are wrong so we have have rights and you should have none.”  We are the force for righteousness, soldiers of the lord, and you are the spawn of Satan.  Any of you who who are reading this post probably didn’t like it when I asserted that the Radical Christian Right are agents of the “Devil.”  I put “Devil” in paranthesis” because what is at stake here are the common sins of arrogance and self-righteousness, and the “Constitutional sin” of favoring theocracy over democracy.  We don’t need to postulate an active evil force, just recognize common human failing to which we ourselves are not immune.
Let’s make it simple, to gain respect you have to give respect.

Whatever is Dick Chaney thinking of as he goes around extolling the virtues of torture?  What is so terrible in the pictures that makes President Obama afraid to release them?  Both Chaney and Obama are appealing to the value of safety.  The difference is that Obama is covering up the terrible effects of of Chanye’s, et al, bad behavior.  I can’t show you the pictures but maybe I can give you a look at the mystery behind them.  That requires a little imagination.  See following, as another way to appreciate torture for what it is.

Interrogater (I) What is your name?

Prisoner (P) Salaam Yousef.

(I)  What is your real name?

(P) If you call me Salaam Yousef I will respond.

(I)  We want to confirm our identification of who you are so we can treat you appropriately and identify you for any legal actions.

(P)  That sounds good, but I am an ignorant man and I’m not sure how I should behave.  I’ve never been in a situation like this before and no one has trained me as to what I should do.

(I)  Just tell the truth and answer my questions and things will go easier for you.

(P)  That is reassuring.  Is that how you train your soldiers to respond if they become prisoners?

(I)  No it is not.  They have the duty and protection of being uniformed soldiers.  Under the Geneva Conventions they are supposed to tell only their name, rank, and serial number.

(P)  That must make for very short interrogations.  Anyhow, I’ve told you my name, my rank is fighter, and I don’t have a serial number.  I have never had a uniform either until you so kindly gave me this prison uniform.  I like uniforms and I wish my group could have afforded them.

(I)  You call yourself a fighter, but you are not a uniformed soldier of an existing nation and therefore you do not qualify for the protections that come with being a prisoner of war.  Your are just a terrorist.

(P)  Are you afraid of me?  Do I strike terror in your bones.  It seems to me that you are in control and that I should be afraid of you.  Am I missing something?

(I)  You are a terrorist and some other members of your group attacked the United States by flying airplanes into our buildings.  That makes you an enemy of our security.

(P)  I see.  We hurt you and you are angry with me and want revenge.

(I)  The United States does not engage in revenge.  We just want information from you so that we can stop your groups from attacking us again.

(P)  Well you are an enemy to things that I hold dear.  You would destroy the moral system I have learned since I was a boy.  So I agree that we are enemies.  But I don’t understand the difference between being a terrorist and being a soldier.  I understand that you think you can do anything you want with me and that is okay from your moral perspective.  But both of us believe in the golden rule, “Do unto others as you would have them do unto you.”  Sadly, because we are enemies we expect to fight each other.  I am a fighter and I fought against you.  You are a fighter and are fighting against me.  But now I cannot fight because I am a prisoner.  Are you going to treat me the way you would want us to treat you if you were my prisoner?

(I)  You should treat me as a prisoner of war because I am a uniformed soldier of the United States.

(P)  But, as you pointed out, I am not a uniformed soldier and we don’t have safe prisons like this one to hold you in if you were captured.   We don’t know much about holding prisoners, so I am trying to learn from you how prisoners should be treated.  By the way, what is the reason that I should treat you better than you will treat me?  I don’t understand that.

(I)  I am supposed to be treated as a prisoner of war because that is part of the rules of the Geneva Convention.

(P)  Are all countries governed by the Geneva Convention?  Like I said, I am just an ignorant fighter and I do not understand these things.

(I)  All countries should abide by the Geneva Convention, even those countries that never endorsed the convention, because it is the civilized thing to do, the right thing to do.

(P) Well I think we should certainly do the right thing, especially when we are in complete control of another person.  But I don’t understand why you should treat me anyway you wish, perhaps treat me very badly, because you are afraid of me.  I can do very little to hurt you while I am a prisoner.  Isn’t that the logic of your Geneva Convention, that prisoners are in a different category from soldiers.

(I)  But you are not a soldier, just a terrorist.

(P) I was a fighter without a country and without a uniform, now I am a prisoner.

(I)  If you don’t stop playing these verbal games with me and start answering my questions then things are going to get worse for you in a hurry.

(P)  I see.  Are you going to put me in a little cage like the North Koreans did with John McCain?  Wasn’t it terrible that they had so little respect for the Geneva Conventions?

(I)  How dare you compare yourself to John McCain.  He was a true war hero.  You are a stinking terrorist and this is your last chance to start cooperating  before you learn some more about how we treat people like you.

(P)  You tell the truth.  I do stink.  Perhaps you could start my new treatment by letting me take a shower.

We are currently spending about $2.3 Trillion on health care in the United States.  It seems like yesterday that I was having trouble conceptualizing a billion dollars.  Now the word trillion keeps showing up.  I guess we should pay economists just because they can count that high.

Ah, but what IS that $2.3 Trillion?  Is it an investment, a bundle of services and products, or an expense?  In answering such questions, does it matter if the money is spent out-of-pocket, through private insurance, or through taxation?  We’ve been losing the health care reform fight in large part because economists have played to conservative rhetoric by calling the $2.3 trillion “expense” and “tax burden.”  The translation of that language is “bad.”  Therefore, “health care reform is the wishful thinking of idealists or liberals and would create a destructive burden on the U.S. economy, and cause lack of competitiveness in world trade, and pander to unions, and lead to a nationwide plague of cockroaches.”

Economists who can count that high tell us that the health “industry” constitutes about 14 percent of the national economy, maybe more.  I can remember when health care constituted about 4 percent of the economy and every expansion was met with gloom and down analysis about damage to the economy.  Well, we are at 14 percent now and the sky didn’t fall.  Better yet, we have a crack in the rhetoric of economists when they start calling health care an “industry.”  Whatever else an industry is, the translation is “good.”  Now we can quote economists about how adding health care jobs is good for the economy.  Economists have discovered that health care workers buy microwaves and cell phones, stuff from the “real” economy, and are willing to concede that there are some good things about the health care “industry.”

Still, we are letting the economists get away with framing health care reform proposals as an “expense” and a “tax burden.”  Finally, with the Obama Administration, we are getting push back rhetoric about health care reform as an economic stimulus.  Whatever an economic stimulus is, the translation is “good.”

Republicans, going back to the Medicare prescription drug battle, came to a momentary truce with their own rhetoric of hostility to “big government” spending (bad), because the money would be spent through private insurers (good).  They build in generous extra profits to private insurers in a bid to lure people away from traditional Medicare (a bad big govenment entitlement) to enriching private business owners and investors (good).  But recently they have gone back to criticizing “big government” spending under W. Bush in an attempt to clean up their anti-government banner.

The rhetoric of economists distracts us from a fundamental grounding for thinking about health care.  Healing from injury and illness, easing the pain when recovery is impossible, and helping people rebuild their lives with adjustments to the losses of permanent injuries and chronic illnesses, are all good: good for the directly affected person, good for the near networks of the affected person, and good for the whole U.S. society.  People are living longer and healthier lives, in part, because of health care successes and that is good.  The fundamental point that is obscured by economists is that health care spending, whatever the vector, is just part of the economy.

The fundamental confusion arises from the historic path of the economics profession that grew rapidly in the 20th Century.  We named ourselves an “advanced” economy because we had “industrialized” and pronounced ourselves good.  Except for a few industrialized competitors we called the rest of the world “developing,” meaning not as good as us because they didn’t make and own as many things.  We knew we were right because we could buy lots of automobiles and roam over the Interstate highways at 70 miles an hour.

Then a funny thing happened.  Our U.S. business leaders, once called the “Captains of Industry,” started moving our manufacturing jobs to foreign lands because they could exploit cheap labor that didn’t bother with demand for health care among other things.  They followed the principal of unfettered capitalism that their individual wealth was more important than having a strong U.S. economy built on industry.  Now the Dow Jones Industrial Average, bellweather for economists for how the economy is doing, lists a whole lot of businesses that don’t look much like what the word “industry” used to mean.  The economists were quick to the rhetorical rescue and now we hear about “goods and services.”  Suddenly it is acceptable that the United States is a service economy.  So, in addition to talking about the health care “industry,” we now hear about the provision of health care services.

We are supposed to “know” that goods are good because they are called goods.  More baseball bats and air conditioners are therefore good.  Services are more ambiguous.  Economists are clear that “financial services” are good even though they are the basic cause of our most recent burst bubble and recession.  We have the problematic strategy that we have to rescue financial institutions to rescue the economy even though the financing supports further de-industrialization by moving more car assembly work to Mexico and South Korea.  So “services” that make a lot of money for the most wealthy without delivering more things, and the more usual meaning of services, are “good.”

Usual services include health care services, and that gives economists enough wiggle room to go back to calling them expenses and tax burdens.  Now we are getting close to untangling economic rhetoric, confusing economic rhetoric used by Republicans and Democrats alike.  We are talking about health care cost as expenses to employers (meaning the stockholders and bondholders of employers) and tax burdens on the wealthy who hate the progressive income tax and all corporate taxes.  This confusion goes along with thinking of labor primarily as cost and only bringing up the importance of jobs and income at election time.  Amazing how wages and salaries swing back and forth between good and bad depending on the frame of reference.

Passing strong health care reform would be a snap if we could rescue the economy from the rhetoric of economists.  Health care reform is good.  Providing more health care services is good.  We the people have to face up to the fact that we have to pay for the health care services we want.  The money that is spent on health care goods and services strenghtens the economy at least as much as any other spending and has the added advantage of creating more years of productive energy and capacity for people to contribute to making their own lives and the lives of others better.  When this is straightened out then we can talk more intelligently about the methods of buying the health care we want.  You know from my previous posts that I strongly favor tax based spending as far more efficient in providing health care per dollar spent.  The production of health care goods and provision of health care services would still be in private hands and there would still be some residual need for private insurance.

We seem to be surviving de-industrialization and maybe we are getting smart enough to force major changes in financial services so that they will return to their proper role of helping the rest of the economy instead of pretending that they are the economy.  “High” finance, whatever else it is, is not an end in itself.  Beware of financial services that feed on themselves and regard the rest of the economy as distractions of buying and selling, providing and using.  When we clear away the public relations of “high finance” we can talk about investing in the health of our society instead of investing in complex derivatives that feed off each other in arcane rounds of transactions that are designed to enrich the manipulators rather than the people.

It continues to amaze me that with all the millions of words in the public sphere regarding climate change and greenhouse gas emissions that very little is said about the core of the problem: the efforts by energy producers and energy users to avoid paying for the full cost of producing energy.  The primary solution is pretty simple: energy companies should charge a fair price for the energy they produce and all of us who use energy should pay it.  When a carpenter builds an addition to your house you expect the carpenter to clean up when the work is done and assume that the price you pay includes the work and the cleanup.  That is how we should pay for any energy, whether it be nuclear, fossil fuel, hydroelectric, wind, or whatever.

The current reality is that energy companies, like many manufacturers, “exteriorize” every cost they can, including cleanup.  It’s fine with energy companies and manufacturers who create toxic waste dumps when the cleanup gets paid for through taxes for the Superfund cleanup program.  It is also fine with energy producers and manufacturers when their workers pay for the illnesses and injuries that come with their employment, both their costs of getting health care and, far more importantly, through shortened lives and injured lives.  Now that it is clear that dirty air injures individuals and climate change will injure many more, we need to charge the full and fair price for producing energy and cleaning up behind.

The “cap and trade” bill before Congress is one way to get major air polluters to pay for the damage they are doing.  The cap and trade mechanism would merely cut the big polluters a little slack, a few years to clean up their energy production.  Forget the “public relations” campaigns and disingenuous advocacy of the polluters.  They don’t want to pay for the problems they are causing.  We consumers get sucked in because we do not want to pay more for our energy.  Climate change is abstract.  A $20 increase in the electric bill feels up close and personal.

Please.  The is no time for listening to economists.   Their collective lack of vision is a big part of the problem.  Collectively, their rhetoric is the backbone of the public relations comments that obscure the concept of a full and fair price.  They count current money flows and their assumptions are the shifting sand of current business and financial practices.  Instead keep your eye on the fundamentals.  If we start paying a full and fair price for all our energy then, for starters we will have solid assumptions for favoring one kind of energy source over another.  Coal companies wont be able to get away with saying their product is cheap when what is true is that coal is cheap if you don’t have to pay for land reclamation after strip mining, don’t have to pay for the poisoning of ground water, don’t have to pay for the damages that are caused by what comes out of the smoke stack.  The same kind of hard numbers are needed for nuclear, ethanol, and even wind created energy.  With fair prices, all the manufacturing, business, and residential uses of energy will have to fit their fair energy costs into their fair prices.  At that point we can trust open market practices to help us make our best economic decisions.  A free market that “exteriorizes costs” is a cheating market that violates the fundamental idea that we should be charged based on the full and fair price of putting energy or a product up for sale.

Even as I was working hard for Obama and congressional Democrats in 2008, I was worrying about the Republican Party.  One of my first posts on this blog considered whether Republicans would withdraw or open up after their losses.  On a news day that focuses on Arlen Specter’s switch back to being a Democrat, I think there is more to be learned on this score from the Senate vote to confirm Kathleen Sebelius as Secretary of the Department of Health and Human Services.  The vote was 65-31 with three senators not voting (Kennedy D-MA, Rockefeller D-WV, Sessions R-AL).  The remaining 56 Democrats voted to confirm.

The lesson I am interested in comes first from looking at the 9 Republicans who voted to confirm.  In one sense their vote is not surprising at all.  It has been Senate tradition to give the benefit of the doubt to the president and to confirm nominees so that the executive branch can function.  Those in the minority reason that they cannot get who they want and are willing to settle for reasonable competence and no corruption.  No one questions that Sebelius has shown competence as the Governor of Kansas.  That won her the votes of both Kansas Republican senators (Roberts and Brownback).

The interesting part is that conservative Republicans tried to turn this vote into a litmus test on abortion on the basis that Sebelius has received campaign contributions from a doctor who performs abortions in Kansas.  31 Republicans lined up with the conservatives.  Forgetting Specter who has just announced he is going to be a Democrat, the remaining 6 Republican votes to confirm were cast by: Bond of Missouri, Collin and Snowe of Maine, Gregg of New Hampshire, Lugar of Indiana, and Voinovich of Ohio.  All are from the Northeast or Midwest.  Collins, Snowe, and Gregg are from Democrat leaning states and are the only Republican senators left in the Northeast.  Bond, Lugar, and Voinovich are from Midwestern states that became swing states in the 2008 election.  Brownback, Gregg, Bond, and Voinovich are retiring and don’t have to make electoral calculations.

The anti-abortion appeal did not move any Democrat Senators.  Only Collins, Snowe, and Lugar were facing re-election battles, but not in 2010.  Collins and Snowe are both women and win in Maine by keeping their distance from the conservatives who have been winning by running on “social issues.”  And I don’t think you can build much analysis of the direction of the Republican Party and the future of bipartisanship by trying to figure out one senator (Lugar).

What will the 32 other Republicans do?  First of all, the Sibelius vote shows they are going to continue to try to make a big deal of their hot-button base issues: Guns, Abortion, and Gay marriage.(GAG)  They have been beating those drums for years and a lot of Republicans will have to bend themselves out of shape to get through the Republican primaries and raise Republican money.   Think of Mitt Romney from Massachusetts who wanted to run on sound business positions.  More importantly, consider that only 21 percent of voters in the United States now say they identify as Republicans and you can pretty well bet that a lot of them will base their vote on GAG with subtexts of lingering racism, anti-intellectualism, and patriotism defined by war-fighting.

It is easy for me to think, “Well the Republicans built their own trap and many of the conservative senators and leaders don’t even know it is a trap yet.”  It is easy for me to think, “Let them earn the rewards they so richly deserve and let the most alienated secede with Governor Perry and troop off into the wastelands of a Texas reservation.”  (See earlier blog post.)  But my better self, my more analytical self says, “We need a constructive and functional Republican Party to serve a watchdog function and to stretch the conversations about important policies.”

What else do the conservative Republicans have to work with?  Orrin Hatch of Utah and Chuck Grassley of Iowa, among others, are thoughtful about a lot of important issues and are certainly not defined by GAG.  So one core political question remains: can a lot of conservative Republicans who care a lot more about taxes, defense, even foreign policy than they care about GAG continue to get away with paying off a little on the GAG issues to stay elected while focusing on the traditional Republican (business) agenda.  My answer is maybe because the GAG afficianodos have nowhere else to go for the most part.

The Democrats are firmly in control of the legislative and administrative agendas, even if they face challenges about getting the votes they need for passage of some of their more assertive policies on health care, education, and energy.  The Republicans are not going to get many shots at GAG issues and are stuck with trying to blow up GAG balloons around tangential matters like the Sibelius nomination.  That may keep their 21 percent happy but it is not a path, by itself, to many election victories.  Republican senators, and other Republicans, are going to face a steady diet of votes and press on health care, education, and energy, in addition to the always issues of the budget and appropriations, military spending, and foreign policy.  Finally we get to the buzz phrase, “The Republicans have run out of ideas.”  My translation of the phrase is that Republican positions on health care, education, and energy have been unpopular for a long time based on public opinion polling and that is showing up now that Democrats are driving the agendas.  Few people love private health insurance.  The overwhelming number of people send their children to public schools and want those schools to be better.  The decline in oil production and increasing dependence on “foreign oil” is obvious.  And Democrats have their own issue constituencies built around civil rights, fair treatment of immigrants, improving the environment, GLBT civil rights (including civil marriage), etc.

If Republicans are going to have a lot of trouble looking good on health, education, and energy, can they make their case on the general operation of government, on taxes, on budget and appropriation issues, on military spending, and on foreign policy?  This is where we finally get focused in on the most fundamental challenges to the electoral future of Republicans and to the potential for constructive bipartisanship which can give them a positive image to counter so much bad karma they are pouring out as exemplified by their opposition to the Sebelius nomination.
Future posts on this blog will pick up these focused questions.

I don’t want to look at torture by the United States either.  I initiated showing the “Ghosts of Abu Ghraib” at Seekers Church and I don’t want to look at many more truths like that which still trouble my emotional tranquility, still show up in my dreams.  I preached a sermon at Seekers on “Seeing What You Don’t Want to See” and I don’t want to return to the subject.  I get all the email from the National Religious Committee Against Torture and I don’t want to open them up and I don’t want to send an email to my representative and senators.  Stories about torture and the release of a lot of critical information by President Obama have been front page fare in the New York Times and the Washington Post and I have mostly skipped past them, read just enough to trigger my resistances and then move on.  But I read Paul Krugman’s column in the New York Times today and I convicted myself of my emotional cowardice.

Given my own cowardice it is hard to be overly critical of all those in the George W. Bush Administration and those in the Congress, Republican and Democrat alike, who knew what was going on and stood aside who, like me, averted their eyes and hardened their hearts.  The Bush Administration is gone, though Dick Cheney is still giving voice to all the hatefulness and destructiveness that it bred.  The Obama Administration is in place and has been willing to shed light into the dark corners, but the issue is so painful that it might just distract the people ofthe United States from gathering support for all the things that are crying out for our attention.

The Republicans are mostly continuing to bluster and are continuing to try to avoid the truth.  They are continuing to lie about the effectiveness of torture in producing useful and timely intelligence.  And Democrat leaders and Democrat watchdogs in the Intelligience Committees are continuing to cringe and dissemble even as other Democrats are calling for truth squads and prosecutions.   The truth is that the torture activities of the United States have done far more damage to the United States than they have done to any enemy.  Cheney and Bush have done huge harm to the moral standing of the United States in the world.  They did huge damage to the CIA and left it divided and fearful of prosecutions.  But, most of all they did huge damage to the moral, social, and political fabric of the United States.

Of course it is divisive to talk about torture.  That divisiveness is part of the legacy of Cheney and Bush and one more way their poison is still affecting us.  But, as Krugman so carefully points out, the torture happened, the diviseness is there.  It is distracting and we can’t just wish it away because it is deep in our unconscious as well as our conscience.

Three things need to happen.   We need to see the truth and more of us, starting with me, need to really look at what is already available.  We need to prosecute people who broke the law and that can be done by the Justice Department.  Most of all we need to encapsulate and isolate Dick Cheney and all his ideological henchmen as enemies of public morality.  I don’t believe in single issue politics because everything is interrelated.  And I believe in political and social retribution that isolates and humiliates Dick Cheney and his ideological henchmen because everything is interrelated and we need to get this poison out of our system.

One of the favorite ways of avoiding the moral impact of torture, of hiding from the corporate shame of being citizens of the United States and thus ultimately responsible for the sins of the United States, is to switch the conversation way from “Was it Wrong” to “Was it Effective.”  And yes, I use that emotional escape as well.  I don’t believe it was effective for a lot of reasons but I am not going to trot out that reasoning because we need to stay focused on “It was deeply wrong and that matters.”

It is hard to think of anything worse than systematic torture.  I try, every once in awhile, to imagine what it would be like to be forced to endure stress positions, ongoing loud music I hate, enduring extremes of hot and cold with no end in sight, extended sleep deprivation, etc.  If you let yourself get emotionally close to such torture, if you can’t just zip past my last sentence, I believe you will realize that we have to say a clear and simple no to having such things done in our names.

Our moral outrage made a war hero out of John McCain because he was tortured, because he endured what was wrong and oppressive.  Then we act surprised that “Radical Islamic Terrorists,” otherwise known as mostly young people with little hope for a decent life under current conditions, make war heros out of their martyrs.  It just shows that they are tapping into the same fundamental moral reality that says no to torture.  Let us build our end of a bridge to them by saying no to torture and hope that it will eventually be noticed and met by a bridge from the other side.  If nothing else, our end of the bridge will be a monument that points our own path, including our path to our reconciliation with God out of repentence for the wrong we have allowed to be done.  If we can’t truly say no to torture then we breathe life into Dick Cheney and are corrupted into sharing the blame for all the divisiveness and hatefulness he continues to sow.

I agree that the bursting of the Mortgage Bubble was the immediate cause of the financial crisis, and I also think we have to dig deeper to understand why the financial crisis became a recession leaving the Untied States with an uncertain economic future.  My reflection on this subject brings me around once again to my perception of a fundamental flaw in unrestrained free market capitalism.  My critique is different than the Marxist critique and it is aimed at supporting programs, mostly already in place, that strengthen the good aspects of free markets.

There is a tin lining in all the bad news about declining housing values and we can learn from it.  While the Federal Reserve, Freddie Mac, and other big financial players are focused on generating new mortgage money at lower rates, and without considering the one-time bonus in the stimulus package for first time home buyers, the decrease in housing prices is already creating more affordable housing.   Notice the not-so-subtle difference in talking about propping up the financial system by getting mortgage money flowing and the goal of providing affordable housing.  Sure they are related, but they are not the same thing.

When you look through the lens of affordable housing you have to ask the question, “What can people afford?”  That question draws attention to the level of what workers are earning.  What workers are earning is a very different lens than looking at the work force through the lens of unemployment rates.  They are related but they are not the same thing.  In the context of housing, lost jobs lead to foreclosures while pay rates affect what people can afford for housing.

Which brings us to the fundamental flaw that I almost never hear economists and conservatives talking about, and only occasionally hear liberals talking about.  The standard business myth/model is that labor costs are the big thing to cut back on to make profits, or to rescue a company in trouble.  It is the big lever in the proposed redirection of General Motors, for example.  Many “theys” say, “We have to cut back on production costs for General Motors cars so they can compete with Toyota, etc.”  And the number one way to cut back on production costs is to wring concession from the United Auto Workers.  The conservatives, for the moment, have won the rhetorical battle that unions are bad because they keep businesses from being competitive by cutting labor costs.  But I am writing about a bigger flaw than the need to protect labor unions.

Cutting labor costs by firing workers, or by reducing pay and benefits, particularly health care and pensions, means that workers have less to spend.  Auto workers can’t buy toasters or massages and that in turn depresses the incomes of toaster workers and massage therapists.  Cutting labor costs produces short term efficiency for a single company, improves the bottom line of profitability for the quarter or the year, but collectively it is very bad for the market.  Collectively, all these profitability and efficiency driven cuts that hurt workers shrivel the general market.

The economists saw no problem in giving away the manufacturing sector of the United States, the clothes making sector, and the exportable service jobs such as telephone banking.  Instead they stuck to their free market ideology and trumpeted the advantage of lower cost goods because the dolls sold by Disney are made in Sri Lanka at 18 cents an hour.   But the people in Sri Lanka can’t build houses in Hoboken at 18 cents an hour.  And people in Hoboken working full-time at $8.00 an hour can’t buy a house, not even with lower housing prices and 4 percent mortgages.  Well, maybe they could buy a trailer in a trailer park.

The Obama prescription for saving General Motors buys into the short range efficiency and competitiveness arguments of cutting income and benefits for workers.  That to me is more fundamental than the dastardly and rapacious arguments of the CEO’s who want their million dollar bonuses because they are making the “tough calls” and are efficiently firing workers and bargaining down their wages and benefits, finding ways to escape from decades long promises for pensions and health care.  On both sides we see a mind set at work that refuses to understand that reducing employment, pay, and benefits shrivels the market and drives us deeper and longer into recession.

We have been able to hide from this unpleasant truth for decades, all through the selling out of workers in the United States by “free” competition with workers in other countries, because increases in productivity and the maintenance of middle class life styles by paying both husband and wife a combined wage that is as good as what a single wage used to be, has kept down the pain.  Now that the pain level is higher, maybe we will be more ready to look at our fundamental flaw.

Since we have already given away so many jobs, there is little we can do other than pressure Sri Lanka businesses, owned by multi-nationals, to provide better pay and benefits for their workers.  Focusing on where the United States still has significant leverage, at least for a few more years, we can do things that help workers in the United States get more employment, wages, and benefits.  There are numerous tactics, but the fundamental strategy has to be forcing the wealthy to use their money in ways that support the common good and not just their individual and family good.  Yes, fundamental income redistribution.  If we do that right it would generate a lot more market and, in turn, a lot more business and investment opportunities because auto workers, et al, could buy toasters and massages.  There would be a lot more places for banks to lend their money with appropriate conservative loan standards.

I’m not talking about forcing the wealthy into poverty by taking everything away in a revolution.  We need to tax the wealthy more to get their money circulating in the job creating and job enhancing sectors of the economy that need ongoing stimulus.  They are already screaming, and pretending outrage with tea bags, at small tax increases and we need to laugh them into submission on that score.  What I’m really interested  in however is making them behave as good stewards of their resources.  That is what we did at the turn of the 20th century with fundamental changes in the rules for interstate commerce, rules for rewarding labor, and rules requiring some transparency.  The wealthy hated all those rules then and the rules ended up generating our modern U.S. economy that enriched everyone and has been a model for the world ever since.

One of the big problems is that we are now operating in an international and multi-national context.  Maybe we will be able to fix a few of the most outrageous practices of multi-national corporations this year such as their pretend off-shore headquarters that allow them to avoid U.S. taxes, their share of paying for what we need through government.  But we need to think big, such as a rule that would require multi-national corporation to pay workers in other countries 90 percent of what workers in the United States are paid for similar work if they want to sell their goods and services in the United States.  Disney dolls would cost more and more dolls would be made in the United States so that doll-makers could afford more toasters at the higher price.  Doll makers in Sri Lanka would lose a lot of jobs unless they could use the 10 percent advantage in labor costs to compete by selling slightly cheaper dolls in the United States.  This is an example of leveling the playing field for the free market to act within.

A far more immediate, and more doable, leveling of the playing field would be to create health care reform along the lines I suggested in earlier postings of this blog.  The proposals emerging from the Democrat dominated Congress are modest steps in the right direction, particularly the proposal to create a public insurance plan to compete with private insurance plans.  Let the private insurers back up their boasts that they are more efficient than public, tax-based, insurance programs.  A big step forward in health insurance reform would have a huge impact on general labor-productivity.  The products and services of U. S. workers would be more competitive in international markets, the health sector of the U.S. economy would be greatly strengthened as the employer fountain it has become, U. S. workers and their families would be healthier, and, best of all, there would be a sudden release of productivity and creativity as workers and start-up companies could move around between jobs, and relocate around the United States, without losing their health care.  Most importantly, more people could buy affordable housing and even the financial sector, at the end of the line rather than the front of the line, would prosper.  The financial sector used to be servants to other businesses and they would return to that appropriate position in the U.S. economy.