Without health care reform, health insurance premiums could almost double by 2020, according to a report by the Commonwealth Fund, a 90-year-old non-profit health care charity.
According to "Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes," employer-sponsored family plans will rise from an average cost of $12,298 in 2008 to $23,842 in 2020 (the same coverage would have cost close to $9,200 in 2003) if health-care costs continue to rise at the current rate.
The study found that:
The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise from $12,298 (the 2008 average) to $23,842 by 2020--a 94 percent increase. However, if health system reforms were able to slow premium growth by 1 percentage point in all states, by 2020 employers and families together would save $2,571 per premium for family coverage, compared with projected trends. If growth could be slowed by 1.5 percentage points--a target recently agreed to by a major industry coalition--yearly savings would equal $3,759. The analysis presents state-by-state data on premium costs for 2003 and 2008, as well as projections, using various assumptions, for costs in 2015 and 2020.
The author of the study, Cathy Shoen, senior vice president of the Commonwealth Fund, said in a news release:
"With health spending projected to double if we stay on our current path, middle- and lower-income families are at high risk of losing their coverage or facing long-term stagnant incomes. Employers and employees share premium costs, but we know that take-home pay and retirement savings are being sacrificed to maintain health benefits. Reforms that slow the growth of health-care costs could go a long way toward health and financial stability for working families."
Employer-based premiums for family coverage increased an average of 33 percent between 2003 and 2008, ranging from a low of 25 percent in Michigan, Texas and Ohio to a high of 45 percent in Indiana and North Carolina.
Figure 3. Premiums for Family Coverage, 2003, 2008, 2015, and 2020
9,249
7,866
10,748
12,298
10,837
13,788
17,599
15,508
19,731
23,842
21,009
26,730
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
U.S. average Lowest state Highest state
2003 2008 2015 2020
Health insurance premiums for family coverage
1 2003: Lowest is North Dakota; highest is District of Columbia. 2008, 2015, and 2020: Lowest is Idaho; highest is Massachusetts.
Data sources: Medical Expenditure Panel Survey–Insurance Component (for 2003 and 2008 premiums); Centers for Medicare
and Medicaid Services, Office of the Actuary, National Health Statistics Group, national health expenditures per capita annual
growth rate (for premium estimates for 2015 and 2020
Sunday, August 23, 2009
Saturday, August 22, 2009
Media Matters: Press should take finger off button in "nuclear option" health care coverage
Weeekly UpDate from:
WWW.MEDIAMATTERS.ORG
Media conservatives aren't content to merely misinform regarding the content of progressive health insurance reform legislation. They want to misinform about the legislative process used to pass that legislation, too. Just think of it: Death panels passed using a nuclear option. What American could support that?
In recent days, talk of Senate Democrats using the budget reconciliation process to pass health care reform legislation has grown. According to Senate rules, bills advanced through the process can't be filibustered, and so the 60-vote threshold that must be met to defeat a filibuster would not apply. Republicans used reconciliation in exactly this way during the Bush years to pass tax cuts in 2001, 2003, and 2005. Senate Republicans also used the reconciliation process to pass a bill permitting oil drilling the Arctic National Wildlife Refuge. (The final version of that bill signed by Bush did not contain the provision on drilling.) So long as the legislation in question impacts the budget, doing so is within regular Senate order.
Conservatives in the media, however, have now chosen to portray such a course of action as the dreaded "nuclear option." As usual, a little history reveals a lot of hypocrisy. The phrase was actually coined by former Majority Leader Trent Lott (R-MS) in 2003 during the Democratic filibuster of U.S. Court of Appeals nominee Miguel Estrada. At the time, Republican aides discussed changing the rules of the Senate to make filibusters of judicial nominees out of order. Lott, reflecting the drastic nature of such a change, called it a "nuclear option." Starting in 2005, Republicans noted that the term polled badly. They began referring to such a rules change as the "constitutional option," and claimed that only Democrats called it a "nuclear option." The media quickly fell in line, repeating the falsehood.
Unsurprisingly, the hypocrisy has continued. Passing budget-related legislation through the reconciliation process and the "nuclear option" have nothing to do with each other.
This hasn't stopped the conservative media from conflating the two. The goal is to portray progressives as a group of anti-democratic radicals, forcing through a supposedly unpopular bill using procedural tricks -- or, in Chris Matthews' words, "blow[ing] up the Senate rules." Fox News vice president and Washington managing editor Bill Sammon was one of the first to draw the false equivalency back in June, and in recent days, the chorus has only grown. Dick Morris did the same on August 10, and Sean Hannity has repeatedly pushed the distortion. The Fox Nation website even chose to illustrate the story using a mushroom cloud.
Just as they did several years ago, multiple mainstream media figures have taken up the right's deceitful talking point, among them A.B. Stoddard of The Hill, Matthews, and even CNN hosts Anderson Cooper and Kiran Chetry. Thus far, factual explanations, such as the one provided by CNN's Josh Levs, have been few and far between.
This distortion has jumped from the media to the highest levels of the Republican Party. When Hannity hosted RNC chairman Michael Steele, he asked about the "by any means necessary" approach Democrats were considering. "Does this mean the will of the American people," Hannity asked, "as evidenced by just about every credible poll, means nothing to them?" (It seems as though NBC/Wall Street Journal polls are no longer credible to Hannity.) Steele agreed: "If it means the nuclear option, it's going to be the nuclear option."
The right-wing distortion here is obvious and blatant. For the sake of its credibility, the media needs to take its finger off the "nuclear" button.
Other major stories this week
Tom DeLay joins Dancing with the Birthers
Disgraced former House Majority Leader Tom DeLay (R-TX) has had quite a week. First, it was announced that he will be joining the new cast of ABC's Dancing with the Stars. Appearing on ABC's Good Morning America, DeLay told Chris Cuomo: "I love dancing. ... You've got to love dancing if you're from Texas." He's right -- we all remember DeLay's deft ability to dance around congressional ethics rules. CNN's Campbell Brown called it DeLay's "second act," but I'm pretty sure his curtain was called years ago.
Far from finished, DeLay made the rounds on cable and network television promoting his new venture as a reality star. On MSNBC's Hardball, DeLay aligned himself with CNN's Lou Dobbs by saying, "I would like the president to produce his birth certificate."
Maybe ABC should rename the show Dancing with the Birthers, because Tom DeLay is apparently a master of el tango loco.
Beck's advertiser exodus continues
Last week we noted:
There was an encouraging development in the ongoing campaign to get hate off our public airwaves. After a host of progressive groups, among them Media Matters and ColorOfChange.org, publicized Beck's recent rant accusing [President] Obama of racism, multiple companies announced that they would no longer advertise on his program -- among them: ConAgra, Roche, Sanofi-Aventis, Radio Shack, GEICO, Travelocity, and Sargento. Reflecting on the development, The Washington Post's Jonathan Capehart said that it might "pump the brakes on some of these wild statements." We can only hope.
Well, Beck's advertiser exodus continues. This week, Farmers Insurance reportedly said it had "ceased placing [ads] on Glenn Beck a week ago." Likewise, GMAC Financial Services, parent company of Ally Bank, announced that it, too, had "ceased advertising on the Glenn Beck program."
The conservative media chattering class is none too pleased with these developments. Radio host Rose Tennent called GEICO "idiots" for pulling Beck's ads, while radio talker Jim Quinn said Color of Change has "kowtowed" advertisers into ditching Beck. On his radio program, Fox News' Sean Hannity even claimed that accusations that radio hosts want the president dead (I, for one don't, remember anyone of prominence making this charge) were part of a "strategy to silence," like "people go[ing] after advertisers."
In other sponsor news, JC Penney reportedly said it has a "policy" that prohibits advertising on Rush Limbaugh's show -- but Media Matters was able to produce audio from El Rushbo's broadcast containing an ad for the retailer. Home Depot also reportedly claimed it doesn't "support" Limbaugh's program, and Media Matters was also able to produce audio of a Home Depot ad airing during the conservative leader's show. We welcome the policies announced by JC Penney and Home Depot, but perhaps now would be a good time for them to state publicly that they will no longer run ads on Rush's show.
When PoliticsDaily.com claimed that "the pressure on advertisers has become a politically charged debate about the right to free speech, censorship and what constitutes hate speech," Media Matters' Eric Boehlert responded: "Do editors at PoliticsDaily.com not understand what 'censorship' means in terms of free speech? ... Of course, only the government can censor free speech." In other words, the First Amendment doesn't guarantee anyone the right to his own show.
Conservative media: Barney Frank is soooo rude
At a town hall meeting in Massachusetts, a woman took to the mic and asked Rep. Barney Frank (D-MA), who is both Jewish and gay, "why do you continue to support a Nazi policy as Obama has expressly supported this policy? Why are you supporting it?" Frank responded: "When you ask me that question, I'm going to revert to my ethnic heritage and answer your question with a question. On what planet do you spend most of your time?" Frank went on to say, "You want me to answer the question? As you stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis, my answer to you is, as I said before, it is a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated. ... Ma'am, trying to have a conversation with you would be like trying to have an argument with a dining room table. I have no interest in doing it.
For conservatives in the media, this was over the line. No, I'm not talking about the Nazi nonsense; I'm talking about Frank's response to the lunacy.
Fox News' Brian Kilmeade blasted Frank's "arrogance" and "smugness" and wondered why the Massachusetts Democrat couldn't just say, "I understand where you're coming from, but ... " His Fox & Friends co-host Steve Doocy repeatedly defended the woman, claiming that Frank's response to her was "rude," out of touch, and laden with "attitude," while never noting the content of the woman's question. Limbaugh called the woman's Nazi sign and question "fabulous" before telling his listeners that Frank "spends most of his time living around Uranus."
In the words of Comedy Central's Stephen Colbert, "I've been watching these town hall meetings, and I've had enough of these uncontrollable outbursts by members of Congress. Hey, congressmen, how are people supposed to scream their questions if you keep interrupting with your answers? And Democrat Barney Frank is the latest culprit."
WWW.MEDIAMATTERS.ORG
Media conservatives aren't content to merely misinform regarding the content of progressive health insurance reform legislation. They want to misinform about the legislative process used to pass that legislation, too. Just think of it: Death panels passed using a nuclear option. What American could support that?
In recent days, talk of Senate Democrats using the budget reconciliation process to pass health care reform legislation has grown. According to Senate rules, bills advanced through the process can't be filibustered, and so the 60-vote threshold that must be met to defeat a filibuster would not apply. Republicans used reconciliation in exactly this way during the Bush years to pass tax cuts in 2001, 2003, and 2005. Senate Republicans also used the reconciliation process to pass a bill permitting oil drilling the Arctic National Wildlife Refuge. (The final version of that bill signed by Bush did not contain the provision on drilling.) So long as the legislation in question impacts the budget, doing so is within regular Senate order.
Conservatives in the media, however, have now chosen to portray such a course of action as the dreaded "nuclear option." As usual, a little history reveals a lot of hypocrisy. The phrase was actually coined by former Majority Leader Trent Lott (R-MS) in 2003 during the Democratic filibuster of U.S. Court of Appeals nominee Miguel Estrada. At the time, Republican aides discussed changing the rules of the Senate to make filibusters of judicial nominees out of order. Lott, reflecting the drastic nature of such a change, called it a "nuclear option." Starting in 2005, Republicans noted that the term polled badly. They began referring to such a rules change as the "constitutional option," and claimed that only Democrats called it a "nuclear option." The media quickly fell in line, repeating the falsehood.
Unsurprisingly, the hypocrisy has continued. Passing budget-related legislation through the reconciliation process and the "nuclear option" have nothing to do with each other.
This hasn't stopped the conservative media from conflating the two. The goal is to portray progressives as a group of anti-democratic radicals, forcing through a supposedly unpopular bill using procedural tricks -- or, in Chris Matthews' words, "blow[ing] up the Senate rules." Fox News vice president and Washington managing editor Bill Sammon was one of the first to draw the false equivalency back in June, and in recent days, the chorus has only grown. Dick Morris did the same on August 10, and Sean Hannity has repeatedly pushed the distortion. The Fox Nation website even chose to illustrate the story using a mushroom cloud.
Just as they did several years ago, multiple mainstream media figures have taken up the right's deceitful talking point, among them A.B. Stoddard of The Hill, Matthews, and even CNN hosts Anderson Cooper and Kiran Chetry. Thus far, factual explanations, such as the one provided by CNN's Josh Levs, have been few and far between.
This distortion has jumped from the media to the highest levels of the Republican Party. When Hannity hosted RNC chairman Michael Steele, he asked about the "by any means necessary" approach Democrats were considering. "Does this mean the will of the American people," Hannity asked, "as evidenced by just about every credible poll, means nothing to them?" (It seems as though NBC/Wall Street Journal polls are no longer credible to Hannity.) Steele agreed: "If it means the nuclear option, it's going to be the nuclear option."
The right-wing distortion here is obvious and blatant. For the sake of its credibility, the media needs to take its finger off the "nuclear" button.
Other major stories this week
Tom DeLay joins Dancing with the Birthers
Disgraced former House Majority Leader Tom DeLay (R-TX) has had quite a week. First, it was announced that he will be joining the new cast of ABC's Dancing with the Stars. Appearing on ABC's Good Morning America, DeLay told Chris Cuomo: "I love dancing. ... You've got to love dancing if you're from Texas." He's right -- we all remember DeLay's deft ability to dance around congressional ethics rules. CNN's Campbell Brown called it DeLay's "second act," but I'm pretty sure his curtain was called years ago.
Far from finished, DeLay made the rounds on cable and network television promoting his new venture as a reality star. On MSNBC's Hardball, DeLay aligned himself with CNN's Lou Dobbs by saying, "I would like the president to produce his birth certificate."
Maybe ABC should rename the show Dancing with the Birthers, because Tom DeLay is apparently a master of el tango loco.
Beck's advertiser exodus continues
Last week we noted:
There was an encouraging development in the ongoing campaign to get hate off our public airwaves. After a host of progressive groups, among them Media Matters and ColorOfChange.org, publicized Beck's recent rant accusing [President] Obama of racism, multiple companies announced that they would no longer advertise on his program -- among them: ConAgra, Roche, Sanofi-Aventis, Radio Shack, GEICO, Travelocity, and Sargento. Reflecting on the development, The Washington Post's Jonathan Capehart said that it might "pump the brakes on some of these wild statements." We can only hope.
Well, Beck's advertiser exodus continues. This week, Farmers Insurance reportedly said it had "ceased placing [ads] on Glenn Beck a week ago." Likewise, GMAC Financial Services, parent company of Ally Bank, announced that it, too, had "ceased advertising on the Glenn Beck program."
The conservative media chattering class is none too pleased with these developments. Radio host Rose Tennent called GEICO "idiots" for pulling Beck's ads, while radio talker Jim Quinn said Color of Change has "kowtowed" advertisers into ditching Beck. On his radio program, Fox News' Sean Hannity even claimed that accusations that radio hosts want the president dead (I, for one don't, remember anyone of prominence making this charge) were part of a "strategy to silence," like "people go[ing] after advertisers."
In other sponsor news, JC Penney reportedly said it has a "policy" that prohibits advertising on Rush Limbaugh's show -- but Media Matters was able to produce audio from El Rushbo's broadcast containing an ad for the retailer. Home Depot also reportedly claimed it doesn't "support" Limbaugh's program, and Media Matters was also able to produce audio of a Home Depot ad airing during the conservative leader's show. We welcome the policies announced by JC Penney and Home Depot, but perhaps now would be a good time for them to state publicly that they will no longer run ads on Rush's show.
When PoliticsDaily.com claimed that "the pressure on advertisers has become a politically charged debate about the right to free speech, censorship and what constitutes hate speech," Media Matters' Eric Boehlert responded: "Do editors at PoliticsDaily.com not understand what 'censorship' means in terms of free speech? ... Of course, only the government can censor free speech." In other words, the First Amendment doesn't guarantee anyone the right to his own show.
Conservative media: Barney Frank is soooo rude
At a town hall meeting in Massachusetts, a woman took to the mic and asked Rep. Barney Frank (D-MA), who is both Jewish and gay, "why do you continue to support a Nazi policy as Obama has expressly supported this policy? Why are you supporting it?" Frank responded: "When you ask me that question, I'm going to revert to my ethnic heritage and answer your question with a question. On what planet do you spend most of your time?" Frank went on to say, "You want me to answer the question? As you stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis, my answer to you is, as I said before, it is a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated. ... Ma'am, trying to have a conversation with you would be like trying to have an argument with a dining room table. I have no interest in doing it.
For conservatives in the media, this was over the line. No, I'm not talking about the Nazi nonsense; I'm talking about Frank's response to the lunacy.
Fox News' Brian Kilmeade blasted Frank's "arrogance" and "smugness" and wondered why the Massachusetts Democrat couldn't just say, "I understand where you're coming from, but ... " His Fox & Friends co-host Steve Doocy repeatedly defended the woman, claiming that Frank's response to her was "rude," out of touch, and laden with "attitude," while never noting the content of the woman's question. Limbaugh called the woman's Nazi sign and question "fabulous" before telling his listeners that Frank "spends most of his time living around Uranus."
In the words of Comedy Central's Stephen Colbert, "I've been watching these town hall meetings, and I've had enough of these uncontrollable outbursts by members of Congress. Hey, congressmen, how are people supposed to scream their questions if you keep interrupting with your answers? And Democrat Barney Frank is the latest culprit."
Competition lacking among private health insurers
RICARDO ALONSO-ZALDIVAR
Associated Press Writer
One of the most widely accepted arguments against a government medical plan for the middle class is that it would quash competition — just what private insurers seem to be doing themselves in many parts of the U.S.
Several studies show that in lots of places, one or two companies dominate the market. Critics say monopolistic conditions drive up premiums paid by employers and individuals.
For Democrats, the answer is a public plan that would compete with private insurers. Republicans see that as a government power grab. President Barack Obama looks to be trapped in the middle of an argument that could sink his effort to overhaul the health care system.
Even lawmakers opposed to a government plan have problems with the growing clout of the big private companies.
"There is a serious problem with the lack of competition among insurers," said Republican Sen. Olympia Snowe of Maine, one of the highest-cost states. "The impact on the consumer is significant."
Wellpoint Inc. accounted for 71 percent of the Maine market, while runner-up Aetna had a 12 percent share, according to a 2008 report by the American Medical Association.
Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.
A study by the Urban Institute public policy center estimated that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people.
"Right now, there's no incentive for insurers or big hospital groups to negotiate with each other, because they can pass higher payments on through premiums," said economist Linda Blumberg, co-author of the report. "A public plan would have the leverage to set lower payment rates and get providers to participate at those rates."
"The private plans would come back to the providers and say, 'If you don't negotiate with me, you're going to be left with only the public plan.'" Blumberg continued. "Suddenly, you have a very strong economic incentive for them to negotiate."
Insurers contend their industry is extremely competitive, and a public plan is unnecessary. About 1,300 carriers operate across the country, although many only have a small share of the market in their states.
"You can have a very competitive market and still have companies with a high market share," said Alissa Fox, a top Washington lobbyist for the Blue Cross Blue Shield Association.
Fox points to the federal employee health program, which also covers members of Congress. It offers a total of more than 260 options and 10 nationwide plans. Despite all the choices, about 60 percent of federal workers pick a Blue Cross plan.
"Insurers need to be of a significant size to best serve their customers and make sure that people get the best value," Fox said.
Nonetheless, lawmakers are concerned. Big insurers are getting bigger. Small businesses in particular have fewer and fewer options for getting coverage.
Congressional investigators this year looked at insurers catering to small employers around the country. The Government Accountability Office found that the median _or midpoint — market share of largest carrier increased to 47 percent in 2008 from 33 percent in 2002.
There's widespread recognition among lawmakers that a health care overhaul should foster more competition among insurers. The debate is over how far to go.
The basic framework lawmakers are looking at would encourage competition, even without a government plan. It calls for setting up a big insurance purchasing pool called an exchange. It would be open, at least initially, to individuals and small businesses. The government would offer subsidies to make premiums more affordable.
Consumers would find it much easier to shop for a plan through the exchange. For one thing, they would be able to readily compare benefits and premiums in different plans. Also, participating insurers would have to take all applicants and not charge higher premiums to those in poor health.
Offering the option of a public plan would supercharge the competition, supporters say.
Blumberg envisions a plan that pays medical providers more than Medicare, but less than private insurance. Her study estimated it could grow to 47 million members, leaving 161 million with private insurance. Even so, that would make the new public plan one of the largest insurers in the country, rivaling Medicare, Medicaid and big private companies such as Wellpoint and UnitedHealthcare.
It's a scenario that gives pause even to traditional adversaries of the insurance companies.
"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."
Snowe, among the few Republican senators still trying to come up with a bipartisan compromise, wants to hold back on creating a public plan for now and give insurers one last chance to show if they can keep costs in check.
That's doesn't go far enough for liberals, who are loath to give the insurance industry tens of millions of new customers supported by taxpayer subsidies.
"It would give the industry a windfall without any countervailing force to require them to lower their costs," said Richard Kirsch, national campaign manager for the advocacy group Health Care for America Now. "The insurance companies could continue to jack up premiums while getting a whole new market."
Associated Press Writer
One of the most widely accepted arguments against a government medical plan for the middle class is that it would quash competition — just what private insurers seem to be doing themselves in many parts of the U.S.
Several studies show that in lots of places, one or two companies dominate the market. Critics say monopolistic conditions drive up premiums paid by employers and individuals.
For Democrats, the answer is a public plan that would compete with private insurers. Republicans see that as a government power grab. President Barack Obama looks to be trapped in the middle of an argument that could sink his effort to overhaul the health care system.
Even lawmakers opposed to a government plan have problems with the growing clout of the big private companies.
"There is a serious problem with the lack of competition among insurers," said Republican Sen. Olympia Snowe of Maine, one of the highest-cost states. "The impact on the consumer is significant."
Wellpoint Inc. accounted for 71 percent of the Maine market, while runner-up Aetna had a 12 percent share, according to a 2008 report by the American Medical Association.
Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.
A study by the Urban Institute public policy center estimated that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people.
"Right now, there's no incentive for insurers or big hospital groups to negotiate with each other, because they can pass higher payments on through premiums," said economist Linda Blumberg, co-author of the report. "A public plan would have the leverage to set lower payment rates and get providers to participate at those rates."
"The private plans would come back to the providers and say, 'If you don't negotiate with me, you're going to be left with only the public plan.'" Blumberg continued. "Suddenly, you have a very strong economic incentive for them to negotiate."
Insurers contend their industry is extremely competitive, and a public plan is unnecessary. About 1,300 carriers operate across the country, although many only have a small share of the market in their states.
"You can have a very competitive market and still have companies with a high market share," said Alissa Fox, a top Washington lobbyist for the Blue Cross Blue Shield Association.
Fox points to the federal employee health program, which also covers members of Congress. It offers a total of more than 260 options and 10 nationwide plans. Despite all the choices, about 60 percent of federal workers pick a Blue Cross plan.
"Insurers need to be of a significant size to best serve their customers and make sure that people get the best value," Fox said.
Nonetheless, lawmakers are concerned. Big insurers are getting bigger. Small businesses in particular have fewer and fewer options for getting coverage.
Congressional investigators this year looked at insurers catering to small employers around the country. The Government Accountability Office found that the median _or midpoint — market share of largest carrier increased to 47 percent in 2008 from 33 percent in 2002.
There's widespread recognition among lawmakers that a health care overhaul should foster more competition among insurers. The debate is over how far to go.
The basic framework lawmakers are looking at would encourage competition, even without a government plan. It calls for setting up a big insurance purchasing pool called an exchange. It would be open, at least initially, to individuals and small businesses. The government would offer subsidies to make premiums more affordable.
Consumers would find it much easier to shop for a plan through the exchange. For one thing, they would be able to readily compare benefits and premiums in different plans. Also, participating insurers would have to take all applicants and not charge higher premiums to those in poor health.
Offering the option of a public plan would supercharge the competition, supporters say.
Blumberg envisions a plan that pays medical providers more than Medicare, but less than private insurance. Her study estimated it could grow to 47 million members, leaving 161 million with private insurance. Even so, that would make the new public plan one of the largest insurers in the country, rivaling Medicare, Medicaid and big private companies such as Wellpoint and UnitedHealthcare.
It's a scenario that gives pause even to traditional adversaries of the insurance companies.
"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."
Snowe, among the few Republican senators still trying to come up with a bipartisan compromise, wants to hold back on creating a public plan for now and give insurers one last chance to show if they can keep costs in check.
That's doesn't go far enough for liberals, who are loath to give the insurance industry tens of millions of new customers supported by taxpayer subsidies.
"It would give the industry a windfall without any countervailing force to require them to lower their costs," said Richard Kirsch, national campaign manager for the advocacy group Health Care for America Now. "The insurance companies could continue to jack up premiums while getting a whole new market."
Thursday, August 20, 2009
Time cover: 'The Real Cost of Cheap Food
'The Real Cost of Cheap Food ...
Why the American food system is bad for our bodies, our economy and the environment,' by Bryan Walsh:
'The crop is heavily fertilized-both with chemicals like nitrogen and with subsidies from Washington. Over the past decade, the Federal Government has poured more than $50 billion into the corn industry, keeping prices for the crop-at least until corn ethanol skewed the market-artificially low.
That's why McDonald's can sell you a Big Mac, fries and a Coke for around $5-a bargain, given that the meal contains nearly 1,200 calories, more than half the daily recommended requirement for adults. ...
[F]ruits and vegetables don't receive the same price supports as grains.
A study in the American Journal of Clinical Nutrition found that a dollar could buy 1,200 calories of potato chips or 875 calories of soda but just 250 calories of vegetables or 170 calories of fresh fruit.
With the backing of the government, farmers are producing more calories-some 500 more per person per day since the 1970s-but too many are unhealthy calories
Given that, it's no surprise we're so fat;
it simply costs too much to be thin. Our expanding girth is just one consequence of mainstream farming.
Another is chemicals.'
Why the American food system is bad for our bodies, our economy and the environment,' by Bryan Walsh:
'The crop is heavily fertilized-both with chemicals like nitrogen and with subsidies from Washington. Over the past decade, the Federal Government has poured more than $50 billion into the corn industry, keeping prices for the crop-at least until corn ethanol skewed the market-artificially low.
That's why McDonald's can sell you a Big Mac, fries and a Coke for around $5-a bargain, given that the meal contains nearly 1,200 calories, more than half the daily recommended requirement for adults. ...
[F]ruits and vegetables don't receive the same price supports as grains.
A study in the American Journal of Clinical Nutrition found that a dollar could buy 1,200 calories of potato chips or 875 calories of soda but just 250 calories of vegetables or 170 calories of fresh fruit.
With the backing of the government, farmers are producing more calories-some 500 more per person per day since the 1970s-but too many are unhealthy calories
Given that, it's no surprise we're so fat;
it simply costs too much to be thin. Our expanding girth is just one consequence of mainstream farming.
Another is chemicals.'
Standing Rules of the United States Senate
Wikipedia, the free encyclopedia
The Standing Rules of the Senate are the rules of order adopted by the United States Senate that govern its procedure. The rules are set by the Senate itself, as set down in Article One, Section 5 of the United States Constitution. The stricter rules are waived by unanimous consent. There are currently 43 rules; the latest version was adopted on April 27, 2000. The Legislative Transparency and Accountability Act of 2006 lobbying reform bill introduces a 44th rule on earmarks.
The Constitution provides that a majority of the Senate constitutes a quorum to do business. Under the rules and customs of the Senate, a quorum is always assumed to be present unless a quorum call explicitly demonstrates otherwise. Any senator may request a quorum call by "suggesting the absence of a quorum"; a clerk then calls the roll of the Senate and notes which members are present. In practice, senators almost always request quorum calls not to establish the presence of a quorum, but to temporarily delay proceedings. Such a delay may serve one of many purposes; often, it allows Senate leaders to negotiate compromises off the floor. Once the need for a delay has ended, any senator may request unanimous consent to rescind the Quorum Call.
During debates, senators may only speak if called upon by the presiding officer. The presiding officer is, however, required to recognize the first senator who rises to speak. Thus, the presiding officer has little control over the course of debate. Customarily, the Majority Leader and Minority Leader are accorded priority during debates, even if another senator rises first. All speeches must be addressed to the presiding officer, using the words "Mr. President" or "Madam President." Only the presiding officer may be directly addressed in speeches; other Members must be referred to in the third person. In most cases, senators do not refer to each other by name, but by state, using forms such as "the senior senator from Virginia" or "the junior senator from California."
There are very few restrictions on the content of speeches; there is no requirement that speeches be germane to the matter before the Senate.
The Standing Rules of the United States Senate provide that no senator may make more than two speeches on a motion or bill on the same legislative day. (A legislative day begins when the Senate convenes and ends with adjournment; hence, it does not necessarily coincide with the calendar day.) The length of these speeches is not limited by the rules; thus, in most cases, senators may speak for as long as they please. Often, the Senate adopts unanimous consent agreements imposing time limits. In other cases (for example, for the Budget process), limits are imposed by statute. In general, however, the right to unlimited debate is preserved.
The filibuster is a tactic used to defeat bills and motions by prolonging debate indefinitely. A filibuster may entail long speeches, dilatory motions, and an extensive series of proposed amendments. The longest filibuster speech in the history of the Senate was delivered by Strom Thurmond, who spoke for over twenty-four hours in an unsuccessful attempt to block the passage of the Civil Rights Act of 1957. The Senate may end a filibuster by invoking cloture. In most cases, cloture requires the support of three-fifths of the Senate; however, if the matter before the Senate involves changing the rules of the body, a two-thirds majority is required. Cloture is invoked very rarely, particularly because bipartisan support is usually necessary to obtain the required supermajority. If the Senate does invoke cloture, debate does not end immediately; instead, further debate is limited to thirty additional hours unless increased by another three-fifths vote.
When debate concludes, the motion in question is put to a vote. In many cases, the Senate votes by voice vote; the presiding officer puts the question, and Members respond either "Aye" (in favor of the motion) or "No" (against the motion). The presiding officer then announces the result of the voice vote. Any senator, however, may challenge the presiding officer's assessment and request a recorded vote. The request may be granted only if it is seconded by one-fifth of the senators present. In practice, however, senators second requests for recorded votes as a matter of courtesy. When a recorded vote is held, the clerk calls the roll of the Senate in alphabetical order; each senator responds when his or her name is called. Senators who miss the roll call may still cast a vote as long as the recorded vote remains open. The vote is closed at the discretion of the presiding officer, but must remain open for a minimum of 15 minutes. If the vote is tied, the Vice President, if present, is entitled to a casting vote. If the Vice President is not present, however, the motion is resolved in the negative.
On occasion, the Senate may go into what is called a secret, or closed session. During a closed session, the chamber doors are closed, and the galleries are completely cleared of anyone not sworn to secrecy, not instructed in the rules of the closed session, or not essential to the session. Closed sessions are quite rare, and usually held only under certain circumstances where the Senate is discussing sensitive subject-matter such as information critical to national security, private communications from the President, or even to discuss Senate deliberations during impeachment trials. Any Senator has the right to call a closed session as long as the motion is seconded.
Budget bills are governed under a special rule process called "Reconciliation" that disallows filibusters. Reconciliation was devised in 1974 but came into use in the early 1980s.
The Standing Rules of the Senate are the rules of order adopted by the United States Senate that govern its procedure. The rules are set by the Senate itself, as set down in Article One, Section 5 of the United States Constitution. The stricter rules are waived by unanimous consent. There are currently 43 rules; the latest version was adopted on April 27, 2000. The Legislative Transparency and Accountability Act of 2006 lobbying reform bill introduces a 44th rule on earmarks.
The Constitution provides that a majority of the Senate constitutes a quorum to do business. Under the rules and customs of the Senate, a quorum is always assumed to be present unless a quorum call explicitly demonstrates otherwise. Any senator may request a quorum call by "suggesting the absence of a quorum"; a clerk then calls the roll of the Senate and notes which members are present. In practice, senators almost always request quorum calls not to establish the presence of a quorum, but to temporarily delay proceedings. Such a delay may serve one of many purposes; often, it allows Senate leaders to negotiate compromises off the floor. Once the need for a delay has ended, any senator may request unanimous consent to rescind the Quorum Call.
During debates, senators may only speak if called upon by the presiding officer. The presiding officer is, however, required to recognize the first senator who rises to speak. Thus, the presiding officer has little control over the course of debate. Customarily, the Majority Leader and Minority Leader are accorded priority during debates, even if another senator rises first. All speeches must be addressed to the presiding officer, using the words "Mr. President" or "Madam President." Only the presiding officer may be directly addressed in speeches; other Members must be referred to in the third person. In most cases, senators do not refer to each other by name, but by state, using forms such as "the senior senator from Virginia" or "the junior senator from California."
There are very few restrictions on the content of speeches; there is no requirement that speeches be germane to the matter before the Senate.
The Standing Rules of the United States Senate provide that no senator may make more than two speeches on a motion or bill on the same legislative day. (A legislative day begins when the Senate convenes and ends with adjournment; hence, it does not necessarily coincide with the calendar day.) The length of these speeches is not limited by the rules; thus, in most cases, senators may speak for as long as they please. Often, the Senate adopts unanimous consent agreements imposing time limits. In other cases (for example, for the Budget process), limits are imposed by statute. In general, however, the right to unlimited debate is preserved.
The filibuster is a tactic used to defeat bills and motions by prolonging debate indefinitely. A filibuster may entail long speeches, dilatory motions, and an extensive series of proposed amendments. The longest filibuster speech in the history of the Senate was delivered by Strom Thurmond, who spoke for over twenty-four hours in an unsuccessful attempt to block the passage of the Civil Rights Act of 1957. The Senate may end a filibuster by invoking cloture. In most cases, cloture requires the support of three-fifths of the Senate; however, if the matter before the Senate involves changing the rules of the body, a two-thirds majority is required. Cloture is invoked very rarely, particularly because bipartisan support is usually necessary to obtain the required supermajority. If the Senate does invoke cloture, debate does not end immediately; instead, further debate is limited to thirty additional hours unless increased by another three-fifths vote.
When debate concludes, the motion in question is put to a vote. In many cases, the Senate votes by voice vote; the presiding officer puts the question, and Members respond either "Aye" (in favor of the motion) or "No" (against the motion). The presiding officer then announces the result of the voice vote. Any senator, however, may challenge the presiding officer's assessment and request a recorded vote. The request may be granted only if it is seconded by one-fifth of the senators present. In practice, however, senators second requests for recorded votes as a matter of courtesy. When a recorded vote is held, the clerk calls the roll of the Senate in alphabetical order; each senator responds when his or her name is called. Senators who miss the roll call may still cast a vote as long as the recorded vote remains open. The vote is closed at the discretion of the presiding officer, but must remain open for a minimum of 15 minutes. If the vote is tied, the Vice President, if present, is entitled to a casting vote. If the Vice President is not present, however, the motion is resolved in the negative.
On occasion, the Senate may go into what is called a secret, or closed session. During a closed session, the chamber doors are closed, and the galleries are completely cleared of anyone not sworn to secrecy, not instructed in the rules of the closed session, or not essential to the session. Closed sessions are quite rare, and usually held only under certain circumstances where the Senate is discussing sensitive subject-matter such as information critical to national security, private communications from the President, or even to discuss Senate deliberations during impeachment trials. Any Senator has the right to call a closed session as long as the motion is seconded.
Budget bills are governed under a special rule process called "Reconciliation" that disallows filibusters. Reconciliation was devised in 1974 but came into use in the early 1980s.
Wednesday, August 19, 2009
Debit Card Trap New York Times
Not many people would knowingly pay more than $35 for a cup of coffee. But far too many people are getting saddled — with no warning — with outsized bills for minor purchases, under a euphemistically labeled “overdraft protection program” that most major banks have adopted over the last 10 years.
Before that, most banks would simply have rejected debit transactions, without a fee, when the card holder’s account was empty. Now, they approve the purchase and tack on a hefty penalty for each transaction.
Moebs Services, a research company that has conducted studies for the government as well as some banks, reported recently that banks will earn more than $38 billion this year from overdraft and bounced-check fees. Moebs also estimates that 90 percent of that amount will be paid by the poorest 10 percent of the customer base.
Federal regulators who stood idly by while this system evolved are considering new overdraft rules that could provide more transparency. If they do not move quickly and aggressively to protect consumers, Congress should step in.
Banks have historically covered bad checks for valued clients, who were invited to opt in to overdraft protection or to link their checking accounts to savings accounts or to lines of credit. But as more people began to use debit cards, the banks started to view overdraft fees as a major profit center and started to automatically enroll debit card holders into an overdraft program. Some banks instituted a tiered penalty system, charging customers steadily higher fees as the overdrafts mount.
A study by the Center for Responsible Lending, a nonpartisan research and policy group, describes what it calls the “overdraft domino effect.” One college student whose bank records were analyzed by the center made seven small purchases including coffee and school supplies that totaled $16.55 and was hit with overdraft fees that totaled $245.
Some bankers claim the system benefits debit card users, allowing them to keep spending when they are out of money. But interest rate calculations tell a different story. Credit card companies, for example, were rightly criticized when some drove up interest rates to 30 percent or more. According to a 2008 study by the F.D.I.C., overdraft fees for debit cards can carry an annualized interest rate that exceeds 3,500 percent.
The banks, which have grown addicted to overdraft fees, will almost certainly resist new regulation in this area. But there are several things that federal regulators must do to protect the public.
First, banks must be barred from automatically enrolling customers in overdraft programs. This must be a service that customers opt in to — and only after they are provided full information about the fees and the penalties they will incur. These disclosure statements must meet the same rules laid out in truth-in-lending laws, since overdraft charges are essentially short-term loans.
Banks must also be required to warn customers in real time when a debit card charge will overdraw their accounts — and what fees they will incur if they still decide to proceed with the purchase.
This will require new technology. But there is almost no chance that the banks will invest in it unless they are legally required to do so. Until that happens, buyers beware. That cup of coffee may be even more expensive than you realize.
Before that, most banks would simply have rejected debit transactions, without a fee, when the card holder’s account was empty. Now, they approve the purchase and tack on a hefty penalty for each transaction.
Moebs Services, a research company that has conducted studies for the government as well as some banks, reported recently that banks will earn more than $38 billion this year from overdraft and bounced-check fees. Moebs also estimates that 90 percent of that amount will be paid by the poorest 10 percent of the customer base.
Federal regulators who stood idly by while this system evolved are considering new overdraft rules that could provide more transparency. If they do not move quickly and aggressively to protect consumers, Congress should step in.
Banks have historically covered bad checks for valued clients, who were invited to opt in to overdraft protection or to link their checking accounts to savings accounts or to lines of credit. But as more people began to use debit cards, the banks started to view overdraft fees as a major profit center and started to automatically enroll debit card holders into an overdraft program. Some banks instituted a tiered penalty system, charging customers steadily higher fees as the overdrafts mount.
A study by the Center for Responsible Lending, a nonpartisan research and policy group, describes what it calls the “overdraft domino effect.” One college student whose bank records were analyzed by the center made seven small purchases including coffee and school supplies that totaled $16.55 and was hit with overdraft fees that totaled $245.
Some bankers claim the system benefits debit card users, allowing them to keep spending when they are out of money. But interest rate calculations tell a different story. Credit card companies, for example, were rightly criticized when some drove up interest rates to 30 percent or more. According to a 2008 study by the F.D.I.C., overdraft fees for debit cards can carry an annualized interest rate that exceeds 3,500 percent.
The banks, which have grown addicted to overdraft fees, will almost certainly resist new regulation in this area. But there are several things that federal regulators must do to protect the public.
First, banks must be barred from automatically enrolling customers in overdraft programs. This must be a service that customers opt in to — and only after they are provided full information about the fees and the penalties they will incur. These disclosure statements must meet the same rules laid out in truth-in-lending laws, since overdraft charges are essentially short-term loans.
Banks must also be required to warn customers in real time when a debit card charge will overdraw their accounts — and what fees they will incur if they still decide to proceed with the purchase.
This will require new technology. But there is almost no chance that the banks will invest in it unless they are legally required to do so. Until that happens, buyers beware. That cup of coffee may be even more expensive than you realize.
Tuesday, August 18, 2009
House Dems seek info from health insurers
DAVID ESPO APCorrespondent
Democrats on a House committee are seeking detailed financial records from dozens of large insurance companies, officials disclosed Tuesday, part of an investigation into "executive compensation and other business practices" in an industry opposed to President Barack Obama's plan to overhaul health care.
The request included records relating to compensation of highly paid employees, documents relating to companies' premium income and claims payments, and information on expenses stemming from any event held outside company facilities in the past 2 1/2 years.
The requests were made in letters signed by Rep. Henry Waxman, D-Calif., who guided a portion of health care legislation through the House Energy and Commerce Committee last month as chairman, and Rep. Bart Stupak, D-Mich., who heads the Energy and Commerce investigations and oversight subcommittee.
They wrote that the committee was "examining executive compensation and other business practices in the health insurance industry." The Associated Press obtained a copy.
The requests were issued at a time when Obama's health care proposal is under intense attack from Republicans and other critics, including the health insurance industry. Much of the opposition focuses on proposals for the government to sell insurance in competition with private carriers.
Obama and other supporters of a so-called government option argue it would help control costs and keep insurance companies honest by forcing them to grapple with competition.
Opponents say it gradually would undermine the present insurance structure, which is built around private insurers, and lead to a system controlled by the government.
The issue drew intense focus over the weekend, after Obama speculated aloud about the possibility that legislation might omit the government role in selling insurance.
The White House said there had been no change in position. But liberals, in particular, expressed dismay, giving rise to increased speculation that Senate Democrats could soon abandon all talk of bipartisanship and draft legislation tailored to their own rank and file. Any such measure would inevitably jettison many of the compromises crafted in weeks of bipartisan Senate talks, and it was unclear whether the talk was a ploy to persuade Senate Republicans to agree to a compromise.
A spokesman for the insurance industry declined to comment on the letter sent by Waxman and Stupak.
Nick Choate, a spokesman for Stupak, said 52 letters were sent late Monday to the nation's largest health insurers, those with $2 billion or more in annual premiums. He said letters were not sent to other industry groups, some of which have been airing television advertising in support of Obama's call for legislation.
The letter from Waxman and Stupak requested the information be provided by early September. While companies are not under legal obligation to comply, the committee could respond to a refusal by voting to subpoena the information at a later date.
Among the documents requested were records relating to compensation paid to any company executive earning more than $500,000 in any year from 2003 to 2008.
Waxman and Stupak also sought documents relating to premiums paid by policy holders, claims payments, sales expenses, administrative expenses and profits, broken down by categories such as employer-provided coverage; individual coverage, Medicare and Medicaid.
Democrats on a House committee are seeking detailed financial records from dozens of large insurance companies, officials disclosed Tuesday, part of an investigation into "executive compensation and other business practices" in an industry opposed to President Barack Obama's plan to overhaul health care.
The request included records relating to compensation of highly paid employees, documents relating to companies' premium income and claims payments, and information on expenses stemming from any event held outside company facilities in the past 2 1/2 years.
The requests were made in letters signed by Rep. Henry Waxman, D-Calif., who guided a portion of health care legislation through the House Energy and Commerce Committee last month as chairman, and Rep. Bart Stupak, D-Mich., who heads the Energy and Commerce investigations and oversight subcommittee.
They wrote that the committee was "examining executive compensation and other business practices in the health insurance industry." The Associated Press obtained a copy.
The requests were issued at a time when Obama's health care proposal is under intense attack from Republicans and other critics, including the health insurance industry. Much of the opposition focuses on proposals for the government to sell insurance in competition with private carriers.
Obama and other supporters of a so-called government option argue it would help control costs and keep insurance companies honest by forcing them to grapple with competition.
Opponents say it gradually would undermine the present insurance structure, which is built around private insurers, and lead to a system controlled by the government.
The issue drew intense focus over the weekend, after Obama speculated aloud about the possibility that legislation might omit the government role in selling insurance.
The White House said there had been no change in position. But liberals, in particular, expressed dismay, giving rise to increased speculation that Senate Democrats could soon abandon all talk of bipartisanship and draft legislation tailored to their own rank and file. Any such measure would inevitably jettison many of the compromises crafted in weeks of bipartisan Senate talks, and it was unclear whether the talk was a ploy to persuade Senate Republicans to agree to a compromise.
A spokesman for the insurance industry declined to comment on the letter sent by Waxman and Stupak.
Nick Choate, a spokesman for Stupak, said 52 letters were sent late Monday to the nation's largest health insurers, those with $2 billion or more in annual premiums. He said letters were not sent to other industry groups, some of which have been airing television advertising in support of Obama's call for legislation.
The letter from Waxman and Stupak requested the information be provided by early September. While companies are not under legal obligation to comply, the committee could respond to a refusal by voting to subpoena the information at a later date.
Among the documents requested were records relating to compensation paid to any company executive earning more than $500,000 in any year from 2003 to 2008.
Waxman and Stupak also sought documents relating to premiums paid by policy holders, claims payments, sales expenses, administrative expenses and profits, broken down by categories such as employer-provided coverage; individual coverage, Medicare and Medicaid.
Monday, August 17, 2009
It’s Hip to Be Round
NY Times By GUY TREBAY
THIS summer the unvarying male uniform in the precincts of Brooklyn cool has been a pair of shorts cut at knickers length, a V-neck Hanes T-shirt, a pair of generic slip-on sneakers and a straw fedora. Add a leather cuff bracelet if the coolster is gay.
In truth this get-up was pretty much the unvarying male uniform last summer also, but this year an unexpected element has been added to the look, and that is a burgeoning potbelly one might term the Ralph Kramden.
Too pronounced to be blamed on the slouchy cut of a T-shirt, too modest in size to be termed a proper beer gut, developed too young to come under the heading of a paunch, the Ralph Kramden is everywhere to be seen lately, or at least it is in the vicinity of the Brooklyn Flea in Fort Greene, the McCarren Park Greenmarket and pretty much any place one is apt to encounter fans of Grizzly Bear.
What the trucker cap and wallet chain were to hipsters of a moment ago, the Kramden is to what my colleague Mike Albo refers to as the “coolios” of now. Leading with a belly is a male privilege of long standing, of course, a symbol of prosperity in most cultures and of freedom from anxieties about body image that have plagued women since Eve.
Until recently, men were under no particular obligation to exhibit bulging deltoids and shredded abdominals; that all changed, said David Zinczenko, the editor of Men’s Health, when women moved into the work force in numbers. “The only ripples Ralph Kramden” and successors like Mike Brady of “The Brady Bunch” had to demonstrate were in their billfolds, said Mr. Zinczenko, himself a dogged crusader in the battle of the muffin top. “But that traditional male role has changed.”
As women have come to outnumber men in the workplace, it becomes more important than ever for guys to armor themselves, Mr. Zinczenko said, with the “complete package of financial and physical,” to billboard their abilities as survivors of the cultural and economic wilds.
This makes sense, in a way, but how does one account for the new prevalence of Ralph Kramdens? Have men given in or given up? Are they finished with asserting the privileges that have always accrued to men. Or is the Ralph Kramden Barack Obama’s fault?
Hipsters, by nature contrarian, according to Dan Peres, the editor of Details, may be reacting in opposition to a president who is not only, as the press relentlessly reminds us, So Darn Smart, but also hits the gym every morning, has a conspicuously flat belly and, when not rescuing the economy or sparring with Kim Jong-il, shoots hoops.
“If we had a slob in the White House, all the hipsters would turn into some walking Chippendales calendar,” Mr. Peres said. Instead, the streets of Williamsburg are crowded with men who are, as he noted, “proudly rocking a gut.” Mr. Peres’s magazine has a term for these people: the new “poor-geoisie.” But the people lining up for $13 lobster rolls at the Brooklyn Flea last weekend hardly looked as if they were worried about making the rent.
“I sort of think the six-pack abs obsession got so prissy it stopped being masculine,” is how Aaron Hicklin, the editor of Out, explains the emergence of the Ralph Kramden. What once seemed young and hot, for gay and straight men alike, now seems passé. Like manscaping, spray-on tans and other metrosexual affectations, having a belly one can bounce quarters off suggests that you may have too much time on your hands.
“It’s not cool to be seen spending so much time fussing around about your body,” Mr. Hicklin said.
And so guys can happily and guiltlessly go to seed.
Women have almost never gotten a pass on the need to maintain their bodies, while men always have, said Robert Morea, a personal fitness trainer. (Full disclosure: my own.) It would be too much, he added, to suggest that “potbellies are suddenly O.K.,” but as lean muscle and functionality become the new gym mantras, hypertrophied He-Men with grapefruit biceps and blister-pack abs have come to resemble specimens from a diorama of “A Vanished World.”
“When do you ever see that guy, anyway?” Mr. Morea asked, referring to those legendary Men’s Health cover models, with their rippling torsos and famished smiles. “The only time you really see that guy, he’s standing in front of an Abercrombie & Fitch store.” Perhaps, he suggested, there is really only one of them. “It’s the same guy. They just move him around.”
THIS summer the unvarying male uniform in the precincts of Brooklyn cool has been a pair of shorts cut at knickers length, a V-neck Hanes T-shirt, a pair of generic slip-on sneakers and a straw fedora. Add a leather cuff bracelet if the coolster is gay.
In truth this get-up was pretty much the unvarying male uniform last summer also, but this year an unexpected element has been added to the look, and that is a burgeoning potbelly one might term the Ralph Kramden.
Too pronounced to be blamed on the slouchy cut of a T-shirt, too modest in size to be termed a proper beer gut, developed too young to come under the heading of a paunch, the Ralph Kramden is everywhere to be seen lately, or at least it is in the vicinity of the Brooklyn Flea in Fort Greene, the McCarren Park Greenmarket and pretty much any place one is apt to encounter fans of Grizzly Bear.
What the trucker cap and wallet chain were to hipsters of a moment ago, the Kramden is to what my colleague Mike Albo refers to as the “coolios” of now. Leading with a belly is a male privilege of long standing, of course, a symbol of prosperity in most cultures and of freedom from anxieties about body image that have plagued women since Eve.
Until recently, men were under no particular obligation to exhibit bulging deltoids and shredded abdominals; that all changed, said David Zinczenko, the editor of Men’s Health, when women moved into the work force in numbers. “The only ripples Ralph Kramden” and successors like Mike Brady of “The Brady Bunch” had to demonstrate were in their billfolds, said Mr. Zinczenko, himself a dogged crusader in the battle of the muffin top. “But that traditional male role has changed.”
As women have come to outnumber men in the workplace, it becomes more important than ever for guys to armor themselves, Mr. Zinczenko said, with the “complete package of financial and physical,” to billboard their abilities as survivors of the cultural and economic wilds.
This makes sense, in a way, but how does one account for the new prevalence of Ralph Kramdens? Have men given in or given up? Are they finished with asserting the privileges that have always accrued to men. Or is the Ralph Kramden Barack Obama’s fault?
Hipsters, by nature contrarian, according to Dan Peres, the editor of Details, may be reacting in opposition to a president who is not only, as the press relentlessly reminds us, So Darn Smart, but also hits the gym every morning, has a conspicuously flat belly and, when not rescuing the economy or sparring with Kim Jong-il, shoots hoops.
“If we had a slob in the White House, all the hipsters would turn into some walking Chippendales calendar,” Mr. Peres said. Instead, the streets of Williamsburg are crowded with men who are, as he noted, “proudly rocking a gut.” Mr. Peres’s magazine has a term for these people: the new “poor-geoisie.” But the people lining up for $13 lobster rolls at the Brooklyn Flea last weekend hardly looked as if they were worried about making the rent.
“I sort of think the six-pack abs obsession got so prissy it stopped being masculine,” is how Aaron Hicklin, the editor of Out, explains the emergence of the Ralph Kramden. What once seemed young and hot, for gay and straight men alike, now seems passé. Like manscaping, spray-on tans and other metrosexual affectations, having a belly one can bounce quarters off suggests that you may have too much time on your hands.
“It’s not cool to be seen spending so much time fussing around about your body,” Mr. Hicklin said.
And so guys can happily and guiltlessly go to seed.
Women have almost never gotten a pass on the need to maintain their bodies, while men always have, said Robert Morea, a personal fitness trainer. (Full disclosure: my own.) It would be too much, he added, to suggest that “potbellies are suddenly O.K.,” but as lean muscle and functionality become the new gym mantras, hypertrophied He-Men with grapefruit biceps and blister-pack abs have come to resemble specimens from a diorama of “A Vanished World.”
“When do you ever see that guy, anyway?” Mr. Morea asked, referring to those legendary Men’s Health cover models, with their rippling torsos and famished smiles. “The only time you really see that guy, he’s standing in front of an Abercrombie & Fitch store.” Perhaps, he suggested, there is really only one of them. “It’s the same guy. They just move him around.”
PAUL KRUGMAN The Swiss Menace
It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”
Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.
Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.
Let’s talk about health care around the advanced world.
Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.
In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.
The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.
Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.
Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.
In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.
So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.
If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.
But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.
So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.
•
Correction: In Friday’s column I mistakenly asserted that Senator Johnny Isakson was responsible for a provision in a House bill that would allow Medicare to pay for end-of-life counseling. In fact, he is responsible for a provision in a Senate bill that would allow a different, newly created government program to pay for such counseling.
Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.
Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.
Let’s talk about health care around the advanced world.
Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.
In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.
The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.
Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.
Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.
In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.
So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.
If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.
But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.
So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.
•
Correction: In Friday’s column I mistakenly asserted that Senator Johnny Isakson was responsible for a provision in a House bill that would allow Medicare to pay for end-of-life counseling. In fact, he is responsible for a provision in a Senate bill that would allow a different, newly created government program to pay for such counseling.
BOB HERBERT This Is Reform?
It’s never a contest when the interests of big business are pitted against the public interest. So if we manage to get health care “reform” this time around it will be the kind of reform that benefits the very people who have given us a failed system, and thus made reform so necessary.
Forget about a crackdown on price-gouging drug companies and predatory insurance firms. That’s not happening. With the public pretty well confused about what is going on, we’re headed — at best — toward changes that will result in a lot more people getting covered, but that will not control exploding health care costs and will leave industry leaders feeling like they’ve hit the jackpot.
The hope of a government-run insurance option is all but gone. So there will be no effective alternative for consumers in the market for health coverage, which means no competitive pressure for private insurers to rein in premiums and other charges. (Forget about the nonprofit cooperatives. That’s like sending peewee footballers up against the Super Bowl champs.)
Insurance companies are delighted with the way “reform” is unfolding. Think of it: The government is planning to require most uninsured Americans to buy health coverage. Millions of young and healthy individuals will be herded into the industry’s welcoming arms. This is the population the insurers drool over.
This additional business — a gold mine — will more than offset the cost of important new regulations that, among other things, will prevent insurers from denying coverage to applicants with pre-existing conditions or imposing lifetime limits on benefits. Poor people will either be funneled into Medicaid, which will have its eligibility ceiling raised, or will receive a government subsidy to help with the purchase of private insurance.
If the oldest and sickest are on Medicare, and the poorest are on Medicaid, and the young and the healthy are required to purchase private insurance without the option of a competing government-run plan — well, that’s reform the insurance companies can believe in.
And then there are the drug companies. A couple of months ago the Obama administration made a secret and extremely troubling deal with the drug industry’s lobbying arm, the Pharmaceutical Research and Manufacturers of America. The lobby agreed to contribute $80 billion in savings over 10 years and to sponsor a multimillion-dollar ad campaign in support of health care reform.
The White House, for its part, agreed not to seek additional savings from the drug companies over those 10 years. This resulted in big grins and high fives at the drug lobby. The White House was rolled. The deal meant that the government’s ability to use its enormous purchasing power to negotiate lower drug prices was off the table.
The $80 billion in savings (in the form of discounts) would apply only to a certain category of Medicare recipients — those who fall into a gap in their drug coverage known as the doughnut hole — and only to brand-name drugs. (Drug industry lobbyists probably chuckled, knowing that some patients would switch from generic drugs to the more expensive brand names in order to get the industry-sponsored discounts.)
To get a sense of how sweet a deal this is for the drug industry, compare its offer of $8 billion in savings a year over 10 years with its annual profits of $300 billion a year. Robert Reich, who served as labor secretary in the Clinton administration, wrote that the deal struck by the Obama White House was very similar to the “deal George W. Bush struck in getting the Medicare drug benefit, and it’s proven a bonanza for the drug industry.”
The bonanza to come would be even larger, he said, “given all the Boomers who will be enrolling in Medicare over the next decade.”
While it is undoubtedly important to bring as many people as possible under the umbrella of health coverage, the way it is being done now does not address what President Obama and so many other advocates have said is a crucial component of reform — bringing the ever-spiraling costs of health care under control. Those costs, we’re told, are hamstringing the U.S. economy, making us less competitive globally and driving up the budget deficit.
Giving consumers the choice of an efficient, nonprofit, government-run insurance plan would have moved us toward real cost control, but that option has gone a-glimmering. The public deserves better. The drug companies, the insurance industry and the rest of the corporate high-rollers have their tentacles all over this so-called reform effort, squeezing it for all it’s worth.
Meanwhile, the public — struggling with the worst economic downturn since the 1930s — is looking on with great anxiety and confusion. If the drug companies and the insurance industry are smiling, it can only mean that the public interest is being left behind.
Forget about a crackdown on price-gouging drug companies and predatory insurance firms. That’s not happening. With the public pretty well confused about what is going on, we’re headed — at best — toward changes that will result in a lot more people getting covered, but that will not control exploding health care costs and will leave industry leaders feeling like they’ve hit the jackpot.
The hope of a government-run insurance option is all but gone. So there will be no effective alternative for consumers in the market for health coverage, which means no competitive pressure for private insurers to rein in premiums and other charges. (Forget about the nonprofit cooperatives. That’s like sending peewee footballers up against the Super Bowl champs.)
Insurance companies are delighted with the way “reform” is unfolding. Think of it: The government is planning to require most uninsured Americans to buy health coverage. Millions of young and healthy individuals will be herded into the industry’s welcoming arms. This is the population the insurers drool over.
This additional business — a gold mine — will more than offset the cost of important new regulations that, among other things, will prevent insurers from denying coverage to applicants with pre-existing conditions or imposing lifetime limits on benefits. Poor people will either be funneled into Medicaid, which will have its eligibility ceiling raised, or will receive a government subsidy to help with the purchase of private insurance.
If the oldest and sickest are on Medicare, and the poorest are on Medicaid, and the young and the healthy are required to purchase private insurance without the option of a competing government-run plan — well, that’s reform the insurance companies can believe in.
And then there are the drug companies. A couple of months ago the Obama administration made a secret and extremely troubling deal with the drug industry’s lobbying arm, the Pharmaceutical Research and Manufacturers of America. The lobby agreed to contribute $80 billion in savings over 10 years and to sponsor a multimillion-dollar ad campaign in support of health care reform.
The White House, for its part, agreed not to seek additional savings from the drug companies over those 10 years. This resulted in big grins and high fives at the drug lobby. The White House was rolled. The deal meant that the government’s ability to use its enormous purchasing power to negotiate lower drug prices was off the table.
The $80 billion in savings (in the form of discounts) would apply only to a certain category of Medicare recipients — those who fall into a gap in their drug coverage known as the doughnut hole — and only to brand-name drugs. (Drug industry lobbyists probably chuckled, knowing that some patients would switch from generic drugs to the more expensive brand names in order to get the industry-sponsored discounts.)
To get a sense of how sweet a deal this is for the drug industry, compare its offer of $8 billion in savings a year over 10 years with its annual profits of $300 billion a year. Robert Reich, who served as labor secretary in the Clinton administration, wrote that the deal struck by the Obama White House was very similar to the “deal George W. Bush struck in getting the Medicare drug benefit, and it’s proven a bonanza for the drug industry.”
The bonanza to come would be even larger, he said, “given all the Boomers who will be enrolling in Medicare over the next decade.”
While it is undoubtedly important to bring as many people as possible under the umbrella of health coverage, the way it is being done now does not address what President Obama and so many other advocates have said is a crucial component of reform — bringing the ever-spiraling costs of health care under control. Those costs, we’re told, are hamstringing the U.S. economy, making us less competitive globally and driving up the budget deficit.
Giving consumers the choice of an efficient, nonprofit, government-run insurance plan would have moved us toward real cost control, but that option has gone a-glimmering. The public deserves better. The drug companies, the insurance industry and the rest of the corporate high-rollers have their tentacles all over this so-called reform effort, squeezing it for all it’s worth.
Meanwhile, the public — struggling with the worst economic downturn since the 1930s — is looking on with great anxiety and confusion. If the drug companies and the insurance industry are smiling, it can only mean that the public interest is being left behind.
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