Los Angeles Times — Universal healthcare coverage appears elusive
The president and his fellow Democrats like to talk about being closer to the goal of universal health care than ever before, but what is being discussed in Congress isn’t really universal health care but rather a plan to regulate insurance companies and force Americans to buy their products or pay a fine. And at the end, at least 17 million people will still be uncovered.
With warnings that private premiums would go up, Medicare coverage would go down, and access to care might be limited, American taxpayers may find the goal of near-universal coverage an unworthy of such a high price.
Examiner colleague Susan Ferrechio points out today that the only choices available to Democrats to remedy the problem are to increase the penalties for lower-middle-class folks who opt not to buy insurance or to increase taxes on others to pay for bigger subsidies for the folks who opt out.
Neither is very appealing politically and as Democrats squabble in the days and weeks that follow today’s vote in the Senate Finance Committee about a government-run health insurance program and whether to tax “gold-plated” policies they are really discussing how to get from 94 percent coverage to 100 percent coverage, which they believe will also reduce costs.
Writer Noam Levey explains the numbers:
“But under pressure to keep the 10-year cost under $900 billion, the Senate Finance Committee bill — which many consider a kind of centrist template — limited those subsidies.
The legislation being voted on today includes $463 billion in subsidies over the next decade and would result in 94% of Americans having insurance coverage, according to an estimate by the nonpartisan Congressional Budget Office.
That is substantially less than the $773 billion in subsidies that House Democrats have proposed in their healthcare bill. The CBO estimated that the House bill would achieve near-universal coverage, or cover about 97% of those eligible.”
Washington Post — Mayo Clinic Faulted for Limiting Medicare Patients
President Obama and others have heralded the cost and quality of care at Minnesota’s famed Mayo Clinic and other operations in America’s Scando-communitarian belt and he and other Democrats have also suggested a government-run, public insurance option to be modeled on Medicare’s set reimbursements for specific care provided to seniors.
But as writer Alec MacGillis shows us, Mayo, like other affordable, high-quality providers, is trying to wriggle free of Medicare and it’s cousin for poor Americans, Medicaid.
The reimbursement rates are awful and the bureaucracy is a nightmare, so those outfits that can attract enough paying or privately insured customers are just opting out.
As the Democratic health overhaul moves forward that means either forcing all providers to accept government insurance (good bye top-notch care) or the creation of a parallel system for the haves while the have nots muddle through a federal phantasmagoria of quacks and bureaucrats.
Cuts to Medicare to finance the expansion of coverage to another 10 percent of Americans seem unlikely to help the situation.
“Mayo officials said Monday that the two moves were ‘business decisions’ that had grown out of longstanding concerns about what it sees as underpayment by Medicare and Medicaid. The officials said they were not meant to influence the national reform debate, in which Mayo has also been advocating against the creation of a government-run insurance option. But they said the moves were indicative of the need for the Medicare payment reforms it has been pushing in Washington.”
Washington Post — Support Troops Swelling U.S. Force in Afghanistan
Writer Ann Tyson looks at the logistical realities of a troop surge in Afghanistan. For the 21,000 combat soldiers the president sent to Afghanistan, another 13,000 support troops have been needed.
If the White House were to add 40,000 more “trigger pullers” to the war a like-sized contingent of support troops (perhaps 25,000) would be needed.
The Los Angeles Times has already looked at the effort by the Pentagon to maximize combat forces by contracting out as many service positions as possible. And the spin down in Iraq will eventually provide plenty of manpower to shift eastward.
But for now, the logistics of finding enough combat and support troops to deliver a counterinsurgency strategy would be a challenge.
“The deployment does not change the maximum number of service members expected to soon be in Afghanistan: 68,000, more than double the number there when Bush left office. Still, it suggests that a significant number of support troops, in addition to combat forces, would be needed to meet commanders’ demands. It also underscores the growing strain on U.S. ground troops, raising practical questions about how the Army and Marine Corps would meet a request from Gen. Stanley A. McChrystal, the top U.S. and NATO commander in Afghanistan.
Defense experts said the military usually requires that thousands of support troops deploy for each combat brigade of about 4,000. That, in turn, exacerbates the strain on the force, in part because support troops are some of the most heavily demanded in the military and are still needed in large numbers in Iraq.”
New York Times — Views on Afghanistan Buildup Bring Clinton and Gates Together in an Alliance
Writers Mark Landler and Thom Shanker look at the powerful alliance between Secretary of State Hillary Clinton and Defense Secretary Robert Gates.
It helped brush back Vice President Biden’s worries about the antagonizing presence of the U.S. in Afghanistan before and may do it again as President Obama reconsiders at length (as Jay Leno said “Don’t be surprised. It took him five months to pick out a dog.”) his strategy for Afghanistan.
Landler and Shanker show how the alliance was forged and how it may drive Obama to again reject Biden’s “small-footprint” approach.
Clinton and Gates seem to have struck up an unusual friendship as their rapport during and after a joint lecture at George Washington University shows.
“Nobody seemed more pleased than Mr. Gates, a survivor of decades of Washington’s bureaucratic battling. ‘Most of my career, secretaries of state and defense weren’t speaking to each other,’ he said. ‘And it could get pretty ugly, actually.’
After their very public joint appearance, the two decamped secretly to the Blue Duck Tavern, a sleek restaurant nearby, where, according to people close to both, they kicked around policy options on Afghanistan over a long private dinner.”
Washington Post — A Vigorous Push From Federal Regulators
A most insightful piece from writer Lyndsey Layton about the regulatory zeal of the Obama administration.
We’ve seen the EPA grab headlines for regulating emissions etc., but Layton goes through the federal register to find many of the small ways in which the administration is intervening in American life.
The moves are cast as an “awakening” of a regulatory apparatus paralyzed by the Bush administration and the story prominently features promises of restraint by regulatory boss Cass Sunstein, but the list of crackdowns, especially by the FDA, is impressive in eight months – Cheerios, Zicam, pistachios, rhinestones and ATVs.
But the biggest regulator of them all is still waiting in the wings.
“Awaiting Senate approval is Obama’s nominee for OSHA director, David Michaels, an Energy Department assistant secretary under President Bill Clinton, who could further ruffle feathers. He has become a recent target of conservative bloggers, who say he is hostile to certain industries. Michaels has called for a more aggressive OSHA, saying that illnesses and death have resulted from the agency not issuing workplace safety rules. He also has argued that tobacco, chemical and other industries have exploited scientific uncertainty to slow or kill federal regulation, even when aware their products pose health risks. Public health organizations have applauded his selection.”
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