Oh, health care economics...you CRAZY!

My little brush with Michele Bachmann on CBS' Early Show the other day has solidified my morning routine of listening to NPR's Morning Edition: the sweet, sweet sound of logic and facts told through soothing voices.

This morning, NPR did not disappoint: I nearly died when I realized Dr. Patricia Danzon, one of my favorite professors at Wharton, was on Morning Edition! She knows more about health care economics than pretty much everyone in the entire world. The NPR story was about Newt Gingrich and Mitt Romney's vacillations on their health care platforms. Given the topic, I knew what Dr. Danzon would say. I had been waiting* for this since the Affordable Care Act sparked the debate over our nation's health care act into a full-on bonfire. The frenzied arguments have died down a bit in recent months, but they're back, baby!

I digress. As I listened to Dr. Danzon's speak, with her smooth British-with-a-hint-of-South-African accent, I thought, "please say it, please say it..."

And she did. Allow me to paraphrase: Health care is already socialized, in the least efficient way possible. And everyone pays for it.

The NPR piece highlights the fact that the individual mandate, vilified as a socialist idea, was actually a Republican concept when first introduced. Romney instated such a mandate in Massachusetts, leading to a population that was 98 percent insured, and Gingrich praised this plan in the past. Now that both candidates are catering to the extreme right, they are falling over themselves to lead the charge against the "socialization" of our health care system.

But our health care system is already socialized, in an extremely inefficient manner. Assume that everyone who walks into an emergency room will be given at least the basic level of care appropriate for their injury or illness. It's perfectly alright to assume this, since this is actually the case all over America. Now, for people who do not have health insurance, when they require medical care they must either pay out of pocket to see a primary care physician (PCP), where costs are more contained, or go to the more expensive emergency room if they are not able or willing to pay. Any of us could do this, but those of us with health insurance go to the PCP unless our condition is truly an emergency. On our health insurance plans, it's much less expensive to go to the PCP. That is, our health insurance plan incentivizes us to go to the PCP. Why? Because the emergency room is an extreme waste of money for any non-emergency health problem.

So who pays for the treatment of those uninsured people who go to the emergency room and then skip out on the bill? We all do. The way this happens can fill a textbook, but essentially we pay for their care through higher health insurance premiums, higher charges at the hospital, and so on. But we're not just paying for a doctor's visit and some antibiotics. We're paying all the costs of emergency care. Logically, we'd be better off if we paid for uninsured people to visit a primary care physician.

Sounds like socialism, but as a country we would pay less for health care and have better results. So, since health care is already socialized, as noted by Dr. Danzon, then what's the problem with a somewhat socialist solution (the Affordable Care Act) to making it more efficient? Is there a better solution via capitalism? I'm not sure if one really exists. This is health care. People's lives. We're not talking about manufacturing or bond-trading here. Different economic principles apply to each industry, and health care is by far the most confusing and rule-defying category.

Why do Romney, Gingrich, and their co-horts insist that the Affordable Care Act needs to be repealed? Why is socialism a dirty word? And is socialism really so bad if, by efficiently providing health care to those who cannot afford it, you also lower your own costs?

*Seriously, every time health care policy was mentioned in any national media outlet, I wondered when they were going to bring on Dr. Danzon. She's THE expert! I took her class on the  economics of the pharmaceutical industry, in which my mind was blown repeatedly, and I worked in her office in the Health Care Management department at Wharton for three years during college.

Bachmann, payroll tax cuts and 2+2=5

I can no longer hold back. I really, really dislike* Michele Bachmann. Today she appeared on CBS' The Early Show, and was at her most Bachmanny. Besides reminding me why I don't watch the major networks' morning "news" shows, she said a lot of dumb $#!&, and really failed to answer the anchor's questions and dodged most of them poorly.

Bachmann accused the House Democrats of leaving D.C. before voting on the extension of payroll tax cuts and unemployment insurance benefits...from her campaign tour stop of Davenport, Iowa. Look, I get that she's running a tough campaign to be the GOP presidential nominee and we are less than two weeks from the Iowa caucus, but you can't accuse the Democrats of being absent when you are also absent, Michele. (I am not going to verify whether or not the Democrats, or Republicans, actually left Washington, because this is not my point.)

Besides that little double-standard she expressed this morning, the fact is that Democrats and even some of the Republican leadership were ready to pass the bill. Late last week, the Senate passed their bill with huge bipartisan support. Speaker Boehner even seemed on board. Then on Tuesday, the House rejected the bill. I am very pleased to say that not a single Democrat rejected the bill. The most recent maddening twist to this saga is that the Republicans are claiming they will not settle for anything less than a one-year extension of the benefits, as opposed to the two-month stopgap extension in the bill passed by the Senate and presented in the House. This totally pisses me off because the original offer of a two-month extension was intended as a bill that would be easier to pass than a one-year extension. All things being equal, I'm pretty sure the Democrats would have been on board with a one-year extension.

An hour after the House vote, President Obama was so pissed off (my interpretation) that he walked into the press secretary's briefing unannounced and talked to the reporters directly. I love it. It sounds like something Jed Bartlet would do. Funny, though, that this morning on CBS Bachmann said something to the effect that Obama is nowhere to be found regarding passing this bill or starting new negotiations.

This leads me to a larger point, that we'll need to explore futher at a later date, of the Orwellian statements coming from the right wing these days. By "Orwellian" I mean statements like "two plus two equals five." Bachmann provides many examples of this. Today, she gets on national TV and says Obama is not involved in the process, while he is in DC working on this, giving his own press conference, has pretty much given up his Christmas vacation...while she campaigns in Iowa. Too many people out there believe Bachmann and the other candidates' words without thinking for themselves or finding another source of information. Too many voters believe that two plus two equals five.

*"Hate" is a strong word, so I try not to use it unless I really mean it. I only feel hatred, or something close to it, for three living people: Dick Cheney, Karl Rove, and Fred Phelps.

First World Problems: Taxes Pt. 1

Lately every complaint that comes out of my mouth needs to be followed with the disclaimer, "first world problems." Honestly, maybe every complaint I've ever uttered needed that disclaimer, or it's sister disclaimer "white girl problems."

Source: The Economist Online, Sept. 29, 2011

There is a significant portion of the population right now that complains about taxes, and I have no sympathy. As U.S. citizens, we don't really pay that much in taxes. Based on a benchmark income of $100,000 per year, our friends in Belgium, Greece, Germany, France and Denmark have an effective tax rate nearly double that of the U.S. Our federal income tax brackets range from 10 percent to 35 percent. That top rate, applicable to individuals making approximately $380,000 and more, is unbelievably distant from the  top tax rate we've ever had: 94 percent in 1944, for people earning over $2.5 million in 2011 dollars. 

Now, don't get me wrong, 94 percent is a ridiculously high tax rate, in my humble opinion. Between the end of World War II and the beginning of Reagan's presidency, the largest tax cut was ushered in by (Democratic) President Kennedy, and the top tax rate was reduced to 70 percent. Gradual cuts over the years have reduced the top rate to 35 percent, and the poorest people in our society end up paying nothing because, in short, taxing someone on a nonexistent or nearly nonexistent income is a joke.

On top of our comparatively and historically low tax rates, this isn't even the real percentage that some people pay. And the richer a person is, the more ways they have at their disposal to decrease the actual percentage of income paid in taxes. The top 400 richest Americans actually pay about 17 percent of their income in taxes, which, as Tim Dickinson recently stated in Rolling Stone, is five percentage points less than a bus driver earning $26,000 a year.

This is not  how a graduated income tax is supposed to work. We'll be discussing taxes more and more over the coming weeks. Get. Excited.

But for now, tell those ungrateful Tea Partiers and the so-called "53%" to sit down and shut up.

For further reading:

The Tax Policies That Increased Economic Inequality

The Twitter

Happy To Be Blue is now on the Twitter, tweeting super insightful comments about the luxury of being liberal. Follow me @happy2beblue.

A challenger

Not since the late '90s have I been so impressed with a hamster website: Hamster for President 2012.

And now I have that damn song stuck in my head.

A promise fulfilled

President Obama ran for office on a campaign touting hope and change. Many of us have been disappointed by certain things that did not change, and a continuation of the status quo that left us hopeless. Finally, the war in Iraq is coming to its official end. While nearly everyone can agree that ousting Saddam Hussein was a positive result, the costs of this war, in terms of lives of U.S. troops, allied forces and civilians, as well as the financial burden on the U.S. government and taxpayers, were crushing. This war crushed each family who lost a loved one to the cause. It crushed our sense of patriotism and American pride. It crushed our federal budget and added enormously to our national debt.

I hope this decision to end the war in Iraq gets the attention it deserves. When one of your "Independent" friends brings up his or her disappointment with President Obama's tenure thus far, remind them of this achievement. Of course, Obama did not accomplish this by himself. But, it was his campaign promise and he saw it through to fulfillment during his third year in office. I'll take it.

Next time I see Barry in person, I'm going to thank him for this...from all of us.

Public health and your tax dollars

I am one of the lucky 250 million people in this country with health insurance. Today I went to an eye doctor for the first time in 2.5 years. I handed over my health insurance card to the woman behind the desk, who has the God-forsaken job of verifying health insurance coverage. Upon first review, she wasn't sure I was covered for vision care, but she began the long, sad process of getting in touch with Blue Cross Blue Shield to see what they would pay for and how much they would pay.

I needed to check my eye health and get an updated prescription regardless of coverage, so I went in to the doctor's office while she investigated my coverage. After the appointment, I walked over to the check out counter to see what I owed for this visit.

"Good news, your insurance covered the exam 100%, and you'll just need to pay for the contact lens assessment."

Now, there are at least 50 million people out there without any health insurance, let alone vision insurance. Because so many of us have reduced health costs as a result of the insurance coverage, demand is higher, which drives up prices.* So, aside from having no insurance, they have to pay a higher fee because some of us are insured! Seems a little unfair, right?

As a Democrat and bleeding heart liberal, I am proud to pay a few extra cents or dollars per year towards the goal of wider health insurance coverage. The alternative, lowering the number of insured people to weaken demand, seems neither progressive nor feasible, as most of us have connected health insurance with employment benefits since World War II. (See Slate's "A short history of health care.")

So pay a little now to insure your neighbor...neighbor goes to eye doctor and gets vision corrected through glasses...neighbor has laser-sharp vision and DOES NOT RUN YOU OVER when they drive down your street...you avoid week-long stay in the ICU, lowering your health costs in the long run.

See how great public health is?

*Another related factor in driving up prices is the fact that many doctors charge a higher fee knowing that the insurance companies will negotiate the price downward.

For those of you who also drive POS cars...

Get a free bumper sticker today to support Barry in 2012. For those of you who actually care about the paint on your car, donate $10 or more and you can get a car magnet.

In all seriousness, supporting Obama on your car is a small but effective thing to do. How do you feel when you are out and about and see an Obama 2012 bumper sticker, window placard or t-shirt? I feel emboldened, just from that small visual reminder that there are people out there who are confident in their liberal political beliefs. And just maybe, when "independents" see 1,000 Obama 2012 bumper stickers over the next few weeks, they will start to see the need to take a closer look at the Democrats' agenda and track record. Hey, a girl can hope...dream...whatever. Can't wait to slap this sticker on the back of my made-in-the-USA 2000 Pontiac.

Outed

The CEO paid a visit to the Denver office this week. One lunch with him and he had me pegged.

Me: I'll have the veggie burger.
CEO: Are you vegetarian?
Me: Actually I'm vegan.
CEO: What is that?
Me: It's like being vegetarian but I don't eat cheese or milk or eggs.
CEO: [pause]...you know, your boy Obama is in a lot of trouble.

The feather extensions in my hair might have also given me away.

Fox News: 99.6% of "poor" people have a refrigerator!!

"I mean, all we'd have to do to raise 700 billion dollars is cut 700,000 NPRs. It's almost too easy." - Jon Stewart

A man after my own heart!

Warren Buffett says, "Stop Coddling the Super-Rich."

"If you make money with money, as some of my super-rich friends do, your [tax] percentage may be a bit lower than mine. But if you earn money from a job, your percentage will surely exceed mine — most likely by a lot."

And then he goes on to explain this situation and the effects in detail. Instead of just offering vague comments like "corporations are people." Ahem.

"Corporations are people." - Mitt Romney

The sad thing is, Romney is my favorite Republican candidate.

I am so sick of the right trying to drum up sympathy for big business, and even more disgusted that voters buy into this. Tell me, why should groups of people and assets (businesses) be protected from taxes that might hurt their profits, but individuals should be expected to stand on their own even if they are a single mother or a cancer patient without health insurance?

This New York Times article is from January, but the point is still relevant about corporate profits not translating to more jobs, and as we've witnessed this year, corporate profits do not necessarily equal greater overall prosperity for the country.

I am not anti-business, nor are the Democrats. I am pro-business; I have an undergraduate degree from Wharton and I've been working in the private sector consistently since graduation. Capitalism is one of the core values that makes America great. Coddling businesses that should (mostly) stand on their own...well, that sounds like some weird Frankenstein socialism for businesses to me.

Going green

From Containment to Sustainability - GreenSource Magazine

Military officials argue for the implementation of sustainable practices as part of overall national security.

Etc.

Good news for gays and their allies: Obama is officially supporting the "Respect for Marriage Act" that bitch-slaps the "Defense of Marriage Act," which in reality wasn't defending a damn thing. One, I love that they're using the word "respect" in the title. The bill's short and sweet objective is "to repeal the Defense of Marriage Act and ensure respect for State regulation of marriage." Fancy that. Democrats trying to give power to the States! ROMA respects the rights of consenting adults to decide with whom they will share their lives and marriage benefits. ROMA respects States' rights. There is much to like about this situation. I think that so many of the supporters of DOMA are looking at the situation illogically and think that they need to deny gays the right to marry in order to protect their own marriage or family. Or perhaps it is a religious issue, but I also find that silly because ROMA obviously does not compel churches to perform gay marriages. I'm so glad I was born liberal.

So...what are they really trying to accomplish? The Institute of Medicine is recommending that among other preventative health services, birth control should be mandatory on all health insurance plans. Without a co-pay. Which would increase access and therefore decrease unwanted pregnancies or unplanned pregnancies in which the mother was less than conscientious in her prenatal planning (i.e. boozing while the fetus was developing). Of course, someone has a problem with this. Jeanne Monahan, director of the Center for Human Dignity (seriously?) at the conservative Family Research Council lists two reasons to be against this: one, that requiring insurers to cover contraceptives violates the rights of people who don't believe in artificial contraception. Since insurance pools money as well as risk for all the policy holders, everyone would be paying for the "free" birth control, whether they believe in it or not. Two, abortion opponents argue that some emergency contraceptives (morning-after pills) can cause "very early abortions" by preventing the implantation of fertilized eggs into a woman's uterus. So these people would rather not increase access to birth control, which would prevent abortions, because the morning-after pill is kind of like an abortion? Because in some cases a sperm and an egg joined together but then had no where to go? Great plan. Something about this leads me to believe that the Family Research Council (another completely lame name for an organization) is not completely focused on reducing the number of actual abortions performed. I don't know what they are focused on, but it doesn't appear that the FRC is concerned with that.

Last night at the Denver Young Democrats Inauguration After Party I was chatting with some of the attendees when I mentioned that I live in the Cherry Creek neighborhood of Denver. Immediately several people jokingly called me out on living in a fancy neighborhood and implied my Democrat card might get taken away. I love this mentality. Being a Democrat means appreciating what you've been given and also what you've been able to earn for yourself in this country. It means go ahead and live in a fancy house or drive a fancy car - just remember you have nice things because you live in the United States of America. Sure, I got decent grades and I earn my salary by working hard. But I am in my current situation because of my public school education and my federal college loans, to name just two big things that immediately come to mind. The government is so far from perfection, but if you think you got to where you are without the help of the government, you are not looking hard enough. (Note: I live in Cherry Creek because I work in Cherry Creek, and my dog demands that I come home for lunch every day. Had to shorten the commute. Democrat guilt compelled me to write this note.)

A few years ago, to widen my perspective I subscribed to the Republican National Committee email list. I started getting sassy with them immediately. They really irked me because one of the first emails I received was addressed "Dear Fellow Patriot." OMG. I started replying to the emails with full educated Democrat sass. And it occurred to me recently that I had not received an email from Reince lately...I got kicked off the list!!!

Inauguration Day!

Today it is great to be a Denvercrat. We are inaugurating our new Democrat Mayor, Michael Hancock, who is replacing our former Democrat Mayor John Hickenlooper, who recently became the new Democrat Governor of Colorado. I guess I've been too hard on Colorado. There are many conservatives here, but I should really stop trying to throw a pity party for us liberals. We are fairly well represented.  

I voted in the election and the subsequent runoff for Democrat Chris Romer, but honestly if you count the number of times I've already used the word "Democrat" in this post, how could I be anything but excited for our current situation?

Today's Events:

11:00 a.m. - 1:30 p.m. Municipal Swearing In Ceremony at Buell Theatre

6:00 p.m. - 9:00 p.m. Mayor's Community Concert at the Denver Botanic Gardens

9:00 p.m. - 11:00 p.m. DYD Inauguration After Party at 3014

I'll be at the concert and after party. Let's take a moment to enjoy this time...before we have to start hitting the pavement for 2012.

Dig in

Climate change is a complicated issue, primarily because of the enormous amount of scientific fact collecting and analysis from every corner of the globe. Add in politics and hidden agendas, and we have a serious mess.

The fact that we originally labeled this problem "global warming" was a huge marketing mistake. Yes, the average global temperature is increasing, but this gives deniers the opportunity to artificially dispute "global warming" every time we experience cold temperatures and a Snowmageddon. If they were actually familiar with the predictions associated with climate change, they would realize that such Snowmageddon was actually probably evidence for climate change. (Though please do me a favor and NEVER use one Snowmageddon, one data point, as proof of anything. You don't want to shame your science teachers and statistics professors.)

Recently NPR posted "Global Warming: A Guide for the Perplexed" as a "simple" explanation of the facts. Honestly, I don't find this to be a very simple guide at all, but perhaps this is as basic as it gets while staying true to the subject matter.

It's no wonder then why so many people, educated or not, shy away from this. It is complicated. It is outside of their realm of knowledge. And worst of all, the solution to such a problem is so enormous that to many the best solution is...denial. In Rolling Stone issue 1134/1135, Al Gore put it best:

"Since this new reality is painful to contemplate, and requires big changes in policy and behavior that are at the outer limit of our ability, it is all too easy to fall into the psychological state of denial. As with financial issues like subprime mortgages and credit default swaps, the climate crisis can seem too complex to worry about, especially when the shills for the polluters constantly claim it's all a hoax anyway. And since the early impacts of climatic disruption are distributed globally, they masquerade as an abstraction that is safe to ignore."

As liberals, we get the satisfaction of digging in deeper, taking in all the information (except perhaps Fox News programming) in an attempt to understand the issue. It is OK to not understand every detail of climate change. It is not OK to deny that climate change is happening simply because it is complicated.

The extra challenge we face is spreading the message. I am as guilty as anyone in shying away from this conversation when I am in mixed political company. The whole point of the Rolling Stone article mentioned above is that while Republicans may be spreading untruths, many Democrats are acting as accomplices by not defending the science behind climate change. So, we're letting people who are partially funded by the "polluters" stomp all over scientific evidence (and our environment, and new technology, and small businesses promoting this new technology...)? What is wrong with us?

From the same Rolling Stone article "Climate of Denial," a quote from Yeats: "The best lack all conviction, while the worst are full of passionate intensity."  Let's all dig in a little more.

One step closer to making sure "President Bachmann" only exists in my nightmares.

Ugly, cute, menacing, cuddly.

The official mascot of the United States.


Streaming Live by Ustream
These little buggers reside in Iowa, FYI.

Life. I mean, "THINGS THAT LIVE."

I'm really riled up today. I'm in a very good mood, but ready for action. This morning I took the LEED AP: Building Design and Construction exam and passed. I've been studying for over a month, which meant I was reading leisurely for four weeks and then cramming and completely freaking out for the past few days.

So I'm reading and cramming and learning all these quantifiable things that have been proven to reduce buildings' impact on the environment, our resources and human health. And it burns me up that people want to trash this, to say climate change and our collective negative impact on the world is fabricated. Fabricated by...I don't know who, thousands of the world's leading (yet obviously evil) scientists? Al Gore? Oprah?

Did you know that buildings in the United States accounted for 8% of global primary energy consumption, per the 2008 data? We as a country gorge ourselves on energy:

"More energy was consumed in the United States than in any other country in 2008...approximately 20% of total global demand." - Buildings Energy Data Book, U.S. Department of Energy. In the words of Joe Biden, "this is a big !@#$%& deal."

Energy is expensive, especially when so much of our traditional source has a finite limit and has to be dug up in the deserts of the Middle East and peddled by OPEC. We get approximately 45 percent of our oil from the Middle East and North Africa, which together hold over two thirds of the oil reserves worldwide and make up a politically volatile region. Well, $#!@. Even Canada (17%) and Mexico (15%) have us over a barrel. 

Logically, shouldn't we search for alternatives to this predicament? There are a couple of main routes. We can "drill, baby, drill," right here in the United States, and stock up on a few barrels while the getting is good. In the process, we might spill oil in the Gulf of Mexico, ruin a national park, and in the case of coal we can just blow the tops off of mountains and let the ash settle in the air and water sources for millions of Americans  (the Americans who dig up that coal for us, coincidentally) and deforms their babies. Or we can explore low-impact, renewable sources that are declining in cost and increasing in efficiency and availability each day. Geothermal heating, wind energy, wave/tidal power, biofuel-based electrical, hydro electric and photovoltaic systems are all being used right now.

We let BP, Don Blankenship, ExxonMobil and their peers off the hook for serious environmental and public health offenses. We hand them subsidies, even though economic rules dictate that government subsidies should show a clear benefit to the public that pays for them. If oil was our only source of energy, subsidies would make sense. But oil is not by any means our only source of energy! And the oil companies post huge profits. Why are taxpayers donating money to an industry that already charges us an arm and a few legs?

Being "business-friendly," the Republicans don't want to hurt the economy by hurting Big Oil. They want to prop them up, old dead trees in a forest blocking tons of new undergrowth waiting to spring up. Big Oil sells oil. But more fundamentally, they sell energy. Why don't we demand that these companies evolve with the market and become energy companies? Why, as a Democrat, do I get called a "communist" when I am saying let the old dinosaur industries die out and allow new sustainable businesses to thrive? That is capitalism, and that is the America I know and love.

And the Republicans want to discredit and make fun of Al Gore? For pointing out that nine of the hottest years ever occurred in the last 13 years? The past decade was the hottest on record, despite experiencing a "solar minimum" for half of the decade. This is actual data. But according to Fox News, it's not concrete evidence.

How did the environment and our public health become political?

There will be many, many more posts on the environment and climate change. Now, go hug a tree.

Funnies

"You know who's never touched a vegetable in his entire life? Dick Cheney. There's no way!" - Bret Saunders, 'BCO Morning Show