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Max Borders.

Borders is a policy analyst and media coordinator at Art Pope's Civitas Institute, and contributes to their blog Red Clay Citizen.  He published a hate piece recently on our own Adam Searing, titled Mandate Mania: Does Adam Searing Hate People?  Max implies that, yes, Adam does hate people.  In addition, Max knows this about Adam: he lies to himself, he wants you to pay for things you don't need, he wants poor people to be uninsured (an odd accusation against the Director of the North Carolina Health Access Coalition), he hates freedom, and finally, Max knows that "Adam thinks he's smarter than you." 

Adam is too much of a gentleman to rebut Borders' vitriolic post.

But I'm not.

This is not just score settling, either.  Borders post serves as an object lesson of the dishonesty of the organs of right-wing propaganda.  Never forget…the only thing they care about is their free-market ideology.  Everything else is irrelevant.

Now for specifics.  Borders responded to a straight-forward post from Adam which asked gubernatorial candidate Bob Orr which mandates he was willing to eliminate in his "market based" health plan.  Fair question, since as Adam noted, the majority of NC's mandates cover medical essentials such as colorectal, breast, and cervical cancer screening, 2 day hospital stay for mom after delivery, and inpatient care following mastectomies.

Borders' venomous response included this bullsh*t quote:

N.C.'s mandates account for 45-50% of premium costs in North Carolina.

This is a lie.  When I asked Max where his data was generated, he referred me to this report by this organization.  Borders' "data" is from a health insurance lobbying group, who describe their mission as "an active advocate for market-oriented solutions to the problems in America's health care system."  Hardly an objective source, don't you know, since their clients stand to benefit directly from their "research findings."  Max is the ever useful tool to be exploited for special interest profit.

Alas, the little Emperor has no clothes, and Max has no data specific to North Carolina.  Max made it up.  Presumably, he extrapolated "research" from insurance lobbyists to spin his fairy tale.  By the way, if you want a list of other treatments considered "optional" (ie. mandated) by Max's resource, they also list: chemotherapy, emergency services, prescription drugs, well-child care (including immunizations), hospice care, diabetic supplies, cleft palate repair, and mastectomy, among others.  I don't know about you, but most of my patients would consider these mandates essential to care, not Cadillac care.

And that's the point.  The majority of so-called mandates are part of standard insurance coverage.  Usual and customary, whether required or not.  What Max calls "coercive" the rest of us, physicians and patients alike, call "standard of care."  Two respected resources regarding health care costs (unlike Max Borders sham resources) do not even mention insurance mandates as cost drivers.  Adam links to them here in his latest post.  Neither report references mandates, which would be hard to believe if they actually accounted for 45-50% of premium costs as they do in Max's imagination.

So Max doesn't do truth and doesn't do research… no surprise there, but what is a reasonable estimate of the cost of mandates?  It is likely somewhere between 5% and 7.6% of premium costs according to The New York Times, the Congressional Budget Office, and the Minnesota Department of Health.  Think of it like this: these mandates function as a consumer protection program.

And if you don't think consumers need protecting then you haven't been paying attention.  Consider the sub-prime mortgage mess or the history of predatory lending.  Do we really want to unleash the greed is good crowd and allow them to more easily plunder the health insurance market?  Buying health insurance is a hell of a lot more complicated than purchasing a mortgage, and the opportunities for unscrupulous sellers would be significant.

Remember this lesson about Max Borders and the right-wing think tanks.  They delude themselves into believing they are  some sort of freedom fighters in Art Pope's Army.  They like to bestow titles upon themselves: Chairman, President, Vice-Chairman, Vice-President, Senior Fellow, Resident Scholar, Research Director, Policy Analyst, Media Coordinator.  None of this matters.  They are nothing more than partisan hacks, as blinkered by their hate-filled ideology as any tribal leader in Northwest Pakistan. 

*Thank you, Keith Olbermann.

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If Paul Krugman is right and passing health care legislation should be the number one priority of Progressives, then this is welcome news.  In a recent poll by the Harvard School of Public Health, a plurality of respondents (45% vs. 39%) said America would be better off with "socialized medicine."  To be clear, neither Clinton nor Obama is advocating what legitimate health policy analysts would define as socialized medicine.*  It cannot be said often enough…under the Clinton or Obama plan if you like your current health insurance coverage, then keep it. 

Nonetheless, it is nice to know that this scare tactic is losing it's effectiveness.  Voters are going to be hearing alot about health care policy this election cycle, so do yourself this favor.  If a so-called analyst is overwrought about the dangers of electing Democrats because they want to "socialize medicine," know immediately that they are not honest brokers of information.  

Our dark doppelganger, the John W. Pope Civitas Institute, is especially guilty of this type of red-baiting smear tactic.  It is standard procedure at Civitas to invoke what they perceive to be the "fear" of socialized medicine.      The Civitas' analysis apparently goes something like this: if a service is paid for with public funds, then it is "socialized."  Note that this is a distinction that is unique to health care.  You do not see Civitas daft over the threat of "socialized" national defense, "socialized" police and fire protection, or "socialized" public education.

A government guarantee of health insurance is hardly socialist, although it is progressive.  We should not allow health care reform to be stymied by using nonsensical and irrelevant terms like "socialized medicine."  Clinton and Obama have legitimate public/private health care proposals to cover 47 million uninsured Americans.  John McCain…does not.

 *Legitimate examples of socialized medicine would be our Veterans Administration or the UK's National Health Service.   Note: Medicare, Medicaid, or S-CHIP funding are not considered part of this group. 

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I must confess that over the past few years I have been gravely disappointed with the white moderate (or "Independents," as they're now called). I could have written that sentence with conviction today, but it was first written by Reverend Martin Luther King on April 16, 1963.  It is part of his famous "Letter From Birmingham Jail": 

I must confess that over the past few years I have been gravely disappointed with the white moderate.  I have almost reached the regrettable conclusion that the Negro's greatest stumbling block in his stride toward freedom is not the White Citizen's Councilor or the Ku Klux Klanner, but the white moderate, who is more devoted to "order" than to justice.

Martin Luther King

Reverend King could have had today's McCain-leaning anti-war Independents in mind when he wrote that from his jail cell.  He added:

Shallow understanding from people of good will is more frustrating than absolute misunderstanding from people of ill will. 

According to a Jan. '08 L.A. Times/Bloomberg poll, 66% of Independents want the US to withdraw from Iraq in the next 12 months.  Folks, if getting our troops home safely is on your Top Ten list of concerns…do not vote for John McCain.  Otherwise, as Rev. King says, despite your good will you have a "shallow understanding" of the McCain candidacy.  Simply put, McCain is the most imperialistic, pro-war hawk in national politics.  It is difficult to reconcile anything less than a full-throated embrace of the Iraq War and the candidacy of John McCain.  Go here if you want to see what that looks like.

Moreover, can the mainstream press please stop calling John McCain a moderate?  Whatever moderate positions he once held (opposition to Bush tax cuts, criticism of evangelical leaders, immigration, campaign finance, etc.) were thoroughly repudiated by the candidate this week as he lurched to the right at a conservative conference.

More importantly, in the areas that the president has genuine influence (as opposed to imagined influence on social issues …ie gun control, abortion, gay rights) McCain is radically conservative.  Here are the two most important:

—Foreign Policy:  McCain never met a war he didn't like (including Vietnam).  You can sum up his foreign policy in 3 words…Might Makes Right.  He currently advocates aggressive positions on Iran and North Korea.  And since he has essentially based his candidacy on what he calls "the transcendent issue of our time…Radical Islamic Extremism" he has forewarned Americans that he can easily (eagerly?) justify military intervention anytime, anywhere.

—Judicial Appointments:  He likes Roberts, Alito, and Scalia.  He also voted to confirm Robert Bork.  Enough said.

John McCain is no moderate.

 

 

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What did we learn from the week of Super Tuesday? Mostly this…if turnout matters, the Democrats kicked some Republican ass.

Just how bad was the Dems smackdown? The numbers are truly staggering.  In the 19 states where both Republican and Democratic primaries were held, Democratic turnout was 73% greater.  Or, in raw numbers:

14.5 million Democratic voters.

8.4 million Republican voters.

On the Democratic side, it was a virtual tie.  Clinton received 50.2%, Obama 49.8%.  It seems likely that what happens in the next few months in the Democratic primaries will determine the next president.  North Carolina may yet have something to say about that.

These are historic numbers.  If this enthusiasm translates into general election votes, than a far-reaching opportunity to build a progressive movement may be at hand.  The question for Democratic voters, then, is which candidate can inspire a movement, not simply win the election.  Which candidate attracts the most new voters?  Which candidate attracts the most diverse coalition of young voters, Hispanic voters, Independent voters and disaffected Republicans?  Who has the longer coat-tails?

From a policy standpoint, the two candidates are so similar that one is left making distinctions without a difference.  Both candidates are equally likely to improve the lives of the majority of North Carolinians with progress on healthcare, economic policy, immigration, and veterans issues. 

So for me, it comes down to this: while both candidates are reliably progressive, which candidate can energize a generation of Progressive voters?  Who can inspire and lead a Progressive revolution?

Barack Obama.

*unlike the New York Times, to my knowledge Progressive Pulse contributors are not prohibited from making endorsements. However, my unofficial scorecard for the Times is: Obama 2 (Frank Rich, Bob Herbert); Clinton 1 (Paul Krugman…he really, really, likes health insurance mandates); McCain 1 (William Kristol…he really, really likes wars); Green Party Candidate 1 (Thomas Friedman…sorry Tom, going Green will not make us forget your role in promoting the Iraq War);  Undecided (Maureen Dowd…too maliciously catty to matter; David Brooks…too obsessed with divining nation's Zeitgeist to matter). 

Addendum:  As luck would have it, the day after this was posted I sat down to read last week's The Nation.  The cover story by Christopher Hayes is titled "The Choice: Why Obama's the best candidate to build a Progressive Majority."  You can read it here.  I particularly liked this quote:

In addition to persuading those who already vote, Obama has also delivered on one of the hoariest promises in politics: to bring in new voters (especially the young). It's a phenomenon that, if it were to continue with him as nominee, could completely alter the electoral math. Young people are by far the most progressive voters of any age cohort, and they overwhelmingly favor Barack Obama by stunning margins. Their enthusiasm has translated into massive increases in youth turnout in the early contests.

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Question:  If you are conservative, what do you call your government's future obligations?

Answer:  Unfunded Liabilities.

If we've learned nothing else from George Lakoff and the "Death Tax," we should recognize the importance of framing the debate.  The Right is constantly in a froth over the projected 75 year costs of Social Security and Medicare.  As long as they are going to get all hysterical about our government's future obligations, we should ask them why they conveniently forget to include our largest "unfunded liability"…national defense.  A plausible argument is made here that military expenses for the federal government are greater than non-military expenses.

Is the cost of life-long care for an Iraq War veteran with TBI (Traumatic Brain Injury…the "signature wound" of the Iraq War) any less of an unfunded liability than the care of Grandpa Joe in a vegetative state after his stroke?  Or…are the future military pensions of today's Iraq War veterans any less of an unfunded liability than our obligation to pay baby boomer Social Security checks?  I don't think so.

As Robert Kuttner says in his superb new book The Squandering of America:

Nobody doubts that the Pentagon will continue spending hundreds of billions of dollars a year to defend (and occasionally jeopardize) America's security.  Project this assumption forward seventy-five years, and you have an "unfunded liability" in the tens of trillions of dollars.  But as long as the U.S, government is in business, there is little doubt that taxes will be collected and the Pentagon will be paid.  Likewise for the mandated payouts under Social Security and Medicare.

So, the next time one of your right-wing friends is afflicted with Entitlement Hysteria over Social Security and Medicare, just tell them the programs are at least as secure as the mother of all entitlements…national defense.  We could shore up the finances for Social Security and Medicare in a heartbeat with a simple nip and tuck from the defense budget.  Another way of looking at it is that the projected long-term shortfall for Social Security is exactly equal to the Bush tax cuts on the wealthiest 1% of Americans. 

Our government's future obligations are an ideological argument…not a financial disaster.

Addendum:  Our North Carolina Senator Elizabeth Dole is so bullish on the future of our national defense entitlement that she has proposed a joint resolution that requires a minimum of 4% of GDP be used for defense spending.  Where there's a will, there's a way.