What a rich, provocative discussion! We at the Campaign for America’s Future are working to promote a widespread citizen debate about health care for all – modeled after the successful coalition that stopped Social Security privatization. And this forum, sponsored by Josh Marshall and provoked by Jonathan Cohn’s new book, has fostered a very important exchange. We are going to be linking people into it for some time.

Several participants have rightly insisted on focusing us on a large order question: what kinds of fundamental reforms are necessary to get a health care system that will cover everyone, improve health and make the health care system much more efficient? And the big debate is over the role of the private health insurance industry: can we regulate and “incentivise” big health insurers to get them to achieve these goals, even though their business model has produced many of the very problems the public wants solved?

A few others have plaintively insisted that all this talk about systemic change and the model of single-payer is politically unrealistic and therefore irrelevant.

Mark Schmitt and others rightly ask if we can combine our long term vision with a constructive participation in the messy realities of the political process. As I noted earlier in this conversation, the public has signaled to the politicians that health care is priority issue, and the politicians (at least on the Democratic side of the presidential race) have responded with a generalized pledge: “I will make sure that everyone is covered by the end of my (first or second) term.” Since they are all scrambling to figure out how to do that, we have an enormous opportunity before us.

I submit that one of the best things we on the “progressive” side of this debate can do this year is to engage the nation – and the politicians – in a public discussion about the private health insurance industry:

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Last fall, as stories surfaced about military families preyed upon by lenders charging 400% and more, the DoD issued a report explaining that overwhelming debts were impairing military readiness. Congress responded with a new law to limit the interest rate that can be charged to military families. The cap is 36%--steep, but far better than what was out there.

Credit card issuers and banks charging verdrafts had lobbied Congress to be exempted from the new regulations. Congress refused, bolstered in part by consumer groups arguing that 400% effective interest is 400%, regardless of who collects it.

After the bill passed, the consumer finance industry shifted their lobbying efforts to the DoD. The lobbying paid off. The new DoD rules drafted by the DoD excludes credit cards, car loans, home equity loans, reverse mortgages, refinancing and tax refund anticipation loans. The banks declared themselves pleased. Congressional Daily quotes the Financial Services Roundtable rep as saying, "Overall, it seems that it tracks pretty close to our recommendation."

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I couldn’t improve on Don McCanne and Maggie Mahar’s articles in response to Jon’s ‘pretend’ points of objection to single payer: the questions of cost-setting and choice with regard to risk exposure. So, I’d like to address some of the political and social issues hovering around the policy questions. What, as johnOneOne begins to answer in his comment to my first post, are the rhetorical 'brain freezes' that inhibit this conversation?

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So now my fun with the Canadian health care haters is done, my final posting here in this most excellent discussion is to clarify how one would get competition into a social insurance system that only had one risk pool.

Maggie Mahar is right to say that private plans as constituted don't have the incentive or the moral authority to do what needs to be done in terms of rationalizing the care system. However Joe Paduda is also right to point out that single-payer lacks the incentives that competition brings to improve efficiency and effectiveness in other markets. But it's not enough just to put everybody in the same pool and mandate community rating and guaranteed issue.

Let's be clear.  The most important thing is to get everybody in a pool that is essentially funded by progressive taxation, so that nobody is directly responsible for their own health care costs. After all rational people agree that those who use the most healthcare usually have the least to do with how much they use.

Now you have essentially three choices.

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Senator Wyden asks “Why Wait?”

My answer: because we want to do it right. And, with all due respect, I do not believe that this could possibly happen under the Bush administration.

I respect the Senator’s desire to reform healthcare—and I think that decoupling health care and employment is a fine idea. While employers need to continue to offer financial support, there is no reason that they should be responsible for selecting health care plans, or trying to figure out how to contain costs while maintaining quality. For most, this is not their area of expertise.

The Senator has pointed out the advantage of his plan for employers: they would no longer be exposed to double-digit health care inflation. Fine—but who would be left holding the bag? Employees—who will be required to buy insurance.

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This week, Maryland became the first state to enact a "living wage" law, HB 430, requiring government contractors to pay their employees a decent wage, in the bill ranging from $8.50 an hour in rural areas to $11.30 an hour in areas of the state with higher costs of living.  Maryland follows the 120 local governments around the country that have required that public money go to companies that pay their workers above the poverty line.

"It doesn't make them rich," said Sen. Thomas M. Middleton, chairman of the Maryland Senate Finance Committee. "We're just lifting them a little bit more out ... of poverty."

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Jessica Valenti wrote a brilliant article in The Guardian about the viciousness and sexualized threats that get directed against women on the web. My thanks to her for post pointing us to it, below. Joan Walsh wrote an incisive analysis as well over at Salon.com, noting that, yes, women get hit with more vicious comments (both more in quantity and greater in viciousness).

But here's what has been missed in the discussion of Kathy Sierra's horrific experience, as far as I can tell: this happens in the world, not just on the web. What's happened to Sierra is a virtual extension of the sexual harassment that hits women in any predominantly male field, what I've come to think of as "barrier" sexual harassment: making it clear to women that they don't belong and will be violated if they stay.

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...is not that it is inherently evil, or inefficient, or cares nought for people. Private insurers are businesses, and as such their motivations are to generate revenues on which they earn a profit.

The problem with private insurance, as so many have pointed out, is that the way the system is set up today incents them to cherry-pick, to avoid claims, to not sell insurance to anyone who may actually have to use it.

And they (I used to be one of "they") are really really good at this.

But if private insurers can't cherry pick, and have to provide coverage to all comers, and if everyone has to have health insurance, then the game has changed. Dramatically.

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In addition to thanking Jon for the great book, I want to thank him for doing the thankless job of just showing up at work every day and helping all of us to better understand the health care system through his invaluable writing for TNR.

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We economists are taught not to look at polls—to shade our pristine eyes from mushy public sentiments.

There’s something to this: you’d never want to build much of story around one particular poll result, and you always want to be suspicious of short-term fluctuations: people’s feelings about the economy can change on a dime based on the cost of their last tank of gas.

But lately there’s been a pervasive “disturbance in the force”—a set of deteriorating poll results regarding people’s feeling about their economic fortunes. I’ll get to the highlights in a minute, but, as someone who mucks around in living standards’ indicators, a number of people have asked me: what’s up with these poll results?

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Given that apparently I've caused the most trouble here (and haven't really gotten my point across too well) I will respond later today about what a vision of a social insurance pool which uses competitive elements to improve health care delivery looks like.

But meanwhile, please go to read my Spot-on post today. While we TPMCafers are taking the high road, I've been asked (really!) to help make a movie about just how evil Canadian health care is!

It was just too tempting not to respond. It is Friday the 13th after all (but not April 1!)

Last week New York Times columnist David Brooks published an intriguing piece called "Dueling Narratives" about a conference he attended in Jordan with people he described as "moderate Arab reformers."

The "Dueling Narratives" to which he referred were not those of Israelis and Palestinians, or Jews and Arabs, but Americans (specifically pro-Israel Americans) and Arabs. According to Brooks, the Arabs mainly wanted to focus on Israel which they view as "at the root" of Middle Eastern problems while the Americans wanted to discuss "the Sunni-Shiite split, the Iraqi civil war and the rise of Iran."

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To begin with, I would like to thank Josh Marshall for hosting this discussion and Jonathan Cohn for writing such a valuable and insightful book. I also appreciate all of the input I’ve received from many of you regarding my plan and health reform in general.

There are so many questions we must ask ourselves when discussing health reform. Which basic benefits should be guaranteed? What insurance reforms should we insist upon? How will we finance this? What changes, if any, should be made to the tax code? And what role should the states play in all of this?

What it really comes down to, though, is how do we get from here to there? How do we eventually reach that goal of universal coverage?

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Amy Goodman has a righteous piece up at Truthdig on the primal, perennial outrage that undergirds the corruption of American politics, namely, the funneling of hundreds of millions of dollars from political candidates to television and radio stations that operate under zero-cost public licenses. Most of the absurd sums that candidates raise goes to commercial broadcasters. So the inside story of American politics is: politicians are the middlemen and -women siphoning money from the pockets of the prosperous to the treasuries of broadcasters.

It's obvious, i. e. logical, that the remedy is public financing. It's also impolitic to make the point.

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That's it. Imus is done.

All I can say is that CBS and NBC both did the right thing.

Now let's hope people who have done far worse things to this country than Don Imus have to pay an equally serious price. Nevertheless, this is good news.

Before addressing Jonathan's points, I will not pretend that those reading these posts do not understand the single payer model, as advanced by Physicians for a National Health Program. Simply, single payer national health insurance would automatically include absolutely everyone, would cover all reasonable, beneficial health care services and products, would be financed through an equitably-funded universal risk pool, and would introduce economic mechanisms to slow the rate of cost escalation and improve quality by reducing administrative waste and by realigning incentives to reinforce the primary care infrastructure and reduce detrimental high-tech excesses.

Those participating in this dialogue generally agree that reform should be targeted to achieve most of these goals (universal, comprehensive, equitable funding, efficiency, higher quality, etc.), but there is disagreement on the model of social insurance that we should try to achieve, and on the political feasibility of each approach.

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Last week I wrote an article for The Guardian (UK) about online misogyny, using Kathy Sierra's experience as a jumping off point.

Last week, Kathy Sierra, a well-known software programmer and Java expert, announced that she had cancelled her speaking engagements and was "afraid to leave my yard" after being threatened with suffocation, rape and hanging. The threats didn't come from a stalker or a jilted lover and they weren't responses to a controversial book or speech. Sierra's harassers were largely anonymous, and all the threats had been made online.

One of the things I wrote in detail about in the article was the unbelievable responses to Sierra's story. Some thought she "deserved" it, some called her complaints (about getting death threats, imagine!) "whining." Sadly, I expected to find these kinds of reactions in certain places on the internet. What I didn't expect was to find them so close to home, and from a progressive "leader" in the blogosphere, no less!

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Matthew’s post seems to be the most controversial, so let jump right in there. He suggests that, contrary to what most of us have been saying,

I am not sure that there's actually a real difference between a pure single-payer system, and market-based competition within social insurance … once everybody is in some type of social insurance pool with some level of progressive taxation and cross subsidy, then how we actually organize the provision and the reimbursement of care does not much matter.

I guess I am not so sure about what Matthew says. ...

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If you're just tuning in to this week's book club, a quick summary of what you've missed.

Jonathan Cohn started things off urging universal health care supporters to "think big" and not preemptively take single-payer off the table because of an artificial concept of "what's posssible." Also offering starting thoughts, Don McCanne offered numbers to put things in perspective, Roger Hickey argued that voters are sick of tinkering, and Joe Paduda pointed out that traditional lines are being crossed by making the business case for single-payer.

But Jacob Hacker, himself the author of a plan, argued that while Cohn's "thinking big" is good, political and fiscal realities can't be ignored.

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Joe Biden has an important oped today, "The Real Surge Story," that really goes after Senator John McCain's continued embrace of military deployments in Iraq.

From Biden's piece:

If the president's plan won't work, what will? History suggests only four other ways to keep together a country riven by sectarian strife:

We allow or help one side to win, which would require years of horrific bloodletting.

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First, congratulations to Jon. The reviews suggest that "Sick" is going to help legitimize discussions of radical national health reform. “Single-payer” is no longer a dirty word.

I understand why some believe that radical reform is politically impossible. But they remind me of those who said that we could never pass Medicare. Eventually, the pain became too great. Too many seniors could not afford care, and popular support trumped the then-powerful AMA. In 1962, Gallup polls showed public support at 69% and President Kennedy called for Medicare in front of crowd of 20,000 in Madison Square Garden.

Still, it wasn’t easy.

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Ever since his maliciously maligned interview with CNN, Al Gore has been tagged with the "invented the Internet" punch line. He never said it, never claimed it, and in fact did push the Internet as a member of Congress for many years ahead of his time. No matter, the myth lives. Until now.

It seems Verizon has taken out a patent on the Internet. All of it.

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I do not oppose the firing of Don Imus lightly.

It is clear that the pain Imus’s comments inflicted on many African American women, their friends and families is significant. That the culture is pervaded by name calling and ethnic and sexual tension does not alter the reality that these particular comments about these particular Rutgers athletes is somehow different. Imus rightly expects his attempts at humor to be processed in the context of a show in which “moron” is often a term of endearment. But that is not the only context which has given Imus’s transgression its weird unique power. First of all, this is not an isolated incident. Imus has long been tone deaf on racial matters and has been criticized for it.

Just as significantly, Imus’s show uniquely combines “morning zoo” insult humor with serious interviews with authors, musicians and politicians including several Presidential candidates.

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I appreciate the opportunity to join the discussion of Jonathan Cohn's book and his opening argument here. Like Jon, I'm torn between what he calls the “hybrid” approaches such as the Wyden plan and single-payer. But, along with Jacob Hacker, I don't quite agree that, “a discussion about changing public policy ought to start with a discussion about which policy would actually work best, whatever the politics.” It's hard to really disagree with such a noble and common-sense statement, but if one really does think that single-payer is a non-starter for political or cultural reasons, while a politically feasible -- albeit less efficient -- alternative is on the table, then it would be foolish and even immoral to hold out for the unattainable ideal, while letting millions of people endure the suffering and inadequate care described in Sick.

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As someone who has worked to assist older adults and people with disabilities get health care for the last 20 years and experienced through countless clients the benefits of a public insurance system (Medicare) that pools risk across millions of people, bargains for reasonable provider rates, as well as guarantees people automatic and affordable coverage, choice of doctors and providers and protection from financial risk, I want to revisit Jon’s critical point in Sick, that all but the most wealthy of us who do not yet qualify for Medicare are vulnerable to needing costly care and not being able to pay for it. On that point, I think we all agree.

What’s fascinating and where further discussion is necessary is the reason we are virtually all at risk, even if we have private insurance. Having watched the private health insurers gain a foothold in Medicare through their offering of private Medicare plans, I’m convinced the chief reason is the private insurers. Highly regulated and with subsidies or not, they will never be able to offer Americans health security. And there’s one very basic reason why.

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I just received an e-mail from a TPM reader who complained that I'm devoting too much space to the Imus controversy. "American popular culture is a cesspool. It will remain such whether Imus stays or goes."

Not a bad point, except for one thing. American popular culture is getting better all the time, especially television. Don't even get me started on "Six Feet Under" which, in my opinion, was the best show EVER on television, cable or regular. I merely submit, for the record, "Friday Night Lights" which is, in my opinion, the finest show ever on regular commercial (NBC) television.

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It's fantastic that Jon's book is finally out, as it seems a long time ago that I saw a couple of early chapters--and since the Democrats win in November the mood is certainly much better for speaking about reform.

But I am not sure that there's actually a real difference between a pure single-payer system, and market-based competition within social insurance. The real difference in the reform argument is not an ideological one between those who believe that market incentives can be made to work within a context of social insurance and those who think that only one pool and one payer can achieve the desired aims. The real difference is instead between those who favor incremental change, and those who want genuine universal coverage.

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Again, thanks to Jon for bringing us together into this conversation and for laying out the contours of the problem so succinctly. It’s sobering, isn’t it, to realize how well his description of early 20th Century conditions corresponds to our own situation?

As a staff member for a state senator who is both the author of SB 840, California’s pending single payer legislation, and the Chair of the State Senate Health Committee and, therefore, obligated to work with all due speed for whatever useful reforms can be crafted, I appreciate Jon’s call for healthcare advocates to work in several time frames at once. But I would invert his concerns. While we don’t want to make the perfect the enemy of the good, neither do we want the incremental to be the strangling death of the remedial.

It’s almost once a week that I hear some variation of the ‘single payer won’t pass so why bother’ argument—and the assumptions behind it are more than a little disquieting.

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My thanks to Jon for writing such a wonderful book and for raising such an important set of issues with his initial post. As Jon would be the first to admit, Sick is not a policy book; it's a deeply textured story about the crumbling of America's employment-based framework of health financing (a central element of what I've called the "Great Risk Shift") and the go-it-alone world of fragmented risk that's inexorably taking its place. But the central point of Jon's book does have substantial policy implications, and I want to trace them out briefly in responding to Jon's important query.

The essence of Sick -- and yes, you still need to read it -- is an animating argument as simple as it is profound: The problem of health insecurity is not a problem experienced only by those on the fringes of American society; it is a problem increasingly affecting all Americans, both directly and indirectly. And the implication of this core argument is equally simple and profound: Any real solution will have to address the problems faced by us all -- rapidly rising costs, widespread gaps in coverage for the insured as well as the uninsured, health care that's not producing a healthy society as well as it could. We can no longer content ourselves with yet another round of gap-filling half-measures aimed at correcting the most egregious failures of our rickety financing structure.

So far, so good. But what does this mean in policy terms? Ay, there's the rub.

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I'm not so sure that the Fortune 500 is adamantly opposed to a single-payer system. While that may be their ideological position, there is a solid business case to be made for "single payer".

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Gwen Ifill understands that revenge is a dish best served cold. She bided her time and then gave Imus the shiv today, while the old racist twists in the wind.

The contrast between Ifill and the white boys Jeff Greenfield, David Gregory, James Carville, Bill Maher and Ham Jordan (all of whom are rallyng behind Imus) could not be more stark. Cannot the old bigot come up with a single African American to support him. What about some Clarence Thomas type? Surely, there has to be some thoroughly discredited African-American who will stand with Imus. If not, wow.

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Beware conservatives sounding reasonable. The mostly positive review of Jonathan Cohn’s book in the Sunday NY Times by Sally Satel of the American Enterprise Institute includes this passage, which subtly hints at how the right is planning to thwart the building momentum toward universal coverage:

But Cohn is himself being unfair when he sweepingly denounces “the principles of modern conservatism” for being “conspicuously short on ... comfort or hope.” In truth, there is nothing inherently pessimistic in choice, self-reliance or limited bureaucracy — the values that underlie a market-based proposal like the one introduced by Senator Ron Wyden, an Oregon Democrat. In this plan, employers would no longer provide insurance and would instead convert those costs into a bigger paycheck, enabling workers to buy private insurance from providers who would then be forced to compete for business by offering better plans. (Wyden’s proposal also offers subsidies for the unemployed.)

Choice, self-reliance, and limited bureaucracy are modern conservatism’s sugar-coated code words for the only value that actually matters to them: weakening the government.

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Kudos to Jonathan for his important new book.

One of the reasons we are talking about what's the right approach -- or the most politically feasible approach -- to insuring all Americans is that millions of Americans are telling pollsters and politicians that the health care system is in crisis. The public has put this issue on the table for the political system -- not the policy wonks.

Individuals, like those profiled in Sick, experience the health care crisis in many ways. But is there a explanatory diagnosis for why the health care system is not serving them?

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Okay. If we're going to get anywhere in our discussion on how to fix our health care system, we'd better look at some numbers that will give us a better perspective of the problem.

This year, according to CMS, our projected health care spending is $2.2 trillion, or $7500 per each individual in the United States. With a median household income of about $46,000, it is easy to understand why a family of four would have difficulty paying its equal (not equitable) share of $30,000. (Before you divert the debate into the subject of apples and oranges, keep in mind that that the topic is health care reform, and the numbers are being used to demonstrate merely the magnitude of the problem.)

When there is general agreement that everyone should be covered, these numbers lead us to the insurance function of pooling risk - for all of us. Traditionally, health insurance provided for a transfer from the many who are healthy to the few with significant health care needs. Distributing costs evenly over the risk pool worked.

Something happened in the interim. Health care costs skyrocketed, but we were caught off guard because they were gradually phased in at high single or low double digit annual rates. But here we are. At $7500 per person, health care simply costs too much for average income individuals to pay their equal (again, not equitable) share of any system of universal coverage. Like it or not, we are now faced with the need to transfer not only from the healthy to the sick, but also from the wealthy to average- and lower-income individuals with health care needs.

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I agree with M. J. Rosenberg. The spectacle of the Boston Globe's Tom Oliphant kissing Don Imus's tarnished ring reminds us of the absurd place of the blowhard pundits in what is laughably considered our national conversation. Imus's buddies know he's one of the gang--what George W. Bush calls "a good man." Hey, y'all, this is how elites work. "Good men" get passes. "Good men" have their crudity overlooked because they give to charity. "Good men" benefit from "solidarity forever," in Tom Oliphant's words, disgracing the name of American unionism. So where's his solidarity with Gwen Ifill?

So I end up on the page with Al Sharpton (this time). There's no excuse for racist trash-talk. None. End story.

One of the most fascinating products of researching my new book, Sick, was also one of the most depressing: the realization that we've been here before.

If you go back to the late 1920s and early 1930s, you'll find a situation that looks more than vaguely familiar. As medical care was becoming more expensive, large numbers of people were finding they literally could not afford to get sick. Many of these people weren't indigent in the narrow sense of the word. They had homes. They had jobs. And yet when they got sick, their lives unraveled. Some went into debt to pay for it. Some rationed their own care. The result was financial misery, medical hardship, or both.

That situation eventually gave birth to the insurance system we have today - a system, based primarily upon job-provided private insurance, that is now faltering as the price of medical care rises. If you read the eight stories in the book, you'll get a sense not just of how devastating loss of insurance can be today, but also of how vulnerable to this problem even the middle class has become - just like it was nearly a century ago.

It's this increasingly vulnerability that has provoked a new debate about universal health care - and given would-be reformers some cause for optimism. But now that this debate is unfolding, it's brought us to yet another familiar place: The argument about what kind of system to create.

On one extreme of the progressive political spectrum you have...

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Ganesh’s post about No Child Left Behind generated a livelier comment stream than we’re used to here at Warren Reports. I want to respond briefly to some of the critical points raised by commenters.

First and foremost, nowhere in his post does Ganesh attack teachers. What he does do is raise the possibility that the status quo – including easily-attained teacher tenure and rigid limitations on differential pay – should be reexamined. I support organized labor and I understand that the NEA and AFT and their local chapters have to represent their members zealously, but I think we mustn’t lose sight of the fact that the purpose of our public education system is to teach students so that they are prepared for the demands of work and citizenship. Of necessity, teachers will always be central to that mission. Moreover, there is no question that they are, as a profession, undercompenstated for the tremendous work they do. Nevertheless, there is also little doubt that the system currently is not accomplishing its objectives. I don’t need to reiterate the familiar statistics about inner city graduation rates or American students’ collective performance relative to students in other developed nations.

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We are supposed to believe that the Treasury Secretary led a huge delegation to China only a few months ago, and was already so disappointed with the reaction that now he has decided to kick off a trade dispute in the WTO? I'm dubious. For one thing, diplomacy, and especially diplomacy with China, requires a great deal more than a few months of effort. Second, for the Treasury Secretary to turn over the initiative to the Trade Ambassador is not a sign of influence in the Administration; it looks like Secretary Paulson has been overruled. Third, the whole effort in the WTO has little chance of producing any immediate effect on China's behavior, or perhaps any effect at all. It's hardly likely to produce currency adjustment, the Secretary's stated goal.

The economic relationship between the United States and China is the big topic of the next twenty years.

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There was a big anti-American demonstration today in the Iraqi city of Najaf. Firebrand cleric Moqtada al Sadr brought his peeps to the street. According to the AP:

Tens of thousands of Shiites-a sea of women in black abayas and men waving Iraqi flags-rallied Monday to demand that U.S. forces leave their country. Some ripped apart American flags and tromped across a Stars and Stripes rug.

The AP also reported that a U.S. military mouthpiece in Iraq, Col. Steven Boylan, an aide to Gen. David Petraeus, the U.S. commander in Iraq:

praised the peaceful demonstration and said Iraqis "could not have done this four years ago.

Are you kidding me? Saddam would not have allowed anti-U.S. protests calling for the U.S. to get out of Iraq? I don't think so. That's one pig you can't put lipstick on.

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Welcome to the TPMCafe Book Club! This is where we regularly invite authors to come and discuss their most recent works with readers and invited commentators. Past Book Club authors include Thomas Frank, Anthony Shadid, Larry Diamond, George Packer, Ivo Daalder/James Lindsay, Robert Dreyfuss, Chris Mooney, Gene Sperling, Gershom Gorenberg, Peter Beinart, Kevin Phillips, Sidney Blumenthal, Reed Hundt and Anne-Marie Slaughter/John Ikenberry.

This week we'll be discussing Jonathan Cohn's Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price.

In the book, Cohn documents the lives of Americans whose lives have been torn apart by America's broken health care system either because of overworked and underfunded hospitals, the inefficiencies and inequalities of the market-based system, and the weight on business of employer-based insurance. Cohn will argue that those advocating universal care must unapologetically hope and push for the ideal, but be ready to compromise if and when political realities assert themselves.

Debating Cohn will be Jacob Hacker, Ezra Klein, Matthew Holt, Robin Podolsky, Don McCanne, Roger Hickey, Maggie Mahar, Joseph Paduda and Diane Archer. -ahg

The big corporate talking point against the Employee Free Choice Act is that it allows card check approval of unions rather than mandating secret ballot elections. But check out today's headline after workers at Trump's Plaza casino voted by 2-1 to join the United Auto Workers:

Trump Challenges Dealers Union Vote

Trump is delaying recognizing the union by trying to get the NLRB to throw out the election results-- a typical move which is part of the usual endless delays that thrawt unions even when a vote happens.

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Real estate agents tend to charge a flat percent of the sale price of a home, typically about 6%. This figure is the same regardless of the agent's talent or experience, and regardless of how much work the agent does or the results he or she achieves. Instead, the agent's compensation is largely determined by the prevailing property prices in the area (compare the median home prices in St. Louis of $180k versus here in Boston of $370k). Double pay for the same work?

Mark Nadel recently posted this smart critique of the realtor industry (including more than 400 footnotes, wow), arguing that this typical fee structure is senseless. As Mark writes,

Oddly, not only is there no evidence that it is any more costly to sell higher-priced homes than median-priced properties, but it is possible that the opposite may be true! Furthermore, the straight percentage fee formula creates little incentive for real estate agents to provide home buyers or sellers with additional value.

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It's tax time! Right about now, you might be patting yourself on the back for all taxes you saved with your Health Savings Account (HSA). Since Bush's tax rules link HSAs to high-deductible health insurance plans -- ones with about a $2,000 deductible -- the Bush administration can take a good deal of credit for the spread of those high-deductible plans.

Only, as it turns out, women pay more. A Harvard Med School study found that average medical costs for both women and men came in under the $2,000 deductible (meaning insurance covered $0 of their costs) but women had more expensive health needs and so paid $1,000 more than men. Or, as the lead researcher put it:

"High-deductible plans punish women for having breasts and uteruses and having babies," said Dr. Steffie Woolhandler, the study's lead author. "When an employer switches all his employees into a consumer-driven health plan, it's the same as giving all the women a $1,000 pay cut, on average, because women on average have $1,000 more in health costs than men."

Here at TPM we often argue about what constitutes racism, anti-semitism, homophobia etc. For some, harsh criticism of Israel is anti-semitic. For some, opposition to gay marriage is homophobic. For some, discomfort with affirmative action is racist.

But for others, arguments over these issues are legitimate and only cross the line into hate speech when one detects an underlying disdain for the group in question. You can criticize Israel all you want but suggesting that the occupation of the West Bank is no surprise coming from the killers of Christ and you probably are anti-semitic. Opposing gay marriage is okay, but suggesting that gay people are immoral or mentally ill and you probably are a homophobe. Oppose affirmative action, okay, but maintaining that African-Americans are intellectually inferior, you are almost certainly a racist.

Using this yardstick (is it a political difference or hate?) and Imus comes out loud and clear as a racist.

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The Ultimate Health Insurance Throw Down. The Rumble in the Book Club. The Death Match to Solve the Health Care Crisis.

Alright, I'm still working on a name. But this is big big big.

Sick author Jon Cohn and a team of health care wonk-elites will be joining us at the Book Club this week to sort out just how far the Democrats should go in pushing toward universal health care. Our distinguished group of debaters already includes Jacob Hacker, Ezra Klein, Matthew Holt, Robin Podolsky, Don McCanne, Roger Hickey and Maggie Mahar. Cohn will kick things off tomorrow.

Don't miss this one. Your health (care) may depend on it.

Enjoy the thread.

Call me a trotskyite, I'm used to it, but I happen to think the Federal government can do a lot of good with non-defense spending. There is no guarantee, but on balance I think the nation can be well-served by an expansion of social programs. Aid to state and local governments can reduce pressure on the regressive taxes on which they tend to rely. Money targeted to benighted school districts can upgrade physical plant, a no-brainer prerequisite for effective instruction. Direct spending on infrastructure, for instance to protect the Gulf Coast and New Orleans. Wire all schools to the Internet. Research in stem cells. High-speed passenger rail.

Now we have had an election with consequences: a Democratic Congress. Their first substantive statement on economic policy is the budget resolution. So what do we get? The House proposes a pissant $14 billion increase in non-defense discretionary spending, about 2/3rds of which suffices to just cover inflation. The Senate proposes $8 billion. Well, you say, at least the Dems will cut off funds for this disastrous war in Iraq. Oh wait . . .

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Should Nancy Pelosi have gone to Syria?

MJ say yes. He passionately believes that the US should be having a robust diplomatic dialogue with Damascus.

While the argument of whether or not the US should be engaging Bashar Assad is an important one -- and in many ways gets at the heart of a difference in approaches to foreign affairs, the real question raised by the Pelosi visit is: should the Speaker of the House be conducting foreign policy?

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