On the front page there is a link to a story to the effect that the health insurance companies think they have already won.  So I have been thinking about how to let them win and turn that into a strategic victory.  Then the answer became obvious.  The problem with universal health care is the word universal.  It is time to make universal health care inevitable, but not aim to win the war today.  How do we do that?  By passing a much simpler law.  Throughout Title XVIII of the Social Security Act (Medicare) substitute the lower age of 55 in place of 65.  In the enabling legislation of SCHIP, substitute the age of 30 for the current maximum.  Call it a day and go home.

Yes, that leaves people in their 20s at the mercy of their states and it leaves people aged 30 to 55 waiting for the next round of reform, but it also paints a clear road map to the day we reach universal health care.  It gives those in the middle range motivation to keep pushing.  And it is a clear victory that does not give the insurance companies a damn thing.

I wrote a long response to Rotwang's most recent blog post.  Now I am being pestered to post it here.  To make sense if it, you likely need to read what Rotwang said too...

Rotwang seems to have a completely garbled message, partly, it would seem, because he is ignoring basic economics and partly because he seems not to realize how crappy private health insurance has become.

No one, let me repeat that no one, lives "in the comfortable womb of good private insurance." No such thing exists any longer. Wealthy people can afford to pay out of pocket for an indefinitely long time and members of Congress provide themselves luxurious health benefits, but the rest of us are already at risk, even those who have the semblance of "good private insurance."

The opponent is not the merciless economist (god how I hate to ever defend economists), it is the utilization review analyst, usually a nurse, who will deny your care for a poorly completed form as quickly as for the fact that it is quack quack quackery from Quacksville. Ironically, the UR analyst also has crappy health insurance.

This is not a new phenomenon to anticipate under a new government health plan (tightened to the bones by the anti-tax crowd), it is what we have had for 40+ years and it has been getting worse every year. When, 40 years ago, your doctor or your parent's doctor asked you to sign a form allowing him to receive assignment of your health insurance payment, you or they should have said, "Hell no, I will pay you and deal with the insurance company myself." That would have delayed, if not blocked, the UR analyst development.

That water is way past under the bridge. And, THAT is why we need single payer. Single payer can free competent health care professionals to perform their services without the constant insolence of UR analysts, who should, collectively, be relegated to one of the lower rings of hell.

Now, having said that, that only scratches the surface of Rotwang's nonsense. As Rotwang well knows, societal decisions are based on allocation of scarce resources. The scarce resource in this instance is not health care, it is economic power, otherwise known as money. Despite our individual desire otherwise, there is a point where society cannot put more resources into health care. To do so takes resources away from other vital matters. I personally think we could easily take $1-200 billion a year out of the military budget, maybe more, and spend it on health care. But, I do not have the clout to make it happen.

When we max out on our willingness to pay, all other health care finance decisions are zero-sum between health care beneficiaries and vendors. For example, in my long ago job in public health finance, we were concerned that fast growing costs for certain elderly would be spent in the opportunity cost of immunizations and other relatively inexpensive but very effective health care for children.

The low hanging fruit in the health care pie is the excessive overhead of insurance companies (including all those UR analysts). The next, not quite as easy to get at amount is the profiteering by nursing homes, hospitals, pharmaceutical manufacturing companies, medical appliance companies, and others in the health care production function. Yes, that includes physicians who, understandably, make up the most bizarre excuses possible for their extraordinary pay relative to other similarly skilled professionals. Then, there is the matter of what to do with momma (or pop); the very existence of the entire nursing home industry reflects a disgraceful failure of the family.

All of that comes before deliberate rationing. I say deliberate, because we have had de facto rationing for quite some time.

I hope Rotwang does not repeat this sort of column. I have long been a fan of his, but scare mongering is no more attractive among progressives than it is among the right.

Okay, there are 60 Democratic Senators.  Some are a little weak kneed, but they signed up with the Democratic Party.  So, it is time for a little hardball.

What I am talking about is the secret hold.  The secret hold is a threat of filibuster.  It has been around since Johnson was the Senate Majority Leader and it exists to avoid actual on the floor filibusters.  However, filibusters can also be shut down with 60 votes, which just happens to be the number of Democratic Party members.

So, it is time for the current Majority Leader to tell the other party they are out of luck.  Threats of filibuster must materialize before anything will happen.  In other words, no secret holds.

Let's see these elected senators demonstrate some spine.

Its half past spring, what spring cleaning have you done?  I still see a dozen posts from the "guess what I read in the headlines yesterday" category.  Um.. Actually, I read the headlines myself and so you don't need to tell me what you more or less remember that some bl-undit regurgitated from the headlines.

Be thoughtful.  Or, at least be witty.

Dang, if you can't do that, please be inscrutable or use creative poor grammar and spelling.

Last option... Be quiet.

"Better," as Lincoln is said to have said, "to remain silent and be thought a fool than to speak out and remove all doubt." Apparently, the self publishing blogosphere needs the Lincoln editor.

July 4th is coming up.  I challenge you all to AVOID trite posts about patriotism.  Its fine to love your country and all, but the other team has spent the last half-century turning patriotism into Xenophobic nationalism, so it is hard to discuss this topic without sounding stupid, trite, or like a Xenophobic nationalist.  There will be plenty of paid fools to make those mistakes, try to discuss something else, such as fairies (mid-summer comes quick on the heels of July 4... check your calendar).

August will be totally boring, even Congress goes home.  Here, let me give you the news now... Universal Health Care will not be passed and signed into law before Congress goes home and Sotomayor will not yet be confirmed.  Republicans will continue to be acting like asses.  The bright spot will be that Franken is finally seated, but we will have plenty of Democratic senators screwing things up.  Now, please, don't get bent out of shape when that comes to pass.  It is already true.  It has always been true.

Now calm down and think about something creative to post about.

On the front page of TPM at this hour (6 pm on the 3rd of June, you can no longer put a permalink to front page articles (thanks to comment, here is permalink) there is a comment from a reader (these comments are selected by the editors, they do not post every one they get....) which ends with... "if all we wanted was recycled, conventional baby boomers wisdom devoid of any observation or original thought?"

I was actually somewhat sympathetic with the earlier part of the message, but I have noticed a growing tendency to attack members of my generation.  I am offended.  Has TPM selected the boomers as their target for discrimination?

The public works program that finally ended the depression is sometimes called WWII, but it is actually DoD (Department of Defense).  It is the Republicans favorite program.  We are still spending gobs of money on it.

My point?  We shouldn't worry that spending money on public programs is long term.  We have some major concerns that we can spend money on and help out the economy.  These include Universal Health Care and Global Warming, not to mention restoring the infrastructure (including mass transit!).

My only hope is that the long term programs we create this time are not total money holes like DoD.

It will soon be time for round two and hardball politics.  Here is the plan:

1. Load it up with as much pork as possible.
2. Not one dime for the 177 districts whose representatives voted no this time.
3. Not one dime in areas that principally support the anti-stimulus Senators.
4. Load up on extra porky pork for just enough "moderate" Republican Senators so they have no choice but to vote for it.
5. Push it through on a no negotiation, party line (plus 2 "moderate" Republican Senators) vote.
6. Tell them on round 3, it will be the same, except all current federal commitments in those 177 districts and other areas will be canceled to pay for the pork for the positive votes.  Draft the bill and have it ready to go.

In other words, it is time to crush the opposition.

The Republicans want "Social Security reform" to solidify and make permanent the tax gains they achieved in the 1980s and under Bush the lesser.  The Social Security Trust Fund surplus, generated by increases in the payroll tax passed in the 1980s, has made the massive tax reductions for the wealthy possible.  Surprisingly, the wealthy are so greedy they do not want to share this money with the rest of us.

Yes, there is money to pay for our government including Social Security, Medicare, health care for all of us, infrastructure, and whatever else you might need.  Somebody has it, and that somebody is the folks that got the tax reductions paid for with our increased payroll taxes.  Tell those greedy folks you have had it up to here with them.

Whenever you hear anyone propose Social Security reform, there is one and only one reform to support:
1. Raise the ceiling on the the payroll taxes (eliminate it) and expand it to non-payroll income.
2. Continue the benefits under current practices (as if the ceiling were not eliminated).
3. Use the surplus thus generated to solve the health care finance problems.

Now cross posted with more discussion @ dagblog.

I am so very tired of hearing about terrorists.  Terrorists are the convenient boogeymen that replace communists for the Republican Party.  We are all supposed to think this is a new and entirely different kind of threat.  Something foreign and, well, Muslim.  Hogwash.

We have lived with "terrorism" for at least 100 years (caution pdf), and were never very terrified by it until it became the necessary foil for the Republican party.  The real terrorists are the folks that take these occasional incidents and turn them into something more than what they are.  My top nomination for a banned word is "terrorism" and all its cognates.  It is pure political rhetoric designed to reinforce the message that we are at constant war (thus, bye bye civil liberties) and to scare us into cow towing to the authoritarians in our midst.