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Wednesday, May 26, 2004

Let's Take Off Our Blinders 

Honestly, it is no longer about whether Bush will win or not, it is now about how badly he will lose. How, pray tell, do I know this? Well, actually, I don't. However, the CBS Polls of May 24th paint one ugly picture for Dear pretend-a-dick.

I'm not in the mood for a comparison of past to present. I'm just going to give the latest polls. We all know his numbers have been sinking. Let's start with the overall performace poll. 41% approve, 64% disapprove.

That makes it official in my book-George W. Bush is an unpopular president. But wait, let me give you some more numbers, even uglier:

  1. Handling of the War:
    • approve 34%
    • disapprove 61%
  2. Direction Of Country:
    • right direction 30%
    • wrong direction 65%
  3. Overall rating:
    • approve 41%
    • disapprove 52%


That is just a small sample of what is really horrible numbers. There is only one set of numbers that are positive for Bush: Terrorism; approve 51%, disapprove 42%.

I can't stress enough, go read the poll numbers. It gives hope.

Something seems rotten in a certain Scandinavian country... 

I commented yesterday on how convenient ShrubCo's press conference planned for this morning was, given the Lying Disaster Monkey's poll numbers and the tepid response to his pack of lies speech on Iraq Monday night. It now seems I may have been even more prophetic than I thought. Via Ezra comes this disgustingly interesting tidbit:
Administration sources tell TIME that employees at the Department of Homeland Security have been asked to keep their eyes open for opportunities to pose the President in settings that might highlight the Administration's efforts to make the nation safer. The goal, they are being told, is to provide Bush with one homeland-security photo-op a month.

That's it. Impeach the bastards NOW! The whole miserable, rotten lot of them! It's the only way we're ever going to be able to take the government's word for anything ever again.

Tuesday, May 25, 2004

so is it just me? 

or did bush's speech from last night not live up to the "comprehensive plan for iraq" that it was puffed up to be? it had a trappings of a plan (five numbered steps and everything!) but each seemed to be nothing more than repackaged (and sometimes not even repackaged) versions of what bush has been saying all along.

let's look at each of his points


Are the rose-colored glasses surgically implanted? 

This is rapidly descending to the level of a temper-tantrum, with the Bush régime behaving toward its critics for all the world like a child sticking its fingers in its ears and chanting "La, la, la, la, I can't hear you!" every time another bit of bad news comes out of Iraq, or every time someone poses an even mildly interrogatory question about how well they really think their latest plan is going to work:

The Bush administration sought on Tuesday to project a unified, optimistic view of its plan to hand over power to an interim government in Iraq, even as President Bush faced criticism over a strategy many find lacking in crucial details.

The Bush strategery is not only lacking in crucial details, it appears on its face to lack any kind of a credible connection with reality as most of us understand that term. Not only did the preznit's pack of lies speech last night offer about the 463d rationale for starting the war in the first place, it contained remarkably little in the way of new anything--policies, rhetoric, details on who might be taking over what limited sovereignty we're planning to grant Iraq on June 30. You know, the trivial little bits of information that nobody really needs to pay much attention to. The important bits they've got all worked out already: a new ambassador, a new flag, a new Oil Ministry (oh, wait: nope!)...

Or, as I remarked to my mom last night as we were sipping wine and watching the news (the only way I can watch the news these days), "Same old bullshit, different day." Maybe I should have said "Same old Bushit..."

Cross-posted from Musing's musings.



What Ails the Health Care Markets? 



Many on the political right believe that the U.S. health care system should be operated as an unregulated market system, without government intervention. (If this sounds alien to you, replace the word 'unregulated' with the word 'free'. The term 'free markets' has gained such religious overtones among some pro-market groups that it no longer has a clear economic meaning. I prefer to call such markets unregulated.)

Totally unregulated markets in health care will not work for reasons that have to do with the basic characteristics of medical care. For simplicity, compare some medical care commodity, say, the provision of an appendectomy to that of some more ordinary consumption good, say, bread. Then consider the differences between the two commodities:

1. Feeling hungry is an adequate reason for a person to decide to buy bread. In contrast, all a patient who will end up having appendectomy knows is that something hurts a lot. Thus, we know our own needs when buying bread, but we are unsure about whether we even need an appendectomy. The level of information is very different in the two cases; in the latter case we as consumers lack most of the necessary information.

There are no such people as specialists who tell us when we should buy bread. But we do have exactly such specialists in health care, usually physicians, who diagnose and inform us about our condition and the best products and services to buy for it. This creates an unusual situation, as the person advising us about these needs is also in most cases the person who is going to sell us the products and services, and is therefore directly going to benefit from our purchases. Just think what would happen if bakers were allowed to decide how much bread we 'need'.

This dependency on professional advice leaves patients quite vulnerable. An unregulated health care market would not stop ruthless providers from exploiting the most desperate and/or wealthiest consumers. One reason why physicians traditionally did not advertize lies in this very fact: such advertizing can never be guaranteed to be objective, given the self-interests of providers and the lack of information most consumers possess.

2. Hunger is quite predictable, and if a person likes bread she or he can plan its purchases long in advance. Much of health care use is very unpredictable. With the exception of routine checkups and preventive care, health care consumption can't be planned in advance. Illness and accidents are uncertain events, and this fact makes health care use also an event which we can't predict with certainty. This is the basis for health care insurance. Insurance solves the problem of unpredictability and the need to keep large sums of money at hand for any major expenses. Instead, insured consumers can pay a fixed smaller sum every month (or have their employers pay it on their behalf).

While having insurance is a good thing, on the whole, insured patients behave differently from those who have no insurance. Just think what you would do if you had insurance for bread eating with no cash down needed. You would probably buy more expensive types of bread and more bread in general. This is what happens in health care markets, too. As a consequence, prices don't have their usual ability to affect consumer purchases. What most people take into account in their calculations is the actual amount of money needed (for example any deductibles and copayments), not the total bill of the treatment. Yet it is this total which is counted in the overall costs of medical care.

3. Quality assessment by patients is extremely difficult. In contrast, most of us can tell when bread is stale, and it usually takes just a small sample to find if we like the taste. Taking small samples of health care services may not be practical. It can even be extremely dangerous. That's one of the reasons why patients employ providers as advisers on the type and quantity of care needed. It's also the reason why pharmaceuticals and hospitals are so rigorously regulated, and why the system of malpractice suits exists.

Quality or effectiveness of health care is not completely known even to its providers. Many treatments are routinely carried out that might have only minor impact on the disease they aim to treat. New technologies are sometimes developed on the basis of nothing much more than a hunch, and they often spread widely before any research can be carried out about their appropriateness.

4. Whether I consume bread or not should have no direct impact on others' welfare (though it may affect others indirectly if I'm very poor and others would like me to have more bread). Whether I get treated for an infectious disease or not is of obvious direct interest to others: If I don't get treated, I am going to be a risk in the community. This means that the society as a whole, usually seen as reflected in the government, has an interest in assuring that infectious diseases and other general health problems are tackled. Markets tend to underprovide such services. Why? Because firms don't have the ability to charge other people for the benefits they receive when someone else's infectious disease is treated. These benefits are not then taken into account in market decisions; only the private demand of those infected will be satisfied by the market forces.

All these differences between bread and various types of medical care explain why markets perform poorly in health care and well in the bakery industry. Competitive behavior in most markets drives prices down, keeps quality up and offers variety to the consumers. But in health care prices may not go down with competition because consumers can't always judge what they are getting in quality, which makes per unit prices meaningless, and because insured patients are not taking the whole price into account in making decisions. Quality may not increase through competition if consumers are truly unable to judge quality, or if they use wrong signals to measure the inherently unknown quality. As an example, think about hospitals offering intricate technological services. Competition between hospitals might make them all acquire the latest gadgets, and consumers might think that a well equipped hospital is a high-quality one. But in reality, such competition may mean that none of the hospitals gets enough patients that actually need these services. The personnel operating the technology may not then get enough practice to remain skilled. And, as noted above, markets will underprovide those medical care services which have strong effects on the well-being of others than the patient under treatment.

For these reasons health care costs keep on rising year after year, despite our best attempts to control them, competition seems to have no real impact on keeping prices low, malpractice suits remain common and government regulation an important aspect of health care. The markets for bread, on the other hand, are doing pretty well with minimal intervention.

Those who advocate unregulated health care markets seem to assume that medical care is no different from bread, and that just getting rid of the government role in health care markets would make an appendectomy as affordable, bland and safe as sliced bread. I hope that this post shows why they are wrong.


(Cross-posted from
Echidne of the snakes).

Off The Cliff 

Bush's speech last night on his "clear vision" for Iraq landed with a thud, according to these observers in Salon.com. And these are not all left-wingers. Some snippets:
  • Michael Lind, senior fellow at the New America Foundation and author of "Made in Texas: George W. Bush and the Southern Takeover of American Politics." George W. Bush began and ended his speech with a brazen lie. He claimed that the United States is in Iraq to fight al-Qaida.... Before the war, Bush, Cheney and the neoconservatives did all they could to convince the American people that there was some link between Saddam Hussein's tyranny in Iraq and al-Qaida. They succeeded in deceiving a large number of Americans. Now Bush is trying the same trick again. He is trying to justify his failed and unnecessary war in Iraq by parading, once again, the corpses of those murdered by Osama bin laden and his followers in New York, Washington and Bali. The shamelessness of George W. Bush is matched only by his contempt for the intelligence of the American people.
  • Karen Kwiatkowski, lieutenant colonel, U.S. Air Force (ret.), served in the Pentagon's secret intelligence unit, the Office of Special Plans, under Defense Secretary Donald Rumsfeld. President Bush has a five-step strategy toward Iraqi deoccupation. The soldier-scholars in the Army War College audience must have been wondering, "Where’s the rest of it?" No mention of deoccupation, only the mush of "We went to Iraq to defend our security, not to stay as an occupying power." And more troops will go to Iraq, more violence will be committed, and we will build a brand new American-style maximum security prison for the Iraqis. Afterward, we'll have a photo op as we bulldoze the cursed Abu Ghraib and build a city park in its place.... The Soviet invasion and subsequent puppetry in Afghanistan lasted 10 years, and four changes of leadership. Monday night, President Bush again asked the American people to be patient. After listening to his vacant, unrealistic and uninspired presentation to a controlled military audience, I think I understand why.
  • Lawrence Korb, former assistant secretary of defense in the Reagan administration; senior fellow at the Center for American Progress. My central concern is that the president has not yet recognized the mistakes he's made and therefore does not have a basis on which to improve the situation. He played fast and loose with the number of troops. And I think we're going to have to put more troops in Iraq in order to provide the security necessary to rebuild the infrastructure. Then he talked about how he's going to go to NATO and thank the 15 countries who provided support and, as he said, almost 20,000 troops. Well, 10,000 of them are British. That means you have to divide up 14 other countries to account for the other 10,000. The president is trying to give the impression that we have a lot of international support, when we don't.
  • Rachel Bronson, director of Middle East studies and the CFR-Baker Institute report on post-conflict Iraq at the Council on Foreign Relations. The most disheartening aspect of the speech was the president's determination to continue to link the 9/11 terrorism with the Iraq war. He backed off a little, by saying that "Iraq is now the central front in the war on terror," but insisted upon defining "our terrorist enemies" in Iraq as those determined to impose Taliban-like rule country by country. Until the president makes clear that we have lost much support in Iraq -- not because of religious extremists, but because of a basic lack of law and order -- it will be difficult to fashion a truly workable strategy for success.
  • Michael Rubin, former political advisor to the Coalition Provisional Authority in Iraq; resident scholar at the American Enterprise Institute. President Bush successfully contextualized Iraq as an essential component of the war against terror. His reminder that the U.S. cannot afford to fail is important, especially in an election year where Democrats and Republicans alike seek to make Bush's management of the Iraq war a campaign issue. Bush was wise to let Iraqis know that Coalition Provisional Authority [CPA] would not simply transfer itself into an embassy on June 30; it will be a mistake if any American continues to occupy CPA headquarters in Saddam's Republican Palace on July 1. There were significant omissions in the Bush speech, however. Before the war both the State and Defense Departments underestimated the trauma of President George H.W. Bush's abandonment of Iraqis in 1991. Iraqis remain unconvinced that the U.S. will stick to its rhetoric and will not once again cut-and-run. While Bush rightly says that, "Whenever people are given a choice ... they prefer lives of freedom to lives of fear," he ignores the fact that Iraqis will not again put their necks on the line if they doubt U.S. committment to their future. Comments by both Secretary of State Colin Powell and CPA Administrator L. Paul Bremer in the past week suggesting that the U.S. might withdraw its troops shook Iraqi confidence in the U.S. Iraqis -- who fear the worst -- will notice that Bush did not roll back Powell's statements.
  • As'ad AbuKhalil, Arab media expert; professor of political science at California State University at Stanislaus. George W. Bush is certainly concerned about his reelection. His plummeting popularity in the polls explains his need for "a major" speech on Iraq. He may have sounded convincing to those in the U.S. who know little about Iraq and who do not follow foreign affairs closely. But for Iraqis (and Arabs in general) Monday's speech will go down as yet another desperate effort to be added to the series of U.S. propaganda campaigns that followed Sept. 11 and the two subsequent U.S.-led wars....Bush and neoconservatives still foolishly refer to a "free Iraq" as a model for the region. They may be right -- if other Arab populations are eager to incorporate into their lives daily car bombs, shootings by soldiers at checkpoints, torture of prisoners by liberating armies, the rise of fundamentalist groups and violent militias, clerical control of political affairs, and many empty promises of democracy. Colonization does not work in the 21st century, and the Iraqis who suffered under Saddam will settle for nothing less than full independence.
  • [Cross-posted from Bark Bark Woof Woof]

    I shouldn’t need to mention this, but… 

    I was not able to see our President’s speech tonight but I see from the headlines that he made the predictable promise to raze Abu Ghraib prison. Considering the foresight and competence that this administration has shown in all things relating to Iraq, I hope someone reminds them to take the prisoners out before they start knocking the walls down.


    Monday, May 24, 2004

    Get rid of that Hummer and buy yourself a Prius... 

    Bubba at Belly of the Beast has an insiders view of the world oil supply situation.
    I work for a major oil company - one that anyone reading this has heard of, and many of you may have used my company's name at the end of a long string of epithets (no it is not Halliburton). My job is such that I get to review the details of a very large number of opportunities that we have on the drawing board for bringing new oil to market. The opportunities that I review are literally in the four corners of the globe and in environments and situations that most people in their right minds would just shake their heads at due the difficulties (both technical, political, and economic) in pulling these projects off. Let me tell you people, the future is scary. There is no easy oil left. I just shake my head and wonder, not only about the future of my company, but the future of the world economy that's life blood is oil.
    The well is literally running dry. We need a Manhattan Project on energy and we need it soon.

    Sunday, May 23, 2004

    It's early days for crying havoc 

    (Cross-posted from Musing's musings.)

    Orcinus has laid out a number of disturbing facts in an excellent post at his site entitled "Jingoes and the fascist impulse" that I can highly recommend. I can't argue with his facts, but I think the conclusion he reaches is a little over the top. The conditions we face in contemporary America are indeed serious and will bear close watch by those of us who are committed to the preservation of our liberties and the fundamental structure of our government.

    However, there are a number of distinguishing factors between late-Weimar Germany and the United States in the present day that suggest to me a similar course of events is unlikely. They include the following:


    1. The Weimar Republic was a new experiment. Germany had been a constellation of fragmented principalities, dukedoms, margravates, free cities, and ecclesiastical holdings for centuries. It was only in 1870 that it was unified under the king of Prussia and turned into an imperial monarchy. There was no real democratic tradition in the country. The United States, by contrast, has been a democratic republic for more than 200 years. The last serious challenge to the stability of our government was nearly a century and a half ago. (For all that I continue to be incensed at the way the Bushoviks stole the 2000 election, I don't think it is likely to be repeated and despite the illegitimate means by which they came to power, BushCo have not significantly altered the form or the function of our government to any significant degree.)

    2. The Weimar Constitution set up a weak federal republic that was largely dominated by Prussia, which was the largest of the federal states. Unlike the U.S. Constitution, it set up a strong presidency. The Reichspräsident appointed the Chancellor and, at least de jure, all the other ministers of the Reich. Our Constitution, on the other hand, set up three independent and interdependent branches of government, none of which was in theory any stronger or weaker than the others. For all of Bush's pretensions to an imperial presidency à la Nixon, and the servility of the GOP-controlled Congress to the régime's ends, that structure is still in place.

    3. As I noted in a comment on Orcinus' post, Article 48 of the Weimar Constitution gave the president the power to use federal troops to enforce "the duties imposed...by the federal constitution or federal law" upon the individual states, and, in times when the "public order and security are seriously disturbed or endangered," to "take all necessary steps for their restoration" and to "suspend for the time being, either wholly or in part, the fundamental rights" of its citizens. The U.S. president may suspend habeas corpus, but no more. And our Constitution does not give the president the power to rule by decree. Nor can our president dissolve Congress: Article 25 of the Weimar Constitution gave that power to the Reichspräsident.

    4. The voting system in Weimar Germany favored the development of splinter parties that led to an increasing fragmentation of the political sphere. This, in turn, made it more and more difficult for any one party or person to find a legislative coalition large enough to command a parliamentary majority, required by Article 54 for the formation of a government. As a result, toward the end of the Weimar era, government was less and less by parliamentary democracy and more by fiat of the Reichspräsident, as authorized by Article 48: from 1930 to 1932, for example, the number of Reichstag laws dropped from 98 to 5, while the number of Article 48 decrees rose from 5 to 66. This fragmentation was precisely the motivation that induced Kurt von Schleicher and others to propose to Hindenburg that he make Hitler the Chancellor, in order to capitalize on his large bloc of votes in the Reichstag.

    5. There does not appear (at least to these eyes) to be a political party in a similar situation to the place occupied by the Nazis in the late 1920s and early 1930s.

    There is also, I believe, a mitigating factor in the apparent resurgence of a moderate faction in the Republican Party as exemplified by the fissures in the GOP's public face of late between Bushovik hacks like Speaker Hastert and more independently minded politicians such as Lindsey Graham and John McCain. If, as seems increasingly likely, the Bushovik wing goes down to defeat in November, this moderate wing of the party may well succeed in regaining control of what was once the party of Lincoln, and pull it back from the abyss to which the wingnut/neocon cabal has driven it.