JustOneMinute

More Creative Accounting From Team Obama - (Count Every Nuke!)

When is a nuke not a nuke?  Per the Times, when it is carried by strategic bomber:

Arms Control May Be Different on Paper and on the Ground
By PETER BAKER

WASHINGTON — An official photograph of a B-52 bomber at Barksdale Air Base in Louisiana shows it with a formidable arsenal of nuclear weapons it can carry all at once — 14 air-launched cruise missiles, four B61-7 gravity bombs and two B83 gravity bombs.

But when it comes to the new arms control treaty to be signed next month by the United States and Russia, those 20 warheads count as just one.

Mr. Baker talks to experts about Obama's new arms deal with Russia and explains that Obama is probably over-promoting the actual cuts in nuclear arms:

“It’s creative accounting,” said Pavel Podvig, a longtime arms researcher from Russia who is now on leave from Stanford University. “They found a way of making reductions without actually making them, and they were happy to accept that because nobody wanted to go to more serious measures.”

We have a Say-Anything President, which is hardly news.  What is noteworthy is that Even The NY Times is starting to call him on it.

No Beatdown Like A Brit Beatdown

TigerHawk stands back in shock and awe as the Brits hold up their end of terminating the special relationship.

Grim Gallup Poll

Per this new Gallup poll, Democrats are really pushing water uphill trying to promote this health care reform.

And do remember - every day Obama spends enjoying his victory lap on health care trying to light a small candle of support for health care is a day not spent talking about jobs, jobs, jobs.

That ought to make Dem strategists nervous; however, as a loyal American, I think Obama not talking about jobs is probably the single best thing he might do to stimulate job growth.

Now, for people not yet sufficently worried about the looming costs of this health care fantasy we have two new "Now they tell us" articles.

As praised by Ross Douthat, the New Yorker's John Cassidy opines on the accounting gimmicks, the weakly enforced individual mandate, and the flammable firewalls preventing employers from dropping health coverage and dumping their employees into the subsidized exchanges.  In his example, the boss can drop health coverage, give his employees raises, and they will pay still less for health care after subsidies.  The boss wins Boss of the Year, the employees are thrilled, and only the taxpayer suffers.

Ahh, but does the taxpayer suffer?  Per this WSJ article by Alan Reynolds, economic research indicates that raising taxes on the rich always produces less revenue than 'expected" by traditional CBO static revenue analysis.  That might lead to a $670 billion tax shortfall for ObamaCare.  Oops.

Peter Suderman of Hit and Run provides a good angst inducing round-up.

Drill, Baby, Drill

They told me if I voted for McCain we would have offshore drilling all over the US...

MORE:  More from the Times.  Greens can relax - if any oil companies actually try to drill anywhere, activists and enviros will file a million lawsuits, joined by amicus briefs from Eric Holder's Justice Dept.

Ask A Rhetorical Question (Ross Douthat Edition)

Ross Douthat is tracking some libs who are now free to tell us what they really think about the new health bill:

Last week, Reihan Salam predicted the appearance, among left-of-center writers, of “thoughtful, honest assessments of flaws in the Affordable Health Care for America Act that were largely overlooked” during the beat-the-Republicans phase of the debate. Now John Cassidy, The New Yorker’s financial writer, has delivered an impressive two-part contribution to the genre. Cassidy supports the health care bill on moral grounds, but he has deep doubts about its fiscal sustainability. On this front, he makes two points that many right-of-center wonks have been hammering on for a while now. First, the individual mandate is “a bit of a sham,” and lots and lots of people will probably just pay the modest fine (or dodge it) until they get sick, at which point they’ll show up demanding their guaranteed insurance policy, sending costs skyrocketing. Second, the subsidies for the individual market are so much more generous than the existing tax deduction for employer-provided health care that employers will have an enormous incentive to offload their employees onto the new exchanges

The example is shockingly simple and so accessible that even a Democratic Congressman could probably understand it.

Ross closes with this non-mystery:

I should note that Cassidy expressed similar doubts before the legislation passed, penning what he called “some vaguely heretical thoughts on health-care reform” back in November. What puzzles me is why an enterprising editor at The New Yorker didn’t suggest turning those thoughts into an actual magazine feature, instead of just letting them gather moss on Cassidy’s blog.

I don't think he is really puzzled.

AND IN THE LONG RUN:  In the long run we are all dead, but before we die we may see the unfolding of the Dem's subtle plan.  In Phase 1 the link between employment and insurance is severed (that, we like), based on the economic described above.  Most people other than some high earners will expect to get their insurance from the government, with a subsidy.

Phase II eliminates the middleman - the Demon Insurers are cut back and we move on to modified single payer.  High earners who have been paying for their insurance all along will still have the right to buy private insurance, but folks receiving subsidies will be offered either the public plan or the public plan.

David Brooks Calls Me "Absolutely Crazy"; He May Be Right, But Where's The Evidence?

David Brooks goes leaping to conclusions and tells me I am absolutely crazy - me, a former TIME Man of the Year!

Two things happened to Sandra Bullock this month. First, she won an Academy Award for best actress. Then came the news reports claiming that her husband is an adulterous jerk. So the philosophic question of the day is: Would you take that as a deal? Would you exchange a tremendous professional triumph for a severe personal blow?

On the one hand, an Academy Award is nothing to sneeze at. Bullock has earned the admiration of her peers in a way very few experience. She’ll make more money for years to come. She may even live longer. Research by Donald A. Redelmeier and Sheldon M. Singh has found that, on average, Oscar winners live nearly four years longer than nominees that don’t win.

Nonetheless, if you had to take more than three seconds to think about this question, you are absolutely crazy.

Wait, I'm still thinking!  Call me crazy, but I am puzzling over the proposition - are we meant to think that Ms. Bullock's personal blow was discovering for herself the truth about her husband's deplorable infidelity, her embarrassment that the rest of us were now privy to her secret strife, or the deplorable infidelity itself?  Put another way, if a tree falls in the forest and no one hears it, was he cheating on her?

Let's reason together.  If Ms. Bullock knew her husband was a hound dog and their deal was that he not embarrass her, then she has experienced both public acclaim and shame in the same couple of weeks, but the actual infidelity is not news to her.  Would she prefer an Academy Award and a cheating, indiscreet husband or no Academy Award and a cheating but discreet husband?  Saying yes to that deal may not be so daft. 

On the other hand, she may have just found this out about the guy, which must be deeply painful.  On the third hand, if she had not found out he was a cheater but he continued to be one, would she have continued with her False Happiness?  For how long?  Eventually truth will out, except when it doesn't.  Is her choice between an Academy Award now accompanied by heartbreak next week, versus no Academy Award and heartbreak next year?  Tricky!

If Brooksie can process all that nuance in just three seconds, he deserves his spot at the Times.  Which he can use to drive the rest of us crazy.

Declare Victory And Move On

The White House has adopted a very sensible strategy in their scuffle with the insurance industry over the over-sold health care bill and the coverage of children with pre-existing conditions - declare victory and move on.  Both sides win - leading Democrats don't want to explain that they can't successfully draft a bill and then proofread it, and the insurance industry doesn't want to explain that they want children to sicken and die.  However, behind the kabuki we detect a musical comedy.

Ricardo Alonso-Zaldivar of the AP started this dust-up last week, and is back with what both sides hope is the public denoument:

Insurance industry agrees to fix kids coverage gap

By RICARDO ALONSO-ZALDIVAR (AP) – 15 hours ago

WASHINGTON — After battling President Barack Obama's health care overhaul the better part of a year, the insurance industry said Monday it won't try to block his efforts to fix a potentially embarrassing glitch in the new law.

In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist said insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year.

Quick resolution of the doubts was a win for Obama — and a sign that the industry has no stomach for another war of words with a president who deftly used double-digit rate hikes by the companies to revive his sweeping health care legislation from near collapse in Congress.

This works for both sides.  Team Obama didn't want to spend time in court explaining why Congress is incapable of drafting legislation that reflects their intent (actually, Congress had a more limited intent, IMHO, but I digress).  And obviously insurers don't want to spend time explaining why they don't want to provide coverage for sick kids (As an aside, since insurance companies mainly recycle our premiums, it is We the Premium Payers who are generously providing this new coverage, as part of our higher rates).

However!  The Politico reprints the stern letter from HHS head Sebelius and the insurer's kow-towing response, and it is laughably obvious that both sides are posturing.

Let's start with Sebelius, from her letter:

First, Congressional intent has, ahh, evolved since they wrote the bill, mainly to keep pace with Obama's over-promising and over-selling of the bill, as discussed in this recent post. 

Sebelius more or less ends the charade when she announces what her firm new regulations will do - children with pre-existing conditions can not be dropped from their parents plan, and they cannot be subjected to specific exclusions and waiting periods based on pre-existing conditions.

That's telling them!  For heaven's sake, that is essentially what the new law already says.  Neither the AP nor anyone else thought that a parent taking insurance as part of an employer group plan would have a problem, and Ms. Sebelius has now assured us that they won't.  Pop the champagne.

The problem is with individuals seeking private insurance for themselves and their family.  There is no "guaranteed issue" requirement effective in 2010 under the new law; there is also no requirement that companies ignore health status in setting premiums.  Here is Alonso-Zaldivar of the AP last week:

The coverage problem could mainly affect parents who purchase their own coverage for the family, as many self-employed people have to do. Families covered through employer plans typically do not have to worry about being denied coverage because of pre-existing conditions.

If an insurer refuses to sell to parents because they have a sick child, well, the insurance company is neither denying the child access to the parent's plan nor providing coverage subject to an exclusion.

As to Ms. Sebelius's assertion that she is preparing regulations that explain that the term "pre-existing condition exclusion" applies to both access to plans (i.e., issuance) and specific exclusions within a plan, well, good luck.  The term "pre-existing condition exclusion" has been defined by statute for years; the definition was not substantively amended by the latest bill.  The notion that she can fly in the face of years of state and Federal law and unilaterally present a new definition is, well, awe-inspiring.  Or laugh inspiring.

That said, this is not a fight the insurers want to pursue in public.  Hence, their very sensible response, which can be paraphrased as "we intend to comply with the regulations as you have described them".  And since she described the current law, that is no big deal. 

Now, if she drafts regulations that over-reach on terms defined by statute, well, I bet somebody will sue, just in the name of responsible governance.  Or, depending on circumstances, an insurer might simply defy the regulations and dare anyone to sue them.

MORE:  From the Times:

In response to a question, Nick Papas, a spokesman for the Department of Health and Human Services, said that the rules would require insurers to offer coverage to children with pre-existing conditions, including families who have not had health insurance in the past.

It was not immediately clear whether the rules would allow insurers to charge higher premiums to families with children with pre-existing conditions than to families that are identical in other respects.

Well, it is immediately clear that Congress did not make the new provisions regarding equal pricing effective in 2010 for children, even though they did move up the effective date for the ban on pre-existing condition exclusions from 2014 to 2010 for children.  The idea that the HHS can unilaterally change the effective date of legislation that Congress just passed is pretty interesting.

IF KATE PICKERT IS WITH ME, WHO WILL STAND AGAINST ME?

From my BFF at TIME:

Despite Administration "Win," Some Sick Kids Will Remain Uninsured

...A "win" for Obama? Well yes. The Administration is enjoying a day of headlines trumpeting its victory over insurance companies. The headline in Politico's daily health care e-mail blast was “SEBELIUS LAYS DOWN THE LAW.” Pretty tough stuff. Plus, the clarification means Democrats will still be able to tout this immediate benefit of health reform during this year's congressional campaigns. But is it a win for sick kids who can't get insurance coverage? Maybe, in some cases.

Although insurers have promised to sell insurance policies to families with kids with pre-existing conditions, there is nothing to stop the insurance companies from charging whatever they want. Until 2014, insurers will still be allowed to set premiums rates in the individual market based on health status. For a kid with a bad health status – like cystic fibrosis, say, or cancer – that means very high premiums that families might still not find affordable. Insurers are not going to simply absorb the cost of covering these expensive cases; they will pass the expenses on to policy holders.

Of course, there aren't many kids in this situation. The vast majority of kids with pre-existing conditions are covered by Medicaid, CHIP or employer-sponsored insurance. Only about 10% of children are uninsured and only a small percentage get their coverage in the individual market, where the pre-existing exclusion issue matters. But the parents of an uninsured middle-class kid with cancer are still going to face a pretty tough financial challenge buying coverage on the open market.

The pre-existing exclusion clarification is a start at helping these families, but it's by no means a complete solution. In other words, a loophole remains and it's one that won't be closed for four more years.

STILL MORE:  Jake Tapper of ABC explains that the bill was not written to do what Congress says it was meant to do:

Eliza Bangit, senior research associate at Georgetown University Health Policy Institute, says that protections for consumers in health care legislation are typically divided into three categories: Access, affordability, and adequacy. The provisions in the bill that explicitly address access -- requiring an insurance company to offer insurance -- begin in 2014.

The protections for children that kick in this year do “not talk about access,” Bangit says. The provisions, she says, really only address adequacy -- requiring that pre-existing conditions are covered by insurance. “The law does not talk about access for children. It could have been oversight, I don’t know. But access is just different from adequacy, it always has been. We always make the differentiation.”

Kansas Insurance Commissioner Sandy Praeger, past president of the National Association of Insurance Commissioners, agrees with this interpretation.

“In looking at the bill, our experts were concerned there’s no ‘guaranteed issue’ until 2014,” Praeger told ABC News. “’Guaranteed issue’ means when you’re out buying insurance, they have to offer coverage to anybody who wants to buy in – there’s nothing about how much they can charge, but they have to offer it.”

Praeger says Congress “intended there to be guaranteed issue, but the bill’s not written that way…It’s not in the law.”

I am not sure why Praeger is so sure that Congress brain-locked on advancing the effective date of the  guaranteed issue provision for children in parallel with advancing the adequacy provision, rather than simply making a judgment about what was practical and politically feasible.  This is not some drafting subtlety, but is a very basic point.  This brave new world in which we judge Congressional intent by their press releases rather than the final bill is troubling.

And on that point the Children's Health Protection Act of 2009 (S643), which was introduced in March 2009 and was eventually folded into the final bill, did not have guaranteed issue language either.  Again, was that also an oversight?  Or was Congress eliminating the HIPAA waiting periods for children with pre-existing conditions, where guaranteed issue is not in play?  Ahhh...

You Might Need a Weatherman To See Which Way The Wind Blows On Global Warming

The Times reports on some sand in the liberal media machine - our nation's weathermen don't seem to be on the global warming bandwagon in acceptable numbers:

The debate over global warming has created predictable adversaries, pitting environmentalists against industry and coal-state Democrats against coastal liberals.

But it has also created tensions between two groups that might be expected to agree on the issue: climate scientists and meteorologists, especially those who serve as television weather forecasters.

Climatologists, who study weather patterns over time, almost universally endorse the view that the earth is warming and that humans have contributed to climate change. There is less of a consensus among meteorologists, who predict short-term weather patterns.

...Such skepticism appears to be widespread among TV forecasters, about half of whom have a degree in meteorology. A study released on Monday by researchers at George Mason University and the University of Texas at Austin found that only about half of the 571 television weathercasters surveyed believed that global warming was occurring and fewer than a third believed that climate change was “caused mostly by human activities.”

More than a quarter of the weathercasters in the survey agreed with the statement “Global warming is a scam,” the researchers found.

The split between climate scientists and meteorologists is gaining attention in political and academic circles because polls show that public skepticism about global warming is increasing, and weather forecasters — especially those on television — dominate communications channels to the public. A study released this year by researchers at Yale and George Mason found that 56 percent of Americans trusted weathercasters to tell them about global warming far more than they trusted other news media or public figures like former Vice President Al Gore or Sarah Palin, the former vice-presidential candidate.

If you can't trust the guy (or hot gal) who tells you whether to bring an umbrella to work tomorrow, who can you trust?

Children With Pre-Existing Conditions - Problem Solved!?!

That was easy!  The WSJ reports that all the HHS had to do was ask nicely and the question of whether children with pre-existing conditions got relief under the new health reform bill was solved:

Insurers said they would comply with regulations the government issues requiring them to cover children with pre-existing conditions, after a dispute with lawmakers over interpretation of the new health-care legislation.

The Obama administration has made near-immediate coverage for sick children a priority in its health-care overhaul. But shortly after the bill's passage last week, insurers contended that the law didn't require them to accept sick children until 2014.

The insurance industry's lobby, America's Health Insurance Plans, initially said the law meant only that they needed to cover treatments for sick children who already were customers.

Kathleen Sebelius, secretary of Health and Human Services, sent AHIP president Karen Ignagni a letter Monday pledging to issue new regulations in coming weeks to clarify that insurers must take applications from sick children starting in September. "Now is not the time to search for non-existent loopholes that preserve a broken system," Ms. Sebelius said.

AHIP said de-linking the requirement to insure sick children from the law's mandate that everyone buy health-insurance coverage, which goes into effect in 2014, could drive up prices in the meantime. But the group said it would do whatever HHS tells it to do.

That was easy!

It's worth remembering that, within reason, the insurance companies can play by any set of rules as long as they all play by the same rules.  If some companies continue to deny coverage to families of children with pre-existing conditions, the firms that take them on will need to restructure as philanthropic enterprises.

And do keep in mind - since the insurers will be able to raise rates, they won't be paying for these kids (lib fantasies notwithstanding); the rest of us who pay insurance premiums will.

In that sense, this preserves the Democratic Party role as the party of random wealth transfers.  Just imagine that somewhere a self-employed software consultant pulling down several hundred thousand a year has been paying for his child's asthma treatment out of pocket because he can't get coverage.   But now he can, thereby leading to an increase in the insurance premiums for everybody else, including Mailroom Mary, who is trying to get by on $25,000 a year.  Such a victory for social justice!

How often will that be happening?  No one knows!  This new rule is not means tested as to beneficiaries and no one is yet eligible for premium subsidies, but Dems are thrilled anyway.  Oh, well - they are thrilled with the individual mandate that forces the young and healthy to subsidize the older and less healthy (but often higher paid).  Random wealth transfers.

If I had to guess I would imagine that, given the recent expansions in Medicaid and S-CHIP, the beneficiaries of this children fol-de-rol will not be low earners and may include a lot of successful self-employed people.  Which is fine.

The WSJ includes this on coverage:

The number of children who would be affected by the broadest interpretation of the law could be relatively small. The Children's Health Insurance Program, a 1997 health-care plan for low-income children, is already credited with extending coverage to about eight million children who are not poor enough for Medicaid and includes rich benefits and low cost sharing.

Roughly eight million children remain uninsured, according to the Kaiser Family Foundation, but just 1% to 2%—or 80,000 to 160,000—have a health condition such as cystic fibrosis or cancer that would disqualify them from private insurance coverage, said Sara Rosenbaum, chairwoman of the health-policy department at George Washington University and a children's health-care expert. Many of those children's families were unaware they could qualify for Medicaid or CHIP assistance or enroll in an employer plan, she said.

"We're talking nationwide about a handful of children" who might benefit from expanded private coverage, Ms. Rosenbaum said. "I can't imagine why insurance companies are fighting this so hard."

It's clearly a losing issue for them, although I do think they had a winning legal argument.  And I am still mystified as to how the HHS can write rules that turn the legislation sideways, but I try to learn something new everyday.

FOR THE DEEPLY SKEPTICAL:  An alternative explanation is that Team Obama did not want an extended discussion about their inability to draft legislation and insurers did not want an extended chat about their unwillingness to insure sick kids, so a tacit understanding was reached - the HHS will pretend to write something meaningful and insurers will pretend to play along; later, they will lapse back to business as usual and HHS will ignore it. 

DEEP SKEPTICISM, CONTINUED:  The Politico releases the victory letter from HHS Secretary Sebelius and the unconditional surrender from the insurance group; we applaud the kabuki but are unconvinced.

Bad News And Sad News

I am catching up with stuff I don't want to catch up with.

Waxman Versus Reality

This is very funny.

Here is the WSJ take on it.

America Doesn't Quit, It Just Refocuses Its Efforts

The NewsBusters are ROFLOL at the Audacity of Barack, who told US troops in Afghanistan to "Never give up.  Never surrender."  Well, almost:

The United States of America does not quit once it starts on something.  You don't quit, the American armed services does not quit.  We keep at it.  We persevere." -- Pres. Obama to US troops in Afghanistan, March 28, 2010

"Democratic presidential candidate Barack Obama is calling for the immediate withdrawal of all U.S. combat brigades from Iraq, with the pullout being completed by the end of next year. 'Let me be clear: There is no military solution in Iraq and there never was,' Obama said." -- Obama calls for immediate withdrawal from Iraq, AP, Sep. 12, 2007 [emphasis added]

So now Obama is President Persevere?  How cool is that?!?  Let's just stroll down memory lane with another 'The surge will fail' snippet, this time from his Senate floor speech in January 2007 where he proposed that the Congress nix Bush's surge and impose a troop withdrawal schedule:

When it comes to the war in Iraq, the time for promises and assurances, for waiting and patience is over. Too many lives have been lost and too many billions have been spent for us to trust the President on another tried-and-failed policy, opposed by generals and experts, opposed by Democrats and Republicans, opposed by Americans and even the Iraqis themselves. It is time to change our policy. It is time to give Iraqis their country back, and it is time to refocus America's effort on the wider struggle against terror yet to be won.

Hey, it helped him get elected President, so mission accomplished.

Who Has Time To Read?

The NY Times has a story on the same toic as my endless post below, namely, does the new health care reform actually assure that all children with re-existing conditions can not be denied coverage?

I said that the answer is no (insurers can still deny coverage outright), that the text of the bill is clear, that this does not lend itself to a regulatory solution but will require new legislation, and that the confusion has been driven by people, especially Barack Obama, who are hung up on speaking English rather than Insurance-ese.

The Times provides a new direction - apparently insurance company legal eagles agree with me that they can still deny coverage, but now Congressman are focusing on their new ESP legislative approach - the bill means what they thought it meant and wanted to it to mean, not what they wrote:

The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.

If you read my long post you will realize the absurdity of that claim.  Just for starters, "pre-existing condition exclusion" has a statutory definition in each state and in the Public Health Service Act; it doesn't just mean whatever some committee member thinks it means.

The new bill had four sections which collectively provided protections for people with pre-existing conditions starting in 2014.  These sections included Sec. 2702, which requires insurers to issue to anyone in their region; Sec. 2703, which obliges insurers not to restrict renewals; Sec. 2704, which bars "pre-existing condition exclusions such as "we will cover everything except bills related to your ongoing cardiac condition", and Sec. 2705, which requires fair pricing (no awards for the healthy or surcharges for the sick).  All these sections are effective in 2014.

But even though all four sections are needed to provide full protection for people with pre-existing conditions, Congress only moved up the effective date of Sec. 2704 to 2010, for children under 19.  That is hardly meaningless, since lots of kids are enrolled under their parent's employer group plans and subject to HIPAA exclusion periods as long as 18 months.

But accelerating only Sec. 2704 could never have been mistaken for a comprehensive attempt to protect all children, including the children of the self-employed.  Either Congress needs to learn to write bills (possible) or they need to admit that this was not an error; their hype got ahead of reality.

I think Dems will prefer to blame Evil Insurance Companies rather than admit that they have gotten trapped by Obama's over-selling of the bill.

For a smidgen of history, here is a Senate bill, the Children's Health Protection Act of 2009 (S643), offered a year ago by Senator Lautenberg and others.  It bars pre-existing condition exclusions in the group and individual market but does not include a must-issue provision, a must-renew provision, or anything about fair pricing.  What is his goal?  Let's ask the Senator:

Approximately 20 percent of school-aged children suffer from a chronic disease including cancer, diabetes, asthma and heart disease.  These chronic diseases are frequently considered pre-existing conditions for the purposes of health insurance coverage.  The Health Insurance Portability and Accountability Act of 1996 limited when insurance companies could deny children health coverage due to a pre-existing condition.  However, a loophole in the law permits an insurance company to limit coverage to a child who goes without health coverage for more than 63 days.

    The Children’s Health Protection Act of 2009 will close that loophole and prohibit insurers from imposing pre-existing condition limitations on children under the age of 25.  This bill is aimed at helping the nine million American children who are uninsured obtain the insurance they need to ensure prompt treatment for their chronic conditions.  In addition, it would potentially help millions of children who are at risk for becoming uninsured if their parents lose their job and health insurance in this economic crisis. 

So he was going to close a HIPAA loophole.  But of course, lots of people who lack insurance for themselves or their kids are not covered by HIPAA.

Lautenberg had originally considered "children" to be anyone under 25; his concept was adopted into the larger reform just passed, with the age reduced to 19:

Provisions that Sen. Lautenberg inserted in the legislation will help make health care more affordable in high cost of living states such as New Jersey and more widely available to children with pre-existing conditions throughout the country. 

    Sen. Lautenberg’s “cost of living” amendment will require the Administration to assess a cost of living adjustment to help ensure fair health care subsidy levels for high cost of living states such as New Jersey.  Another provision that Sen. Lautenberg fought to include in the bill will eliminate pre-existing condition exclusions for children under the age of 19.  The provision aims to help some of the nine million uninsured American children obtain the insurance they need to gain access to prompt treatment for their chronic conditions. 

    Earlier this year, Lautenberg introduced the Children’s Health Protection Act (S. 643) to address this issue.  An estimated twenty percent of school-aged children suffer from a chronic disease such as diabetes or cancer.  These chronic diseases are frequently considered pre-existing conditions for the purposes of health insurance coverage.  Currently, insurance companies can deny or limit coverage to children with pre-existing conditions if their family has been without health insurance coverage for more than two months. 

That is where this provision came from.  It never included "Must Issue" or "Must Renew", but did enhance HIPAA a bit.  For Dems to pretend otherwise at this late date is disgraceful, but predictable.

FWIW:  Last December when the Dems were taking up the manager's amendment which incorporated this "pre-existing conditions exclusion" fix it was not a Top Three selling point.  Now the White House has it at number one, mainly because the White House is describing something not in the bill.

MY LATEST UNHOLY ALLIANCE:  David Dayen of Firedoglake says this:

Guaranteed issue doesn’t mean a whole lot on its own without accompaniment with some form of community rating. Otherwise, the insurer can increase premiums to such a degree for the particular family that they wouldn’t be able to afford insurance without keeping the child off the policy.

Top Democrats may be outraged by the insurance industry’s intransigence, but nowhere in the law – to my knowledge – did they add any community rating language to cover this initial guaranteed issue for children. There is modified community rating for all along with guaranteed issue when the exchanges start up in 2014.

...The guaranteed issue for children provision came into the Affordable Care Act late in the game, and does not seem to have been well thought-out.

I dispute his characterization of the "no pre-existing condition exclusion" as guaranteed issue, and I think the concept did have a year-long history as the Lautenberg bill, but I like his point that the bill just doesn't say what it needs to say to get Dems where they claim to be.

IS EZRA KLEIN STILL DUCKING THIS?  Last week in an on-line chat the WaPo's health care sage parroted the White House line:

New York, NY: Hi Ezra: I am an emergency physician in New York and have been following your reporting with great interest. Many of my patients are asking me about the future of "pre-existing conditions" and denial of coverage to children and adults due to various illnesses. Can you tell me when according to this legislation, insurance companies will no longer be able to deny coverage to children and adults with pre-existing conditions?!

Sincerely, Boris Markovich MD

Ezra Klein: Yep. For children, it's kicks in a couple of months from now. For adults, it's not until 2014.

Uh huh.

EZRA UPDATE:  Ezra Klein steps up and steps away:

It looks like the Obama administration will issue some regulations saying that their view is that the language involves both access to insurance and the benefits kids get when they're insured, but it's not clear whether that'll matter (some experts think it will, but I'm skeptical, particularly if insurers want to evade it). Another option would be to pass another bill strengthening the benefit, though Republicans might filibuster that. The likeliest outcome, I think, is that this early deliverable -- like most of the early deliverables -- isn't worth much, and the bill really goes into effect in 2014.

I can summarize the expert opinion to which he links - it would be really great if insurers paid for these kids, there can't be many and it won't cost much, Congressional intent can be inferred from how they promoted the bill and not how they wrote it, so let's just go for it.  Wow.

I especially love this:

Because §2704 is intertwined with §2702’s availability provisions as a result of the structure of §1201 (indeed, non-discrimination in coverage and benefits has meaning only in the context of insurance enrollment), §2704 as amended has meaning only in the context of enrollment. In other words, the advance protections given child enrollees under the PPAC have meaning only in the case of children who are in fact able to enroll in coverage. One thus sees in PPAC §10103 a clear Congressional intent that in the case of children, the Act’s non-discrimination protections become effective in their entirety within 6 months of the date of enactment.

Right.  Set against that is that Congress has a specific provision for enrollment and they did not accelerate that to cover children in 2010.  However, what they did accelerate is perfectly meaningful in the context of employer group insurance, where the parent cannot be turned down and the only question is to what length of HIPAA-type exclusion period might the child be subject.

As to Congressional intent, Sen. Lautenberg intended to close a HIPAA loophole, not solve the problems of people not covered by HIPAA.

Mitch McConnell Versus Barack Obama In A Pre-Existing Condition Smackdown

It doesn't get better than this (I am sorry to say...) - Senate Permanent Minority Leader Mitch McConnell and Barack Obama have vastly different understandings of a highly touted provision of the newly-enacted health care reform.  They can't both be right!  Let's roll the tape.  OK, roll the transcript - here is the Senator, from last weekend:

Just one day after the president signed this bill into law, we got word that one of its celebrated early features -- a ban on discriminating against children with pre-existing conditions -- won’t immediately protect children after all.

The Senator is referring to this AP story which was supported a few days later by Kaiser Health News.

But my goodness - Barack Obama has been telling people since December that children with pre-existing conditions cannot be denied coverage.  Here is in on December 19 2009, discussing the Senate "managers's amendment", one of the last acts before the final Senate vote:

And a recent amendment has made these protections even stronger.  Insurance companies will now be prohibited from denying coverage to children immediately after this bill passes. 

Here he goes again in a weekly radio address on January 9, describing the immediate benefits of the health reform bill:

Uninsured Americans with a pre-existing illness or condition will finally be able to purchase coverage they can afford.

Children with pre-existing conditions will no longer be refused coverage, and young adults will be able to stay on their parents’ policy until they’re 26 or 27 years old.

Obama made the claim in Iowa after the bill was passed.  And the White House talking points released after the bill was signed led with the same claim:

Let's start with how health insurance reform will expand and strengthen coverage:

This year, children with pre-existing conditions can no longer be denied health insurance coverage. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.

So who is right?  And how did we reach this level of misunderstanding?  I can help.

First, the AP, Kaiser Health News and Mitch McConnell are correct.  Folks reassured by an appeal to authority will note that the AP has quotes from two Democrats supporting their interpretation:

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

...Full protection for children would come in 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

Folks who distrust authority and want to see for themselves will be fascinated by the supplement to this post, where we dig through the text of various bills to piece the arguments together.

What went wrong?  Basically we have witnessed a communications breakdown between people who speak English (like Barack Obama, who is not a student of insurance arcana) and the people who speak "Insurance".

The Senate manager's amendment was described in their December 19 press release thusly:

Immediate ban on preexisting condition exclusions for children. Health insurers will be immediately prohibited from excluding coverage of preexisting conditions for children.

We can find a similar description from the House, released in February:

No Pre-existing Coverage Exclusions for Children

The President's proposal eliminates pre-existing condition exclusions for all Americans beginning in 2014, when the Exchanges are operational. Recognizing the special vulnerability of children, the plan prohibits health insurers from excluding coverage of pre-existing conditions for children, effective six months after enactment and applying to all new plans.

Now a speaker of English might not recognize that "pre-existing condition exclusion" has a specific meaning and legislative history (e.g., 2007, 2009) within the health insurance field; HIPAA imposed new Federal standards in 1996.  Put simply, insurers deny coverage to people; they exclude coverage of conditions.

A pre-existing condition can affect your health insurance coverage. If you are applying for insurance, some health insurance companies may accept you conditionally by providing a pre-existing condition exclusion period.

Although the health plan has accepted you and you are paying your monthly premiums, you may not have coverage for any care or services related to your pre-existing condition. Depending on the policy and your state’s insurance regulations, this exclusion period can range from six to 18 months.

So previously a health insurer could simply refuse to enroll a particular applicant or they could accept an applicant subject to restrictions on coverage of the applicant (or in this case, an applicant's child).  If we are talking about a group plan offered by an employer, turning the applicant down is not an option; HIPAA regulated the waiting periods during which a pre-existing condition exclusion could be applied, and this new bill reduces those waiting periods to zero for children (after it takes effect in September 2010).

Anyway, the manager's amendment came out and speakers of English took "no more pre-existing coverage exclusions for children" to mean "children could not be excluded from coverage on the basis of pre-existing conditions".  The self-styled Wonk Room at Think Progress provides an example; Barack Obama himself provided another.

Which takes us where?  My guess is that the people who do this for a living have known for a while that Obama was just making stuff up.   (How Mitch McConnell and his fellow Attack Senators missed this is an annoying puzzle.  I know they were not involved in the final negotiations that led to this text, but still - they should feel free to read the bill and hold the other side accountable before the final vote.)

And what happens next?  MSNBC got a response from HHS saying all would soon be well:

"Under the Act, plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition. To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today."

Nonsense - if HHS could solve this by regulatory fiat, why would Congress vex themselves by passing bills?  This will require a legislative fix (Some Democratic Congressman was quoted as saying just that, and I managed to lose the link.)

If, I say if this was an actual oversight by Congress then they will need to pass new legislation to fix it.  Republicans risk being painted as ogres if they oppose it, but Obama risks being mocked as Biden-esque for touting benefits that weren't actually in the bill.

Based on the structure of the bill (as described below), I don't think this was any sort of oversight or drafting error; I think Congress took a small, simple step towards immediate reform so they could point to something that would actually happen in 2010, and Obama misunderstood and misoverrsold it.

INTO THE BILL:

The text of the Senate bill can be found here.

The structure of the bill is that parts of it modify existing legislation (the Public Health Service Act); the relevant passage being modified is here.

Page three of the Senate bill provides a table of contents we can use as a bit of a road map for the bill:

‘‘SUBPART I—GENERAL REFORM
‘‘Sec. 2704. Prohibition of preexisting condition exclusions or other discrimination
based on health status.
‘‘Sec. 2701. Fair health insurance premiums.
‘‘Sec. 2702. Guaranteed availability of coverage.
‘‘Sec. 2703. Guaranteed renewability of coverage.
‘‘Sec. 2705. Prohibiting discrimination against individual participants and
beneficiaries based on health status.
‘‘Sec. 2706. Non-discrimination in health care.
‘‘Sec. 2707. Comprehensive health insurance coverage.
‘‘Sec. 2708. Prohibition on excessive waiting periods.

Section 2704 (p. 81 and following) addresses the pre-existing condition exclusions; 2705 disallows pricing differences (including rebate awards to the healthy) based on health status.  2702 says insurers must issue to anyone in their region, and 2703 says they must renew.  The net effect of 2701 to 2705 is that insurers must offer and renew insurance with anyone, can't price differently based on pre-existing conditions, and can't decline to cover (i.e, exclude) specified pre-existing conditions.  All of this takes effect on January 1, 2014.

But wait!  Much later (p. 2065, line 14) we come to an amendment moving forward the effective date of Section 2704 for children under the age of 19:

(e) Section 1253 of this Act is amended insert before the period the following: ‘‘, except that— ‘‘(1) section 1251 shall take effect on the date of enactment of this Act; and ‘‘(2) the provisions of section 2704 of the Public Health Service Act (as amended by section 1201), as they apply to enrollees who are under 19 years of age, shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act.’’.

Well, that is something - Section 2704 was accelerated for children.  But what about Sections 2701, 2702, 2703 and 2705?  Nope.  If insurers offer coverage it cannot be subject to exclusions, but nothing in these laws obliges them to offer anything.

As the AP noted, this is not a big deal for people operating in the employer group market, where HIPAA guidelines are already in place.  However:

The coverage problem mainly affects parents who purchase their own coverage for the family, as many self-employed people have to do. Families covered through employer plans typically do not have to worry about being denied coverage because of pre-existing conditions.

Parents whose kids are turned down by an insurer would still have a fallback under the law. They could seek coverage through state high-risk insurance pools slated for a major infusion of federal funds.

Presumably the Obama fallback spin will be that, net of the changes in the employer group market and the increased funding for high-risk pools, kids ought to be able to get coverage.  Of course, that is different from Obama's claim that "Children with pre-existing conditions will no longer be refused coverage", but maybe it's close enough.

WORDS MEAN WHAT HE WANTS THEM TO MEAN:  It's Obama in Wonderland, but it's the rest of us that are left wondering what he means.   I think that Obama, by merrily conflating "pre-existing condition exclusion" with denial of coverage, is trying to make domestic policy by gaffe the same way he has tried to make foreign policy by gaffe.

DID CONGRESS UNDERSTAND THE BILL?  Maybe!  In rationalizing the need for an individual mandate, the bill includes this (p. 320):

(G) Under sections 2704 and 2705 of the Public Health Service Act (as added by section 1201 of this Act), if there were no requirement, many individuals would wait to purchase health insurance until they needed care.

From which we infer that Congress understood that Section 2705 was an important part of the new protections for people with pre-existing conditions.  But they didn't accelerate it for children.

REPEATING FOR EMPHASIS:  A year ago S 643 was introduced in the Senate.  Do you think these people believed they were eliminating any right of insurers to deny coverage outright?

Children's Health Protection Act of 2009 (Introduced in Senate)

S 643 IS

111th CONGRESS1st Session

S. 643

To amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit pre-existing condition exclusions for children in group health plans and health insurance coverage in the group and individual markets.

Trouble In Paradise

Charlie Savage of the NY Times explores the divisions within Team Obama over the legal basis some of our counter-terrorism policies.  My favorite:

“I think the change in tone has been important and has helped internationally,” said John B. Bellinger III, a top Bush era National Security Council and State Department lawyer. “But the change in law has been largely cosmetic. And of course there has been no change in outcome.”

Sunday Morning!

Away we go.

'24' - Gone But Not Quite Forgotten

Unlike the Terminator, '24' won't be back.  Whatever - the producer cites rising costs, a declining audience, and creative fatigue.  No kidding - a few weeks back my wife fell asleep during an episode and I just sat there feeling jealous of her.

That said, the show may have delivered its best line this year.  Jack Bauer and a sidekick had infiltrated a Russian mob but the situation went south, Jack chaneled his inner Jack Bauer, and then had to explain the resulting carnage to his boss.  That led to the following:

Jack:  We knew the Russian was viloent when he approached him.

Flabergasted boss:  "Violent?!?  He's dead on the floor!

In Trust Funds We Trust

Megan McArdle breaks some unwritten rule or other by asking a rhetorical question about the Social Security Trust Fund:

Every time I write anything about Social Security, I get at least one person arguing that everything is fine because after all, the trust fund is not going to run out until 2036 or so.

I want to assume good faith, but I have a hard time believing that anyone takes this argument seriously.  Today, because social security payments exceeded revenue, we're going to either have to raise taxes, or borrow more money, in order to cover the benefits.

How would this be different if we didn't have the trust fund?

Since you asked!  This was all hashed and re-hashed during the 2005 Social Security debate, and I am not at all a fan of the trust club fiction.  This old post from that bygone era makes the same point as Megan, subject to a supplement and a caveat.

First, the supplement - in addition to the "raise taxes or borrow more money" choices, Congress could choose to cut Social Security benefits.  But this is one area where the accounting fiction of the trust fund has some legal heft.  While the trust fund has a positive balance, the Social Security Administration has the statutory authority to redeem their bonds and pay out the current level of benefits; it would take an affirmative act of Congress to reduce the level of benefits (and that won't happen).

However, once the trust fund is depleted, Social Security can not, by law, pay out more than it takes in.  If Congress declines to act at that later date then Social Security will limp along as a true "pay as you go" transfer mechanism at some level of benefits lower than "promised".

So, to answer Megan's question - the trust fund provides temporary political and legal cover to a Congress that would rather kick this problem down the road.

I'LL SAY IT ONE MORE TIME:  Promoters of the trust fund fantasy liked to holler that the trust fund secures benefits because unless the Treasury honors the trust fund assets it will be defaulting on Treasury bonds.  Clinton's Treasury disagreed with that "analysis" back in 1999, pointing out that Congress could avoid paying on the bonds simply by legislating a reduction in benefits.  Treasury would stand ready to redeem trust fund assets, but (if the new benefits were low enough) the Social Security Administration would have no legal basis to demand their redemption.

Now, politically some future Congress is unlikely to be so bold.  But if they are, it won't represent any kind of a default on Treasury bonds.

Kids With Preexisting Conditions Still Not Covered Until 2014

Over at Firedoglake and the Daily Kos, the news has arrived that the new health reform has a drafting subtlety which gives the lie to Obama's notion that children with pre-existing conditions cannot be denied coverage starting six months from now.  Yes, this was reported two days ago by the AP, but still - cognitive dissonance presumably delayed the penetration of this news.

McJoan at DK is more explicitly daft with this headline:

Shocker: AHIP Already Finding Loopholes in Health Insurance Reform

Can't spell 'AHIP' without 'AP'.  Let's see - the AP had this story and got reaction from Congressional press flacks within "hours after President Barack Obama signed historic health care legislation".  Does that sound like AHIP discovered the loophole, called the AP, called Congress, then sat around for two days?  Since the flaw was in the Christmas-time Senate bill, my guess is that some Democratic staffers discovered this quite a while back; the notion that they just happened to be perusing the historic legislation a couple hours after it was signed is absurd.  So what did the President know and when did he know it as he touted the plan's immediate impact on sick children?

Let us not exempt the Firedogs from our wrath - deep thinker David Dayen explains how we got to this pretty pass:

What’s going on here is that some insurance company – or the trade group, AHIP – read the language in the bill and interpreted it favorably to their industry. They’re trying to wiggle off the hook of offering coverage for children with pre-existing conditions TWO DAYS after signage of the law.

Sure, that's what is going on - on his planet.  Back in reality, some staffer noted this after the Senate bill was passed; normally it would have been fixed in a House-Senate conference, but Scott Brown's surprise victory closed that door.  And since a provision like this will never fly under the Byrd rule since it is not budget-related, Dems sat on the bad news until it was too late to go back, overselling the bill in the meantime.

How Republicans missed it is beyond me - they should have been screaming that Obama is lying about his own bill and asking what other errors are being signed into law.  Too late!

Eventually the bright lights at Firedoglake and DKos may want to actually read the relevant legalese.  This recent post of mine should help get them started; the underlying Senate bill is available here (groan - I originally used a different .pdf, so my page numbering is not helpful).

As to what about this is "ambiguous" or subject to regulatory fiat, I have no idea.  The law is actually pretty clear - the new provision barring contracts from offering insurance subject to limitations on coverage of pre-existing conditions (Section 2704) is given effect six months after passage.  Hence the reporting that kids with pre-existing conditions who are currently insured must soon be covered for everything, with no exclusions.

However, this ban on "pre-existing condition exclusions" was defined in the old law which this bill amends.  The old definition was left intact and has nothing to say about whether insurance must be issued.  The explicit language in the new bill saying insurers cannot discriminate on the basis of health status appears in amended Section 2705.  Guaranteed availability and renewal are in amended sections 2702 and 2703 (this appears at p. 81 and following of the newly linked Senate bill).  All of these provision were originally slated to take effect in 2014; later in this bill certain benefits for children were accelerated by stating that Section 2704 took effect in six months for people under the age of 19.

But the guaranteed issue and no discrimination clauses were not accelerated!  Legally, Congress spoke quite clearly - kids currently covered must soon have any restrictions based on pre-existing coverage lifted from their contract.  But no insurer has an obligation to issue until 2014.

Well, if regulations trump statutes I guess Obama can fix this easily.  Otherwise, we need new legislation, which I doubt Republicans will oppose (but which they will no doubt amend.)

As to the broader question of what other surprises does this bill hold for us, who knows?

WAS THIS EVEN AN ERROR?  The Senate talking points on the glory of their bill opens with this:

How The Patient Protection and Affordable Care Act Helps Children
Quality, Affordable Health Care for All Children

Elimination of Pre-existing Coverage Exclusions for Children
o In recognition of the special vulnerability of children, the Patient Protection and Affordable Care Act prohibits health insurers from excluding coverage of pre-existing conditions for children, effective six month after enactment.

Only someone who knew nothing about insurance would read that to mean that insurers must issue to all comers; since the Senate put the must-issue requirement in a different section and provided new funding to interim high-risk pools for people with a pre-existing problem, any judge would infer they were well aware of the distinctions in play here.  The current language may simply reflect a compromise between folks who wanted to hold everything off until 2014 and people who wanted to move everything for children forward to 2010.

And since the Senate talking points are worded clearly and carefully, I remain convinced that some people have known for weeks that Obama was over-selling his bill based on phony intelligence.

THE ERROR WAS ELSEWHERE:  As I keep digging I am becoming convinced that the Senate knew what they were doing, even if no one else did - the original Dem talking points promoting the bill last December said the bill included this:

Immediate ban on preexisting condition exclusions for children. Health insurers will be immediately prohibited from excluding coverage of preexisting conditions for children.

As noted, "pre-existing condition exclusions" are a distinct concept; essentially, it is an insurance policy rider saying the child will be covered for everything except his (pre-existing) diabetes.  Consequently, such insurance is helpful if the kid breaks his leg, but does nothing for the ongoing diabetes situation.

But anyone familiar with the lingo would know that prohibiting coverage exclusions is different from requiring coverage (i.e., must-issue).  I think libs saw what they wanted to see, misreported this freely (amplified by Obama himself), and the Senate Democrats who prepared this kept their little secret to themselves.

One might even guess that had Republicans been involved in the final discussions they would have picked up on this.

LEST YOU THINK LIBS CAN'T FIGURE THIS OUT:  Here is a paper from Timothy Jost of the Institute for America's Future, in which he appraises both the Senate and House bills.  He provides some useful examples of what "pre-existing conditions exclusion" actually means (my emphasis):

[The legislation in Congress] would end insurer discrimination on the basis of health status, prohibit pre-existing condition exclusion clauses, ...

or

Insurer refusal to cover pre-existing conditions: Mary just graduated from college and is working at a restaurant as a waitress as she looks for a more permanent job. She has been trying to find an insurance policy in the nongroup market that will cover her until she can find a job with health benefits. Mary has asthma, however, and most insurers to which she has applied have rejected her. One insurer offered her a policy but at a very high rate and with a pre-existing conditions exclusion clause that excludes coverage for any medical treatment related to her asthma or, in fact, for her entire respiratory system.

I think Mr. Jost understood the Senate bill perfectly well, even if Barack Obama did not.

Back In Iraq

The Times tells us abut Gen. Ray Odierno, the top American commander in Iraq.  Here is something for libs to love:

Results from an election considered crucial to Iraq’s democratic evolution suggest a potentially explosive split in power, but General Odierno said he would meet President Obama’s deadline to reduce the number of American troops in Iraq to 50,000, from 98,000 today, by the end of August. Among those expected to leave Iraq then is the general himself.

And a utterly expected cloud on the horizon:

During a visit to Washington before the election, the general said he was advocating the establishment of an Office of Military Cooperation within the American Embassy in Baghdad to sustain the relationship after the Dec. 31, 2011, deadline for withdrawing all American troops. He expressed doubts that the Iraqi government would request the presence of American ground forces after the deadline, although the bilateral treaty leaves open the possibility.

“We have to stay committed to this past 2011,” he said. “I believe the administration knows that. I believe that they have to do that in order to see this through to the end. It’s important to recognize that just because U.S. soldiers leave, Iraq is not finished.”

Finally, the Times invents a controversy:

General Odierno has now been in Iraq for 45 of the 84 months of the war, a period of his career that parallels the uneven narrative of the conflict, for better and worse.

His tactics as commander of the Fourth Infantry Division in Salahuddin in the months after the invasion in 2003, which were criticized as overly aggressive, created a public impression of him as a heavy-handed, even brutish, leader.

Thomas E. Ricks, the military writer who has waged what amounts to an argument of years with the commander, stridently criticized General Odierno’s first tour in Iraq for what he said were ogre-like tactics and bitingly called him “Shreko” in an online column last month.

Many people dispute such characterizations, portraying him as a skilled commander who helped devise and then carried out the counterinsurgency strategy that, with the increase in soldiers that President George W. Bush announced in January 2007, helped stem the sectarian violence. The senior commander at the time, Gen. David H. Petraeus, received most of the public attention, but officers and analysts say that General Odierno made the strategy a success.

"Many people dispute such characterizations".  Are they kidding?  "Many people" includes Thomas Ricks himself, who panned Odierno in "Fiasco" (about the early years of the war) and praised him in his follow-up about the surge titled "The Gamble".  Let's cut to Ricks himself, writing in the WaPo in Feb 2009:

The Dissenter Who Changed the War
As the No. 2 Commander in Iraq, Raymond Odierno Challenged the Military Establishment, Pressing for More Troops and a Long-Term Strategy to Guide Them

By Thomas E. Ricks
Special to The Washington Post
Sunday, February 8, 2009

Army Gen. Raymond T. Odierno was an unlikely dissident, with little in his past to suggest that he would buck his superiors and push the U.S. military in radically new directions.

A 1976 West Point graduate and veteran of the Persian Gulf War and the Kosovo campaign, Odierno had earned a reputation as the best of the Army's conventional thinkers -- intelligent and ambitious, but focused on using the tools in front of him rather than discovering new and unexpected ones. That image was only reinforced during his first tour in Iraq after the U.S. invasion in 2003.

As commander of the 4th Infantry Division in the Sunni Triangle, Odierno led troops known for their sometimes heavy-handed tactics, kicking in doors and rounding up thousands of Iraqi "MAMs" (military-age males). He finished his tour believing the fight was going well. "I thought we had beaten this thing," he would later recall.

Sent back to Iraq in 2006 as second in command of U.S. forces, under orders to begin the withdrawal of American troops and shift fighting responsibilities to the Iraqis, Odierno found a situation that he recalled as "fairly desperate, frankly."

So that fall, he became the lone senior officer in the active-duty military to advocate a buildup of American troops in Iraq, a strategy rejected by the full chain of command above him, including Gen. George W. Casey Jr., then the top commander in Iraq and Odierno's immediate superior.

Communicating almost daily by phone with retired Gen. Jack Keane, an influential former Army vice chief of staff and his most important ally in Washington, Odierno launched a guerrilla campaign for a change in direction in Iraq, conducting his own strategic review and bypassing his superiors to talk through Keane to White House staff members and key figures in the military. It would prove one of the most audacious moves of the Iraq war, and one that eventually reversed almost every tenet of U.S. strategy.

And on Odierno's change in tactics:

Odierno was determined to operate differently on his second tour of duty, but he will not talk about how his transformation occurred. "I think everyone's changed," he said, brushing aside the question in one of a series of interviews in Iraq over the past two years. "We've all learned." 

The Times and any remaining editors are surely aware that Ricks is on both sides of the Odierno fence.  As to the notion that Ricks "bitingly called him 'Shreko'" just last month, well, it is less clear who is being mocked since Ricks put those words in the mouths of White House staffers:

In a move that could force President Obama to break his vow to get all combat troops out of Iraq by August of this year, his top commander in Iraq recently officially requested keeping a combat brigade in the northern part of the country beyond that deadline, three people close to the situation said Wednesday.

...The feeling in the corridors of the White House is that the general is asking the right questions, but a bit clumsily, and certainly too early for political comfort, especially in Iraq, which is about to hold a national election. So I suspect the administration's bottom line for Odierno was, Hey, Shreko, put a sock in it until after the Iraqi elections, because what we need is a new Iraqi government to be formed so it can quietly begin talking to us about re-visiting some of those 2008 SOFA agreements about future troop levels.

Didn't Odierno realize Obama had a health care bill to pass?

Crime And Thought Punishment

Shikha Dalmia of Forbes and Reason contemplates a vast campaign of civil disobedience in defiance of the health care mandate:

Any strategy of nonviolent civil resistance has to first make a good faith effort to achieve its end through the available political and legal means. But there comes a time when changing the law requires acts of conscience.

For opponents of ObamaCare that time is Dec. 31, 2013. That's when the individual mandate will go into effect. If ObamaCare hasn't been repealed by Congress or nullified in court by then, its opponents would be justified in urging Americans to refuse to buy coverage or pay fines and dare authorities to come after them.

By some estimates, Uncle Sam will need to hire an additional 17,000 IRS agents or so just to enforce the coverage mandate. But even if a few million Americans simultaneously refuse to abide by it, they could easily overwhelm the system.

Well, it depends on the meaning of "overwhelm" - the legislation includes a pre-emptive retreat in the clause related to enforcement of the mandate.  This is from page 131 of the 906 page .pdf Senate bill:

‘‘(g) ADMINISTRATION AND PROCEDURE.—
‘‘(1) IN GENERAL.—The penalty provided by this section shall be paid upon notice and demand by the Secretary, and except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68 [link to Tax Code].

‘‘(2) SPECIAL RULES.—Notwithstanding any other provision of law—

‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.

‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary shall not—
‘(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or ‘‘(ii) levy on any such property with respect to such failure.’’.

And from Subchapter B of Chapter 68 of the Tax Code we glean this:

Sec. 6671. Rules for application of assessable penalties

(a) Penalty assessed as tax

The penalties and liabilities provided by this subchapter shall be paid upon notice and demand by the Secretary, and shall be assessed and collected in the same manner as taxes.

Now, I am not smart enough to be a Democrat and I am surely not smart enough to be a Democratic Congressperson, but I am having a hard time reading Section 2, where criminal penalties and liens are waived, as a commitment to tough enforcement. [I am a day late on this - apparently, Dems are delighted that no actual enforcement can take place:

A September letter from a top tax official had said failure to pay the fines could ultimately lead to the most severe penalty under federal law for tax evasion, a $100,000 fine and five years in jail.

Now Democrats are touting protections they have added to limit the reach of the tax man. “The bill specifically prohibits the IRS from confiscating taxpayer assets, from using liens or levies, or imposing criminal penalties of any kind — including jail time — because of a lack of health care coverage,” Speaker Nancy Pelosi’s office said in a statement.]

Which is understandable - we know lots of Democrats, such as Tim Geithner, Tom Daschle and Charles Rangel, who are confused by the concept of taxes and won't be troubling themselves with this latest wrinkle in the tax code.  And no one really expects Eric Holder to be arresting a bunch of confused Dems who have more important things to do than comply with a new boatload of Federal paperwork requirements.  So it was nice of Congress to make a nod toward equal treatment and admit that they won't be coming hard after anyone else who ignores this law, either.

Presumably a new Congress could amend the enforcement provisions if non-compliance becomes a problem.  Of course, if non-compliance is a problem Congress might want to reflect on the disease, rather than the symptoms.

BONUS PUZZLE FOR THE ACCOUNTANTS AND TAX LAWYERS:  Imagine some poor chump owes $6,000 in regular Federal income taxes and a $750 penalty for non-compliance with the mandate.  He mails in a return with a check for $6,000 marked as "Full payment for taxes owed/No penalty".

Can the Feds deem his payment to be $750 for the mandate penalty and $5,250 for his taxes, leaving him short (and subject to liens) on $750 for his taxes?

Obviously, this would let them sidestep the "No Enforcement" clause cited above.  The result would be non-enforcement for people who don't owe other taxes; I will guess there are more Dems than Reps in that group.

THE OLDIES ARE STILL THE GOODIES:  Bill O'Reilly and Congressman Anthony Weiner reprise the immortal "Who's On First" routine.  The gist:

Weiner: The IRS does not collect the fine.

O'Reilly:  So who collects the fine?

Weiner: That's right.

What's scary is that Weiner claims O'Reilly is making stuff up; Weiner himself is either misinformed or lying.

HMM:  Wage garnishment is also known as a wage levy, but I have the notion that it might well be different from a levy on property (such as a bank account), which means that a levy on wages would be allowed under ObamaCare.

Putting The T&A In 'TSA'

What will those devious Al Qaeda operatives think of next?

Terrorists Could Use Explosives in Breast Implants to Crash Planes, Experts Warn

Female homicide bombers are being fitted with exploding breast implants which are almost impossible to detect, British spies have reportedly discovered.

The shocking new Al Qaeda tactic involves radical doctors inserting the explosives in women's breasts during plastic surgery — making them "virtually impossible to detect by the usual airport scanning machines."

Well, I suppose we should encourage all red-blooded patriots to engage in vigilant threat assessments of female passersby.  It's a small price to pay for freedom.

Or, we could just de-brief Tiger Woods.

And let's give belated props to the Eerily Prescient security team at Southwest Airlines, which was on this years ago.

DID THE 9/11 COMMISSION MISS THIS?  The 9/11 hijackers spent a lot of time in strip clubs.  We can now infer they were recruiting, not taking a break from the rigors of jihad.

It Looks Like The Dems Forgot To Repeal The Law Of Unintended Consequences

The AP reports that, despite Obama's urgent and inspiring rhetoric, children with pre-existing conditions may still be turned down by Evil Insura until 2014.  But what did Obama really know, and when did he know it?

Gap in health care law's protection for children

By RICARDO ALONSO-ZALDIVAR (AP) – 7 hours ago

WASHINGTON — Hours after President Barack Obama signed historic health care legislation, a potential problem emerged. Administration officials are now scrambling to fix a gap in highly touted benefits for children.

Obama made better coverage for children a centerpiece of his health care remake, but it turns out the letter of the law provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

I smell a rat.  The recently signed bill is simply the legislation passed last Christmas Eve by the Senate; it is the proposed reconciliation effort that should be chock full of surprises.

So rather than try to convince us that it was only after the bill was signed that top Dems read it and realized there was a problem, why not tell us what the President knew and when he knew it?  There is just no way some heroic Dem staffer fought off his or her hangover and discovered this glitch in the last day or two.  How long have then been keeping this little secret while the President oversold the bill to the public?

And how did Republicans miss it all these months?  What kind of rabid noise machine are we running, anyway?

MSNBC has a clarification from HHS:

*** UPDATE *** HHS has this response: "Under the Act, plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition. To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today."

Hmm.  If the Secretary needs to issue regulations to assure that there is no ambiguity, that suggests that there currently is ambiguity.

SINCE YOU ASKED...

Subject to the caveat that I Am Not A Lawyer, the problem seems to be this - the new bill works its magic by amending (and renumbering) existing legislation, but an important definition from the old law was overlooked and remains in the new law.  I can't find the specific language in the Senate bill relating to children [Eureka - see below], which has me wondering whether it really is in the reconciliation bill; that obviously conflicts with the AP talk of the bill Obama just signed, and how it might qualify as a budgetary item eludes me, but maybe we can sidestep that problem.

In the old law we find this we find this on preexisting conditions and exclusions:

SEC. 2701. INCREASED <<NOTE: 42 USC 300gg.>> PORTABILITY THROUGH LIMITATION ON PREEXISTING CONDITION EXCLUSIONS.

(a) Limitation on Preexisting Condition Exclusion Period; Crediting for Periods of Previous Coverage.--Subject to subsection (d), a group health plan, and a health insurance issuer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if-- (1) such exclusion relates to a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date; (2) such exclusion extends for a period of not more than 12 months (or 18 months in the case of a late enrollee) after the enrollment date; and (3) the period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage (if any, as defined in subsection (c)(1)) applicable to the participant or beneficiary as of the enrollment date.

(b) Definitions.--For purposes of this part-- (1) Preexisting condition exclusion.-- (A) In general.--The term `preexisting condition exclusion' means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date.

So henceforth (or in 2014) an insurer cannot revise their standard contract to say that the enrollee is covered for everything except, e.g., his diabetes treatment.

Which is fine, but if the new bill's language (wherever we finally find it) says that starting in six months insurers cannot apply preexisting condition exclusions to children under 19, well, that is not the same as saying they must enroll those children.  Children currently covered subject to an exclusion would get relief, I suppose.  Prospective new customers with problematic children may be told to beat it and come back in 2014.

And the proposed regulatory fix - redefine 'pre-existing exclusion' to mean more than Congress said it means - sounds like an overreach.  But who wants to sue on behalf of an insurer's right to deny medicine to kids?

EUREKA:  Here we go, from the Senate bill, p. 777 of 906:

(e) Section 1253 of this Act is amended insert before the period the following: ‘‘, except that—
‘‘(1) section 1251 shall take effect on the date of enactment of this Act; and ‘‘(2) the provisions of section 2704 of the Public Health Service Act (as amended by section 1201), as they apply to enrollees who are under 19 years of age, shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act.’’.

OK, re: "‘(2) the provisions of section 2704 of the Public Health Service Act (as amended by section 1201", that is on page 36 of the Senate bill; it strikes clause (a) of the old law but leaves in place clause (b), which defines "preexisting condition exclusion".

On page 37 we come to Section 2705, which specifically prohibits discrimination based on health status; we also can find the new and improved 2701, which implicitly bars pre-existing condition discrimination by explicitly stating that prices can vary based on on age, family/individual, rating area, tobacco use.

But it is 2704, not 2705 or 2701, that takes effect in six months.

So how about that - by accelerating the new Section 2704 for kids under 19, Congress provided relief for kids currently limited by an insurance rider but did nothing for kids to whom insurers are saying "no".

Yet Another Ticking Time Bomb Scenario For Obama

A Federal judge has ordered the release of a detainee considered by some to be the most dangerous terrorist at Guantanamo.

Right now the DoJ is appealing and playing for time; perhaps they will get lucky and win on appeal.

But if not, what then?  Will they defy a judge's order and hold Mohamedou Slahi anyway?  Or will they defy the military and intelligence analysts, not to mention common sense and Obama's past rhetoric, and release him?  The Allahpundit dredged up this blast from the past from The One:

“I am not going to release individuals who endanger the American people,”

That was when Obama was playing at tough on national security and contemplating preventive detention.  It was almost a year ago, and who knows how the winds have shifted since then?

I predict a Bold Third Way!  Since it is all about energizing the base, I think Obama will not only cut the guy loose, he will guarantee him free health care for life.  That is living up to our values!

Is There Any Limit To The Power Of Congress?

Ezra Klein, who is nobody's go-to guy on questions of Constitutional law, explains that the newly signed health care reform will probably survive challenges to the individual mandate.

Law prof Richard Esenberg is not so sure:

Still, the individual mandate may be different. Professor Barnett writes that "[w]hile Congress has used its taxing power to fund Social Security and Medicare, never before has it used its commerce power to mandate that an individual person engage in an economic transaction with a private company." It's one thing to be subject to regulation because you are providing for yourself what you would otherwise buy in an interstate market. It's quite another thing to argue that, because your refusal to consume a product may affect interstate commerce (if the young and healthy do not insure, the old and sick will have to pay more), you can be made to buy it.

Some scholars and lawyers prefer to emphasize Congress' authority to tax and spend to promote the general welfare. Jack Balkin, for example, thinks that this makes the case for the constitutionality of the individual mandate "easy." For Professor Balkin, there is no need to construct Rube Goldberg-like scenarios of commercial impact. "The government can make you pay taxes," he says. Because the failure to insure will result in a tax (as opposed, I guess, to a stint in Leavenworth), there is nothing to see here.

Perhaps not. There is certainly case law that, while not mandating that conclusion, provides some substantial support. But it ought not to be that easy. The power to tax is, the power to destroy. While taxes may have a regulatory purpose, there should be some limitation on the ability of Congress to accomplish by taxation is there truly no limitation on Congress' ability to coerce through taxation what it cannot do through regulation? Should Congress really be able to take, as is the case here, up to two percent of a person's income because she has failed to do what Congress cannot compel her to do? Does a fine become permissible as long as it is connected through the Internal Revenue Service?

Since the topic is health, suppose the government legislated that all of us must submit to semi-annual weigh-ins, with testing for nicotine use and illegal drugs, subject to an income tax penalty for declining the test.  Suppose the Congress also mandated that we must sign a "Consent to Search" form allowing the Food Police to conduct snap inspections of our kitchens, in a zealous quest for excess butter and ice cream.  (As a sop to civil libertarians, information gathered by means of these drug tests and spot inspections can be used only for counseling, not criminal prosecution.)

So, my question to libs who love the mandate - would those logical, health oriented extensions of the mandate idea be constitutional?  If not, why in the world not?

Prof. Esenberg makes the same point but without my rhetorical overkill:

It will be tragic because the notion of a Congress limited by the scope of its enumerated powers will have finally suffered the coup de grace. The Bill of Rights (once famously - and now ironically - thought to be unnecessary given the structural limits on the power of the national government) will become the only limitation on the power of Congress. If Congress can require you to buy health insurance because of the ways in which your uncovered existence effects interstate commerce or because it can tax you in an effort to force you to do anything old thing it wants you to, it is hard to see what - save some other constitutional restriction - it cannot require you to do - or prohibit you from doing.

I appreciate that many people - including most of my colleagues in the legal academy - see nothing wrong with this. There are, to be sure, still political constraints on Congress. Even if Congress can ration trips to McDonalds, it won't.

Interesting - we are moving to a world where the only limit on Congress is its own sense of political expediency.

Bill Gates To Acquire Nuclear Capability

Unnerved by the failure of the Obama Administration to contain Iran, Bill Gates declared his intention to develop nuclear capability.  All eyes now turn to Steve Jobs, who will no doubt unveil an app for that shortly.

Enslaved At Last! Enslaved At Last! Thank God Almighty, They're Enslaved At Last!

The House passes health care reform and a long-time Dem dream is fulfilled - the creation of a huge middle class entitlement should allow the Dems to position themselves as the party that will fight for your right to ever more generous health care paid for by Somebody Else. Mark Steyn has more on Dependence Day at the overloaded Corner; extensive excerpts at this link.

Ross Douthat points out that the rubber will meet the road soon enough:

We’ve been arguing about the health care bill, in all its many iterations, for more than a year. Along the way, liberals have made a lot of predictions about what its passage will mean for America — for our health care system and our health, our economy and our long-term solvency. It will be interesting, to put it mildly, to see if they end up coming true.

For instance, if liberals are right, health care reform will save tens of thousands of lives every year. Not some lives, on the margins, in hard-to-measure ways that may or may not justify the bill’s price tag. Tens of thousands every year.

Some estimates bear those optimistic figures out; others emphatically do not. But if the bill passes, we won’t have to rely on projections. American life expectancy will either leap upward, vindicating the bill’s supporters, or it won’t.

Hmm.  A lot of the coverage won't kick in for four years; in the vast scope of history that is a mere blink, but by then it may be very hard to turn back.

And here is a puzzle for the mathematically minded - just how much of a change should we see in life expectancy?  Obviously, the "lives saved" notion does not mean Obama has made others immortal.  Modelers will really need to make assumptions about "deaths deferred", since we all have to go sometime.  If anyone has thoughts on what sort of a baseline increase we ought to see in life expectancy and a cogent explanation of their thought process, that would be fascinating.  (Yes, I am deeply doubtful that actual results will change much, but we won't know that until maybe 2016).

THE CAKE IS BAKED:  Life expectancy is currently projected to be extended due to the decline in smoking and reduced due to the increase in obesity; the projected net impact is shorter, fatter lives.

Traditional Sunday Evening "On The Road Again" Open Thread

Did anything happen today?

Count Every Vote

Let's watch some sausage being made!

Apparently House hold-out Bart Stupak will announce at 4:00 (i.e., about twenty minutes from now) whether his pro-life concerns have been satisfied.

UPDATE:  Stupak and his group are now "Yes" votes, which should put reform over the top.  Per the NY Times Prescriptions blog, an Executive Order (plus unannounced goodies?) were Stupak's price:

Representatives Driehaus, Kathy Dahlkemper, Marcy Kaptur and others join Mr. Stupak at the news conference to announce that the president’s proposed executive order will allow them to vote for the health care legislation. Ms. Dahlkemper notes that she considers the bill now a “full life” or “whole life piece of legislation.

The Michigan Democrat, in citing the president’s executive order further outlining prohibitions against the use of federal funds for abortion, announces that he will vote for the legislation. “The real victory here or the real winners here are the American people,” Mr. Stupak concludes, noting that 31 million more people would receive health-care coverage.

On the president’s executive order, colleague Sheryl Stolberg notes: “The White House, sounding a note of confidence about the passage of the health care bill, has just announced that after its passage, Mr. Obama will sign an executive order that will reaffirm the measure’s ‘’consistency with longstanding restrictions on the use of federal funds for abortion.’’

Obviously, Executive Orders can easily be changed by this executive or any of his successors.

Because He Reads The Wrong Books?

Matt Yglesias presents "An Influential Idea I Didn’t Get in a Book".  The gist - profit in perfectly competitive markets is zero (after returns for labor, capital, and presumed managerial expertise), so businessmen seek to create market imperfections:

This competitive market sure looks like a horrible place! You might make a living there, but you sure as hell aren’t going to get rich. Think of the immigrant family that owns the dry cleaning shop around the corner—long hours, hard work, modest income. That’s your capitalism and it pretty much sucks.

Obviously the whole reason to become a businessman in the first place is to get rich. Operating a business in a competitive marketplace is for suckers, or immigrants with limited English ability. The whole name of the game is to do something else. Get a license for something. Get into a line of work with network effects. Win government contracts. Get your hands on some intellectual property. Become a monopoly. Find some barriers to entry. If you think about Bill Gates, who’s about as successful a businessman as they’ve got, and he’s doing a whole bunch of those things simultaneously. That’s how you get rich.

First, wow - I never understood the motivation of the typical small businessman in quite that way.  It's great to know that fourteen year old cocooned libs are advancing policy ideas for the rest of us based on their rich understanding of the world.

Secondly, whoa!  Dare I mention Adam Smith, who made that very point back in 1776?

“People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.”

Thirdly, we can scarcely wait for the day when Matt discovers (perhaps not by way of a book?) that Big Business is not automatically "conservative", but is often happy to ally itself with Big Government in the course of seeking rents.

Finally, I'll wager that if Matt attempts to provide a continuing series based on ideas he didn't get from books, he should be good for material until spring Kansas is knocked out of the tournament  I stop laughing.  Which will be soon, but not right away.

Back, After My Personal Investigation Into Health Care In America

My apologies for the unexpected black-out, but I was having a personal health care showdown.  On Wednesday I had a painful inflammation on  my elbow; my doctor gave me some antibiotics and said that if it gets worse I should go to the hospital.  On Thursday my arm was noticeably worse, so I went to the ER.  Before you could say "MRSA" I was hooked up to the high-priced IV antibiotics, to which I responded nicely, eventually.  So, no stories about flesh-eating bacteria or one-armed bloggers.  I was finally put back on the streets an hour ago, and it is great to be back.

Let's make this a "Count every vote" health care thread.

Tough Votes! (Or, Is There Any DNC Talking Point Too Absurd For Ezra Klein To Parrot Happily?)

Ezra Klein delivers a laugher on healthcare reform; Megan McArdle has already spanked him, but why should she have all the fun?

Over to Ezra:

For some time, I've been trying to find good polling from the passage of Medicare. According to Greg Sargent, though, the Democrats beat me to it

For about fifteen seconds I tried using Google to find good polling data on the passage of Medicare.  For folks feeling lucky, here is the top of the list from my first search, on "gallup poll medicare 1965":

Health Care Reform Circa 1965: Polling on Medicare

My goodness, that is from Ezra's very own Washington Post back in July of 2009, now being recycled by those intrepid sleuths at the DNC.

Ezra concludes his excerpt with this:

After Lyndon Johnson was elected, a Harris poll found only a minority, 46%, supported a Federal plan to extend health care to the aged. Today, of course, Medicare is overwhelmingly popular.

Had Ezra read on, he might have found a bit more context:

Following Pres. Lyndon Johnson's election, Americans remained somewhat divided on the plan, with 46 percent telling Harris pollsters in Feb. 1965 that they'd prefer "a Federal law which would provide medical care for the aged by a special tax, like Social Security" and 36 percent more inclined to support "a plan of expanded private health insurance."

Hmm, Medicare was more popular than a private alternative.  DId Ezra know that and just forget to pass to on, or is this Book of Revelation time?  Let's soldier on for more surprises:

Asked another way, 62 percent said they favored "President Johnson's program of medical care for the aged under Social Security." A smaller majority, 56 percent, backed the American Medical Association's alternative plan, which would have "everyone who could afford it covered by private health insurance" and "those who couldn't afford it ...covered under a government health plan."

Assessing these conflicting views, pollster Louis Harris concluded, "So deep is the concern about medical care for the aged that the American people would welcome any of a variety of national plans."

So asked another way there was still more support for Medicare than the private alternative.

Let's cut to Ezra's punchline:

I wonder how many of the legislators who took the tough vote to move Medicare forward regret doing that today.

The tough vote!  A bit more research (I cleverly went with "medicare senate votes 1965"and took the first result) shows us that Medicare passed the House in April by a tough vote of 313-115 and went to the Senate where a similar bill wheezed through on July 9 by 68-21.  The House-Senate conference reported a bill on July 26 and the final product cleared the House by 307-116, the Senate by 70-24, and was signed into law on July 30.  Hey, in time for the August recess, just like Obama wanted!

Some Times story mentioned that the bill cleared the relevant Senate committee by a tooth-pulling 12-5.  As to bipartisan backing, the final bill was supported by a majority of House Republicans (70-68) and 40% of the voting Republican Senators (13-17).

Well.  I wonder how many of the lefty bloggers who took the tough decision to move this DNC talking point forward regret doing that today.

DARN THAT PESKY CBO:  This New England Journal of Medicine history of the passage of Medicare includes this lesson:

Johnson did one more crucial thing over the course of the winter and spring of 1965: he managed the economics of the Medicare and Medicaid legislation. This was much easier to do in 1965 before the creation of the Congressional Budget Office, which now provides independent economic reviews of all legislation, and a similar office within the White House, the Office of Management and Budget. But it was still necessary then, as now, to confront arguments that expansions of health care coverage were unaffordable. To do this, Johnson detailed loyal aides, including Cohen and Treasury Department personnel, to work quietly with legislators on designing taxes and benefit packages. When Mills still expressed concern about the costs of adding Part B and Medicaid to the Medicare package in March 1965, Johnson told him not to worry:

I'll take care of that, I'll do that. . . . When they asked me, do you want to put in another 400 or 500 million [to cover Mills's Medicare expansion], . . . what did I say about it? . . . I said we had an old judge in Texas one time . . . we called him Al Caldy . . . old Al Caldy Roberts, and he said, when they talked to him one time that he might've abused the Constitution and he said, "What's the Constitution between friends?" And I say, tell Wilbur that 400 million's not going to separate us friends when it's for health. . . .²²

Cavalier as Johnson may sound here, especially in light of the huge subsequent costs of these programs, his comments signal an unpleasant reality worth pondering: Johnson underestimated the numbers and evaded economic projections to smooth the passage of Medicare and the rest of his Great Society program. An accurate economic forecast might have sunk Medicare. Moreover, Francis Bator, a national security aide to Johnson at the time, recently asserted that during 1965 Johnson also suppressed news of the escalation of the Vietnam War and its attendant costs so that Congress would not question whether the nation could afford the president's Great Society initiatives

And the lesson:

Sixth, the most heretical generalization to emerge from the historical experience may be the following. The expansion of health care to large populations is expensive, and presidents may need to quiet their inner economists. Johnson decided, in effect, to expand coverage now and worry about how to afford it later. Accurate cost estimates might very well have sunk Medicare. In fact, this generalization holds across every administration from Harry Truman to George W. Bush. Major expansions of health care coverage rarely fit the budget and generally drew cautions (and often alarms) from the economic team.²⁴ Of course, under current federal budgetary circumstances, managing the economics of health care reform may be more difficult than ever before.

Wanted, Dead Or Dead

The Eric Holder Comedy Tour aired some new material on Osama bin Laden and the intensive planning that has gone around his possible capture:

Attorney General Eric Holder told a congressional panel Tuesday that the question of reading Osama bin Laden his Miranda rights is absurd — because he won’t be brought in alive.

“Let’s deal with reality,” Holder said. “You’re talking about a hypothetical that will never occur. The reality is that we will be reading Miranda rights to the corpse of Osama bin Laden. He will never appear in an American courtroom. That’s the reality. ... He will be killed by us, or he will be killed by his own people so he’s not captured by us. We know that.”

Wow.  We captured Khalid Sheikh Mohammed alive.  Just recently the Pakistanis, with US assistance, captured the number two Taliban leader. 

Now, if I had to bet I would say a Predator gets Osama before the Special Forces do, but that is hardly a sure thing.  Except to Eric Holder, of course.  My goodness - does Team Obama seriously plan to just wing it if Osama is captured?  Or is Holder just out of the loop, or out of his mind?

A Klein Bit Of Brain Freeze

Ezra Klein was swept into the presence of The Pelosi to hear her plans for passing health care reform. The result was brain-freeze (my emphasis):

But today, Pelosi made her clearest statements yet on how she means to finish this bill. The issue is how to sequence the Senate health bill, which the House doesn't like, with the package of fixes (including, Pelosi said, the elimination of the Nebraska and Florida deals, the delay of the excise tax, more affordability and oversight provisions and more funding of community health centers), which the House does like. There are a number of procedural options on the table, but today, Pelosi said that she favors the “deem and pass” strategy.

Here's how that will work: Rather than passing the Senate bill and then passing the fixes, the House will pass the fixes under a rule that says the House "deems" the Senate bill passed after the House passes the fixes.

The virtue of this, for Pelosi's members, is that they don't actually vote on the Senate bill. They only vote on the reconciliation package. But their vote on the reconciliation package functions as a vote on the Senate bill. The difference is semantic, but the bottom line is this: When the House votes on the reconciliation fixes, the Senate bill is passed, even if the Senate hasn't voted on the reconciliation fixes, and even though the House never specifically voted on the Senate bill.

It's a circuitous strategy born of necessity. Pelosi doesn't have votes for the Senate bill without the reconciliation package. But the Senate parliamentarian said that the Senate bill must be signed into law before the reconciliation package can be signed into law. That removed Pelosi's favored option of passing the reconciliation fixes before passing the Senate bill.

Is that what the parliamentarian ruled did?  Gee, I thought he ruled that the Senate could not take up a reconciliation until the underlying bill was signed into law.  By eerie coincidence, Klein reported the same thing on March 11, with a post headlined "Senate parliamentarian rules that bill must pass before reconciliation can be used".

If the Senate has to wait until Obama signs the Senate bill as passed in unamended form by the House before they can take up the reconciliation "fixes", then there is no way that Obama can have a joint signing ceremony where he signs both bills at once.

This next bit from Klein is utterly baffling:

So now the House will vote on reconciliation explicitly and the Senate bill implicitly, which is politically easier, even though the effect is not any different than if Congress were to pass the Senate bill first and pass the reconciliation fixes after.

The effect is not any different?  Well just for starters, what does Obama sign?  The House-passed bill of "Senate plus fixes" is not textually identical to the Senate-passed bill.  Per that tedious Constitution (which, even if it is living and breathing, will have its last gasp this week if this strategy is upheld), the President needs to sign a bill passed by both houses - where is that bill?

Or are Pelosi and Klein arguing that the House will vote on a 'rule' under which two separate bills pass simultaneously, one then being sent to the President and the other to the Senate?  Why even bother with that bizarre facade, then? Per the "enrolled bill" scenario described and considered by Jonathon Adler, if the House and Senate leadership deem a bill ready for presentation to the President, it is ready, regardless of what has transpired before.  This point is back in the news today.

A point to ponder - critics have noted that employers may be reluctant to hire while their prospective liability under health care reform remains up in the air.  If the House passes this bill by a method that is highly likely to end up in the courts and prolong the suspense as to the status of the health reform effort, will that be bad for jobs, jobs, jobs?

Fauxmentum

Democratic leaders are trying to bluff their way to victory with the health care bill:

Democratic leaders scrambled Sunday to pull together enough support in the House for a make-or-break decision on health-care reform later this week, expressing optimism that a package will soon be signed into law by President Obama despite a lack of firm votes for passage.

The rosy predictions of success, combined with the difficult realities of mustering votes, underscore the gamble that the White House and congressional Democrats are poised to make in an attempt to push Obama's health-care plans across the finish line. The urgency of the effort illustrates growing agreement among Democratic leaders that passing the legislation is key to limiting damage to the party during this year's perilous midterm elections.

But House Minority Leader John A. Boehner (R-Ohio) pledged to do "everything we can to make it difficult for them, if not impossible, to pass the bill." He also joined other Republicans Sunday in warning that Democrats would pay for the legislation by losing even more seats than expected in November.

The most optimistic talk on Sunday came from the White House. Obama senior adviser David Axelrod predicted that Democrats "will have the votes to pass this," and press secretary Robert Gibbs declared that "this is the climactic week for health-care reform."

But Rep. James E. Clyburn (S.C.), the Democrats' chief head-counter in the House, cautioned that the party has not yet found the 216 votes needed to win approval of the health-care bill passed by the Senate in December.

"We don't have them as of this morning, but we've been working this thing all weekend," Clyburn said on NBC's "Meet the Press." "I'm also very confident that we'll get this done."

This is a transparent fauxmentum strategy.  The Dem leadership is looking at a small group of hard-core "No" votes, a large group of committed "Yes" votes (who will later feign surprise when the reconciliation effort falls apart in the Senate), and a swing group that does not want to vote on this at all because they don't want to lose their jobs, offend the leadership, or torpedo the Obama Administration.

The leadership plan is to pretend that any day now they will sound the whistle, announce that the train is leaving the station, and holler "All aboard that's getting aboard".  At the fateful moment of decision (they hope), enough of the swing bloc will opt for placating the leadership and promoting Team Obama, and the bill will pass.

Now, will they blow the whistle without the votes in hand?  I am sure they are bluffing, but I don't know what they will do if their bluff is called.  I Boldly Predict that this will be an interesting week.

It Took Nearly Seven Years...

Paul Krugman finally answers a rhetorical question he posed in September of 2003. Way back then he was bashing Bush for Iraq (natch) and for going hat in hand to China to talk to them about their undervalued currency.  His Nobel Prize for international trade was still in the future, so on the gloomy prospects of a currency confrontation between China and the US the extent of his "analysis" was this:

But [President Bush, by way of Treasury Secretary Snow] got no satisfaction. A quick look at the situation reveals one reason why: the U.S. currently has very little leverage over China. Mr. Bush needs China's help to deal with North Korea — another crisis that was allowed to fester while the administration focused on Iraq. Furthermore, purchases of Treasury bills by China's central bank are one of the main ways the U.S. finances its trade deficit.

Nobody is quite sure what would happen if the Chinese suddenly switched to, say, euros — a two-point jump in mortgage rates? — but it's not an experiment anyone wants to try.

That was during the 2003 recession and recovery when the Fed was keeping the Fed Funds rate below 2%.

But the years have passed, as has the Bush Administration, and now Paul Krugman has joined the world in decrying the undervalued Chinese currency.  And he has answers on the economic front!

Tensions are rising over Chinese economic policy, and rightly so: China’s policy of keeping its currency, the renminbi, undervalued has become a significant drag on global economic recovery. Something must be done.

...

If Treasury does find Chinese currency manipulation, then what? Here, we have to get past a common misunderstanding: the view that the Chinese have us over a barrel, because we don’t dare provoke China into dumping its dollar assets.

What you have to ask is, What would happen if China tried to sell a large share of its U.S. assets? Would interest rates soar? Short-term U.S. interest rates wouldn’t change: they’re being kept near zero by the Fed, which won’t raise rates until the unemployment rate comes down. Long-term rates might rise slightly, but they’re mainly determined by market expectations of future short-term rates. Also, the Fed could offset any interest-rate impact of a Chinese pullback by expanding its own purchases of long-term bonds.

It’s true that if China dumped its U.S. assets the value of the dollar would fall against other major currencies, such as the euro. But that would be a good thing for the United States, since it would make our goods more competitive and reduce our trade deficit. On the other hand, it would be a bad thing for China, which would suffer large losses on its dollar holdings. In short, right now America has China over a barrel, not the other way around.

Hmm, some of those points were obvious even to me back in 2003.  As to debunking the "common misunderstanding" that China has us over a barrel, one wonders why that was less obvious back when Bush was raising the issue. One might also wonder whether Krugman was contributing to that misunderstanding with his "Nobody is quite sure what would happen if the Chinese suddenly switched to, say, euros" fog-burst.  And while we are wondering, we might ask when it was that Team Obama solved the North Korean problem that featured so prominently in Krugman's 2003 rhetorical sally.

So many questions.  No doubt some will be cleared up by a Krugman column in 2017.

MORE:  Dan Drezner decries Krugman's bellicose unilateralism and manages to limit his "I told you so-ism" to much less than seven years.

Why Is He Running? Just BeKaus

California's next Senator Mickey Kaus gets some attention from Deborah Soloman of the NY Times Magazine:

Questions For Mickey Kaus

The Blogging of the Candidate

By DEBORAH SOLOMON<

After years of sitting in a room in Southern California writing a blog for Slate magazine, you’re planning to challenge Senator Barbara Boxer in the Democratic primary in California in June. What led you to get into politics? 

I’ve been a blogger since 1999, and it hasn’t done the job. In California, the Democratic Party is worse than it was when I started. The only thing left is the interest groups. It used to be a functioning party independent of labor, and now that has atrophied.

Mickey's Manifesto was presented at The Huffington Post over the weekend (Briefly, he will be going after liberal sacred cows like a Hindu on a bender.  Well, he phrases it differently...).  Why is he declaring there and not Slate?  We get a clue:

Now that you’re running, can you continue to write for Slate, which is owned by The Washington Post and may not want to be issuing paychecks to political candidates? 

I’m certainly going to blog during the campaign. The question is whether it’s for Slate or whether it’s not for Slate.

Dems who find Obama insufficiently cerebral will flock to Mickey's banner.

Sure The Health Bill Stinks, But Blame The Republicans

Ezra Klein peddles the latest Dem spin should the reconciliation door slam shut on eager Democratic health care reformers:

The thinkable has happened, and the Senate parliamentarian has ruled that the president must sign the health-care reform bill before the House and Senate can act on a reconciliation package.

In the Democrats' Senate Caucus meeting today, Kent Conrad apparently argued that this left the Democrats in an even stronger moral position. The reconciliation rider fixes unpopular elements of the health-care bill: the Nebraska deal, the Florida deal, the excise tax and so forth. If Republicans figure out some nuclear level of obstruction that could actually derail the reconciliation process, then they will effectively own the worst elements of the Senate bill, and Democrats can just spend their time hammering Republican obstructionism that has so lost touch with reality that they'd rather keep legislation they're against than let Democrats fix it. Or so goes the argument.

OK!  Democrats wanted to pass a good bill but Evil Republicans wouldn't let them.  That is why we see sixty members of the Dem caucus on record passing the December Senate bill, a majority of the House, all Democrats, ratifying it (if Nancy can work her dark magic), and President Obama signing it.

Some points to ponder:

1 - Hold your fire.  Conrad isn't really trying to persuade moderate, independent and uncertain voters with this patent BS; his target audience is nervous House Democrats, many of whom have a strong will to believe that passing some sort of bill makes sense.  Conrad is simply trying to jolly along their process of self-delusion and rationalization.

2 - The Democratic message machine has spent the last year failing to convince the Great Unwashed of the glories of their health care reform.  Are they really going to break through with this Blame-the-Republicans message?

3 - Why won't the Republicans just say "We all agree, the bill stinks - send us to Washington and we will fix this"?

It's Easter season - let's find out how many Democrats believe in miracles.

Senate Parliamentarian - Obama Must Sign On Dotted Line

Roll Call reports hard news for the Dem strategists hoping to reconcile a bill that hasn't been passed:

The Senate Parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package, senior GOP sources said Thursday.

The Senate Parliamentarian’s Office was responding to questions posed by the Republican leadership. The answers were provided verbally, sources said.

House Democratic leaders have been searching for a way to ensure that any move they make to approve the Senate-passed $871 billion health care reform bill is followed by Senate action on a reconciliation package of adjustments to the original bill. One idea is to have the House and Senate act on reconciliation prior to House action on the Senate’s original health care bill.

Information Republicans say they have received from the Senate Parliamentarian’s Office eliminates that option. House Democratic leaders last week began looking at crafting a legislative rule that would allow the House to approve the Senate health care bill, but not forward it to Obama for his signature until the Senate clears the reconciliation package.

What Is He Waiting For?

The NY Times runs a guest op-ed by Prof. Richard Schmidt, who tackles the question of sudden acceleration in Toyotas.  Prof. Schmidt studied the sudden acceleration problem for Audi in the 80's and has some thoughts:

THE Obama administration has said that it may require automakers to install “smart pedals” on all new cars. This kind of system — already used in BMWs, Chryslers, Volkswagens and some of the newest Toyotas — deactivates the car’s accelerator when the brake pedal is pressed so that the car can stop safely even if its throttle sticks open.

The idea is to prevent the kind of sudden acceleration that has recently led to the recall of millions of Toyotas. Federal safety regulators have received complaints asserting that this problem has caused accidents resulting in 52 deaths in Toyotas since 2000. Smart pedals might help prevent more such accidents if the cause of unintended acceleration turns out to be some vehicle defect.

But based on my experience in the 1980s helping investigate unintended acceleration in the Audi 5000, I suspect that smart pedals cannot solve the problem. The trouble, unbelievable as it may seem, is that sudden acceleration is very often caused by drivers who press the gas pedal when they intend to press the brake.

I am sure driver brain-lock is to blame some of the time; others are OK with the "It's the stupid driver, stupid" theory as well, as an explanation for some incidents.

However, Prof. Schmidt closes with an odd puzzle:

The fix now championed by the Obama administration could work in situations in which there is an actual vehicle defect. It would tell the car that if it receives signals to both accelerate and brake, the accelerator should go dead so that the brake alone will work.

But this smart-pedal system can be of no use if the driver is simply pressing the accelerator and not touching the brake. The unintended acceleration — and the crash — would still occur.

What the smart pedal may do, however, is finally give us a sense of whether sudden acceleration tends to stem from operator error. If the reports of acceleration continue (and the smart pedals work properly), then there will be nothing and no one left to blame but the driver.

It's a longish op-ed and maybe Prof. Schmidt lost his train of thought between the first and last paragraphs, but really - if the "smart pedal" technology is already installed in certain types of cars (Prof.Schmidt cited BMW, Chrysler and Volkswagen),why not look at the data?

I tried, and was left with a head-scratcher - in 2009, per this NPR database, Volkswagen/Audi had the highest rate of complaints per 100,000 vehicles sold, at 11.5; Toyota/Lexus was second with 7.5, and BMW was third at 5.8.

In 2008, Volkswagen led the pack again, this time with 21.8 complaints per 100,000 vehicles sold; Toyota/Lexus was second at 6.8, pushed hard by BMW at 6.3.

2007, however, was odd - Suzuki roared off with the prize, scoring 27.4; Toyota/Lexus was second at 15.2, then Volkswagen at 8.0 and BMW at 5.4 (I ignored Jaguar at 24.3 because that was 4 incidents amongst 16,460 cars).

So it seems that some sort of data set already exists as to whether the smart pedal can prevent runaway cars and avoid accidents. I was not able to pry into the NHS database and figure out whether these hapless BMW and Volkswagen drivers were crashing or having a frightening but ultimately harmless moment of fright before the throttle over-ride took over.  But Prof. Schmidt ought to!

Global Warming, Local Skepticism

Gallup tells us that public belief in global warming is fading; Charlie Martin at Pajamas Media tells us that the independent data sets demonstrating global warming may not be that independent.

I have several objections to the Gallup article.  First, they trumpet a trend but bury the current level of public attitudes:

Americans' Global Warming Concerns Continue to Drop

Multiple indicators show less concern, more feelings that global warming is exaggerated

PRINCETON, NJ -- Gallup's annual update on Americans' attitudes toward the environment shows a public that over the last two years has become less worried about the threat of global warming, less convinced that its effects are already happening, and more likely to believe that scientists themselves are uncertain about its occurrence. In response to one key question, 48% of Americans now believe that the seriousness of global warming is generally exaggerated, up from 41% in 2009 and 31% in 1997, when Gallup first asked the question.

The trend is important, but after skipping past several charts and paragraphs we learn that the majority hold another view:

A majority of Americans still agree that global warming is real, as 53% say the effects of the problem have already begun or will do so in a few years. That percentage is dwindling, however. The average American is now less convinced than at any time since 1997 that global warming's effects have already begun or will begin shortly.

Which leads me to me second quarrel with this article.  Setting aside for the moment questions of dubious data, the IPCC was unequivocal in their 2007 conclusion that global warming was happening.  The key disputes are whether there is a significant human contribution to that warming, and whether any proposed plan to mitigate the human contribution can pass any rational cost/benefit test, both in the developed and developing world. 

Gallup took a stab at sorting through this nuance with a question about whether warming is due more to human activity or natural climate cycles:

In a sharp turnaround from what Gallup found as recently as three years ago, Americans are now almost evenly split in their views of the cause of increases in the Earth's temperature over the last century.

In 2003, 61% of Americans said such increases were due to human activities -- in line with advocates of the global warming issue -- while 33% said they were due to natural changes in the environment. Now, a significantly diminished 50% say temperature increases are due to human activities, and 46% say they are not.

The debate is going the wrong way for Al Gore but it is hardly over.

James O'Keefe Back For More

Patterico tells us that ACORN nemesis James O'Keefe may have targeted HUD as well.

Scott Rasmussen Explains The Polling On Health Care

Scott Rasmussen has a good article in the WSJ explaining the steady public to ObamaCare.  His Big Finish:

The reason President Obama can't move the numbers and build public support is because the fundamentals are stacked against him. Most voters believe the current plan will harm the economy, cost more than projected, raise the cost of care, and lead to higher middle-class taxes.

That's a tough sell when the economy is hurting and people want reform to lower the cost of care. It's also a tough sell for a president who won an election by promising tax cuts for 95% of all Americans.

Well, that, and Obama can't sell lemonade by the side of the road...

The Very Complicated Health Care Reform Process

The Times and the WaPo explain that the reconciliation process seems to require reconciliation of an existing law - Congress can't reconcile talk and good intentions, as Keith Hennesey explained recently.

That means the House has to pass the Senate bill they don't like, then hope the Reid is able to shepard a reconciliation bill through the Senate maze.

Sinister Republicans are fanning the embers of distrust that already (and always) exist between the House and Senate (E.g., ask any House Dem how happy they are that the Senate is abandoning Waxman-Markey on cap and trade.)  Here is nasty Mitch McConnell:

"House Democrats will have to decide whether they want to trust the Senate to fix their political problems," McConnell said. He listed perks that Senate Democrats won for Nebraska, Louisiana, Florida and labor unions; House members insist that all must be removed through a separate "fixes" bill under special budget reconciliation rules.

"They will be voting, when they pass the Senate bill, to endorse the Cornhusker Kickback, the Louisiana Purchase, the Gator-aid, the closed-door deal, the special deal for the unions, which may or may not bother any Democrats, I don't know," McConnell said.

Not to mention Bart Stupak and his problems with the Senate language on access to Federally subsidized abortion.

Sen. Lamar Alexander wins the metaphor du jour contest:

“We believe what the president is doing is asking House Democrats to hold hands, jump off a cliff and hope Harry Reid catches them,” Senator Lamar Alexander of Tennessee, the No. 3 Republican, said on Tuesday. “And Senator Reid is not going to have any incentive to catch them because by the time the reconciliation bill gets to the Senate, the president will have already signed the health care bill into law and he’ll be well on his way to Indonesia.”

Left unmentioned - Harry Reid will be trying to catch the leaping House Dems while Republicans parade by with trombones and kick sand at him.  (For the non link-clicker, that would be invoking the Byrd rule and offering many, many amendments.)

Looking For The Reset On The Reset Button

Obama continues to discover that bering The One ain't all it's cracked up to be:

Delay on Arms Pact Slows Reset of U.S.- Russia Ties
By PETER BAKER and MARK LANDLER

WASHINGTON — When President Obama got on the telephone with President Dmitri A. Medvedev of Russia last month, he was under the impression that they were finally close to wrapping up a long-delayed arms control treaty that he had originally expected to sign in December.

But to Mr. Obama’s surprise, Mr. Medvedev was not ready to sign off on a deal and raised issues that required more discussion, American officials said. As he hung up, the officials said, a frustrated Mr. Obama realized that the two sides were not as close as he had thought and sent negotiators back to the table.

The fitful effort to fashion a treaty that would be a signature achievement of his presidency has demonstrated the hurdles Mr. Obama faces in his drive to reset relations with Russia after years of tension.

I am going to hope this next bit is just ther eporter's flourish and not based in reality:

After months of delay and discord, administration officials said, they have learned that when it comes to deal-making with Moscow, nothing is done until it is done, and rarely will it go as smoothly as anticipated.

They have just figured out that dealing with the Russians can take a while?  I'm done laughing, and I don't believe it.

This Is Your Life

As storage gets relentlessly cheaper, everything will be commemorated:

PITTSBURGH — On a cold, wet afternoon not long ago, Aron Reznick sat in the lounge of a home for the elderly here, his silver hair neatly combed, his memory a fog. He could not remember Thanksgiving dinner with his family, though when he was given a hint — “turkey” — it came back to him, vaguely, like a shadow in the moonlight.

Two years ago, Mr. Reznick, who has early-stage Alzheimer’s disease and is now 82, signed up for an experiment intended to help people with Alzheimer’s and other memory disorders. The concept was simple: using digital pictures and audio to archive an experience like a weekend visit from the grandchildren, creating a summary of the resulting content by picking crucial images, and reviewing them periodically to awaken and strengthen the memory of the event.

The hardware is a little black box called the Sensecam, which contains a digital camera and an accelerometer to measure movement. Worn like a pendant around the neck, it was developed at Microsoft’s research lab in Cambridge, England.

Vicon, a British company that has licensed the technology, wants to market it to young people interested in logging their lives and posting the results to Web sites like Facebook and YouTube. For the elderly, though, it could herald a new kind of relationship between mind and machine: even as plaque gets deposited on the brain, everyday experience is deposited on silicon, then retrieved. 

Storing sounds (easy!) and smells (less easy) would provide even more memory cues.

Because It Feels So Good When They Stop?

It's not jobs, jobs,jobs, and it's not even health care - Nancy Pelosi has allowed Denis Kucinich and some like-minded anti-war Dems three hours to debate their bill to force a troop withdrawal from Afghanistan.

The bill would not have the force of la nor is it tied to actual funding, so it is really just a chance for progressives to posture for the check-writing audience and demonstrate to the rest of us their ineffectuality.

Liberals in the House, who have spent much of the past year complaining that other congressional Democrats and the White House are insufficiently progressive, will get a chance this week to vent about one of their biggest concerns: the war in Afghanistan.

House leaders will allow three hours of formal debate, probably Wednesday, on an antiwar resolution written by Rep. Dennis Kucinich (Ohio), one of the leading antiwar voices in Congress. The resolution, which has 16 co-sponsors, calls for the United States to remove all of its troops from Afghanistan in 30 days -- or by the end of the year, if it is determined that trying to do so in a month would be too dangerous. 

The resolution will invoke the 1973 War Powers Act, which Congress passed in protest of the escalation of the Vietnam War by a series of presidents without formal congressional authorization. It requires congressional approval for a president to put troops in a military conflict for more than 90 days.

Hey, what about the famous Authorization for the Use of Military Force passed after 9/11?  Good question:

Congress passed a resolution authorizing military force in Afghanistan in 2001, after the Sept. 11 attacks, and some congressional scholars doubt Congress can invoke the act now to force changes to President Obama's war policy.

But Nancy has her reasons:

"There are many members in the caucus who are eager to have a vote soon on Afghanistan," House Speaker Nancy Pelosi (D-Calif.) said when Kucinich proposed the measure. "This may satisfy that need."

The vote will be a measure of the depth of opposition to Obama's war policy, because it is not tied to troop funding, which lawmakers in both parties are loath to vote against.

Proper progressives need reassurance that their guys are on their side, even if it means nothing.

Edging Towards The Lifeboats

The Politico reports that Nancy Pelosi, the future former House Speaker, is seeing cracks in her facade of power:

House Speaker Nancy Pelosi is not accustomed to the word she’s been hearing far more frequently in recent days: “no.”

Over the past two weeks, Pelosi has faced a series of subtle but significant challenges to her authority — revolts from Democrats on the Ways and Means Committee, the Congressional Black Caucus, the Blue Dog Coalition and politically vulnerable first- and second-term members.

The dynamic stems from an “every man for himself” attitude developing in the Democratic Caucus rather than a loss of respect for Pelosi, according to a senior Democratic aide. But it’s making Pelosi’s life — and efforts to maintain Democratic unity — harder.

If she can find 216 votes for health care she becomes a genius again. 

And what does this seeming olive branch from Stupak mean?

TAWAS CITY, Mich. — Prospects are good for resolving a dispute over abortion that has led some House Democrats to threaten to withhold support of President Barack Obama's health care overhaul, a key Michigan Democrat said Monday.

Rep. Bart Stupak said he expects to resume talks with House leaders this week in a quest for wording that would impose no new limits on abortion rights but also would not allow use of federal money for the procedure.

"I'm more optimistic than I was a week ago," Stupak said in an interview between meetings with constituents in his northern Michigan district. He was hosting a town hall meeting Monday night at a local high school.

"The president says he doesn't want to expand or restrict current law (on abortion). Neither do I," Stupak said. "That's never been our position. So is there some language that we can agree on that hits both points — we don't restrict, we don't expand abortion rights? I think we can get there."

Health care reform advocates will say that Stupak's conciliatory approach means Nancy has advanced to the one yard line (and may even call for a booth review!).  Gloom-and-doomers will say that reform is so dead that Stupak is trying to avoid being tarred by fellow Dems as a key villain.

We'll know by Easter!  Unless this vote is put off until Arbor Day, or Memorial Day, or Flag Day (not a normal day for Dems to celebrate, but still...), or the 4th of July, or whenever.

Subsidizing Solar

The rainmakers in Spain threw subsidies mainly at the plain, I guess:

Solar Industry Learns Lessons in Spanish Sun
By ELISABETH ROSENTHAL

PUERTOLLANO, Spain — Two years ago, this gritty mining city hosted a brief 21st-century gold rush. Long famous for coal, Puertollano discovered another energy source it had overlooked: the relentless, scorching sun.

Armed with generous incentives from the Spanish government to jump-start a national solar energy industry, the city set out to replace its failing coal economy by attracting solar companies, with a campaign slogan: “The Sun Moves Us.”

Soon, Puertollano, home to the Museum of the Mining Industry, had two enormous solar power plants, factories making solar panels and silicon wafers, and clean energy research institutes. Half the solar power installed globally in 2008 was installed in Spain.

Farmers sold land for solar plants. Boutiques opened. And people from all over the world, seeing business opportunities, moved to the city, which had suffered from 20 percent unemployment and a population exodus.

But as low-quality, poorly designed solar plants sprang up on Spain’s plateaus, Spanish officials came to realize that they would have to subsidize many of them indefinitely, and that the industry they had created might never produce efficient green energy on its own.

In September the government abruptly changed course, cutting payments and capping solar construction. Puertollano’s brief boom turned bust. Factories and stores shut, thousands of workers lost jobs, foreign companies and banks abandoned contracts that had already been negotiated.

But it was money well spent because we learned a lot:

“The industry as a whole learned a lot from what happened in Spain,” said Cassidy DeLine, who analyzes the European solar market for Emerging Energy Research, a firm based in Cambridge, Mass. She noted that other countries had since set subsidies lower and issued stricter standards for solar plants.

Yet, despite the pain that Spain’s incentives ended up causing, in many ways they fulfilled their promise, Ms. DeLine said.

“Even though incentives can create bubbles and bursts, without them this industry won’t take off,” she said. “The U.S. is really behind Europe on this, and if we wait until solar is cost-competitive on its own, we may miss the boat and an opportunity to shape the market.”

Since Obama is intent on lashing solar support to a defunct cap-and-trade bill, we won't be repeating the Spanish experiment until the recovery here is well under way.

Even Boring Bob Herbert Sees The Obvious

NY Times snoozefest Bob Herbert has realized that Obama's relentless push for health care reform has become a problem:

Instead of focusing with unwavering intensity on this increasingly tragic situation, making it their top domestic priority, President Obama and the Democrats on Capitol Hill have spent astonishing amounts of time and energy, and most of their political capital, on an obsessive quest to pass a health care bill.

Health care reform is important. But what the public has wanted and still badly needs above all else from Mr. Obama and the Democrats are bold efforts to put people back to work. A major employment rebound is the only real way to alleviate the deep economic anxiety that has gripped so many Americans. Unaddressed, that anxiety inevitably evolves into dread and then anger.

But while the nation is desperate for jobs, jobs, jobs, the Democrats have spent most of the Obama era chanting health care, health care, health care.

However, Mr. Herbert can't quite get himself to the point of noticing that the endless Obama push for remaking three huge sectors of the economy - health care, energy, and financial services - is creating the sort of uncertainty that impedes a recovery.  Over to McQ of Q&O:

Actually they [jobs] will materialize by themselves – unless government gets in the way, imposes new taxes (health care reform and cap-and-trade, etc.), more onerous regulation and otherwise keeps the business climate roiled and uncertain.  Thus far, that’s precisely what the administration and Congress have managed to this point.

I don't see Team Obama embracing this perspective until after November, when newly empowered Republican chairman can distract them with madcap investigations.

SEND BETTER SNARK:  Dennis the Peasant does our dirty work:

But if health care reform doesn't pass, Barack Obama will appear to be weak. Apparently, he prefers to appear clueless.

You know, it isn't really a matter of the Administration and Congressional Democrats dicking around on one issue of 13+ months, it's that they've spent 13+ months dicking around with the wrong one issue. And when someone with the intellectual horsepower of a Bob Herbert gets that figured out before Obama, Reid or Pelosi, you know things aren't going to end well for the Democrats come November.