Jonathan Kantrowitz

A very important point from Ezra Klein in the Washington Post:

Virtually all insurance in this country receives heavy government support. But whereas the support for old-age and low-income/disability insurance is pretty straightforward and efficient, the support for employers who provide private insurance to mostly middle and upper-income workers is opaque, inefficient and often ignored when the time comes to talk deficit reduction…

Most of the people who have health-care insurance and don’t get it from Medicare, Medicaid or the military/veteran’s systems are getting it from their employer. And the reason they’re getting it from their employer is that health-care benefits — unlike wages — are tax deductible. That ends up being a huge subsidy for people who get health care through their employers. Between 2010 and 2014, the Joint Committee on Taxation estimates that this break will cost the Treasury about $660 billion. It’s the single most expensive tax expenditure in the entire tax code.

Open letter to President Obama (Please read the entire article:)

More than 250 of America’s most eminent legal scholars have signed a letter protesting against the treatment in military prison of the alleged WikiLeaks source Bradley Manning, contesting that his “degrading and inhumane conditions” are illegal, unconstitutional and could even amount to torture.

The list of signatories includes Laurence Tribe, a Harvard professor who is considered to be America’s foremost liberal authority on constitutional law. He taught constitutional law to Barack Obama and was a key backer of his 2008 presidential campaign.

Tribe joined the Obama administration last year as a legal adviser in the justice department, a post he held until three months ago.

He told the Guardian he signed the letter because Manning appeared to have been treated in a way that “is not only shameful but unconstitutional” as he awaits court martial in Quantico marine base in Virginia…

Under the terms of his detention, he is kept in solitary confinement for 23 hours a day, checked every five minutes under a so-called “prevention of injury order” and stripped naked at night apart from a smock….

He is shackled at all times.

How can this happen in America? In the immortal words of Robert Welch “Have you no sense of decency, sir? At long last, have you left no sense of decency?”

From Robert Reich secretary of labor under President Bill Clinton:

When I was a small boy I was bullied more than most, mainly because I was a foot shorter than than everyone else. They demanded the cupcake my mother had packed in my lunchbox, or, they said, they’d beat me up. After a close call in the boy’s room, I paid up. Weeks later, they demanded half my sandwich as well. I gave in to that one, too. But I could see what was coming next. They’d demand everything else. Somewhere along the line I decided I’d have a take a stand. The fight wasn’t pleasant. But the bullies stopped their bullying.

I hope the President decides he has to take a stand, and the sooner the better. Last December he caved in to Republican demands that the Bush tax cut be extended to wealthier Americans for two more years, at a cost of more than $60 billion. That was only the beginning — the equivalent of my cupcake.

Last night he gave away more than half the sandwich — $39 billion less than was budgeted for 2010, $79 billion less than he originally requested. Non-defense discretionary spending — basically, everything from roads and bridges to schools and innumerable programs for the poor — has been slashed.

The budget he just approved will cut Pell grants to poor kids, while states continue massive cutbacks in school spending — firing tens of thousands of teachers and raising fees at public universities. The budget he approved is cruel to the nation’s working class and poor.

The right-wing bullies are emboldened. They will hold the nation hostage again and again.

New Analysis Shows Over $50 Billion in Asthma Costs, Tens of Millions of Cases, Including 7 Million Children

In a major first-ever report analyzing detailed asthma incidence and cost data, Health Care Without Harm (HCWH), the Alliance of Nurses for Healthy Environments (ANHE) and the National Association of School Nurses (NASN) conclude that the already staggering human and financial toll of asthma in the U.S. is likely to increase if Congress acts to stop important updates to the Clean Air Act.

More than 24 million Americans — including 7 million children — suffer from asthma, with direct and indirect costs of treating the nation’s worsening asthma epidemic already exceeding $53 billion, according to the report.

The HCWH/ANHE/NASN report states:

“Science has established that air pollution from cars, factories, and power plants is among the major causes of asthma episodes. Air pollutants that can contribute to asthma include ground-level ozone smog, sulfur dioxide, particle pollution, and nitrogen oxides. Carbon dioxide pollution can also worsen asthma in several ways, such as by driving climate change (rising temperatures increase ozone smog concentrations) and by increasing production of airborne allergens like ragweed pollen (which is another trigger for asthma episodes). Legislation that would greatly reduce the authority of the Environmental Protection Agency (EPA) to reduce these air pollutants under the Clean Air Act would prevent improvements in air quality – stopping reductions in emissions of carbon dioxide, fine particles, soot, and other pollutants – and would make it harder for children and adults with respiratory problems such as asthma to breathe.”

According to the report:

- More than 688,000 children had to go to the emergency room because of asthma in 2008.
- Asthma episodes keep children out of school (accounting for about 10.5 million lost school days in 2008) and take adults out of the workplace (accounting for more than 14 million lost work days in 2008).
- Asthma was responsible for nearly 2 million emergency-room visits in 2007. In severe cases, asthma episodes can be deadly; in 2007 alone, more than 3,400 people in the United States died as a result of asthma.

The total estimated incremental direct cost of asthma in the United States is more than $53 billion a year. Who bears these costs? According to the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, almost 15 percent of the costs are paid out-of-pocket by the patient. That is equivalent to just under $8 billion a year. Private insurance covers more than 38% of the costs, equivalent to more than $20 billion a year. That leaves almost half of the cost of the asthma epidemic to be paid by taxpayer-funded federal programs such as Medicare and Medicaid.

According to a recent EPA analysis, the Clean Air Act amendments of 1990 currently prevent 1.7 million cases of asthma exacerbation and by 2020 will prevent 2.4 million. By blocking the EPA from making additional needed updates today, federal lawmakers would be allowing increases in soot, smog, carbon, and other air pollution that would cause asthma incidence to increase. The cost of these additional cases would also increase the taxpayer bill, and could lead to an increase in private insurance costs as well as increased out of pocket expenses.

Brenda Afzal, MS, RN, U.S. climate policy coordinator, Health Care Without Harm said: “Congress is literally talking here about taking the breath away from millions of American children and adults. Because they have a disease that is very susceptible to pollution, Americans with asthma provide members of Congress with 24 million compelling reasons for the EPA to be allowed to proceed with needed updates to federal Clean Air Act standards. By siding with polluters and against their constituents with asthma, Congress is ignoring the public health and financial implications of pollution-related illness. That’s why we were pleased to hear President Obama restate his opposition to these proposals and attempts to insert them into the budget debate. We think it is vitally important for Americans to understand what is at stake if these attempts to prevent the EPA from modernizing the Clean Air Act succeed.”

According to Barbara Sattler, RN, DrPH, FAAN, the chair of the board of the Alliance of Nurses for Healthy Environments, “Nurses work every day with Americans dealing with asthma, a chronic, sometimes debilitating condition that affects millions of children and adults. The extent of the asthma epidemic and its related costs outlined in this report are staggering. Nurses are profoundly distressed about congressional efforts that would prevent improvements in air quality that have a direct affect on both people with asthma and what they must pay for care.”

“Students miss more than 10 million school days a year because of asthma,” said Sandi Delack, RN, BSN, M ED, CSNT, president of the National Association of School Nurses. “School attendance is strongly correlated with academic success and graduation, and so additional days lost will add to the toll asthma takes to not only its patients, but our society. With cleaner air, we could reduce the costs associated with asthma episodes–funds that could be better used toward education and wellness programs, to make sure all children succeed academically.”

UNDERSTANDING THE SCIENCE: ASTHMA/AIR POLLUTION

Science has established that air pollution from cars, factories, and power plants is a major cause of asthma attacks. A research study published in 2002 estimated that 30 percent of childhood asthma is due to environmental exposures. Studies also suggest that air pollution may contribute to the development of asthma in previously healthy people. Key air pollutants that trigger asthma include ground-level ozone, sulfur dioxide, particulate matter, and nitrogen oxide.

Carbon dioxide pollution can also worsen asthma. One of the best-documented impacts of climate change is an increase in ground-level ozone smog concentrations, in response to rising temperatures (the hotter the temperature and the more incident sunlight, the more ozone tends to form). In 2004 and 2007, a multi-disciplinary team of experts showed that warming temperatures will cause more days with unsafe ozone levels.

PENDING MEASURES IN CONGRESS

Despite the negative impacts of air pollution on public health, there are several Congressional measures that would prevent improvements in air quality. During the week of April 4, several votes to block the EPA are in motion, and some members have been working to add EPA-blocking language to a new budget deal that has to be worked out this week in order to prevent a government shut-down.

The House is expected to vote on Energy and Commerce Chairman Fred Upton’s bill that would block the EPA from reducing carbon pollution. The bill, HR 910, would also throw out the EPA’s scientific finding that carbon is a health-threatening pollutant.

In the Senate, several proposals to block or slow down the EPA’s efforts to reduce carbon pollution have been offered:

- Senate Minority Leader Mitch McConnell is using Upton’s HR 910 as an amendment. Like the original, it would permanently repeal the Clean Air Act’s authority to set limits on GHG pollution, threatening the CAA’s health benefits and increasing our dependence on foreign oil.
- Senator Jay Rockefeller has introduced an amendment that would delay implementation of EPA’s GHG standards for stationary sources under the Clean Air Act for at least 2 years. Blocking EPA from updating Clean Air Act safeguards with new standards to reduce emissions of life-threatening pollution from power plants and other major sources– whether initially just one year or two – could be extended again and again.
- Senator Debbie Stabenow has introduced an amendment that would block enforcement of carbon pollution safeguards for two years, prevent accurate accounting of emissions from agricultural activities and allow large emission sources to be built or modified with no requirement to limit their carbon pollution.
- Senator Max Baucus Amendment: Would prevent accurate accounting of emissions from agricultural activities as well as allow large emission sources to be built or modified with no requirement to limit their carbon pollution.

ABOUT THE GROUPS

Health Care Without Harm is an international coalition of more than 430 organizations in 52 countries, working to transform the health care industry worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment.

The National Association of School Nurses is the expert voice for optimal student health and for professional development of school nurses. NASN believes every child should have access to a school nurse all day, every day. The National Association of School Nurses supports the health and educational success of children and youth by developing and providing leadership to advance school nursing practice by specialized registered nurses.

The Alliance of Nurses for Healthy Environments, launched in 2008 by a group of national nurse leaders from several nursing sub-specialties, works to promote healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-based practice, and influencing policy.

Really interesting article and comment:

Barry Bonds Closing Arguments: Guess You Had to Be There

The Government apparently presented no direct evidence Bonds knew he was taking steroids:

Assistant U.S. Attorney Jeff Nedrow said Thursday that based on testimony from other ballplayers—who said they bought steroids from Mr. Bonds’s trainer, Greg Anderson—”you can infer Bonds knew he was getting steroids.”

That’s a stretch. Especially when the Government’s witnesses were cooperators getting immunity or leniency for their own steroid use.

Among the defense arguments:

Mr. Bonds was taking legal corticosteroids—anti-inflammatory drugs prescribed by his doctor—that can cause similar side effects to performance-enhancing drugs.

…. Mr. Bonds’s lawyers never denied that Mr. Bonds used an undetectable steroid called “The Clear” in 2003; they acknowledged that he took the substance at the behest of his trainer, Mr. Anderson, but said Mr. Anderson never told Mr. Bonds what the substances were. Mr. Bonds told the grand jury he thought he was taking flax-seed oil.

Essential Reading:

Ludicrous and Cruel by Paul Krugman

…House Republicans, led by the Budget Committee chairman, Paul Ryan, unveiled their budget proposals…Republicans have once again gone all in for voodoo economics — the claim, refuted by experience, that tax cuts pay for themselves.

Specifically, the Ryan proposal trumpets the results of an economic projection from the Heritage Foundation, which claims that the plan’s tax cuts would set off a gigantic boom. Indeed, the foundation initially predicted that the G.O.P. plan would bring the unemployment rate down to 2.8 percent — a number we haven’t achieved since the Korean War…

The Heritage Foundation projection has large tax cuts actually increasing revenue by almost $600 billion over the next 10 years.

A more sober assessment from the nonpartisan Congressional Budget Office tells a different story. It finds that a large part of the supposed savings from spending cuts would go, not to reduce the deficit, but to pay for tax cuts. In fact, the budget office finds that over the next decade the plan would lead to bigger deficits and more debt than current law.

And about those spending cuts: leave health care on one side for a moment and focus on the rest of the proposal. It turns out that Mr. Ryan and his colleagues are assuming drastic cuts in nonhealth spending without explaining how that is supposed to happen.

How drastic? According to the budget office, which analyzed the plan using assumptions dictated by House Republicans, the proposal calls for spending on items other than Social Security, Medicare and Medicaid — but including defense — to fall from 12 percent of G.D.P. last year to 6 percent of G.D.P. in 2022, and just 3.5 percent of G.D.P. in the long run.

That last number is less than we currently spend on defense alone; it’s not much bigger than federal spending when Calvin Coolidge was president, and the United States, among other things, had only a tiny military establishment. How could such a drastic shrinking of government take place without crippling essential public functions? The plan doesn’t say.

And then there’s the much-ballyhooed proposal to abolish Medicare and replace it with vouchers that can be used to buy private health insurance.

The point here is that privatizing Medicare does nothing, in itself, to limit health-care costs. In fact, it almost surely raises them by adding a layer of middlemen. Yet the House plan assumes that we can cut health-care spending as a percentage of G.D.P. despite an aging population and rising health care costs.

…In short, this plan isn’t remotely serious; on the contrary, it’s ludicrous.

And it’s also cruel… As the Center on Budget and Policy Priorities points out, of the $4 trillion in spending cuts he proposes over the next decade, two-thirds involve cutting programs that mainly serve low-income Americans…

It’s not the money, it’s the right wing agenda:

How small differences could lead to a shutdown By Ezra Klein

Boehner and Reid say they’ve “narrowed the issues.” That means they’re very close on total spending cuts (somewhere around $35 billion) and very clear on what’s left to negotiate. The problem, however, is that as small as a policy rider over federal funding for Planned Parenthood might be, the distance between the two parties on the underlying issue is great. Democrats were appalled yesterday when Republicans made a one-week stopgap contingent on a rider barring Washington, DC from using its own money to fund abortion for low-income women (so much for home rule). The stop gap went nowhere, even though the issue of how DC can use its own funds is, in the national context, small.

And the problem isn’t just the policy. What the two parties are trying to prove about themselves, and about their relationship going forward, is very big. John Boehner is trying to convince Republicans in the House and Republicans in the country that they can trust him, that he’s conservative enough and steely enough to represent their interests in negotiations with the Democrats. And Democrats are trying to show that they will not be rolled over in negotiations simply because the Tea Party is unwilling to compromise, that they still control the Senate and the White House and they plan to act like it. These negotiations are really about the next negotiations, and the negotiations after that. Both parties worry that if they compromise now, they only embolden the other side later. And later is when the stakes get really high.

For that reason, more than a few observers and participants have suggested to me that perhaps a shutdown tonight would be healthy. Better, they say, that Democrats and Republicans test what happens if they refuse to compromise now, when the consequences can be contained, than later, when the fight will be over the debt ceiling and the consequences could be catastrophic. That they may be right is a depressing commentary on the forces buffeting our political system right now, and the very real, very large risks they pose to the country.

Congressman Jim Himes (CT-4) today voted against a piecemeal, partisan spending bill that would eliminate access to reproductive rights for many women while increasing defense spending. The bill authorizes non-defense spending for one week and defense spending for the remainder of the fiscal year.

“We can’t run the government week-by-week any longer—we need a complete spending plan for the federal government, and we need it now,” Himes said. “I’m willing to consider just about any reasonable cut, but today’s bill was a cynical ploy by the Majority that demonstrates they are not serious about solving our nation’s fiscal problems or preventing a shutdown. They avoid cutting defense, cuts even Sec. Gates has supported, and are using the fear of a government shutdown to attempt to sneak through an assault on women’s reproductive rights. The Speaker needs to join the adult conversation about the budget and cooperate in a genuine attempt to reach a compromise the majority of Americans can support.”

There is broad support for cuts to defense spending as part of any effort to reduce the federal deficit, yet today’s bill increases defense spending by two percent.

Today’s defense appropriations bill also contained language not associated with spending in the form of “policy riders,” provisions that traditionally have not been permitted in appropriations bills. The legislation considered today contained two such requirements, lumping together the women of the District of Columbia and Guantanamo Bay detainees. It prohibits the District of Columbia from spending its own local taxpayer-raised funds on abortions for low-income women and also prohibits the transfer of Guantanamo Bay detainees.

“These provisions have nothing to do with the budget, would not do a thing to reduce the deficit, and won’t save the government a dime,” Himes said. “It’s time for the Speaker to stop allowing the Tea Party to hijack the government and to have an honest discussion about federal spending.”

Himes has worked and voted across party lines to cut billions in spending. In this year alone, he has already supported over $11 billion in cuts to redundant and outdated programs. Last year, he co-founded the Spending Cuts and Deficit Reduction Work Group and proposed over $70 billion in specific cuts. Additionally, Himes crossed party lines over a dozen times to join Republicans in supporting an investigation into the connection between earmarks and campaign contributions. Finally, Himes has been supportive of the work of the Simpson-Bowles Commission on Fiscal Responsibility and Reform, which put forth a plan to balance the federal budget by 2014 and reduce the debt to 60% of GDP by 2023.