March 26, 2010

Excerpts from Dominion by Matthew Scully

Realism is seeing reality. And the two hardest realities are life and death. We share with animals in the fellowship of both, and there never was a better reason to be kind and merciful than the leveling death which will find us all. (p. 46)
'Killing "for sport" is the perfect type of that pure evil for which metaphysicians have sometimes sought. Most wicked deeds are done because the doer proposes some good to himself ... [but] the killer for sport has no such comprehensible motive. He prefers death to life, darkness to light. He gets nothing except the satisfaction of saying, "Something that wanted to live is dead. There is that much less vitality, consciousness, and, perhaps, joy in the universe. I am the Spirit that Denies."' (p. 77, from The Modern Temper (1929) by Joseph Wood Krutch, as quoted in A View to a Death in the Morning: Hunting and Nature Through History (1993) by Matt Cartmill)
I know that vegetarianism runs against mankind's most casual assumptions about the world and our place within it. And I know that factory farming is an economic inevitability, not likely to end anytime soon. But I don't answer to inevitabilities, and neither do you. I don't answer to the economy. I don't answer to tradition and I don't answer to Everyone. For me, it comes down to a question of whether I am a man or just a consumer. Whether to reason or just to rationalize. Whether to heed my conscience or my every craving, to assert my free will or just my will. Whether to side with the powerful and comfortable or with the weak, afflicted, and forgotten. (p. 325)
Meat is today a luxury item, large-scale livestock farming an irrational and inefficient enterprise, and the suffering it inflicts morally untenable. It will not do to say, with writer David Plotz in the online magazine Slate, that "Calves are adorable, but veal is delicious. ... God gave man dominion over the beasts of the earth [and] if an animal has economic utility, we should farm it." That is not a serious argument. It is an excuse for evading serious argument, for doing what he pleases and getting what he wants, the whims of man in their familiar guise of the will of God. Nor is it any answer to say, with Judge Richard Posner, that the law should be neutral and let corporate farmers answer to "consumer preference" alone. When the law sets billions of creatures apart from the basic standards elsewhere governing the treatment of animals, when the law denies in effect that they are animals at all, that is not neutrality. That is falsehood, and a license for cruelty. (p. 389)
If we cannot do something humanely, without degrading both the animals and ourselves, then we should not do it at all. (p. 391)
Kindness to animals is not our most important duty as human beings, nor is it our least important. How we treat our fellow creatures is only one more way in which each one of us, every day, writes our own epitaph -- bearing into the world a message of light and life or just more darkness and death, adding to the world's joy or to its despair. (p. 398)
Dominion: The Power of Man, the Suffering of Animals, and the Call to Mercy, by Matthew Scully. New York: St. Martin's Press, 2002

environment, environmentalism, animal rights, vegetarianism, anarchism, ecoanarchism

March 23, 2010

The 3% Nonsolution

A common figure for annual health care spending in the U.S. is 2.5 trillion dollars (according to the Dept. of Health and Human Services (HHS), it was 2.34 trillion dollars in 2008 and projected to have been 2.47 trillion in 2009 and to be 2.57 trillion in 2010).

The "historic" health care bill just signed into law has an estimated cost of just under 1 trillion dollars (938 billion). But that's over 10 years. So make it 100 billion dollars annually, or about half the cost of the crusades in Iraq and Afghanistan.

Thus, the bill will represent less than 4% of the country's health care spending.

Small change indeed.

Especially as HHS projects total spending to increase to almost 4.5 trillion dollars by 2019.

This "monumental" reform bill will represent less than 2.7% of the next 10 years' health care spending.

Its only significance is criminalizing not having insurance and forcing people into private "coverage". A cruel mockery of care, this is blatant extortion on behalf of corporate profits.

March 22, 2010

On the big medical insurance bill

Ironic Times House Passes Mild Modification to Health Care System -- After 100-year debate.

Ralph Nader, "A Remnant of Reform": 

The health insurance legislation is a major political symbol wrapped around a shredded substance. It does not provide coverage that is universal, comprehensive or affordable. It is a remnant even of its own initially compromised self — bereft of any public option, any safeguard for states desiring a single payer approach, any adequate antitrust protections, any shift of power toward consumers to defend themselves, any regulation of insurance prices, any authority for Uncle Sam to bargain with drug companies, and any reimportation of lower-priced drugs.

Most of the health insurance coverage mandated by this legislation does not come into effect until 2014, by which time 180,000 Americans will die because they were unable to afford health insurance to cover treatment and diagnosis, according to Harvard Medical School researchers.

The bill’s 2,000 pages afford many opportunities for insurance companies to further their strategy of maximizing profits by denying claims, restricting the benefits of their present customers, and the benefits of the new customers who are mandated to buy their policies, all backed by hundreds of billions of dollars of federal subsidies.

Its main saving grace is that it is so inadequate and so delayed in implementation that the position supported by the majority of people, physicians and nurses –- full Medicare for all –- will have abundant opportunities to build around the country. The spiraling price hikes by the insurance industry are sure to spur the single payer movement to new popularity. (See

Chris Hedges

This bill is not about fiscal responsibility or the common good. The bill is about increasing corporate profit at taxpayer expense. It is the health care industry’s version of the Wall Street bailout. It lavishes hundreds of billions in government subsidies on insurance and drug companies. The some 3,000 health care lobbyists in Washington, whose dirty little hands are all over the bill, have once more betrayed the American people for money. The bill is another example of why change will never come from within the Democratic Party. The party is owned and managed by corporations. The five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009. The Washington Post reported that up to 30 members of Congress from both parties who hold key committee memberships have major investments in health care companies totaling between $11 million and $27 million. President Barack Obama’s director of health care policy, who will not discuss single payer as an option, has served on the boards of several health care corporations. And as salaries for most Americans have stagnated or declined during the past decade, health insurance profits have risen by 480 percent.

Obama and the congressional leadership have consciously shut out advocates of single payer from the debate. The press, including papers such as The New York Times, treats single payer as a fringe movement. The television networks rarely mention it. And yet between 45 and 60 percent of doctors favor single payer. Between 40 and 62 percent of the American people, including 80 percent of registered Democrats, want universal, single-payer not-for-profit health care for all Americans. The ability of the corporations to discredit and silence voices that represent at least half of the population is another sad testament to the power of our corporate state to frame all discussions.

Margaret Flowers, Physicians for a National Health Program, in response to Howard Dean saying "Americans want choice ... Nobody in America likes the government telling them what to do":

The American people want a choice of health care provider and choice of treatment. This bill does neither. Let people choose their doctor and treatment. Under private insurance, the private insurers make the decision. This bill would entrench that system of private insurance. It’s going to continue to leave people out – with the resulting suffering, bankruptcy, foreclosure and preventable death. And that’s not acceptable.

We were excluded from this conversation. This was not a conversation based on data or evidence. It was based on the fact that the industry had their hand in this throughout this legislation and it was written in their favor.

[One might also point out that making it illegal to not have insurance and not providing a nonprofit public alternative to the private insurance market are in fact mockeries of choice. Medicare for All would maximize choice.]

March 19, 2010

Fact Sheet: The Health Care Bill

Jane Hamsher at Fire Dog Lake has put together a fact sheet about the "health care bill" (click on the title of this post for her original comments as well as references):



1. This is a universal health care bill.The bill is neither universal health care nor universal health insurance.

Per the CBO:

  • Total uninsured in 2019 with no bill: 54 million
  • Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Insurance companies hate this billThis bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009.

The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.

3. The bill will significantly bring down insurance premiums for most Americans.The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.

Annual premiums in 2016, status quo / with bill:

  • Small group market, single: $7,800 / $7,800
  • Small group market, family: $19,300 / $19,200
  • Large Group market, single: $7,400 / $7,300
  • Large group market, family: $21,100 / $21,300
  • Individual market, single: $5,500 / $5,800
  • Individual market, family: $13,100 / $15,200
4. The bill will make health care affordable for middle class Americans.The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.

A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.

5. This plan is similar to the Massachusetts plan, which makes health care affordable.Many Massachusetts residents forgo health care because they can’t afford it.

A 2009 study by the state of Massachusetts found that:

  • 21% of residents forgo medical treatment because they can’t afford it, including 12% of children
  • 18% have health insurance but can’t afford to use it
6. This bill provide health care to 31 million people who are currently uninsured.This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.
7. You can keep the insurance you have if you like it.The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.

Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.

8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.There is insufficient evidence that employers pass savings from reduced benefits on to employees.
9. This bill employs nearly every cost control idea available to bring down costs.This bill does not bring down costs and leaves out nearly every key cost control measure, including:
  • Public Option ($25-$110 billion)
  • Medicare buy-in
  • Drug reimportation ($19 billion)
  • Medicare drug price negotiation ($300 billion)
  • Shorter pathway to generic biologics ($71 billion)
10. The bill will require big companies like WalMart to provide insurance for their employeesThe bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.
11. The bill “bends the cost curve” on health care.The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019.

“Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.

In 2009, health care costs were 17.3% of GDP.

Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)

Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)

12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012

Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.

13. The bill prohibits dropping people in individual plans from coverage when they get sick.The bill does not empower a regulatory body to keep people from being dropped when they’re sick.

There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.

14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state.

Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level.

15. This bill will stop insurance companies from hiking rates 30%-40% per year.This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.
16. When the bill passes, people will begin receiving benefits under this bill immediatelyMost provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014.

Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.

17. The bill creates a pathway for single payer.Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer.

Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.

18. The bill will end medical bankruptcy and provide all Americans with peace of mind.Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.
  • In 2009, 1.5 million Americans declared bankruptcy
  • Of those, 62% were medically related
  • Three-quarters of those had health insurance
  • The Obama bill leaves 24 million without insurance
  • The maximum yearly out-of-pocket limit for a family will be $11,900 on top of premiums
  • A family with serious medical problems that last for a few years could easily be financially crushed by medical costs

March 18, 2010

Public option, private deals

As Miles Mogulescu writes at Huffington Post, even as Obama promoted the public option as a politically feasible compromise instead of Medicare for all -- and most analysts considered it to be politically necessary if not having health insurance was to be criminalized -- he had already promised the pharmaceutical and hospital industries that it would not be in the final bill.

One big sham.

The Democrats now do the work of the Republicans, and the Republicans benefit by opposing the obviously shitty result, eventually regaining control of government, when they in turn will provide the means for the Democrats to regain control. Round and round we go, both parties taking turns being the spokesman for the same moneyed interests, a tiresome game of good cop–bad cop but with grave consequences that nobody can any longer deny (endless expanding war, widening gap between rich and poor, disappearance of the middle class).

Unfortunately, that's how our "democracy" is set up: like a sports contest. Winner-takes-all is not representative democracy. And it has now been perfected to the opposite of democracy, in which our only choice is to vote against someone, since there is nothing to vote for.

[Election Reform]

March 15, 2010

Doug Racine sabotages single-payer in Vermont

As reported last week, gubernatorial candidate Senator Doug Racine "unveiled his long-awaited health care reform bill", In fact, his bill is a revision of S.88, an already-introduced bill to establish a single-payer system and universal coverage in Vermont (along with its companion bill in the house, H.100). Racine's version, however, changes it to instead establish a committee to study a few options for a couple of years that might then move us towards universal "access".

This is despicable.

human rights, Vermont

President has made a mess of health care reform

Douglas Turner writes in The Buffalo News (click the title of this post):

A year ago President Obama strolled confidently into the garden of good and evil, bit deeply into the apple and created the mess he and congressional Democrats are in now concerning health insurance reform.

Only a few heady weeks into his presidency, Obama called his first White House health care summit. It was not with those who got him elected, folks from the neighborhoods, the universities, the clinics and officials from hard-pressed state and local health agencies.

Thinking he was still in Chicago, Obama blithely muscled such non-entities aside and settled in with silk-suited brass from the health insurance trade, the hospital conglomerates and the prescription drug business.

With trusted Chicago aides at his elbow, Obama made an amoral deal with the drug manufacturers that has poisoned everything that happened since. He had a debt to pay. The drug makers had donated tens of millions to his Senate and presidential campaigns.

Just after this summit, Obama secretly promised the Rx people that there would be no government jaw-boning with the industry to get lower prices for seniors and others. Obama also promised them there would be no drug importation from Canada and other reliable foreign countries.

This, after then-candidate Sen. Obama promised his administration would enter into talks for lower prices and would bring cheaper but identical products in from Canada. As a U. S. senator and presidential candidate, Obama voted for both.

I am indebted to reporters Tom Hamburger, who broke the story last year about this amazing turnabout, and Paul Blumenthal, who recently added important details. Obama’s 180-degree switch sent a signal to all legislators with close ties to special interests. Obama had campaigned on transparency and chasing lobbyists out of town. Now, it all moved behind closed doors, just as in the ferment over Hillary Clinton’s failed health care proposals 15 years before. The lessons then and now: Don’t trust the people.

On April 15, 2009, there was a secret meeting at the Democratic Senate Campaign Committee at which the drug industry outlined its advertising campaign for health insurance reform. Another part of the $80 billion deal was filling in some, but not all, of the doughnut hole in Medicare Part D.

Seeing that Obama didn’t believe his own campaign rhetoric about transparency, the Senate Finance Committee began its secret talks on what constituted health insurance reform. Max Baucus, D-Mont., is chairman. Charles E. Schumer, D-N. Y., is a prominent member. Baucus emerged on June 20 and called Obama’s unsavory deal with the drug industry “a once-in-a-lifetime opportunity.” It certainly wasn’t for sick people with limited incomes.

Not long afterward, Senate Democrats got all wobbly about the public option that passed the House. This would be a government-supervised and subsidized insurance program. It would have been the best yardstick by which private health insurance costs could be measured and controlled. On Oct. 28, Sen. Joe Lieberman, D-Independent, said he would block any bill that contained the public option. Many senators, awash in insurance industry money, shed crocodile tears at the demise of the public option.

Obscured in quarrels over details is the collapse of public trust.

Now, instead of cost control, we are arguing over a symbol: The idea that Democrats need to pass something, even though it won’t produce better health care.

Nothing better symbolizes that special hell into which Obama’s dealings sent health care than a rule being shaped by Rep. Louise M. Slaughter, D-Fairport, and chairwoman of the Rules Committee. She would have the House symbolically approve the Senate bill that would cost New York taxpayers $1 billion a year in added Medicaid costs. Part of the money subsidized payoffs to Vermont, Nebraska and Michigan to buy their senators’ votes last Dec. 24.