Health care Archives
Obama needs to break with neoliberalism and embrace the public provision of public goods like Roosevelt and Eisenhower once did -- from energy and infrastructure to education and healthcare.
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Obama has already been compared to FDR. But do his proposals really measure up?
No, says Michael Lind from the New America Foundation in today's Salon. In a fantastic critique of Obama's budget, Lind argues that his proposal reflects the ongoing dominance of market fundamentalism. If Obama is to recreate liberalism and achieve a transformational presidency, Lind argues, he must break with this ideology and embrace the public provision of public goods -- just like Roosevelt and Eisenhower once did -- from energy and infrastructure to education and healthcare.
Lind echoes my recent call in the Huffington Post for Obama to put forth a new economic philosophy, and he cites Breakthrough's Shellenberger and Nordhaus as offering "the Roosevelt approach" on energy:
The problem with alternative energy sources like solar power and wind power is that they are still too expensive, compared to coal, natural gas and nuclear energy. The answer, according to a minority of enviromentalists like Ted Nordhaus and Michael Shellenberger, should be massive, Manhattan-style public sector R&D to discover ways to bring alternative energy prices down -- in absolute, not just relative, terms, to maintain cheap electricity for American industry and American households. That would be the Roosevelt approach. But the Obama approach is to use a cap-and-trade system to artificially raise the prices of conventional energy, in the hope that private capital (with modest help from public capital) will pay for efforts to invent a cheaper solar cell or wind turbine. The fact that most of the left embraces cap-and-trade should not blind us to the fact that cap-and-trade is a classic example of an indirect, overly complicated, "market-friendly" neoliberal approach, touted originally by conservatives and neoliberals as an alternative to the allegedly discredited "top-down, command-and-control" approach that gave us, among other things, the TVA, the Manhattan Project and the Internet.
Here's the full piece:
Continue reading "How Can Obama Really Become the Next FDR?" »
Don't miss the chance to see Conley speak tomorrow, January 27th, at Berkeley Arts and Letters with Michael and Ted introducing.
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Dalton Conley, Breakthrough Senior Fellow, sociology professor at NYU and author of the upcoming book "Elsewhere, U.S.A.: How We Got from the Company Man, Family Dinners, and the Affluent Society to the Home Office, BlackBerry Moms, and Economic Anxiety," sat down with Ted Nordhaus to answer some questions about social and economic inequality in America, and the impacts of the current recession on recent socioeconomic trends in the United States. Don't miss the chance to see Conley speak tomorrow, January 27th, at Berkeley Arts and Letters with Michael and Ted introducing.
Q&A:
Ted Nordhaus:
You have written extensively about the impacts of rising social and economic inequality on American culture and society. What would you identify as the key drivers of rising inequality?
Dalton Conley:
Wage inequality has increased for a variety of reasons, perhaps the most important being what economists call "skill-biased technological change" meaning that the new economy skews rewards heavily toward folks who have the most hi-end cognitive and emotional skills and credentials (i.e. educational degrees). But total inequality has increased also because of family dynamics: more and more families are two-earner households with high-earners marrying high-earners, thereby doubling (almost) household inequality.
Nordhaus:
Over the last few decades, up until the current recession, America has experienced both consistently high levels of economic growth and rising levels, by some accounts unprecedented levels, of economic inequality. How are those two phenomena related and do you think it is possible to have a high growth economy without rising levels of inequality?
Conley:
The rewards of growth have been typically unequally distributed in the U.S. For instance, the last time we experienced inequality levels equal to contemporary ones was 1929, right before the crash. So it remains to be seen what the impact of the current bear market will be. There are, however, examples abroad of societies that have managed to obtain standards of living similar to (or better than) ours without such extreme inequality. Northern Europe comes to mind.
Nordhaus:
What do you think the impact of the current recession will be on social inequality? Are we likely to see declining levels of inequality and if so, what impact would you expect that to have on Elsewhere U.S.A?
Conley:
I think inequality may lessen if the evaporation of all this abstract wealth holds fast. However, already public policy has been directed to restoring the old ways. Even if inequality declines, I still think folks will be haunted by economic anxiety. In good times we fear that others are doing better than us in relative terms. In bad times, we fear losing what we have in absolute terms.
Nordhaus:
You write more specifically about the ways in which rising inequality is self reinforcing. The more money affluent Americans make, the higher the opportunity costs of not working become. The resulting greater incentive for affluent Americans to work more, not less, then exacerbates income inequality all the more. Would you expect a recessionary economy in which income inequality was declining to result in a reversal of this dynamic? With the opportunity costs of family time and leisure declining, would you expect affluent Americans to take more time away from work and with their families? What impact might that have on Americans who work in the service sectors to which affluent Americans have in recent decades outsourced so much of their lives?
Conley:
I could see a potential upside of more folks living a slower lifestyle--cooking at home more and outsourcing less childcare and other aspects of what was once family life; this might be an upside of a tepid economy. However, the monkey wrench in all this is the fact that we are burdened with enormous household (and national) debt thanks to our recent consumption binge. So most of us--thanks to credit card bills or mortgages that exceed the value of our homes--don't have the option of working less and enjoying simpler pleasures we had forgotten about. We are going to be working for our interest payments and feeling perhaps even more pressure to earn.
Nordhaus:
You write a lot about the ways in which modern life, and particularly the market, has increasingly erased many of the old modernist dualities - work and leisure, public and private, market goods and public goods - mostly in the negative; but aren't there real benefits to many of these trends as well, in terms of the creation of all sorts of technologies and new personal/professional spaces that allow for greater flexibility and control over when, how, and where we work, play, shop, and lived?
Conley:
Definitely, but the skills we need to manage these are new. The ability to multi-task--i.e. attend to several streams of interactive data exchange while not losing any of those threads, is perhaps as important as perisistence, brains or other skills that are prized. I am not trying to be judgemental and make some nostalgic claim that things were "better" in the days of yore; rather, I am merely trying to describe a new social landscape that comes with plusses and minuses.
Nordhaus:
You also write about the rise of the intravidual - about the ways in which the collapse of so many of those dualities has led to a fracturing of the self. Is this really a new development? How is this different than Whitman's observation that we "contain multitudes" penned more than a century ago? Haven't we always contained multitudes and multiple selves?
Conley:
That may be the case. However, I think back then there was still a clear(er) division between front-stage (i.e. public persona) and back-stage (our private self). Today with Facebook updates (and so on), public cell phone conversations, and the blurring of home and work, this dichotomy has eroded, combining with other dynamics I describe in the book, to lead to a greater--perhaps--fragmentation of our consciousness, I argue.
Nordhaus:
How do the social safety net and the institutions necessary for its provision need to evolve to address America's increasingly complex social and economic arrangements?
Conley:
We have to face the fact that the social safety net devised in the 1930s (and even the 1960s amendments) were made in the context of a much less affluent society where household budgets were much more devoted to basic necessities. Today what we "need" is much greater (education, high quality health care, family care and so on) and often relative in nature (better schools -- better than what?). These are much more difficult to provide using the old-school social insurance model.
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About the book:
Over the past three decades, our daily lives have changed slowly but dramatically. Boundaries between leisure and work, public space and private space, and home and office have blurred and become permeable. How many of us now work from home, our wireless economy allowing and encouraging us to work 24/7? How many of us talk to our children while scrolling through e-mails on our BlackBerrys? How many of us feel overextended, as we are challenged to play multiple roles-worker, boss, parent, spouse, friend, and client-all in the same instant?
Dalton Conley, social scientist and writer provides us with an X-ray view of our new social reality. In Elsewhere, U.S.A., Conley connects our daily experience with occasionally overlooked sociological changes: women's increasing participation in the labor force; rising economic inequality generating anxiety among successful professionals; the individualism of the modern era-the belief in self-actualization and expression-being replaced by the need to play different roles in the various realms of one's existence. In this groundbreaking book, Conley offers an essential understanding of how the technological, social, and economic changes that have reshaped our world are also reshaping our individual lives.
The goal of a "stimulus" is to put the economy back on the path it was on before the downturn started. But this should not be the goal of Obama's economic plan--to return us to the time when college grads went to Wall Street to make a quick buck by trading back and forth on dubious mortgages.
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Last week, Obama announced his stimulus package, a plan to spend nearly 800 billion dollars on infrastructure projects, modernizing schools and health records, expanding clean energy production, providing much-needed relief for state budgets, and extending tax cuts to 95% of working Americans.
By most standards, this is a big stimulus plan that could do a lot to bolster confidence, increase consumer spending and unfreeze credit. And yet, as Paul Krugman put it last week,
"To close a gap of more than $2 trillion -- possibly a lot more, if the budget office projections turn out to be too optimistic -- Mr. Obama offers a $775 billion plan. And that's not enough.
... The bottom line is that the Obama plan is unlikely to close more than half of the looming output gap, and could easily end up doing less than a third of the job."
Continue reading "On Obama's Stimulus: Don't Look Back, Forge Ahead to a New Century of Prosperity" »
Calling 2009 a "clean break from a troubled past," Barack Obama today announced his priorities for an economic stimulus package.
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In Northern Virginia today, President-elect Barack Obama addressed the nation, introducing a few basic goals and guidelines for an economic stimulus package that could cost as much as a trillion dollars.
Well aware that the large price tag on the stimulus, referred to as the "American Recovery and Reinvestment Plan," Obama included language about setting a foundation for economic growth now in order to return to a place of fiscal responsibility as the economy gets back on its feet. However, Obama was not shy about the need for the government to step in and spend, now:
"It is true that we cannot depend on government alone to create jobs or long-term growth, but at this particular moment, only government can provide the short-term boost necessary to lift us from a recession this deep and severe. Only government can break the vicious cycles that are crippling our economy - where a lack of spending leads to lost jobs which leads to even less spending; where an inability to lend and borrow stops growth and leads to even less credit."
Continue reading "Obama's Stimulus Plan: A Foundation for Growth?" »
Henry Waxman (D-CA) defeated long-time Chair of the House Energy and Commerce Committee, John Dingell (D-MI), winning the gavel of the influential committee in a 137-122 vote of the House Democratic Caucus.
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Representative Henry Waxman of California defeated Representative John Dingell of Michigan in the battle for the gavel of the influential House Energy and Commerce Committee today.
Over the past two weeks, the two senior Democrats waged one of the most hotly contested challenges for committee chairmanship in recent Congressional history. Waxman was announced the victor today after a 137-122 vote of the full House Democratic Caucus, ending Dingell's nearly 28 year reign as Chair of the committee, which has jurisdiction over several key issues, including energy, interstate commerce and health care.
Continue reading "Waxman Bests Dingell in Contest Over Influential House Committee" »
Daschle entrusted by Obama to steer health care reform forward.
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From the Wall Street Journal Online:
Former Senate Majority Leader Tom Daschle has accepted President-elect Barack Obama's offer to serve as secretary of Health and Human Services, according to an official familiar with the situation.
Atop HHS, Mr. Daschle is expected to play a key role in moving Mr. Obama's ambitious health care agenda through Congress...As a veteran of Washington and of Capitol Hill, he brings knowledge about how to move legislation through Congress. He has a particular interest in health care and is co-author of a book published this year, "Critical: What We Can Do About the Health-Care Crisis."
Its interesting how many of Obama's appointments are people who have experience in the legislative branch, including Joe Biden. With talk of either Clinton or Kerry at State, Rahm as Chief of Staff, and now Daschle accepting the HHS position, it is starting to look like many key members of the Obama administration will have spent significant time in Congress. Hopefully this points to Obama's willingness to work closely with legislators, a departure from the past eight years and Bush's less-than-Constitutional expansion of executive power.
Rahm Emanuel Challenges CEOs to Embrace Universal Health Care, Unions; Stresses Clean Energy Infrastructure in Stimulus Spending
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President-elect Barack Obama's incoming Chief of Staff, Rahm Emanuel, called for major reforms to our nation's health care, financial, and energy systems at the Wall Street Journal's CEO Council today, challenging CEOs to embrace an ambitious reform agenda.
"When it gets rough out there, a lot of business leaders get out of the car and say, 'We're OK with minor reform.' I'm challenging you today, we're going to have to do big, serious things," Rahm Emanuel said, speaking at a forum convened to elicit corporate opinion on the challenges facing the new president.
The soon-to-be White House Chief of Staff said the Obama Administration sees the economic crisis as an opportunity to advance a suite of bold solutions that would put America back on track. "You never want a crisis to go to waste," Mr Emanuel said, before continuing, "and what I mean by that is it's an opportunity to do things you couldn't do before."
Mr Emanuel said the incoming administration would "throw long and deep," taking advantage of the economic crisis to advance wholesale changes in health care, taxes, financial re-regulation and energy. "The American people in two successive elections have voted for change, and change cannot be allowed to die on the doorsteps of Washington," he said.
Continue reading "Obama's Chief of Staff Says to Prepare for Major Reforms in Energy, Health Care, Economy" »
Does insuring more people really cost less?
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From the Obama Campaign Health Care Plan FAQ:
"Q. Obama says his plan will save $2,500 annually for my family. How?
A. ...[By] ensuring every American has health coverage, which will reduce spending on the "uncompensated" care of uninsured people who end up in emergency rooms and whose care is picked up by institutions and then passed through higher charges to insured individuals."
The claim that we can reduce spending by reducing costly and inefficient emergency care by extending health care to more people certainly made the rounds this past campaign. Obama mentioned this fact in the debates and in his stump speech. It is an ultimate political winner--think about it: "we are going to lower everyone's costs by giving health care to more people." Is there anything that people would support more than this idea?
Continue reading "Health Care and Moral Hazard" »
To understand issues surrounding health care reform in America, it is important to understand the difference between health care and health insurance.
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One of the leading causes of confusion when it comes to health care reform is the misuse and conflation of the terms "health insurance" and "health care." This sort of confusion manifests itself throughout the debate.
Insurance is the pooling of risk. The members of an insurance plan pay a premium that is used to help those members who face an adverse event. In the case of auto insurance this could the cost to repair a rear-end collision, in the case of health insurance this might be the cost to repair broken bone. Insurance as it exists is marked by two pillars:
Continue reading "What is Health Insurance?" »
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