The Mighty Fang's massage

The Mighty Fang gets a cat massage. He is purring big-time during this whole process. He's just a big floppy shiny liquid-eyed doofus.

-- Badtux the Cat-owned Penguin

And the birthers flock like hooded doves...

KKK hoods, that is.

It's all about one thing, and one thing only: Obama's race. "Everybody" knows that those Negros are lazy shiftless liars. So even though Obama says he was born in Hawaii, "everybody" knows he must be lying.

There is not a lick of evidence that Obama was born anywhere except where he says he was born. You've seen the birth certificate, as have I, and you've seen the statement by Hawaii's births registrar, as have I, and neither of us have seen anything that contradicts their statements -- and neither have the birthers. But they automatically assume Obama is lying because, well, he's BLACK. And everybody knows those Negros are all shiftless liars.

-- Badtux the Racism-smellin' Penguin

Universal health care is... terrorism?!

Left: Is Rep. Roy Blunt of Missouri really Batman's adversary, The Joker, in disguise?

Universal healthcare is terrorism? That's the latest Fox News talking point.

I just have one question to ask Fox News at this point. As you probably know, Israel hates terrorism. Hates it with a passion. They do everything they can to stamp out terrorism with every asset and resource that they have.

And Israel has universal healthcare.

So, Fox News: Are you saying that Israel's government is committing terrorism against the Israeli people?

Meanwhile, Rep. Tom Price (R-GA) and Roy Blunt (R-MO) say that Medicare is evil and should be eliminated. I heartilly recommend that the GOP run on this platform in the 2010 elections. Running on a platform to eliminate LBJ's socialized government healthcare will be, like, just SO much a win for the Goopers. Medicare is the second-most-popular government program *ever* (behind only Social Security), and nothing will elect Democrats better than the Goopers running against Medicare. Permanent Democratic majority, woot!

-- Badtux the "Gah! The Stupid! It burns!" Penguin

Jefferson Davis: the Donald Rumsfeld of the Confederacy

My take, from reading on the American Civil War, is that Jefferson Davis was the Donald Rumsfeld of the Confederacy. He made bizarre personnel decisions based upon personality rather than upon whether people were doing the right thing. He utterly ignored significant logistical problems such as the state of the Confederate railroads, diverting all resources needed to keep the Confederate logistical and communications infrastructure going into building ironclads that made no (zero) difference in the outcome of the war. He relieved generals who were doing a good job with limited resources, such as Joe Johnson who was trying to keep Sherman from marching anywhere Sherman wanted, and micromanaged things that did not need micromanaging such as the operations of the Army of Virginia. He appointed people because they were yes-men rather than because they were the best man for the job, he was arrogant, he was a tyrant towards his subordinates, in short, it is unclear how this man could have ever been considered qualified to be President of the Confederate States of America. Except, well, he had been Secretary of War under President Franklin Pierce so everybody apparently assumed he would know how to run a war better than some random joe off the street. But he didn't.

My take: Jefferson Davis shows that a military background is no guarantee that a man can lead. The Confederacy's logistical problems were enormous. At the beginning of the war, for example, the Confederacy had only one ironworks capable of building locomotives (in Richmand VA). Yet Davis pursued a quick and glorious victory while ignoring the logistical problems entirely, diverting that ironworks to building ironclads rather than maintaining the Confederate railroads, eventually leading to the collapse of the Confederate rail network, and, therefore, the collapse of the Confederate armies as they literally starved while thousands of tons of food rotted at railheads for lack of trains to move them to where the armies needed them. Tactics win battles. Logistics win wars. By ignoring logistics, by putting the railroads way down on the priority list to where he didn't even give his "railroad czar" a staff or any power to nationalize recalcitrant railroads the way Lincoln did, President Davis insured the collapse of the Confederacy as its armies literally starved to death.

What is bizarre is the cult that Southerners built around Jefferson Davis after the war. He had clearly been incompetent and inept as President of the Confederacy. Yet every single Southern state has counties named after him, monuments all over the place to him, and so forth. It is to laugh, how the losers build a cult around the person who led them to disaster.

-- Badtux the Puzzling Penguin

I am becoming ordinary

I sold my V-Strom 650 today, my last motorcycle. I am now that much more boring. I am sad :-(.

-- Badtux the Boring Penguin

So what's the deal on healthcare R&D?

So will increasing the efficiency of the U.S. healthcare system cause healthcare R&D to decline? Let's take a look, first of all, at pharmaceuticals R&D, which accounts for roughly half of all healthcare R&D (sorry for the blurry screenshot of an OECD data set, unfortunately it was impossible to save the graph directly, click on it to make it bigger): As you can see, the U.S. may be a huge player because of the sheer size of its economy -- roughly the same size as the entire European Union combined -- but as a percentage of national income (GDP), the United States is an also-ran in pharmaceuticals research.

So now what happens when we add non-pharma healthcare R&D into the picture? The U.S. comes out looking a bit better then:

The blue is government health R&D spending, the white is private R&D spending. Still, even with the better US showing in non-pharma R&D, the picture is clear. The United States does not spend a large percentage of its gross national income on health R&D compared to other OECD nations -- only 0.45%, as vs. 0.68% for Sweden, for example.

So, now let's consider the notion that reducing health care expenditures via increased efficiencies (as vs. rationing) will somehow reduce these R&D expenditures. First, note that over half of these R&D expenditures are government expenditures. The notion that governments will reduce their R&D spending because of removal of waste from the health care system is ludicrous. Secondly, the U.S. currently spends 17% of national income on health care. The notion that the 0.25% of GDP necessary for private R&D to continue cannot be funded at that spending level is ludicrous.

In short: If you look at the sheer scale of health care spending, compared to the much smaller scale of R&D spending, you'll note that private R&D accounts for less than 1.5% of current healthcare spending. The notion that capping expenditures at the current rate and forcing increased efficiencies upon the system will somehow drive private healthcare R&D out of the market is less than compelling given just how small the percentage of healthcare spending devoted to R&D really is.

-- Badtux the Healthcare Economics Penguin

Suspended animation

Over on MotoTux, I talk about Death Wobble and steering engineering as I fix a mysterious shimmy.

-- Badtux the Wrenchin' Penguin

Should Bernanke be reappointed?

That is the question that President Obama has to answer, since the end of Ben Bernanke's first term of office is coming up at the end of this year. And on this question I firmly stand with one of the economists that I respect more than anybody else in the economics world, Nouriel Roubini, whose claim that Ben Bernanke prevented the current recession from becoming the Great Depression 2.0 is likely true.

Look: Bernanke did *everything* that a central banker is supposed to do in a crisis of this sort. He slashed interest rates, he injected massive amounts of liquidity into the financial markets via every means at his disposal, he pushed trillions of dollars of money into the economy by cranking the Fed's presses into overdrive, there isn't a central banker anywhere on this *planet* who has ever done better than Bernanke when faced with $4.5 *TRILLION* in asset value disappearing out of the economy in the aftermath of a bubble collapse. The fact that none of this was a magic bullet that magically solved the problem is irrelevant. There *isn't* a magic bullet available to a central banker when so much wealth vaporizes out of your economy. Bernanke did everything that Fed control of monetary policy allows. Beyond that point he was reliant upon the politicians to do the right thing -- and, alas, the record of the politicians in response to this crisis is mixed. But that's not Bernanke's fault. Bernanke did his job. It's the politicians who didn't do theirs.

In short: Bernanke should be reappointed. He has done his job and done it well, and his speeches make it clear that he knows what his next job is going to be once the economy starts chugging along again (i.e., start pulling back to prevent hyperinflation). There is no (zero) reason to not re-appoint him, other than partisan politics, which is a darn foolish thing to indulge in when talking about something as important as the value of the dollar.

-- Badtux the Economics Penguin

Another 12 mile hike

Just got in about 45 minutes ago and ate some supper. Now I'm heading to bed. I'll leave you guys with a cat to keep you company:

see more Lolcats and funny pictures

-- Badtux the Tired Penguin

The Prostate Cancer Lie

One of the fun things about lying with statistics is just how easy it is, if you pick the right statistics. And the right wing does just that when they shout, "the U.S. has the best prostate cancer treatment in the world! Universal healthcare will kill men!"

Roughly 50% of 50-year-old men have undiagnosed prostate cancer in autopsies. Of those men, roughly 3.8% of them will go on to die of prostate cancer, generally in their 70's or 80's. This is true whether we are talking about Canada, the United States, Australia, England, France, or any other nation where most of the population is of Western European descent (for some reason Asians seem genetically resistant to prostate cancer and die at a much lesser rate compared to everybody else and we don't have good enough numbers for Eastern Europe yet). In short, most people with prostate cancer are never diagnosed with prostate cancer, and most people with prostate cancer die of something other than prostate cancer.

Roughly 25 out of every 100,000 men of Western European descent will die of prostate cancer in any given year. This is true whether you are talking about the US, Canada, the UK, France, Australia, or New Zealand:

The MORTALITY RATE -- the dark blue line -- is roughly equal amongst all the nations populated primarily by Western Europeans. The INCIDENCE RATE -- the rate at which we diagnose prostate cancer -- varies wildly however. The U.S. has very effective detection of prostate cancer, thus the incidence rate is much higher than in other nations. Because we diagnose more prostate cancers, the number of deaths as a percentage of diagnosed prostate cancers is lower than in other nations, which is the figure that the tighty righties use to "prove" that the US has better prostate treatment than other nations. But this is an artifact of how often we diagnose prostate cancer. The number of deaths as a percentage of population remains pretty much the same as in other nations with modern healthcare systems and a mostly-European population.

In short, there is nothing exceptional about U.S. treatment for prostate cancer. As many people die in the US of prostate cancer, around 25 per 100,000 population, as in every other modern nation populated by Western Europeans. All that IS exceptional is in how many of the underlying prostate cancers we diagnose and treat -- most of which would have no effect on life span if left alone. That's what the mortality rates say, and when the tighty righties try to spin over-treatment that has no effect on mortality rate as "better prostate treatment", it's spin -- that's all.

-- Badtux the Healthcare Penguin

Note: Some may question why the U.S. and Canada are lumped together as "North America" on the above graph. That's because prostate cancer mortality rates are indistinguishable between Canada and the United States -- despite Canada spending half as much on healthcare!

Modern fascism is boring

Once upon a time, fascism was exciting. You had your shiny jackboots and colorful flags with cryptic mystic symbols on them: You had your death camps: You had your colorful leaders wearing military uniforms and requiring everybody to salute to him:

You had really cool tanks and bombs and airplanes that they used to attack nations all over the world:

But today's fascism is boring. Today's fascism is... Healthcare?!

Yes, the latest right-wing meme is, fascism is universal healthcare! Which means, OMG, Canada is a fascist nation! Gosh, I had my suspicions, I mean, last time I visited Canada their cities were so clean, and the people so polite, it was clear they were hiding something because every American knows that cities are supposed to be grimy decaying hellholes full of rude people who would lose half their vocabulary if you cut off their index fingers, but what a secret!

But still. Universal healthcare? That's what modern fascism is all about, according to the right wing? But I want jackboots! Why do those silly Canucks not have jackboots?! BORE-ing! I guess those Canucks are just trying to lull us into complacency by adopting universal healthcare rather than universal warfare. Why, if we don't watch it, soon the Canucks will emerge from their fascist hell-hole and conquer us all with their eeeeeevil fascist UNIVERSAL HEALTHCARE bwhahahahaha!

And now for video proof of the evil Canuck conspiracy (yes, I know this guy says "Commie" but that's just another spelling for "Canuck", right?):

OMG! It's all a conspiracy! The Canucks are going to DESTROY US ALL with their eeeevil UNIVERSAL HEALTHCARE! Why, their white-coated doctors must be lining up at the border this VERY MOMENT to invade and... and... give us healthcare. The horror! Oh the horror!

-- Badtux the Snarky Penguin

The state of modern policing

Henry Louis Gates can now perform this routine with authentic conviction:

Because the proper response to an irate 60 year old black man limping along on his own front porch (Gates needs a cane to walk) who is yelling at you accusing you of racism is to, well... arrest him and prove it. Way to go, Cambridge PD!

BTW, I just love the name of the crime "disorderly conduct". It sounds so... German. "Ve must haff ORDER! Heil!" But hey, since pretty much any kind of behavior other than meek submission can be viewed as "disorderly", it makes a great catch-all for when you want to deal with an uppity nigger and teach him his place, yessiree!

-- Badtux the Snarky Penguin

Why is health care so expensive?

Health care is currently taking up $2.8 TRILLION dollars of our economy, or roughly 16% of GDP. In 1960, fifty years ago, health care was taking up 5.2% of national GDP. So health care has gotten way expensive over the past fifty years. Is that good, or bad? Let's take a look...

Disease	Outcome 1960	Outcome 2009	Cost of treatment
Leukemia	Go home to die	33% survival rate after 5 years	$1,000,000
Liver failure	Go home to die	Transplant, almost 100% success rate	$400,000
Heart failure	Go home to die	Heart transplant	$300,000
Heart valve failure	Go home to die	New heart valve	$130,000
Kidney failure	Go home to die(*)	Dialysis or transplant	$130,000

And it goes on and on. Pages and pages of diseases where my mom's 1960 edition of the Merck Manual says "send patient home to die with palliative care" now have actual treatments. Most of these treatments were very expensive to develop, and many address rare but deadly diseases like leukemia where amortizing the costs over large numbers cannot be done, unlike, say, myopia, which afflicts 30% of Americans and thus allows the costs of developing LASIK to be amortized over millions of people so people can pay for it out-of-pocket.

So to a certain extent, it's good that health care spending has increased since 1960. We now have treatments for far more diseases than if we'd stayed at a 1960 level of health care spending. People blast the health insurance industry and Medicare for causing health care spending to skyrocket, and to a certain extent that's true -- without the pooling effect and resulting distortion of the free market created by health insurance and Medicare, we could never have increased health care spending to this extent, because sick people are consuming 16% of national GDP, yet produce nowhere near 16% of national GDP -- they simply could not afford this level of healthcare if forced to pay entirely out-of-pocket. But: The only reason we have these treatments in the first place is because of the pooling effect created by having health insurance and Medicare -- otherwise nobody could afford to buy them, and they would never have been developed because the few millionaires able to pay for these procedures out-of-pocket would be too few to justify developing them.

Okay, so now we have the #1 cause of the increase in health care spending: new and expensive medical procedures and drugs. The problem is that there is no inherent upper bounds here, and we're already creaking under the burden of 16% health care spending. Still, we do not want to cut off innovation by eliminating the ability of drug companies and researchers to create new medical procedures to cure as-yet-uncured diseases, so we don't want to just blindly say "No more spending, we cap health care spending at its current rate forever." We have to do that -- we go bankrupt as a nation otherwise -- but we have to be smart about it. We can cap spending at the current rate, but if we make the system more efficient we can get more medical innovation without compromising care.

The problem is, how do we do that? Well, here's how NOT to do it:

1. Tort reform: According to the CBO, tort insurance premiums for the last year they had full data for (2004) was $6.7 billion dollars. This is less than 0.3% of healthcare spending. And the CBO also casts a skeptical look on the claim that "defensive medicine" causes extra health care spending, noting that all such claims are based on one medical procedure in a hospital setting and there's no evidence that this happens in other settings, and noting that strict tort limits have had minimal effect upon healthcare spending between states with them and states that don't have them, finding for example that a tort limit makes only 1.4% difference at most in total health care spending costs. Indeed, California has had strict tort limits on malpractice claims since 1975, yet is still one of the most expensive states to receive medical treatment in. Frankly, you'd get as much savings by regulating doctors' purchases of stethoscopes and tongue depressors as you'd get with tort reform -- it's that trivial an expense for the healthcare system as a whole.
2. Make all healthcare out-of-pocket free market: Problem is, 16% of the nation's GDP is tied up in healthcare, but sick people don't make 16% of the nation's GDP. This would cause a significant decrease in health care spending by making any treatment more advanced than those available in 1960 too expensive for individuals other than millionaires to purchase, and would kill all medical advancement since there'd be no way to amortize the costs of development of new expensive medical treatments.
3. Prevention. We have ample evidence that prevention makes no real difference in overall healthcare spending -- fat people for example die earlier (at average of age 70), meaning they never get the expensive diseases that health people get in their 80's. We have studies on this -- see this one on obesity, and this one on smoking, for example, which prove that fatties and smokers actually save us money by croaking sooner. That said, we should decidedly fund prevention, but because it makes us healthier -- not because it saves any money.
4. Eliminate all private health insurance. Private health insurance accounts for only 35% of all healthcare spending in the USA. Of that, only 20% is overhead and waste (private insurers are currently running an 80% payout rate, i.e. 80c of every premium dollar goes towards healthcare). So we could save a maximum of 5% of total US healthcare costs by eliminating private health insurance, or reduce total spending from 17% of GDP to 16.15% of GDP. Which is useful, but this isn't going to solve the problem altogether, continuing inflation of provider costs will wipe out that savings almost immediately. Note that eliminating private health insurance isn't absolutely necessary to reduce provider administrative costs -- see below.
5. Create a Medical Costs Board to set reimbursement rates for providers and premium rates for health insurers, without a must-issue/cannot-cancel mandate on insurers: Providers and insurers would simply game the system. Insurers would kick sick people out of their insurance pools and insure only healthy people, and providers would simply shift costs and game the system by prescribing more treatments to get more money. The net result of this is 40% uninsured like in Taiwan in 1994 -- the least-healthy 40% would simply get gamed right out of the system.
6. Create a must-issue/cannot cancel mandate on insurers to avoid the above problem, without a must-buy mandate on individuals: Individuals simply wouldn't purchase insurance until they got sick, resulting in an insurance company death spiral as only sick people bought insurance -- and remember, sick people don't make 16% of national GDP.

So how do we control costs? Looking at what other countries have done, here's the deal:

1. All people must be in the system, via mandates on both individuals and on insurance pools (whether public or private is irrelevant for this item). Otherwise insurers or providers will respond to cost controls by kicking people out of the system, much as, e.g., state Medicaid boards are responding to cost problems by reducing Medicaid eligibility. Universal coverage is a prerequisite to *any* effective control of costs, otherwise the system responds by kicking people out.
2. Reduce administrative overhead. It is estimated that as much as 20% of the cost of the current system is administrative overhead caused by our multi-payer system. We could eliminate 97% of these costs by going to single-payer Medicare For All, but even if we retain the multi-payer system administrative overhead for providers can be reduced significantly. Doctors and hospitals should have *one* set of forms and procedures to follow for all claims, perhaps by the Federal Government setting up central claims-handling dispatch centers similar to the way they set up central check processing centers to dispatch checks quickly to their issuing banks. This center should also handle pre-approvals in a consistent manner via maintaining a map of diseases to benefits to approved treatments and providing ombudsmen to handle appeals in a consistent and timely manner. This would let doctors go back to being doctors, instead of insurance company lawyers.
3. Reduce incentives for over-treatment. Doctors should not be allowed to send patients to hospitals and diagnostic testing centers that they are part-owners of, doctors and hospitals should not be allowed to make a profit on medications and diagnostic testing that they prescribe (which gives incentive to over-medicate and over-test), and doctors' fees for procedures should be capped at a maximum per-patient level so that anything above that level, he gets only his expenses for the procedure -- no additional profit.
4. A ban on consumer-oriented drug advertising. We have plentiful evidence now that drug advertising leads to overtreatment. We should go back to the way it was when I was a child, when drug advertising was aimed at doctors and consisted of a brochure and a box with samples of the new drug.
5. A Medical Payments Board negotiates pricing and maximum reimbursement rates with all hospitals, drug makers, and providers (or their industry groups thereof) in order to allow for some margin but nobody gets rich off the illnesses of others. Medicine should be a calling, not a way to become a millionaire. Go into banking if you want to be a millionaire.
6. Increased incentives for people to go into primary medicine so that we have more primary care providers, without the crippling debt that is currently keeping people from going into primary care or causing them to overprescribe and game the system for the money to pay their outrageous medical school debt.

The experience of Taiwan, which covered 40% of their population with $0 increase in medical costs when they went single-payer, shows that we can squeeze at least 40% increased efficiency out of the current U.S. system without affecting the quality of care. That will take us at least until the end of the next decade before healthcare treatment innovation costs eat up that savings and we have to start imposing hard caps and start making hard decisions that will affect the pace of medical innovation or even cause that dreaded R-word (rationing) to rear its head. Most of these changes would be much much easier with a single-payer system -- otherwise we end up adding another layer between providers and insurers to bring providers' administrative costs down to a reasonable level -- but as a minimal first step, we need to bring everybody into the system. HR3200, the current AMA-endorsed proposal in the House of Representatives, is not going to solve this costs problem, but it does take a significant first step -- it brings everybody into the system and gives everybody, not just sick people, a reason to care about the next step of bringing costs under control by increasing the efficiency of the system.

-- Badtux the Healthcare Penguin

* The first kidney dialysis happened in March 1960, but it was an experimental treatment available in only a few locations.
** My thanks to those I've had Twiscussions with on Twitter for helping me dig up a lot of the data and formulate a lot of the conclusions mentioned above

Is the recession over?

That appears to be what Brad DeLong thinks, although he predicts a sluggish recovery with no real job growth. But Paul Krugman points out that consumer spending is going nowhere at all. It's still sitting at 5% under last year's average -- which itself was brought down significantly by the disasterous 4th quarter of 2008 -- and he agrees with Harvard's Martin Feldstein who says what we're seeing is an inventory bounce as excess inventories are depleted and manufacturing starts back up again. Both Krugman and Feldstein attribute positive value to the stimulus package (and when those two agree on something -- which they don't do all the time, they tend to be rather rivals -- it's worth listening to them), which Krugman asserts has prevented the economy from falling into a new Great Depression. And finally, Nouriel Roubini seems to largely agree with Feldstein, Krugman, and DeLong. In short, even though we may be moving into "recovery", it's going to seem an awful lot like recession for a lot of people for a long time.

From a standpoint of economic outlook, I tend more towards Paul Krugman's view than Brad DeLong's. Yes, we're getting a manufacturing bounce as inventories are depleted and companies like GM and Chrysler re-start their long-idled factories. And the stimulus package plus the Fed's monetarist interventions appear to have averted a new Great Depression, perhaps because deficit spending saved the economy from utter collapse. But Krugman holds economic activity is not going to return to previous levels -- and drop unemployment significantly -- at any point in the near term future. The current stimulus package clearly isn't enough to make up for the decline in consumer spending, and runs out of steam at some point next year anyhow. Yet President Obama, scared of being accused of being a "socialist" (bwahahaha! As if the Rethugs weren't going to call him one anyhow), has decidedly ruled out another stimulus package, thus condemning over 30 million formerly-employed Americans to utter impoverishment and homelessness within the next year.

So what's going on here? Clearly demand is low, and is not rising. Furthermore, it's not going to rise, because of the US's poor social safety net. Unemployed people aren't spending because they're trying to survive on unemployment checks and odd jobs, employed people aren't spending because of the horrendous state of what qualifies as "unemployment insurance" today. If people had some assurance that if they became unemployed, their home and car payments would be taken care of, they would not be so reluctant to spend. But unemployment insurance in most states is a joke. For example, unemployment benefits were capped at something like $500 per month in Arizona last time I lived there, which would not have even paid the rent on my apartment.

As a result of the failure of the U.S. unemployment insurance system, if people see a possible period of unemployment coming up because of an economic downturn, they quit spending and instead start saving so that they won’t lose their home and car during that period of unemployment. That puts us into paradox of thrift territory, where individual thrift makes unemployment that much more likely. At this point, even if car and mortgage loans were available on the loose terms available pre-2008, I doubt we would see a serious uptick in demand — people are too worried about their own jobs to spend money on major purchases right now.

What this points out is that a social safety net is not only good for the working Americans who would fall into it during a recession or even a depression. It is also good for business as a whole, since it moderates the economic cycle by keeping consumers spending even if the economy appears to be in a downward cycle, by adding a measure of insurance that would otherwise be achieved by increasing their savings rates (and thus plunging us into paradox of thrift territory). No sane economist should oppose a reasonable social safety net — it is an excellent way to keep demand high even during recessionary periods, and thus an excellent way to prevent a recession from turning into a depression — but, sad to say, sane economists get little face time in today’s government and press :(.

But we don't have such a safety net, and we have a President so terrorized by the thought that Republicans might call him "socialist" that he won't propose one, just as he refuses to propose job creation credits, a jobs program, or any other mechanism for dealing with the misery that this jobless "recovery" is going to bring to far too many Americans (but not to our ruling class of course, who got a TRILLION dollars in freshly-printed Fed bills during the course of this disaster). I guess the end conclusion is that we're fucked, we're fucked up every orifice, and we're going to stay fucked unless every one of these ruling class motherfuckers who don't give a shit about America and Americans (except for millionaire-Americans like themselves) is hanging from the end of a rope strung over the nearest hefty oak tree, at which point we're *still* fucked because rule of gun inevitably leads to rule of thug and we just get fucked a different way. The end game I see is Somalia writ large. I hope I'm not alive to see it... but I fear I shall. Alas.

-- Badtux the Apocalyptic Penguin

Can't-do America

How we ration health care in America -- if you are in the United States, health care is rationed according to your family income and insurance status. If you need, say, a knee replacement, and you have money and insurance, you immediately jump to the front of the queue. If you need a heart-lung replacement due to chemotherapy killing your lungs, well, you'll get the first one but then your insurance will be dropped and you will be sent home to die.

Yet every time anybody proposes to solve this problem of people being killed by this nation's heartless, brutal, and murderous health care system that rations by sending healthy people to the front of the line and sending sick people home to die, we're told "it can't be done." Nevermind that every other industrialized nation does it, they're can-do nations and we're can't-do America. We can't do this, we can't do that, we can't, can't, can't, can't.

Once upon a time, forty years ago today, America could send a man to the moon. After the space shuttle program winds down next year, we won't even be able to send a man into orbit. And it's all because of the America-hating "can't-do" Americans, who are destroying this nation with their constant refrain of "can't, can't, can't, can't, can't". Well, for any of you can't-do Americans who manage to find their way to this post: Fuck you. Fuck you and closed-minded stupidity and ignorance. Fuck you and your selfish brutality of "can't can't can't" that relegates thousands of Americans to death each year for the crime of merely getting sick. Fuck you up every orifice of your America-hating carcass. You and your refrain of "can't, can't, can't" and your stingy small-minded selfishness have taken this once-great nation from being able to send a man to the Moon until today when we can't even make our own UNDERWEAR, for cryin' out loud. But of course, your Party commissars on Hate Radio, Chairman Rush and his Little Green Book that tells you what to think, and so forth, says that this nation's reeking carcass that can't even make its own underwear anymore is the world's greatest nation so USA! USA! USA! Yeah right. Go eat some more fried foods from Wal-mart and get your only exercise by clicking the TV clicker and kill yourselves with your unhealthy "lifestyles", already. You're a wart, a blot, a disgrace to what America once was and perhaps some day can be again, and if you had one speck of morality in your feeble-witted "brain" you'd go out back behind your house with your favorite handgun that you stroke every day while masturbating to Glenn Beck's demented cry-fest and put a bullet through your head. But of course your piggish waddling self is never going to do anything like that, because that would require that you admit you've run this once-great nation into the ground with your sickening cry of "can't, can't, can't", and your Party commissars on Hate Radio tell you that's not true so you'll never admit it.

So it goes, in the reeking carcass of a nation that once could send a man to the moon, but today can't even make its own underwear.

-- Badtux the Rude Penguin

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Walter Cronkite

I haven't talked about his death because reality is that American TV journalism died when he retired in 1981. Today, the buzzards of sycophantic government and corporate ass-kissing who replaced him celebrate Cronkite's career while spitting on what he did. And what he did was real, and true: He reported the truth. Not the government's truth, not corporate truth, not radical's truth, but the truth as he saw it based on the data that he and his reporters gathered.

We don't have that today. What we have today from TV "news" is propaganda from government and corporate shills thinly disguised as "news". If not for the Internet, there would be no outlet for real news in America today.

And that's the way it is.

-- Badtux the News Penguin

Happiness is a warm cat

Yesterday was a twelve-mile day. That's how many miles I hiked between 2pm and 6:30pm, for an average 2.67 mph. Not bad for a penguin who couldn't walk 6 months ago :).

The Mighty Fang is currently purring on my lap and staring up adoringly at my face. Fat furball knows where his kibble comes from, yessiree. Or is merely imagining what penguin tastes like. Whatever.

I'm heading out to ride my motorcycle, it's tired of lurking in my garage. Well, as soon as TMF finishes his current purr-and-adore session. Later.

-- Badtux the Cat-owned Penguin

137

The Mighty Fang is sprawled in the hallway where I can't go through without stepping over him. His tummy is in classic tummy rub position, inviting me to reach down and rub it. If I do so, of course, he will dig in with all four paws, claws extended. Conclusion: The Mighty Fang wants to know whether penguin tastes like chicken, and will accomplish this either by tripping and killing me, or directly.

Little number 137 is haunting me. I am working on a song, a very dark and bitter song. If I finish it today or tomorrow I will share it.

-- Badtux the Haunted Penguin

Friday music blogging

I'm feelin' a bit country right now.

-- Badtux the Music Penguin

Today was a four-cup-of-coffee morning

see more Lolcats and funny pictures

-- Badtux the TGIF Penguin

New GOP talking point: House plan outlaws private health insurance

As I've mentioned there's an infinite number of idiotic things right-wingers believe about healthcare. Most of those are either either stupidity or lies. But now that the actual bill is available and they are starting to read it, another factor is coming into play: Illiteracy.

Simply put, HR3200 does not outlaw private health insurance, it simply moves regulation of private health insurance from McCarran-Ferguson to ERISA. What is confusing the wingnuts (not that they need help getting confused) is that the actual bill is over 1,000 pages long, it is written in legalese rather than English, and it is set in the middle of a large array of other legislation that it must work around without destroying. This necessarily means that it does some nifty tricks to side-step some of the implications. For example: For employer-provided health insurance meeting requirements for deduction as health care coverage under federal law, federal regulation already applies via ERISA This is 95% of all outstanding health insurance plans right now. But individual plans (as defined under the terms of Section 2791 of the Public Health Service Act), which are 5% of health insurance plans, are regulated by the states under the provisions of the McCarran-Ferguson Act of 1945, which places private health insurance under state control.

So the question is how to enforce the mandates upon insurers -- the must-issue and the flat-rate-pool mandates -- without overturning McCarran-Ferguson. Neither Congress nor the majority of states want the Federal government to be in the business of regulating insurance in general. Simply amending McCarran-Ferguson to exclude health insurance as a state-regulated class doesn't work either, because it's not *all* health insurance that Congress wants to regulate, just *primary* health insurance. Supplemental policies are of supreme disinterest to Congress and they're quiet happy to let the states continue regulating those. Besides, insurers could raise some legal actions if Congress tried to regulate already-issued insurance that was issued under McCarran-Ferguson.

So the solution that the wonk assigned the task of making this happen arrived at was to create a new ERISA-eligible group for all future individual insurance to be offered through -- the Health Insurance Exchange. This starts on page 72 of the bill. Since it is an ERISA-eligible group, it can be regulated through ERISA without touching McCarran-Ferguson in general. But then comes the task of how to make all individual insurance be offered via the Exchange. And the solution the wonk devised was to outlaw the issue of new individual policies under McCarran-Ferguson, which is done on page 16, which when you get to page 19 would force all new individual policies to be issued via the ERISA-regulated Exchange rather than via the state-regulated McCarran-Ferguson private market (but which does not touch existing small-group and large-group insurance as defined on page 14). In short, it's a work-around for McCarran-Ferguson which avoids the necessity to have to actually *change* McCarran-Ferguson -- existing private insurance policies can still be regulated by the states, it's just that new individual insurance that meets primary insurance requirements must go thru the Exchange where it can be regulated under federal ERISA rules instead. And wingnut heads explode upon reaching page 16, and they erupt shouting "ObamaCare outlaws private insurance!" without ever getting to page 19 much less page 72.

This points to a major problem wingnuts have with a 1000+ page bill -- you have to read the whole damned thing to know exactly how page 16 relates to page 19 and page 72, you have to know the legal background of health insurance beforehand to understand how the pieces relate to the other major pieces of federal regulation like ERISA and McCarran-Ferguson, you have to have basic literacy in the legalese involved in this massive piece of wonkery, and wingnuts lack the patience, background, or the reading comprehension to do this. The bill does not outlaw private insurance, of course. It just shifts issuance of individual policies to the Exchange so it can be regulated under ERISA rather than McCarran-Ferguson. But to someone who suffers from legal illiteracy and a case of the paranoids, taking page 16 out of context means you arrive at the erroneous conclusion "ObamaCare outlaws private insurance!", which was boldly published in a national forum without the slightest attempt to validate the conclusion with, well, somebody who knows even the tiniest bit about health insurance regulation and how the new bill interacts with the current regulatory framework.

So it goes. In wingnut land, ignorance is strength. And on that basis, they must be mighty goddamned strong, doncha think?!

-- Badtux the Healthcare Wonk Penguin

Chilling

Hot on the heels of the whole "healthcare is tyranny!" nonsense that the right wing is pushing regarding healthcare (WTF? Are these people batshit crazy? Nevermind, I know the answer to that!), I then made the mistake of clicking on a link over at The Political Cat, and came to the web site of S-21 Prison, one of Pol Pot's places to send political prisoners.

I click on the photographs, black and white and grainy and sometimes torn and spotted with blood. I click through them and notice the children, children who have no names, only numbers. Like Number 137, a beautiful, beautiful child despite the limitations of a torn and blood-smeared photograph. Dead. Like all the prisoners at Tual Seng, all of whom were executed as the Vietnamese soldiers that liberated Cambodia from Pol Pot's rule approached. There are only twelve known survivors of the tens of thousands of prisoners that passed through S-21.

This is what tyranny looks like: A beautiful child, dead, gone, nameless, with nothing but a torn and blood-stained photograph to attest that she ever existed.

-- Badtux the Grim Penguin

The actual ObamaCare bill introduced

Yesterday, HR 3200, the America's Affordable Health Choices Act, was introduced in the House of Representatives. This bill has been scored as costing $100B per year for subsidies for families so that families will not need to spend more than 15% of their income for health insurance, a fairly trivial sum by government standards, which will be 60% funded by shifting Medicaid uncompensated care funds to pay for the subsidies and 40% funded by increasing taxes on the wealthy by $40B per year (note that Bush gave the wealthy a $150B/year tax cut, so Obama is taking back $40B of what Bush gave). President Obama basically has told Congress, "get this shit done".

I am still reading through this bill but it is very similar to the discussion draft that I discussed earlier. Most of what I noted there still applies. There are some additional details about the employer mandate that I will cover later -- specifically, what qualifies as a small business is ludicrously low. But I need to read the bill before I do another long commentary on it -- it's 1,000 pages long, so that's going to take a while!

-- Badtux the Health Care Penguin

Bastille Day

220 years ago, a mob of Parisians and revolting soldiers overwhelmed the Bastille Prison in Paris. There were only seven prisoners in the prison at the time, and 98 of the attackers died, but that really didn't matter. It was the effective end of the rule of King Louis XVI. Within four years both Louis and his young wife, Marie Antoinette, would be dead, heads chopped off by the guillotine.

"Let them eat cake" has never been a viable public policy in a democracy (and yes I know Marie Antoinette never said that -- but the sentiment certainly would not have been disagreeable to her). A democracy must reflect the will of the majority of its people, or else it will be overthrown and a new government installed which better represents that will. Only a tyranny can long force upon a people a system which results in the unneeded deaths and suffering of 30% of the population that has either no or poor access and great uncertainty and probable impoverishment to any of the other 55% of the population that is subjected to it, and that system is our current healthcare system here in the United States. The majority spoke in the November 2008 election, and said to a young charismatic politician from Chicago, "fix this shit" -- and installed a Congress of the same party with the majorities to do it.

The people have spoken. They demand universal health care without the uncertainties and cruelties of the current system. "Let them eat cake" is not a viable policy to any of us who cherish our necks. Note the "us". I am in the top 10% income bracket, and it is my neck on the line too. Yet there are still idiots who shout, "you would have us pay for your health care!" (no, you cretins, *I* will be paying for *your* health care, since you're too stupid to be in the top 10% of income). There are those who shout, "there is no right to health care!" (Note to cretins: In a democracy, if the majority wishes to create a new right, they can do so -- and did, in November 2008). They shout "Personal responsibility!" as if it were possible for anybody other than a millionaire to pay for the $1M for leukemia treatment, only the pooled resources of a large number of people can possibly pay for treatment in a modern medical system and there is nothing "personal" about that. They would defy the will of the majority of Americans and continue to impose a system that is bankrupting the nation and causing grave harm to the mental and physical health of the nation. They are, in sum total, as undemocratic and dangerous a minority as the minority of nobility and royalty in France in 1789, who hate the will of the people with a passion that Marie Antoinette would have understood well.

And let us not mince words here: If these people have their way -- if they kill any meaningful effort to bring true universal health care to the United States of America -- the majority is not going to go away. The only way to continue forcing the current evil system upon America and Americans is via tyranny and force, and that cannot go on without an explosion that would make the storming of the Bastille look like a kindergarten playground scuffle. In the end, a sensible person must acquiesce to the will of the majority, even if the majority is in his opinion a bunch of boobs and morons who would rather elect a dry drunk chimp to the Presidency than a sincere and good man who had the misfortune of being an intelligent man in a kingdom of morons. The alternative... ah yes. Let us ask King Louis XVI and his young wife Marie Antoinette about that, shall we? For those of us who value our necks, that is a sobering thought.

-- Badtux the History Penguin

Thought for today

Given who the GOP has grilling SotoMayor (Jeff Sessions of Alabama and Lindsey Graham of South Carolina), why don't they just break out with the Confederate flags and white hoods? White redneck crackers being obnoxious, WTF? The GOP really expects to get *any* Hispanic votes in the future after this?!

-- Badtux the Somewhat-amused Penguin

(Hey, it's always amusing watching GOP fail, as long as they aren't taking the *rest* of us with them -- and Sotomayor is getting confirmed short of suddenly exploding on the stand and shouting "Kill Whitey!", so why NOT just munch popcorn while watching the GOP kill their electoral chances outside of the racist belt for the foreseeable future?)

Stupid things right wingers believe, part 9,233,487

If you go to the Minneapolis Fed site, you'll see an inflation calculator in the right-hand margin. If you put $1 into it, with a starting year of 1913 and an ending year of 2009, you'll see the number $22.06 pop out.

The right wingers divide 22.06 by the number of years (96) and say, "see, we've had a 23% yearly inflation rate since 1913! The dollar is worthless!" The sandwich mistress who took my $5 bill and gave me a sandwich an hour ago might disagree, but anyhow, it doesn't matter: the right winger's argument is math fail, because we're talking about COMPOUND interest -- each year's inflation is based upon the previous year's value of the dollar, not upon 1913's value of the dollar.

The equation to calculate compound interest is (1+i)**n where i is the interest rate and n is the number of years. For example, $1 compounded at 5% interest for 10 years is $1.63, *not* $1.50 as you might expect if you're an idiot. So if we're trying to discover the inflation rate over the past 96 years, we need to take the 96th root of $22.06, then subtract 1 from it. Which is 1.03275-1, = 0.03275, = 3.275% average yearly inflation over the past 96 years.

Now, you might ask, "is 3.275% average yearly inflation a good thing?" But of course! As I've previously pointed out, without inflation, money turns into mattress stuffing rather than being in banks. And we want money in banks because bank lending allows the capital expenditures to respond to future demand using the future income generated by that future demand, and thus allows a capitalist system with functioning banks to be far more flexible and nimble at meeting consumer needs. I.e., a capitalist system simply works better -- is more flexible and nimble -- if we have a moderate amount of inflation each year, where "moderate" is generally considered by economists to be somewhere between 2% and 4%. Which, I might point out, describes 3.275% to a tee.

So anyhow: There's the math. Next time some idiot wingnut says "we've had 23% inflation every year since 1913!", you can whack him upside the head with this math until he staggers off, bleeding what pitiful mattress stuffing substitutes as "brains" from his ears. Have fun!

-- Badtux the Math Penguin

see more Lolcats and funny pictures (What I feel like doing to right-wing idiots sometimes).

Would make another post, but...

The Mighty Fang wants to be fed, and I'm tired after a long hike in the Marin headlands.

see more Lolcats and funny pictures

-- Badtux the Cat-owned Penguin

Why is health care insurance different?

As pointed out in my previous posting on the subject of health care insurance, pooling of funds is necessary in order to pay for expensive treatments such as leukemia treatment that otherwise would not be available (because leukemia treatment costs, on average, $1M, and very few people have $1M). This means the pool pays rather than the individual, which causes a decoupling of payment from cost, which causes an infinite upward spiral since providers now no longer have a free market check upon what they can charge for their services. At this point the free market advocate says, "it can't be! Why don't we see this kind of spiral in auto or home owner's insurance if this is correct?!"

In fact, you do see an upward spiral caused by this decoupling, but the upward spiral is limited because the items are replaceable for a fixed sum of money. For example, because insurers, not individuals, pay for most collision damage, auto makers charge far more for body repair parts than they would if it were an entirely free market, and auto body shops that cater to insured customers charge far more than if they had to compete for business based on cost. However, there is a natural limit: the spiral stops once repair costs become greater than the cost of the item. If the repair costs quoted are too much, the insurer will simply give you the money to buy a new one, rather than pay outrageous repair costs. Similarly, if repairing fire damage to your house costs too much, the insurance company can say, "Well, so much for that. Here's the payoff for the value of your house, pay off your mortgage and go buy another one." In short, if home or auto repair people try to charge too much, the insurance company simply buys you another one of what got destroyed, and the repair providers make $0 rather than making a profit.

But if you get sick with leukemia, the insurance company can't turn to you and say, "$1M for leukemia treatment is too much, here's $100,000, go buy another life." You only get one life. You can buy another car or another house if the repairer charges so much that it's cheaper to buy another one, but your one life is it. So with health insurance there's no upper bounds on repair costs imposed by the inherent value of the product, unlike with cars or houses, because the product being fixed is, literally, your life when you're talking about health insurance. So there's no natural upward boundary imposed by the replacement cost of the thing being fixed, because you can't replace your life. Once it's gone, that's it.

So that's the bottom line on why free market insurance works for home owner's and autos, but not for health insurance. Autos and homes can be replaced. Your life can't. That's the fundamental difference, and is why every attempt at "free market" health insurance has run into spiralling out-of-control costs and eventually required significant and extreme state intervention in order to keep costs at a reasonable level. The OECD numbers don't lie: the more government involvement in health care, the cheaper it becomes. Given that currently the median family income of the USA is around $50K, and the average yearly cost of a family health care policy is 25% of that, we need to do something about health care costs or we end up like the USSR, which collapsed when its military-industrial complex sucked up 40% of GDP. Except for us, it's going to be our health-industrial complex that collapses us if we don't do something -- and, like, soon (since those OECD numbers were published only three years ago, US health care spending has risen from 15.5% to 17% of GDP!).

-- Badtux the Numbers Penguin

Things that make a penguin scratch his head

1. Jeff Sessions, R-KKK, is going to be the GOP frontman against the Sotomayor nomination. What, David Duke wasn't available?
2. The Mighty Fang keeps trying to get at the computer desk where I'm eating my supper of tasty tuna and noodles. Thing is, he doesn't eat either tuna or noodles -- if he got at them, all he would do would be lick them. WTF with that?!
3. The Freepers are attacking 11-year-old Maliya Obama for wearing a Peace t-shirt. Keepin' it classy, GOP guys... WTF, they didn't have any infants to steal lollipops from?
4. My feet have *grown* over the past couple of years. My old hiking boots killed my feet at Yosemite last week. I went and bought some new ones today, they're half a size larger! WTF with that?!
5. The lunatic right-wing "Birthers", led by World Nut Daily, are still claiming some vast conspiracy including major news media, the Hawaii birth registrar, Haiwaiian newspapers, etc. to disguise fact that Obama is a secret Nigerian Muslim or some silliness like that. Even the right-wing National Review calls their argument "frivolous", yet still they continue. WTF with that?
6. The Young Republicans ran a racist against a convicted felon. What does it mean that the racist won? Does that mean there's more Republican racists than there are Republican criminals?

-- Badtux the Head-scratchin' Penguin

Why does the free market not work for healthcare?

That's what the numbers say -- the more "free market" a healthcare funding system is, the more expensive it becomes. The more state involvement in healthcare, the less expensive a healthcare system becomes. That is the reality. To a certain extent we can simply accept that reality and move on (unless you are a right-wing ideologue, in which case your ideology takes precedence over reality). But if we understand why that is so, perhaps we have some guide that will help us create a better healthcare funding system.

The core problem is one of the expense of modern disease treatment. Leukemia treatment, for example, costs on average $1 million. Luckily not everybody gets leukemia. Thus we can insure ourselves against the cost of leukemia treatment via risk pooling -- if leukemia strikes one out of every 1,000 people, we can gather 1,000 people together and have each toss $1000 into the kitty for leukemia treatment, and then if one of them gets leukemia, we have that $1M to pay for the treatment.

In other words, the cost of modern medical treatment makes risk pooling mandatory, or else you end up with a lot of dead bodies in the streets because only millionaires could afford health care. The problem is that once you have risk pools, you divorce payment from cost. It is no longer the individual who is paying, it is the pool.

The net result is that a free market health care system is no longer possible if you wish to have a modern medical system. Once you divorce payment from cost, the normal mechanisms of the free market cannot operate -- people no longer seek the least expensive health care that achieves acceptable results, so providers have no incentive to control their costs. If there is no external mechanism to force them to control their costs, they will not do so. Thus every "free market" health care funding system has shown a death spiral of upward costs as providers "game" the pools for extra funds rather than controlling their costs. The only thing that has been shown to stop this upward spiral is severe government intervention into the health care market -- either by serious intervention at the funding level (e.g. single-payer, or severe regulation of health insurance funds and provider reimbursement rates), or via the draconian solution of making all providers state employees (the British solution -- which, BTW, I do not recommend for a variety of reasons).

In short, people pushing for a "free market" solution for health care funding are proposing unicorns -- imaginary solutions that cannot work in the real world because reality is that modern medicine simply is too expensive to work that way. They assume that leukemia treatment would suddenly become affordable to non-millionaires if not for "evil government", when the reality is that modern medical technology is simply too expensive for that to happen, the development costs for new procedures, drugs, and tools are too high for the cost of these things to be driven down severely via free market competition. Risk pooling, which inherently divorces payment from cost and thus subverts the mechanism that makes the free market work, is thus absolutely necessary to ensure that expensive treatments are available to those who need them, but the "free market" zealots utterly ignore that reality. They are like Communists who assume that human beings will not be selfish and lazy if placed into a pure Communist system -- they ignore key facets of reality. And thus, like Communism, their proposals for "free market healthcare" would result in huge numbers of dead bodies if actually put into reality. Luckily, in a democracy, even the American public isn't stupid enough to do that -- while President George W. Bush proves Americans will vote against their own best interests, themselves and their own dying for lack of health care most certainly would incentivate them to do otherwise. Nothing like the threat of death to motivate someone to say "no way!".

-- Badtux the Reality-Based Penguin

Ten crazy things right-wingers believe

One thing that has become clear, looking at the right-wing responses to the health care proposals in Congress, is that they are, to put it bluntly, batshit crazy. Here's ten of the crazy things they believe, in no particular order, and limited to ten only because they have an infinite number of crazy things they believe.

1.Only Americans have liberty. Because universal health care "takes our liberty", and all other Western democracies have universal healthcare, only Americans are truly free. And unicorns are real, and cotton candy grows on trees. This would certainly be news to the average arrogant snooty liberty-obsessive Frenchman, who would point out that he has every liberty Americans have except the liberty to die like a dog in the streets for lack of health insurance, be bankrupted by bills his insurer won't pay if he develops a serious illness, or be driven into permanent poverty after a serious illness because nobody will hire you after a severe illness because of the $1M surcharge their insurer would immediately slap onto your company's group health insurance policy. At this point the lunatic handwaves and says "He's not free, he just doesn't know it."

2. At which point the crazy right-winger says, Nobody ever dies for lack of health insurance in America. Which of course is ridiculous. Excess mortality studies show that uninsured and underinsured Americans are more likely to die of a wide variety of illnesses than insured Americans. At this point the lunatic puts his hands over his head and says "I see nothing, I hear nothing, Eric De La Cruz never existed."

3. Every other healthcare system has waiting lists and rationing. Of course, there is neither waiting lists nor rationing in the French healthcare system, but he'll handwave that, "there's some specialty X where it might take two weeks to get an appointment in France, so THERE!".

4. Only Americans have access to advanced treatments. Of course, that is not true (click the France article above), but that is not a problem, he has faith, FAITH I say, in his Party commissars at Cato Institute and talk radio and Fox News, and surely they wouldn't lie to him!

5. Taxes are slavery. I already dealt with that one.

6. Government can't do anything right. Said on a government-created Internet as he sits in his home protected by a government fire station as a government police officer goes by, as criminals who would break into his home and kill him languish instead in a government prison, after going to his job on a government road and being paid his contractual wages because he has the ability to go to a government court to force back wages to be paid to him.

7. Medicare is a horrific nightmare of rationing, waiting lists, and the government telling you what doctor you can see and when. It's astounding how the right wing can outright lie with a straight face. Medicare patients have more freedom to choose their own doctor, are more satisfied with the care they receive, and nobody ever tells a Medicare recipient's doctor what care to provide. The same is not, of course, true with private insurers, who regularly fight with doctors to avoid paying for procedures that people need.

8. A government healthcare system would be horribly expensive! The only problem: Every single statistic says that's not true. The more government involvement in healthcare, the cheaper healthcare seems to become. Indeed, when Taiwan went single-payer in 1996, the savings were so enormous that the year afterward, they covered 40% uninsured WITH NO INCREASE IN OVERALL COSTS because of getting rid of the horrific administrative inefficiencies imposed by having 1500 different payers each of which have their own rules and their own procedures, which requires as much as 60% administrative overhead from some providers to negotiate the system. There is a point at which you don't want more government involvement because it reduces your choice and affects the quality of care -- Britain has arrived at that point (in Britain's socialized medicine system, all doctors are government employees, all hospitals are owned by the government, and private insurance is illegal) -- but nobody proposes that system for America.

9. Canada and Britain. You notice that in the right-wing healthcare universe, there are only two other countries? Countries like France, Switzerland, Japan, etc. that get excellent results with their universal healthcare systems always seem to get omitted from any discussion by the right wing, perhaps because Switzerland shows that you can have drug innovation in a universal system (the Swiss drug companies are second only to the US in innovation, even though Switzerland is a much smaller nation), while France and Japan show that you can get excellent cancer treatment in universal systems.

10. America has the best health care system in the world. Arguably true, *if* you are one of the 70% of Americans with private insurance or Medicare. If you are one of the 30% who are uninsured or on Medicaid, that is quite untrue -- you do not get the best healthcare in the world, you get 3rd world care. That shows in the statistics, where, other than breast and prostate cancer statistics (where the American Cancer Society has done a stalwart job of making sure that breast and prostate cancer screening are available for all Americans), the U.S. compares horribly with most Western nations -- higher infant mortality, lower lifespan, fewer doctors, and fewer hospital beds today than we had in 1973 when our population was much smaller. In short, what this shows is that the core health care *provider* system works quite well for the 70% of Americans who have full access to it -- but we have a funding problem, where it bankrupts people far too often and cuts 30% of Americans entirely out of the real system and relegates them to a 3rd world ghetto healthcare system.

We're spending the most, but getting mediocre results. We can do better. But the lunatics in the right wing, with their preference for believing their Party commissars at Cato, Heritage, hate radio, and Faux News to believing, well, in REALITY, just put their hands over their ears and yell "LALALA I can't hear you! Tyranny! Waiting lists! Best in world! Lalalala!". It's sad, really, how grown men and women can be so childish as to want to live in a fantasy world of unicorns and cotton candy trees rather than the real world that the rest of us live in, the world where facts are facts, France has one of the best health care systems on the world, and the U.S. system for funding healthcare is fundamentally broken. So it goes -- there will always be those more interested in believing their delusions, than in what is real and true.

-- Badtux the "Too many lunatics!" Penguin

Aaand, I get a response:

Dear Mr. Tux:

Thank you for contacting me regarding the increasing costs of health coverage and your support for H.R. 676, the United States National Health Insurance Act. I appreciate hearing from you on this important and timely matter.

The need for a high-quality, accessible and affordable health care system has never been more urgent. There are currently forty-seven million uninsured Americans, eight million of whom are children. Another fifty million are underinsured. Although the U.S. spends twice as much on health care per capita as countries with universal coverage, the World Health Organization ranks us 37th in overall health system performance.

I am proud to tell you that I am a co-sponsor of H.R. 676. H.R. 676 addresses many of the health disparities in our health system by guaranteeing every resident of the United States access to a full range of medically necessary services, including primary care, prescription drugs, mental health care and long term care. There are no co-pays or deductibles under this program. The role of the government would be limited to collecting revenues and disbursing payments; care would continue to be delivered privately. Patients could continue to use the same hospital, physician or health clinic from which they currently receive services. H.R. 676 is supported by over 210 labor unions and more than 100 grassroots groups across the country. The former editor of the New England Journal of Medicine, two former Surgeon Generals and 14,000 physicians support national health insurance.

The complexities and ambiguities of our current system are part of why I support universal healthcare. Once again, thank you for contacting me. Your views help shape the way I represent our district, and I value your opinions.

Sincerely,

Michael M. Honda
Member of Congress

Customer service response of the week

A customer asked about why a feature X (which the product did not have) was not documented in the manual for their product. Here was the response:

Thank you for providing this feedback on [our product]. We appreciate the input. I asked the person who wrote the manual about this and she indicated that there was no way include everything [our product] can't do in the manual, so she put in what [our product] can do. She then indicated that I go back to work.

Snark isn't a provence of penguins alone, heh :).

-- Badtux the Snarky Penguin

To Rep. Mike Honda, US House of Representatives

I am a constituent whose mother has been a health care provider for 40 years. Our current healthcare system with its multiple "Separate but Equal" discriminatory ghettos for the poor, children, disabled, and the elderly is broken in fundamental ways far beyond funding, and I am dubious that the Tri-Committee proposal with its 800+ pages of patches to a broken system will result in anything other than a broken system with lots of patches that still continues to give unequal healthcare based on age and financial capability.

We need a system that fundamentally changes the game and provides equality of health care for ALL Americans. Please urge your colleagues to submit HR 676 Singlepayer Healthcare For All for CBO scoring so that we can fairly compare it to the Tri-Committee proposal, and please give single-payer advocates a voice at the table and give their legislation a fair chance at being heard rather than relegating them to a circus sideshow. At the very least, please do not vote for any bill which would outlaw California's SB-840 (Health Care For All), which will be signed by our next governor and provide universal single-payer health care for all Californians (if you do not vote for HR 676 first).

Thank you,
XXXXXXXXXX (redacted)

And on a lighter side...

see more Lolcats and funny pictures

Oh the horror!

-- Badtux the Cat-loving Penguin

A letter to my Congresscritters

I am a constituent whose mother has been in the health care industry for forty years now and seen how badly the current insurance industry is serving the health of our nation, especially over the past fifteen years. She regularly encounters times when doctors have to fight the insurance companies daily to provide the healthcare that their patients need, and sometimes they fail and patients die for lack of care insurers won't pay for. Please, please do not do anything that will help the profits of these vicious leeches who are killing my fellow Americans with their greed and bureaucratic bean-counting. These murderers (and I do not use the term lightly) deserve nothing more than the corporate death penalty: A nation-wide single-payer health insurance system, modeled upon Medicare, for ALL Americans.

As your constituent, I am joining Public Citizen in calling upon Congress to pass HR 676 (The United States National Health Insurance Act). A single-payer system of national health insurance that eliminates private insurance would save nearly $400 billion now wasted annually on administrative costs, enough to pay for high-quality, comprehensive care for all. There has been a groundswell of public support for a single-payer solution in polls, town hall meetings, and rallies throughout the country. France proves that single-payer can provide top-notch care, the most advanced treatments, and the best healthcare outcomes for less than 60% of the cost of the current US system. There is no reason not to consider it as a solution to the corrupt, inefficient insurance companies that my mother and her colleagues have to fight every day to get the care their patients need.

Americans have demanded to know why Congress has failed to consider the most popular health reform proposal, one supported by a majority of the public. I demand to know this too. If you truly care about America and Americans, have the Congressional Budget Office immediately evaluate HR 676 along with any other reform proposals – the next crucial step toward including single-payer in an honest, transparent debate on health care reform. It is essential to compare the cost of single-payer with the cost of other health reform proposals being considered right now.

Please support HR 676 today by demanding CBO scoring for single-payer health care and including single-payer in all discussions about health care reform.

Thank you,
xxxxxxxxxxx (redacted)

In Libertopia, everything is unicorns

In Libertarian Utopia -- Libertopia, taxes are slavery. So nobody pays taxes in Libertopia. This works because everybody plays fair and nobody tries to take stuff via force. So you don't need a government with taxes to pay police. And the trees grow cotton candy.

In Libertopia, well, okay, so there are nasty people out there. But everybody has guns and has no moral qualms about using them. Well, okay, normal people have moral qualms about killing their fellow man, but in Libertopia that won't disadvantage normal people and allow the most thuggish and morality-free to take over and rule their fellow man due to their greater willingness to kill, because in Libertopia the guns are smart and only kill bad people, not good people!

Well, okay, so guns don't work that way. So in Libertopia, people form voluntary groups to hire police officers to protect them. A neighborhood with forty homes in it would get together voluntarily to hire a police officer to patrol the neighborhood and arrest criminals and bring them to trial before a jury of the homeowners and then hang the criminals. And in Libertopia, there are never any deadbeats amongst that group of homeowners who refuse to pay their fair share towards the cost of that police officer, because in Libertopia , everybody is always cheerful and helpful and pays their fair share.

Well, okay, so like with homeowner's associations today, there's deadbeats who won't pay their fair share towards protecting and maintaining their community. So what we do then is make paying the homeowner's association's dues *mandatory*. If you don't like it, the homeowner's association can seize your house and sell it to someone who *will* pay the dues that the majority of the members of the homeowner's association have levied upon themselves.

And at that point, you are now in reality, rather than Libertopia.

Libertopia is a unicorn, a fictitious animal that cannot exist. Like Communism, it ignores unpleasant truths about human nature -- the fact that many men are violent and will seize things via force of arms if not countered by equally violent men, the fact that most men are NOT violent and thus are prey for the violent if they do not collectively join together to counter the violent, and the fact that far too many people are selfish deadbeats who will not pay their fair share of the costs of maintaining public safety and basic infrastructure unless they are forced to do so. In the real world, the trees do NOT grow cotton candy, and Libertopia is just another ridiculous fairy tale to use to entertain the gullible.

I live in reality, which is often harsh and vicious and brutal, not in a fairy tale. Any system of social organization that does not recognize reality, which relies upon unicorns -- made-up nonsense -- in order to work, is automatic fail and will be swept away by the tides of history. The current Republican extremists, with their hatred of democracy and desire for the closest thing to Libertopia that they can achieve, are in the end pushing for a failed ideology just as much so as the Communists in the latter days of the USSR, and if they actually did achieve their goal, the result would be the same: Societal collapse, anarchy, and then the rise of a strong-man dictator to take over the ruins of a once-great nation.

We have the reality we live in, not the utopia we wish we had. This is it, folks. Governing based on cotton candy trees and unicorns does not, cannot work. So let's quit the nonsense, roll up our sleeves, and get to work doing things that will work, rather than pretending that unicorns are real.

-- Badtux the Pragmatic Penguin

The right to life does not stop at birth

On the evening of July 4, 2009, Eric De La Cruz died, killed by the patchwork U.S. "healthcare" system and its infuriating inability to provide a working system of healthcare for all Americans. This young man had a congenital heart defect which was quite solvable by a heart transplant, but because he was uninsured and Nevada Medicaid won't pay for transplants, he died.

233 years before Eric De La Cruz was killed by our "healthcare" system, some guys in Philadelphia wrote these words:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed ...

Over 18,000 Eric De La Cruz's are killed by our "healthcare" system every year because of its refusal to pay for needed care for all Americans who need care. This is a slaughter of innocents, over six times the death toll of the 9/11 attacks PER YEAR. Clearly our "healthcare" industry is killing, slaughtering, tens of thousands of innocents per year guilty of nothing except being born poor or maybe not the brightest bulb in the chandelier or just plain unlucky, and has no intention to stop doing so. Whenever any industry infringes so baldly upon our inherent human right to life, it is completely within the realm of our founders' intents to have our government secure these rights, and if it does not do so, to change our government if necessary -- which we did, in November 2008, when we elected President Obama on a platform of healthcare reform and withdrawal from Iraq.

There are some people who say that the right to life is conditional -- that you have a right to life only if you have the ability to pay cash for your health care. There are others who say there is no such right because it is not listed in the Constitution of the United States of America, 9th Amendment of the Constitution nonwithstanding. This is utter nonsense. Rights are granted to us by our Creator, not by a piece of paper, and are absolute, not conditional, and the right to life is the most fundamental right without which all other rights are meaningless. When any entity infringes upon this most fundamental of our human rights, it is well within the provence of government as envisioned by our founding fathers to deal with this threat to our most fundamental human rights via whatever means are necessary -- which, in the case of our corrupt murderous health insurance industry, should with all fairness be the death penalty just as much as for any other mass murderer, but I'll settle for Medicare For All single-payer health insurance and let those bastards spend the rest of their lives begging for alms on streetcorners.

-- Badtux the Human Rights Penguin

Hilarious Honduras hypocrisy

It is hilarious that you see the same lefties who were blasting the Busheviks for their clear violations of the Constitution contort themselves to excuse Zelaya’s violations of the Honduran constitution because, well, because Zelaya was best buds and pals with Hugo Chavez so that must make him a good guy, huh? Makes you wonder if they were just playing partisan politics during the Bush years rather than having any real regard for the US Constitution…

As noted by several posts at Why Now, Zelaya was flown out of the country by the military immediately after the Supreme Court ordered his arrest for violating Article 239 of the Honduran Constitution. The military says they flew him out of the country rather than arrest him because they were afraid he was going to try to get his supporters to rescue him if they arrested him, resulting in bloodshed. Undoubtedly the military's act was illegal -- they only had legal authority to arrest him for refusing to leave the Executive Mansion after removing himself from office via Article 239, not to kidnap him and fly him out of the country -- but a "coup"?! Nonsense. Utter nonsense. If it were a coup, the military would be in charge. Reality is that they aren't -- the Vice President took charge as required by the Honduran Constitution, and constitutional rule continues in Honduras.

My take on it: The loony lefties defending Zelaya are hypocrites and morons, no different from the right-wingers who defended Bush. Zelaya was a rich boy who decided he wanted to be President and took Bush's dictum of "life would be easier if this were a dictatorship" seriously. Pal'ing around with Hugo Chavez doesn't make him somehow a "hero of the people", and blasting Honduras for taking their Constitution seriously and calling a legal removal of their President for violating their Constitution a "coup" just shows the intellectual bankruptcy of far too many on the loony left.

-- Badtux the Constitutional Penguin

I leave civilization for three days and...

Sarah Palin resigns as governor of Alaska? WTF?! Since when did a Republican resign just because of a measly little criminal investigation? Hell, Saint Ronald Reagan (bless his dark evil shriveled little heart) even *laughed* about doing illegal things to help the Contras, and suggested that Poindexter and Ollie North ought to be given medals! Now *that* is the proper Republican response to a criminal investigation... "F*ck the law", outright fist-pumpin' defiance.

This penguin is just open-beaked flabbergaped... though I suppose if you're Alaskan, you're pumping your fist in the air and shouting, "Yes! The bitch is gone!". Maybe now Alaska will quit being this weird insane area danglin' out in the wind like the balls of America, and go back to being this weird forgotten place that nobody really thinks about. Alaskans can hope, I guess.

-- Badtux the Astounded Penguin